Hydrate for Heaven's sake

What is the highlighter colored beverage in your hand?  Are you actually drinking a soda with your name on it because it had your name on it? Listen, folks, I get that the marketing geniuses over at Gatorade have you pretty well convinced that your 30-minute foray to the gym to jog on the treadmill while watching Ellen qualifies you as an athlete. And Coke well they're coca cola they've been making soda an addictive beverage since it came on the market but what are the real facts about hydration?

• Fluid is important, it keeps you sharp, can perk you up like a wilting flower for that 330 meeting with your boss.  But some tips to keep in mind:
• Ditch the sugary stuff- extra calories- extra weight
• Limit the caffeine 
• If you're going to be working out for an hour or more try a beverage with added sodium
• Monitor your urine color- clear to pale yellow means you're well hydrated.  If you're looking at fluorescent or school bus yellow march yourself to the nearest water fountain and have a drink.
• Do yourself and the environment a favor and bring a reusable bottle along.  You'll always have a drink and you won't kill a whale with you wasteful plastic.

So key points here:

• water is not boring.  If it is stop eating so much sugar and salt so you can actually taste your food.  Try La Croix waters or any other of the wide variety of flavored and carbonated waters on the market.  Flavor your own with some essential oils, herbs, lemon or other fruits.
• bring your own.  You'll feel better and mother nature will love you more and maybe she won't drop a tree on your house or something.
• check your pee
• light post it yellow= good
• school bus yellow =bad

Drink up

the reluctant dietitian

Nutrition philosophy

If you had asked me my nutrition philosophy several years ago it would have been something along the lines of everything in moderation, eat a variety of foods for health to fulfill your senses and tastes but after 6 years of working in a hospital my current nutrition philosophy is:
Eat a fucking vegetable.
Just one, every day, forever. Preferably not a potato in the form of a fry or a chip.
That's it.
There is no magical vegetable that I will tell you to eat although if you'd like me to assign you one off the top of my head I can. You there eat beets. They'll make you super healthy... make your eyes bright, your teeth white and child birth a pleasure. Plus for funzies if they're fresh they'll make your pee red. Eat a vegetable, preferably not the same one every day, ideally 4-5 servings a day, but at this point I'll settle on one.
We are fantastically terrible at eating our vegetables. Only 6% of Americans meet their recommended veggies per day. Most people only get less than 2 cups of fruits and veggies per day when it should be 4-5 cups per day, and when we look at who is meeting that, the numbers drop to 1% of adults getting their recommended amounts.
Now you can say I don't like vegetables but I challenge you: have you tried every vegetable ever in every possible way it could be prepared? No? Go find a new vegetable and try it in a new way. Purée that bad boy and hide it in your spaghetti sauce.
My challenge for you is to try, no actually do, eat a vegetable every day, for the next week, month, year... see how you feel. Heck get crazy try to hit that 4-5 cups a day. Tell your friends, start a movement... eat a fucking vegetable.

Batch Cooking

Batch cooking is a great way to eat healthy for those of us that are constantly on the go (ie busy nurses that work 12 hour shifts).  Prepare foods ahead of time on days when you have extra time and set it aside for busier days. Recipes can be as simple or as complicated as you like.  Think about things like prepping extra chicken breasts to use in salads and sandwiches, larger portions of quinoa or brown rice and large batches of vegetables. If you’re not much of a cook experiment with microwaveable sides such as brown rice or wild rice packets as a fast way to add healthy complex carbs and fiber to your diet. Bagged salads are a fast and easy way to make half you plate vegetables. And rinsed canned beans are an easy way to add vegetable protein.  

2015-2020 Dietary Guidelines

There have been a lot changes in the 2016 year, among them were the 2015-2020 Dietary Guidelines released January 7^th of this year.  The guidelines are reviewed every 5 years based on current research and are meant to help professionals create healthy diets.  New changes include guidelines on added sugar, caffeine, sodium and cholesterol.

                Added sugar is a growing problem.  The new guidelines recommend limiting added sugars to 10% of a person’s total daily caloric intake. For a 2000 calorie diet that is approximately 200 calories or 50 grams of sugar. Unfortunately at this time there is no way to easily identify how much added sugars are in foods.  In 2018 new food labels will listed added sugars separately from naturally occurring ones.  Until then check the ingredients for words that will identify added sugars such as honey, agave, molasses, and anything that ends in ose such as fructose. 

                Caffeine made an appearance for the first time in the guidelines as well.  The recommendation is for 400mg or less per day.  On average coffee has between 100-200mg, Breakfast tea contains 60-90mg, black tea has 30-60mg and green tea has 25-50 mg.  The guidelines don’t make any recommendations to consume caffeine merely that there are no increased risk of major chronic diseases at this level of intake.

                The 2015 guidelines loosened up slightly on sodium recommendations removing its 1500 mg restriction for African Americans and people over 51 years old.  However the recommendation stays intact for those with hypertension (high blood pressure), prehypertension and heart disease.

                Also removed from the guidelines is the recommendation to limit cholesterol.  The guidelines do continue to recommend replacing unhealthy fats (saturated and trans fats) with more healthy fats (unsaturated fats).   The recommendation remains to limit saturated fat to 10% of diet (remember for heart patients this is even stricter 5-6% or approximately 13g).  The recommendation for trans fats remains less than 1%.  Remember to check the ingredient list for these hidden fats with the words “partially hydrogenated.”

                These guidelines are used to shape the My plate (https://www.choosemyplate.gov/MyPlate-Daily-Checklist) which is a helpful visual representation of what these guidelines mean.  The fact remains however that it is difficult to think of these guidelines in terms of what an actual diet would look like.  Try to remember to make half of your plate fruits and vegetables shooting for at least 7 servings per day (1 cup raw/1/2 cup cooked), 3 oz of lean proteins, with the final ¼ of your plate whole grains. Use these updated guidelines to help you read labels and bring healthier foods into your diet.  And remember that more so than any one magic food it is overall diet quality that makes the difference. 

Tis the Season for Giving

Take a moment to think about being hungry.  How does it feel?  How do you fix being hungry?  Now imagine not knowing where your next meal will come from.  For millions of Americans that is a reality 42.2 million to be exact.  1 in 6.  I've been fortunate to never been hungry.  I've been hangry but not food insecure. Today I spoke about nutrition and budgeting at a Senior Nutrition Program here in Salinas. Having worked for a supplemental food program I was vaguely aware that there was a similar program for seniors.  For those of you not in the know, the Alliance of Aging's Elderly Nutrition Program is a grant-funded program created to improve the nutrition of the elderly as well as create new social opportunities.  Today participants also received donations from the food bank as well.  Not only does the program provide for in center meals, they also do home delivery and a Senior Farmers Market Nutrition Program which gives seniors a one-time financial incentive to shop at Farmers Market.
I want you to imagine for a minute that you are 70 years old.  You have some health problems.  You're unable to drive far and you're living on a limited budget.  What are your priorities?  Do you eat?  Do you pay bills?  Do you keep the lights on?  Just imagine.  Don't assume it can't happen to me I put money away and I have a family.  Just imagine, you're a senior, you're isolated, you count on this one meal a week and donations for food.  What would you want to eat?  What would you need to supplement?  Ok, hold that in your mind.  When you see donation bins this winter for the food bank, hold that in your mind. Imagine one step farther what would a nutritionally adequate meal look like.  What would you eat for dinner if you were to eat your healthiest meal?  Hold that in your mind and Donate that.  Donate dried beans and low sodium canned beans, brown rice, whole wheat pasta, low sodium canned vegetables, Canned fruit in water or its own juice.  Donate dried fruit and unsalted nuts.  Don't use the food bank as a waste bin for the foods you don't want.  Just because they are poor they shouldn't "just be grateful for what they get."

Now for some startling statistics:
About 5,000 nutrition service providers together serve over 900,000 meals a day in communities all across the United States.
Monterey County Food bank feeds 1/5th of Monterey County with 6 million pounds of food.
34% of Monterey County residents are food insecure.

I remember the day I learned why WIC only goes until age 5 for kids.  That is when school lunch programs pick up.  Hunger is an issue that spans across all age ranges.  It's personal and many times you don't know who around you is or has suffered from hunger. Seniors and children are most likely to suffer from hunger issues.  Don't let America's obesity epidemic fool you into thinking that hunger is not an issue.  I remember when I first went to work for WIC thinking that hunger did not look like what I thought.  The unfortunate reality is that low nutrition low-cost foods are readily available while low-cost nutrient-dense foods are not so much.   As so many call for us to come together, I will add my voice to the call.  Be good to one another this holiday season and every other day think of those less fortunate than you.

Grocery Shopping Tips

Start by making a list and making sure you’re not hungry before you go.  Shop the perimeter of the store searching for Choose mostly foods (bread, cereal, produce, dairy) vs food products (fruit snacks, diet soda, cheese spread), with a short ingredient list. Keep the 3-3-300 Rule: 3g Saturated fat, 3 g fiber or more, less than 300 mg Sodium (140mg or less is even better). Avoid aisles you don’t need to go down.

When you reach the produce aisle make sure to include something from each color group and remember you need 5-9 servings per day.  Fill in the gaps with canned and frozen produce to keep costs down.  Just remember to look for low sodium vegetables and fruits packed in water or its own juice. In the meat aisle be sure to include fish twice a week- this can be canned. Otherwise choose lean meat:

Beef: flank steak, sirloin tip, eye of round, top round, tenderloin, top loin, rump roast, extra lean ground beef.

Poultry- white meat without skin.

Pork: tenderloin, center loin, Canadian bacon. 

Keep in mind you lose about 25% with cooking so to get a 3 oz portion buy 4 oz.

In the cereal aisle look for the first ingredient to be a whole grain.  Check the nutrition facts for at least 3 g fiber, less than 5% sodium, and 10g or less sugar. Similar rules apply to the bread aisle. Look for whole grain as first ingredient, as much as possible buy breads with 3-5g fiber per slice and 5% or less sodium. Fruits vegetables make the best snacks try them with hummus or nonfat yogurt (by itself or plain yogurt mixed with low sodium seasonings for vegetables). Choose whole grain, low fat snacks. Use caution with protein bars-check sugar. Always check serving sizes.

In the dairy aisle choose nonfat of 1% for family members over 2 years old or unsweetened dairy alternatives if you prefer.  Check the sugar content of your yogurt.  Look for added sugars. Yogurt will have naturally occurring sugars from lactose (milk sugar).

                                    Regular: 15-16g

                                    Greek: 6-9g

                                    Icelandic: 6g

Subtract these numbers from the sugars listed in the nutrition to get the grams of added sugar.

Remember that a good diet is about overall diet quality; make sure as you reach check out that the the majority of your cart is healthy real foods.  Avoid last minute temptations of breads, candy, and sweetened beverages while standing in the checkout line. 

Thriving

I'm taking a coaching class because while I feel like I've got a pretty decent grasp on the nutrition stuff sometimes imparting this knowledge is questionable. This week we had a session on thriving and I'm starting to understand why Kaiser has grabbed onto that as their mantra. How do you know you're thriving? What are the top 5-10 things that make you feel like you're thriving? Can you pay attention to this for the week, month, year and store these moments up? I know for me it is hard to identify. I know that moment I first meet a patient in rehab I light up. I want to hear their stories and see what I can do to help. I know when my mare learns something from me and I think "now we're a team!" But 8 more things? That's tough.

Take a moment and take stock of what is going well in your life. Then think what life would look like if you were thriving. Compare the two maybe think about some goals you can make to get to thriving. For me this is terrifying. I lost my mare this year, and my boyfriend left and work had a strike. The world feels so uncertain to me as I prepare to go to grad school that I just want to say I get it. It's safe here in the I don't want to make plans because they fail. So even if your one little step is to take note of what makes you thrive,do that until you feel able to take the next step. And maybe once you've got that you can say maybe this week I'll try doing a little more of x.  Until you've got yourself a few goals to work on. Baby steps. 

Thrive: to develop well or flourish

Go forth and flourish my dears.