Eat, Brush, Floss

How what you eat can help reduce the cavities in your teeth.


apple teethEveryone needs 3 D’s for their health: Doctor, Dentist and Dietitian! I’m sure everyone understands the importance of doctors. If you’re reading this blog chances are you also understand the importance of dietitians. But how many of you give thought to the impact it would make on your health if you saw your dentist more regularly? What if you were able to get better fitting dentures? What if you took care of the toothache that bothered you? Chances are you’d be eating and enjoying food a whole lot more!

Consider that the National Institute of Dental and Craniofacial Research has found that 5% of older adults have no teeth, 92% have had cavities in their teeth and 23% have untreated decay! I bring this to your attention because we often don’t think about the implications of having poor dental health but it is linked to our daily well-being.

What are cavities and how do I get them? What should I know as an older adult?

Cavities in the teeth result when the strong enamel on your teeth breaks down. A cavity forms when the bacteria in your mouth ferment sugars from the foods you eat and creates acids. Our saliva helps to protect teeth from these acids but over time we can still develop cavities especially if we don’t have good oral hygiene.

Also, older adults are more likely to get cavities because let’s face it…our teeth have been through a lot more slices of birthday cakes than most! Aside from wear and tear older folks are more likely to develop cavities because of other dental conditions like dry mouth, gum disease and gum damage from poorly fitting dentures.

Can what I eat help prevent cavities? What would this look like?

Absolutely! There are 2 groups of foods you should consider—cariogenic foods and cariostatic foods. Cariogenic foods lead to new cavities and even worsen existing cavities. They contain the sugars that mouth bacteria like to feast on. Cariostatic stops new cavities from forming because they buffer against the acids made by bacteria.

At this point you’re probably thinking cariostatic = good and cariogenic = bad! I don’t want you to think that you should stop eating cariogenic foods altogether! I would advise that you:

1)    Pair cariogenic foods and cariostatic foods during meals and snacks so that they negate each other.

2)    Rinse mouth with water after each meal or chew xylitol gum.

3)    Practice good oral hygiene.

Cariostatic Cariogenic
Protein foods (egg, nuts, fish, meat, poultry)

Dairy Foods (cheese, milk, plain yogurt)

Most vegetables

Sugarless gums

Fibrous foods (apple, celery, popcorn)

Sweets (cookies, candies, cakes)

Salty snacks (crackers, chips, pretzels)

Hot and cold cereals

Breads and pastries

Sweetened beverages (juice, soda, sweet tea)


What does good oral hygiene look like?

1)    Brush your teeth 2X per day with fluoride toothpaste once when you wake up and once when you go to bed.

2)    Floss at least 1X per day.

3)    Visit your dentist for regular cleaning.


Special Thanks to Trinh Le for her assistance with this post.




Photo credits:


5 Exercises You Can Do Without Getting Out of Bed!

Improve your posture and flexibility before your morning coffee.  

Rise and shine! There’s nothing like a morning stretch to rev up your body. But, if you haven’t been exercising for a while you’ll understand how hard it is to start. This is why I want to start you out with some super simple exercises that can be completed without even getting up. These exercises are meant to supplement your current daily exercise routine, which for some of you could be a little (like tending the garden or evening strolls) or a lot! A good exercise program is like a healthy diet: you need variety. You can spice up your regular routine by adding these 5 simple exercises. Once you’ve got these 5 exercises down remember to check back for more!

The following 5 exercises will help with your flexibility and your posture. They are meant to be completed lying down or sitting up in your bed or on the floor. The last 2 exercises (chest stretch and back twist) can be done on a chair.

1. Bridges


How to:

  • Lie on your bed.
  • Place your hands at your side. Bend your knees and place your feet below your knees.  Let your knees be hip width apart.
  • Pull in your belly button.
  • Push your hips up towards the ceiling.
  • Hold for 5 seconds.  Keep breathing.
  • Lower back down to the bed slowly.

How Often: Repeat 10 times. Rest; repeat 10 more times.

Why:This will help make your legs and your stomach

2. Big Stretch

Big Stretch

How to:

  • Lie on your bed and reach your arms behind you as far as you can.
  • Point your toes towards the end of the bed.
  • Take several deep breath, count to 15 then relax

How Often: Repeat 3 times.

Why: This will help with your posture and should feel really good!

3. Gentle Twist 
Gentle Twist 1

How to:

  • Lie on your bed; knees bent and your feet flat on your bed, lined up under your knees.
  • Bring your arms out to the side, palms up
  • Slowly drop both knees over to the right. Pause here for 20 seconds, breathing and relaxing.

How Often: Repeat on other side.

Why: This will relax your low back and hips and help you move better when walking and dancing!

4. Chest Stretch
Chest Stretch

How To:

  • Sit up straight in a chair.
  • Take a deep breath and reach your arms out to the side as wide as you can while squeezing your shoulder blades together.  This stretch is looks like you’re going to give someone a big hug!
  • Keep breathing as you count to 20, and then relax.


How Often: 3 times per day.

Why: This will make it easier to sit up nice and straight.  Keep your beautiful posture!

5. Back Twist 

Back Twist

How to:

  • Sit up nice and straight in your chair with your feet flat on the floor.
  • Slowly twist to the left from the waist without moving your hips. Then turn your head to the left too.
  • You can hold on to the back of the chair to twist a little bit further to the left.
  • Count to 20 then relax.
  • Do the same thing on the other side.

How Often: Repeat 3 times on each side.

Why:This will create more movement in your back and help with posture.

Disclaimer: It is best to consult your physician before starting a new exercise routine.



**Special thanks to Dr. Carol Giuliani (PhD Level Physical Therapist) whose contributions made this blog article possible. **

**Thanks to Trinh Le for her assistance in developing this post.



Happy National Registered Dietitian (RD) Day!: 5 Reasons to see an RD and a Food Challenge

Happy national registered dietitian’s day everyone and for that matter, happy nutrition month! Every March RD’s across the country celebrate our love for food (something that I do on a daily basis) and our commitment to our profession.

RD Day 2014

Before I delve into the food part, let me put in a plug for the profession. I get a lot of people asking me ‘So what is the difference between a “nutritionist” and a “registered dietitian (RD)?’ The simple answer to that is a “nutritionist” is not guaranteed to have completed any training in nutrition.

On the other hand, an RD (or RDN) is an expert in nutrition who has completed the necessary education to practice. He/she is trained to give you science backed answers to your questions about food. Sadly, while our love for food may be as simple as an ice cream sundae on a summer afternoon, our knowledge of how food works in the body is constantly changing. It gets even more confusing if you also have a condition (like diabetes, cancer, heart disease and so forth) because what you eat and how you eat it becomes crucial to your well-being. RDs are here to help us navigate through this confusion!

Here are 5 reasons for why you would see an RD1:

1.      You have diabetes, heart disease, high blood pressure, kidney disease, cancer or other chronic conditions. An RD can help you come up with an individualized eating plan that safely helps you change your diet without comprising taste or nutrition.

2.      You have digestive problems. An RD will work with your physician to help fine-tune your diet so you are not aggravating your condition with fried foods, too much caffeine or carbonation.

3.      You’re concerned that aging has affected your ability to eat. A RD can help with food or drug interaction, proper hydration, special diets for hypertension and changing taste buds as you age.

4.      You want to lose/gain weight. An RD can suggest a healthy weight gain or weight loss plan that includes proper nutrition and regular physical activity to help you gain or lose weight safely. 

5.      You want to eat smarter. An RD can help you sort through misinformation; learn how to read labels at the supermarket; discover that healthy cooking is inexpensive, learn how to eat out without ruining your eating plan and how to resist workplace temptations.

Now, let’s get back to the simple joys of eating! This month, the Academy of Nutrition and Dietetic (the national organization that oversees all RDs) has a simple slogan: Enjoy the taste of eating right. I want you to ponder that because “eating right” means something different for everyone. For example, “eating right” for someone who has diabetes and wants to lose weight is different from someone who is malnourished. Regardless of what “eating right” means for your goals, I want all of us to focus on how we can also make food taste its very best.

spices 1

Some of you may have remembered from a previous post (Spice it Up!: insert hyperlink with text: that I gave some tips for how to prepare food for more flavor. There are some useful tip sheets at the bottom of that blog post that can help you get started. My challenge to you this month is:

1)     Revisit that blog post,

2)    Download the tip sheets at the bottom of the post AND

3)    Try 1 tip per week to consciously make your food taste great! (Don’t forget to share your experience and more tips in the comments below)

Here’s to healthy and TASTY eating!

Special thanks to Trinh Le for her work on this blog post.



  1. Tips adopted from:



Favorite Reads for Easier Chewing and Swallowing

IMG_1495Like previous years, I’ve been on the road most of June and July visiting my students.  I’ve traveled 3200 car miles and taken 5+ plane rides.  Our students have done a 
spectacular job this summer during their clinical internships!!  Way to go Class of 2013!!

I’ve also done a lot of talking and researching about dysphagia and how to best prepare easy to chew and swallow foods.  As we learn more about this topic I realize that many foodservice operations and caregivers don’t have access to some really great resources.

If you are trying to tackle pureed foods or thickened liquids for your loved one there are two books that you must read.

1.  Soft Foods for Easier Eating by Sandra Woodruff, RD and Leah Gilbert-Henderson, PhD.  You will find techniques in meal preparation and gain access to some of the most flavorful and delicious recipes.  The authors have done an excellent job tackiling some hard to puree foods like pasta,  beef and fish.

Flavorful Fortified Foods2.  Flavorful Fortified Food by Digna Cassens MHA, RD and Linda S. Eck Mills MBA, RD, FADA.  If you have been looking for quick and easy ways to add LOTS of calories and protein this book with be your answer.  Digna and Linda have given you small portions that pack in the calories, protein and vitamins and minerals.  If the idea of an easy to prepare 8oz/1cup milkshake  made with real food that has 550kcals and 13 grams of protein sounds appealing…you will love this book!!

Happy Reading and it is good to be back!! ~Amanda

It’s May and that means it’s Older Americans Month!! Unleash the Power of Age (and nutrition)!!

OAA 2013It is May!!  When I think of May I think of the May pole (did anyone else have a May pole when they were kids?) AND Older American’s Month (OAM).  Well, to be honest, I also think about North Carolina strawberries!  Yummy!  This year the theme for OAM is (drum roll, please), Unleash the Power of Age!  What are you doing to unleash your power?  

When I think about the theme the idea of super-heros immediately comes to my mind. Can you tell I’m a parent of a 7 year old?  Ha!  

All joking aside, very soon many states we will have more seniors than they do school aged children.  Those seniors will be (and are) critical to the success of every community!  My hope is that we will continue to see older adults teach younger adults about canning, healthy cooking, freezing, gardening and nutrition.  The younger generation will need older adults to unleash the power of food and nutrition knowledge to keep them healthy.  I also hope that we can work together to take the idea of “farm to school” and apply it to be “farm to nursing home.”  Older adults in nursing homes should have access to better food.  Food that is local and food that is healthy.  It will take all of us to make that a reality!

So, get ready for May and think about how you can unleash your super powers!!  




Sodium Restricted Diets…How low can you go?

salt shakerThere is no denying that most Americans eat far too much sodium.  A diet rich in processed foods is also rich in sodium.  Reducing sodium in your diet (regardless of age, ethnicity or family history) can assist you in lowering your blood pressure.

What exactly does low sodium mean?  I generally consider a diet consisting of ~2400mg/day to be a great goal when aiming for a low sodium target.   That being said, don’t get too excited and totally eliminate all the sodium in your diet.  A recent meta-analysis (1) indicates that going below 1800 mg/day can actually raise your risk of dying.  Of course, that makes sense as our bodies do need some sodium to help manage fluid levels, muscle contractions and nerve function (not to mention improving the taste of our food during aging).

So how much is 2400mg of sodium?  Well, about 1 teaspoon, so not much.  Here are some interesting facts (2) about sodium in the typical American diet:

  • 77% of the sodium in our diet comes from processed foods
  • 12% is naturally occurring
  • 11% is added during cooking or baking

If you are working on meeting a target of 2400mg of sodium in your diet, a great way to get started is to eat more fresh foods (especially fruits and vegetables) and foods that are in season.  These foods usually contain less sodium and are tastier!!

Click here to learn more.  Enjoy!


Salt Image:  Image courtesy of CarlosPorto /

(1) Heart. 2013 Jan 24.

(2) Fast Facts from the FDA

Nutrition and Urinary Incontinence

Hi Friends,

I’ve now been asked by four people to comment on foods and fluids and how they relate to urinary incontinence (UI).  For those of you who aren’t familiar with UI, I’d recommend you visit this website.  UI is one of those conditions that most people don’t like to discuss and very rarely bring up with their dietitian….which is too bad.  Foods and fluids play a major role in the management of UI.  Here are just a few tips that may help:

  • Drink your water, don’t avoid it.  I find most folks think that drinking less will help them better manage their UI.  Not so.  Staying hydrated and drinking 2 liters of fluid/day seems to help with better management.
  • Eat your protein.  I know, I’m back at it talking about protein but less face it…our pelvic floor has lots of muscles and those muscles need protein to fuel them.  Lack of protein in the diet certainly isn’t going to help with muscle integrity.  Read more about protein here.
  • Talk with your doctor or dietitian to be sure you aren’t deficient in micronutrients like Magnesium, Calcium, Vitamin B12, Vitamin C and Zinc.  All of these nutrients have a link to UI and doing some investigating into your diet may help you.
  • Reduce your caffeine and alcohol intake.  Several studies have suggested that decreasing and/or eliminating caffeine and alcohol is linked to fewer episodes of UI.
  • Be careful with sugar sweeteners.  Sweeteners like aspartame have been found to contribute to UI.  If possible, I’d encourage you to find foods that either don’t use these sweeteners or that would use a more natural sweetener (like honey).
  • Be careful with foods that could be consider bladder irritants.  Foods that are spicy or acidic (tomatoes, citrus foods, etc.) are notorious for irritation in the bladder and may cause some burning during urination.
  • Keep reading about dyes.  This is an area I’m continuing to learn about but there is more and more literature discussing the use of food dyes and its link to UI.  Dyes like Yellow No. 5 have been linked to bladder spasms and irritation.


Photo credit: nickwheeleroz / / CC BY-NC-SA

Creative ways to swallow crushed medications

If you are helping someone with medication management you may have encountered the need to “hide” their crushed pills in food.  Of course, we aren’t doing this to be deceitful but to help “the medicine go down”…as Mary Poppins would say.  Our goal is to use the food as the delivery method for the crushed medications.

It sounds easy until the person tires of the food or “discovers” the food is the delivery method for medications.  This may sound familiar to those of you who care for adults with dementia.

Here are some of my ideas on foods that can be used to deliver crushed meds:

-Yogurt (get the full-fat, whole milk kind: it works much better)
-pureed fruit (any kind…bananas, apricots, strawberries, mixtures)  We use the Gerber pureed fruits a lot (they are real tasty!!).
-Pimento cheese (delicious on a cracker)
-Any kind of salad (egg, tuna, etc.)
-Ice cream (just scooped)
-Grits (or Farina)
-Cheese dip (like pub cheese)
-Any kind of little debbie cake (I know, not what you thought you’d hear the dietitian say…but you can cut a swiss roll (or oatmeal cream pie, etc.) in half, put the meds in the cream and then put back together and serve with a fork). They are soft, easy to chew and have tons of flavor.
-Pudding or Mousse
-Avocados or mild guacamole
-Cottage cheese
-Cream cheese
Of course we aren’t talking a lot of volume for any of these…Enjoy!
Image Location:  nutella-spoon-2.jpg

Dining With Dementia

The past few weeks have been busy around “the office.”  I’ve been driving around NC visiting students as they complete their clinical rotations.

I recently received an email from the folks at Chicagoland Methodist Senior Services (CMSS).  If you’ve never heard of  CMSS, visit here to learn more.  They are an incredible organization specializing in Chicago senior care.

Since both of us work with seniors who have dementia, we thought it would be a great idea to share practices around eating and dementia.  My post, Eating with Dementia provides five practical tips that will help mealtime be more successful.  Be sure to visit the link to learn more.

Karoline Hutson, with Chicagoland Methodist Senior Services, was nice enough to provide the below post:

Dining with Dementia:

A meal can easily turn into a stressful situation for someone with dementia – not to mention for the person providing care. In our memory support communities, we have found these tips helpful in creating a calm, pleasant dining experience for our residents:

  • Use different colored dishes. For example, use a red plate and a blue mug on a yellow placemat. This helps distinguish each item for their proper use in addition to defining the food on the plate.
  • Create a delineated space for each individual. When serving several people, use a square table rather than a round one; this can help to prevent confusion regarding which items are to be used by each person.
  • Play to the sense of smell and incorporate it into the dining experience. Using fresh herbs and spices helps to stimulate senses, memories, and conversation.
  • If there are options to choose from, do not use menus or verbal descriptions. Choices should be made after the food is seen, smelled, and perhaps even tasted.
  • If using utensils properly is an issue, serve finger foods or make the meal into a sandwich, which is easily done if you get creative. Now is not the time to worry about being neat and tidy.
  • If there is a loss of appetite that is leading to unhealthy weight loss, fortify a simple dish with extra ingredients. For example, serve a comfort food like mashed potatoes and mix in sour cream, cheese, or bacon to add some fat content.
  • Be sure that the dining environment is calm and free from distractions such as loud noises and unpleasant smells. Play soothing music and allow enough time for everyone to eat at their own pace.

The most important thing is remain observant – most problems can be easily solved with a keen sense of awareness and a little creativity. If you have any questions or want to share tips of your own, feel free to join the conversation at our Dealing with Dementia Facebook page!


Thanks Karoline!!  Happy Eating!