Survival Mode... if I knew then, what I know now.

So I’m 6 weeks into life with 3 boys under 3 and a half.  And I just keep telling myself, more children have been had, at one time, under more primitive conditions than my comfortable home, with playroom, plethora of toys and baby gates... lots. of. baby gates.   As I write, my 6 week old is on my lap because today is a non-swing, napless kinda day - you know the kind, and if you are without children at the moment... you will ;). Putting my growing, mental to-do list aside while I'm confined to the chair, I reflect on the numerous classes I’ve taught and attended, articles read and written, on how to rear and (in my line of work) feed children.  It occurs to me - how many of these said “experts” ACTUALLY had or remember life with children?  Normal, functioning, perhaps multiple children?  

This coming from a woman who spent her early, childless, know-it-all, driven, twenties ticking off countless new moms as a children’s nutritionist and lactation consultant.  Ha. haha.  ha ha ha ha ha.  Oh the imminent eye rolls and cursing from those poor women lugging their screaming infants and snotty tots out to the car.  

I was blessed with a first child who fought sleep and nursing.  I knew all the book-smarts on nursing, I even went back to old text books, desperate to simply troubleshoot the situation - I TAUGHT this, I WILL make it work!   I was determined to nurse that boy!  After 4 agonizing, tearful, frustrating, painful and fruitless weeks - I pumped every feeding - every bottle for 11 months.  Special bonding experience? What?  Between me and Medela maybe.   My second was a better nurser, my third is by the book.  Ha!  Either it took me 2 years of practice to master it, or kids are just different - novel idea.  Especially when it comes to children, there comes a time when you take what you know, do the best you can and, well, wing it to survive.  

I'm learning its easy to fold, and look to a plethora of processed foods and Fast Food to just get them fed.  But there is a happy medium that establishes good habits, gives kids proper nourishment and keeps us sane (relatively speaking :) ).  Here are some potentially “frowned upon” new-mom survival suggestions with my RD filter:

1. Frozen can absolutely be your friend.  Fruits and veggies - every meal if need be. For meats (i.e. chicken nuggets), the trick is to look for the least amount of ingredients - without additives (its frozen - that’s the “preservative”).  Tyson has some decent options - I’ll let you know when I find my favorite.  You’re aiming for <1500-2000 mg sodium per DAY, so let that be your guide - 400-600 per meal is acceptable.  Always look for NO Trans fat and low saturated fat (3-4 g or less) - aim for Canola or Olive oil in the ingredients, with vegetable oil as a distant second vs. soybean or safflower.  Pair with fresh items, not fried, like french fries (i.e. fruit, corn, whole grain pasta, or whole wheat toast/crackers etc as your carb).  Stock up on frozen meals like Cedarlane, Amy’s bowls, or Kashi - be choosy though - you can’t go solely by brand. (Same guidelines as above) 
2. Use and abuse peanut butter and yogurt - great protein, good fats (PB), live cultures (yogurt).  The key is to keep it as simple as possible - i.e. ground peanuts or minimally flavored greek yogurt.
3. Don’t be afraid of rotisserie chicken cooked at the store.  Its lean, “fresh,” and can be used for multiple meals.  
4. Whole wheat waffles - morning noon or night.  Batched homemade then frozen or Kashi waffles are my favorite.
5. Certain granola bars and fruit/yogurt “squeezies” travel well and are helpful with church nurseries, early mornings & “I’m done” nights.  Not all are created equal - our favorites are Lara bars, Cliff kids A-Z organic bars, Kashi peanut peanut bars and a plethora of organic fruit and veggie pouches - with or without yogurt.  We get Happy Baby delivered monthly through Amazon.com because its cheaper with more variety.  And coupon search for others.  Yes, you are losing some of the nutritional integrity with the pouches since they are heated to ridiculous temperatures before packaging. Homemade, fresh/frozen is always preferable - aaaand welcome to survival mode - these are still difficult veggies for kid consumers (spinach, broccoli, beets etc) with high antioxidant fruits (like berries, many times out of season, expensive & messy in cars ;)) and some with yogurt (see above).  They typically have lower sugar and calories than juice, with more nutrients. I’ll take it in a pinch for sure  We limit ours to 1 (sometimes 2) a day, since they can be downed in a record 2 seconds by my 19 mo old.  (*advise - not to be sole nutrition for babies who are under 9 months to a year, who should be learning how to eat with a spoon vs. straw/sucking of solids). 
6. Don’t sacrifice family dinners.  This is our new-year’s resolution for 2012.  Its late once my husband is home.  Its easy to throw them in front of a cartoon to, well, regroup.  The family sitting down together is important not only for building table manners, saying grace as a family, and portion control, but as they get older, fostering open communication etc.
7. If you DO find time to cook, get your “sea-legs under you,” or simply feel daring - The Sneaky Chef is my new favorite cook book.  

May the force be with you.  

Clearing Up Coffee Confusion

So I’m 9 months pregnant and oh the looks I get when I’m carrying a cardboard, steaming cup. It’s coffee folks! You’d think I was walking around with a bottle of Jack Daniels in broad daylight. And how do YOU know it’s not decaf? Well, chances are it’s not... but that’s not the point. I must thank you, little old lady with the snide comment, for the blog influence :)!


So - coffee - good? Bad? "Moderation - huh?” Here’s the latest.


Aside from comments and looks during pregnancy, I also get clients and acquaintances alike who’ve chosen to make the “big step” of cutting out coffee. Then expect a pat on the back for it. Poor you. That’s about all I can offer. Life must suck now! Lol.


We’ve lumped coffee drinking in with unhealthy habits like drunkenness and smoking. We view the strung out, sunken-eyed, over-worked employee with a cigarette in one hand and coffee in the other as one of those “unhealthy coffee drinkers.” Looks more like a Meth addict if you ask me.


So here’s the bottom line... all recent, credible findings suggest, COFFEE drinking offers no serious detrimental health effects. In fact, if you want to improve your health, its better to focus on other lifestyle factors like, ummmm, weight loss, exercise, increasing fiber, eliminating all recreational drugs, etc ;) - instead of avoiding coffee, which can actually be helpful to your health.


Well, that’s moderate amounts right? Sure, if SIX cups a day is moderate – that’s the established upper tolerable limit – or the equivalent of about 600 mg. Its about 2 Starbucks, Grande black brew or 6 (8oz) cups of “Folgers.”


It doesn’t mean your latest high calorie “coffee concoction” either. The excessive calories will do more harm over time than the minute amount of coffee you MAY be getting somewhere under the whipped cream. And not ALL forms of caffeine, are created equal - Coffee is very complex.


Why the flip-flopping over the years? Well, we’ve just recently been able to isolate the hundreds of compounds in coffee and other potential lifestyle factors that cloud results - like lack of exercise and smoking (two things that are common with heavy coffee drinking).


Although not a miracle food, coffee can protect against Type 2 Diabetes, Parkinson’s disease, liver cancer, and liver cirrhosis. It can help with focus and thinking. New findings regarding cardiovascular benefits are currently being studied – but early findings look good there too!


Now for pregnancy. Caffeine crosses the placenta, to the fetus (unlike Sucralose and Aspartame hgm hgmmm – sorry I couldn’t resist). The fetus is very sensitive to caffeine  (because it's teeny tiny) and metabolizes it very, very slowly. The position statement of the American College of Obstetricians and Gynecologists as well as Harvard researchers, recommend less than 200 mg of caffeine a day during pregnancy (8 oz of caffeinated tea and a 12 oz soda have about 50mg, and 8 oz of coffee has about 100 mg).

If you have HTN and are having trouble getting your blood pressure down, try switching to decaf (for some coffee benefits without the caffeine) and see if that makes a difference. But there is no need to simply cut it out unless its posing a problem. 


Also, brew/drip vs. french press/boiling is the preferred method of prep because of a compound called cafestol that is filtered out. When left in, it can affect your LDL (bad cholesterol). Espresso falls somewhere in the middle (some cafestol is filtered out, but not all).


Tea offers DIFFERENT benefits than coffee and recent studies have confirmed that tea is still not nearly as beneficial as coffee. This could be because U.S. tea is much weaker than other countries’ tea and coffee, or it could simply be due to a lack of study in this area.


So...


Starbucks anyone?

Nourishment and Nostalgia vs. Guilt and Gluttony

I recently spoke about emotions surrounding food and the misuse of food for anything but nourishment or nostalgia.  The Holidays are Food Suicide.  Not only are we surrounded by amazing food this time of year, but we are typically with, or reminded of, ones who may cause us to misuse food for emotional purposes to begin with.  I ended the presentation with this Holiday Food Filter, that will hopefully weed out unnecessary calories and put you one step closer to appropriately viewing and consuming food in the new year!    

HOLIDAY FOOD FILTER:

What is the purpose of this food?

Are you legitimately hungry?  If so, eat a substantial meal. You will consume a lot more calories, before recognizing said hunger, than if you were to eat a quality meal and follow it up with a serving of something yummy.  No grazing on chocolate-peanut buttery goodness.  Fill up on the turkey, then enjoy the goodness.  

Is this food simply providing nostalgia - grandma’s famous _________ ? Which is okay!  Food should provide pleasure, and bring back fun memories.  However, how many other foods today have provided nostalgia?  Can you hold off until tomorrow when you have a fresh set of calories to pull from? Thanksgiving never lasts for one meal, or even one day!  We’re spoiled rotten.  Don’t kid yourselves, you’ll be eating left-overs all week!  So spread it out.  Fit a little, portion controlled, nostalgic food into each day.  Remember, the goal is weight maintenance during the Holidays.  

Am I going to thoroughly enjoy this food?  IS IT PERFECT?

Is the food you’re “splurging on” amazing?  Take a bite, if not, then move on.  This is not the time to think about starving children in Africa, they won’t get your Cherry Pie.  Move on to something else that you only get during the Holidays.  These are valuable calories, spend them on something you are going to 100% enjoy.  Slyly, trash the rest, or better yet, wipe them onto your husband’s plate - he gets more calories anyway. :)

How do I practice self control with this food? 

Find a way, or get rid of it.  God calls us to self control in every area.  Portion some into a dish, and eat that! No eating from the pan, as tempting as that can be.    Keep from being alone with favorite foods.  Store them out of site - back of the fridge, microwave, cupboard etc.  Eat slowly, enjoying every single bight, put your fork down between bights - whatever it takes to savor it.  

Am I eating this food to solely fill an emotional void? 

This is the danger zone.  The food does not provide nostalgia, is not being used to satisfy legitimate hunger, you’re not really enjoying it, it’s “there” and you’re woofing it down with no self-control -- it’s filling a void!  If you’re waiting to be alone, to eat way too much of it - chances are, it’s filling a void. Call a good friend.  Find something else to keep you busy - read a book, crochet, draw, go for a walk, get out of the house or go to bed. Spend some time with God, pray, meditate, read His word.  Find a great podcast - Tim Keller has excellent messages addressing emotional health.  

Take the emotion and guilt out of food so you can actually enjoy it again.   

A Pre-Holiday Diet, This Dietitian's Favorite Fad

So, the Holidays are here.  This is when everyone stands me up for Nutrition appointments and typical dinner conversation with the Dietitian includes... “for real, how do I drop 10 lbs by the Holidays?”  ummmm, Spanx?  lol.  

So here it is, A Transparent Dietitian’s preferred, quick Holiday/Wedding fix to, “just tell me how to get it off.”  

*drumroll please*  “Eliminate Anything White.” Yup, that’s white sugar (and anything containing it), white flour, white potatoes, white pasta etc.  (many throw in banana too, which DOES happen to be a high-er calorie fruit, but is much like a sweet potato in that it has fiber and a ton of nutrients.  So I wouldn’t put this on the essential list, unless you know you consume massive amounts of banana :) ).  I would add to the diet (although not white) the elimination of fruit juice and the limiting of milk/yogurt to 16 oz a day (non-fat), but not eliminating.

I like this method because its a great jump start, that will hopefully continue into the New Year, you can do it FOREVER, and always lighten up a little as needed for special occasions, without “throwing in the towel” completely.  There’s also no need for damage-control when you’ve reached your goal (Atkins), you rarely have to back-track (weight wise) to re-enter “eating” civilization (because you never leave it), and after “getting used to it,” most can stick to it better than any fad out there.   

The key to weight loss IS calories, BUT, we typically over-eat and incessantly snack on the “white/refined” things. Okay, not typically, ALWAYS!  (i.e. cakes, cookies, pies, chips, sodas/sweetened teas and coffee drinks, white bread, crackers, pasta etc).   I cannot tell you how often I get, “I just eat too much fruit, that’s my problem.” Baaaahahahahaha, no, I promise, that’s not your problem.  Its the other things you’re ignoring and sneaking, that apparently don’t exist if eaten after 10pm or are in the form of a drink.

I have a brother in law who has had great success with this. Using the “Better Plate" as a guide (below), you are not eliminating any major food groups, can sufficiently fuel your body, and cut out the “triggers” that not only bring on extra fat, but extra water and bloating as well.  All the while, increase essential (typically missing) nutrients like whole grains, antioxidants and fiber in the process - all good things.    If you want to tighten the belt even more, you can eliminate ALL grains and still get sufficient carbs and nutrients from milk/yogurt, fruit, beans/lentils and sweet potato, this happens to be my preferred method - no non-sense!

Note - start it now - shed a little weight and water - then lighten it up from Thanksgiving through New Years.   Few things bother me more than someone who says... "no thanks, I’m dieting," at the Thanksgiving table.  No pity.  There are 11 other months of the year to cut calories and shave pounds than the most FUN month to eat in.  It doesn’t mean go over board, with permission to be gluttonous for a month or so - but no restricting either.  If you can maintain your weight through the Holidays and not feel deprived - job well done.  

May the force be with you, and Steven, thanks for the inspiration, great job!

Plate and Pyramid Perplexity

“Now, first lady Michelle Obama is helping roll out another tool to fight America’s obesity epidemic: ChooseMyPlate.gov, the new food icon and website that Obama administration officials say is a lot easier to understand and follow than the old food pyramid from which we’ve learned for nearly two decades. “As long as they’re eating proper portions, as long as half of their meal is fruits and vegetables alongside their lean proteins, whole grains and low-fat dairy, then we’re good. It’s as simple as that,” the first lady said at the MyPlate.gov unveiling at the US Department of Agriculture, which developed the MyPlate icon.” -John Garcia ABC News

Pretty sure Ms. Obama is a LAWYER. Pretty sure this is one of the most colorful wastes of time since… well, the “MyPyramid” icon. And, who says we “learned” anything from the Pyramid the last 2 decades? Have you walked into a school lately? Perhaps a mall? How bout a beach or a HOSPITAL? Wow.

Now, don’t get me wrong, I do commend Ms. Obama for her healthy initiatives and think she has the greatest of intentions, but I also feel she’s working with folks at the USDA that should know better!

We’re paying for pretty new posters and “icons,” while our kids are nutritionally stupid, and their parents aren’t much better off. We can mandate homosexual history education and women’s rights to reproduction, but we won’t teach our kids how to EAT!? Something we HAVE to do! Daily. Everyone. Dietitians, health professionals and MOMS, have been trying to get PROPER nutrition education in schools and healthier school lunches for YEARS, but I’m so glad we were able to push through this [redundant] “campaign”, so our kids, parents and cafeteria workers can STILL BE CONFUSED!

To MyPlate’s defense - in the full article - Ms. Obama mentions a parent not having time to measure out proper portions of foods “i.e. 3 oz meat etc.” True. (BTW in my practice I’ve never recommended this, nor have I come across any parent that does it). She states the “plate” as something easier to visualize, and that the Pyramid is confusing. Agreed.

However. As long as America classifies French fries as veggies, and mac and cheese as grains, we are in serious trouble.

The problem…

All current and previous government sponsored attempts to classify food into pretty pictures and “icons” STILL does not tell us how to feed our families. For instance…

Do you see the problem? All foods are “properly categorized” using both MyPlate AND MyPyramid methods – I even threw in buzz words I get in my office all the time, somehow indicating the meal is now “healthy” – however, this is a high calorie, high sugar, high starch, high sodium and high saturated-fat meal – hardly balanced -- with ALL foods falling into the “carbohydrates” macronutrient category and a Diabetic nightmare. Not to mention the lack of COLOR and variety – there are NO antioxidants, no phytonutrients and no Omega 3 fatty-acids. THIS, ladies and gentlemen is where we’ve messed up in the school system – this, and providing a CHOICE for KIDS while forcing Cafeteria directors to stay within a ridiculous budget.

Classifying food as fruit, grain, vegetable… etc. doesn’t help at all. Who came up with that anyway?! It makes no sense. Our bodies treat food differently based on what MACRONUTRIENT category they belong to: Carbohydrate, Protein and Fat. Hence the mass confusion, a concept that I didn’t learn until I was in COLLEGE! Now, there are more nutritious carbs, proteins and fats than others, but a proper balance of THAT is what we should be striving for.

Instead, check this out…

It’s not perfect, there are parameters that should be explained, aaand that’s why I’m here.  Some foods will always fall into multiple categories. But if this was ALL I was using to base my family’s nutrition off of – we’d be in MUCH better shape. BTW Diabetics, tape this to your fridge and follow it like a cult! It will drastically help in blood sugar control.

That’s my two-cents anyway, because you asked right? ;)

A Dietitian's Struggle

So, in an effort to be the most Transparent Dietitian I can be, that is the name of my blog, is it not? And in light of my last blog entry, I found it important to let you in on one of my husband’s and my biggest nutrition struggles. Yes, being married to a transparent Dietitian means you too must be transparent :). Ha ha, no, he agreed for me to share.

We are both, hmmm, vertically challenged (requiring less calories daily), love rich, decadent sweets and are both quite “emotional,” of course I prefer the terms “passionate about life” ;). With great emotion, comes great self-soothing. Aaaand what does a Baptist soothe with best? Food! Lol. Our struggle is simply maintaining our calories in a healthy range daily. DAILY, as in ONGOING. Ongoing, as in FOREVER.

Keeping our bodies at a calorie balance is tough. Some never achieve it. Some have such high metabolisms they’ve never had to “work on it,” but at some point in life, we will all choose to focus on or ignore our caloric needs. As I’ve said before, its a crucial, non-negotiable, step one, and for some, where they will stop, as we strive to achieve a physically healthier life, or refuse to acknowledge its importance.

My husband plays with an extra 10 lbs he’d rather not have. He finds stressful, long days, and enticing foods, make it difficult not to exceed his budgeted 1500 calories at times. He overshoots too many days – weeks – months in a row and steadily gains weight. For me, it’s the opposite, coupled with over-compensation. I tend to teeter on maintenance and weight loss calorie recommendations (whether I ‘need’ to lose weight or not) and push the limits with my exercise, because I’m a perfectionist. It’s never good enough, and never will be. Follow that up with emotional, over-eating largely out of over-restriction and “rinse, wash, repeat,” you’ve got a very unhealthy relationship with food. Neither mentality is a healthy one. Both involve a sinful reliance on self, and most certainly, gluttony and recklessness at some point.

As I’m writing, I’m still not sure many of you are getting this concept. We. Will. Always. Have. To. Watch. Our. Calories. ALWAYS. Even Billionaire’s have to budget. There is no time in our lives, NO TIME, when we will be able to simply consume calories without needing to turn around and expend them. It’s not how our bodies were designed.

Our view of “weight loss” and health has been so skewed by gimmicks, marketing, quick “fixes” and fads, that we somehow think there is a beginning, and an end to health. There is never, NEVER a time when we simply have “achieved” health and can coast with Bon Bons and Krispy Kreme’s for the rest of our lives. We have to change this way of thinking.

Your “number” may change based on your current season of life. I don’t need as many calories now, even pregnant, than I needed when I was 9 years old. But there is always a number, always a calorie requirement, that if we don’t meet, consistently, we’ll fail to maintain an appropriate weight. All other health efforts are null and void if we don’t maintain a healthy weight.

Notice I keep saying “healthy weight.” Healthy weight = a weight at which you are comfortable. When you’re joints and knees don’t ache simply from excess weight. It’s when your lab work improves and your risk for preventable diseases decreases. When you’re sleeping better at night. When you can move around without becoming winded. When you simply feel good, clear minded, and able to best function in life.

We are all a work in progress. If you take nothing away from this blog entry, take this: health is a constant discipline. There is no beginning, no end. Some days we hit the mark, some days we miss it completely. The goal, is to have more days that we healthily hit the mark and pick ourselves up when we don’t, better yet, ask a more powerful God to pick us up, striving to make those times fewer and shorter. Get back to work.

The secret to weight loss, and a healthier life...

CALORIES!!!!

See ya!

Lol. Okay, enter the inevitable eye rolls and yells at the computer – please refrain from throwing objects. Buuuut, it really is math. MATH. Now, if you’re still reading, you’re offering me excuses as to why it’s not the calories for you. You’re mumbling, “I’ve tried that, *expletive*!” OR, “Just wait till you turn 30!” Yes, yes, I’ve heard I should expect wonderful things when I hit the big 3-0; I’m waiting with baited breath. However, it is simply black and white, non-opinionated, proven fact, that you must burn more or as many calories as you take in, to lose or maintain your weight. If you eat more calories than you need, you will gain weight. End. Of. Story. It is the FIRST step to any weight loss, or healthy initiative – the FIRST. And it is essential.

Now, there are VERY FEW exceptions. Yes, I know, you all fall under the “exceptions”category. Well, guess what, most of the exceptions, have solutions – HA!

1. Have your Thyroid checked – it’s a simple blood test. If your MD (not an Herbalist!) finds there are problems, insist on a medication regimen with close following. A strict medication regimen should result in a normalized metabolism.

2. So, your Thyroid’s fine -- Visit a facility that offers an instrument for measuring REE (Resting Energy Expenditure) its called Indirect Calorimetry and usually involves a breathing apparatus. Not a contraption you stand on or a calculation at your local gym. This will give you a more accurate representation of the calories your body is burning at rest – AKA THE GOAL. For most – its between 1100 and 1500. I’ve seen ONE patient with a metabolism close to 900 – and she had a diagnosed metabolic disorder from birth! She was also average weight – how bout’ them apples.

3. Not in denial? Simply jump in. Try 1200, 1500 or 1800 calories. Not real scientific I know, but even if I do the math specifically for you, I will place you in the closest of these categories. Start low and move up as needed.

(Now, I won’t begin to ignore medications and disease states that may cause water retention – edema – steroids and the like, that cause weight gain or excessive hunger. Please discuss changing these medications with your MD if weight gain is an issue for you. However, limiting your calories can still help dramatically in these cases).

The math. 3500 calories is equal to 1 lb. The trick is finding a way to cut these calories from your days, without putting yourself into starvation. This is harder for shorter ladies, aiming for 1100-1300 calories a day for WL, where this may only be a deficit of 200-300 calories from your normal 1300-1600 calorie day, resulting in 1 lb per 2 weeks. Tall men might be able to handle a deficit of 1000 calories a day without too much restriction - this is about 2 lbs loss per week. Obnoxious? Yes. Healthy? Afraid so. Consuming fewer calories than your REE or BMR will result in starvation -- limited early weight loss with plateau or gain thereafter, and inevitably… Cranky. Pants. Wow. Do us all a favor and eat.

Your challenge. Find a non-cumbersome way to STRICTLY track your calories - STRICTLY! Food journals are rarely maintained long-term. If its not easy, you won’t do it. I get that. Here’s what we do. Jordan, my favorite, and hottest client, aims for 1500 calories a day, most days of the week. He writes NOTHING down. Why? Because he lives by the “cash system” for calories. He has 300 calories to spend for breakfast, 600 for lunch and 600 for dinner. This just works well with his schedule. Occasionally he borrows from lunch for his coffee concoction, and from dinner, for his frozen custard concoction – but still sticks to his calorie “cash.” No credit here, well, because credit = love handles.

We use these phone apps to stay within our “calorie cash allotment,” they are my favorite! Calorie King and Eat This Not That.

I don’t care WHAT you order or bring for lunch, remember, this is step ONE, without mastering this step you DO NOT go on, and without losing excess weight, you will be defeating the purpose of ALL healthy dietary modifications. I want your calories, snacks, nut-bowl-trips, fancy coffees, desk-drawer chocolates and “juice with meds,” to fit within your calorie allotment. We can talk about the quality of your calories later. Get to work.