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: https://3squaremealsblog.wordpress.com/2010/10/18/spice-it-up-how-to-add-flavor-and-tickle-to-your-taste-buds/) 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.

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REFERENCES

  1. Tips adopted from: http://www.eatright.org/Public/content.aspx?id=4294967631

PHOTO REFERENCES:

  1. http://www.eatright.org/NNM/#.Ux3dvPmsgyo
  2. http://www.mohrresults.com/wp-content/uploads/image/icecream.jpg
  3. http://www.freegreatpicture.com/food-seasoning/the-seasoning-ingredients-hd-112

http://www.freegreatpicture.com/food-seasoning/condiment-32106

Colored Plates: What do Fiestaware and Dementia Have in Common?

Got Fiestaware?  My mom does…she has a whole set of plates and bowls in lots of vibrant, beautiful colors.  Having a meal on a colored plate just seems to make mealtime more fun!

I recently read a great post from The Alzheimer’s Reading Room discussing the use of colored plates in Alzheimer’s patients.  (FYI: The Alzheimer’s Reading Room is a great resource for those with or caregiving for someone with Alzheimer’s.  They have great resources and an active community for you to connect with.  I highly recommend them!!)

The post mentions that colored plates help Alzheimer’s patients see their food more clearly, which as you can imagine, seems to help with intake.   This isn’t a new phenomenom but one we’ve been using in the practice of dietetics for some time.  Colored plates help those with visual impairment see contrast and therefore enhance intake.  Our brains also seem to pick up on the colors and may influence us to eat differently.  In particularly, red plates do seem to increase intake.

So to answer the original question…what do Fiestaware and dementia have in common?  That colorful Fiestaware (or a colored disposable plate) could be an easy trick to helping your loved one with or without dementia eat more!

Have a great weekend!  Sunday is Grandparent’s Day…be sure to honor and/or remember your grandparents!!

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Resources:

1.  The Alzheimer’s Reading Room:  http://www.alzheimersreadingroom.com/2011/11/thanksgiving-postscript-wont-eat-didnt.html#more

2.  Photo:  Kenan Crawford Hill

Protein Is Good For You…Right? Does it make your bones brittle?

I was recently speaking with a women’s circle group about protein consumption during their 70’s, 80’s and 90’s (years of life).  There was a room full of women who were asking lots of questions about how much protein they should consume to prevent muscle loss and strive for optimal health during aging.  One woman raised her hand and asked “What about animal protein and calcium?  I heard that eating too much animal protein can make your bones brittle?”  Wow!  I was so impressed by her question because this is something that is talked about (lots) in the nutrition world.

I thought I would share my answer here in case any of you have the same question.

Animal Protein and calcium intake do go hand in hand.  Many people have read that increasing animal protein intake may increase calcium excretion…and therefore lead to poor bone health and a potential for more fractures (wrist, spine and hip). Not a good thing.  However, in the past 2-3 years we have learned more about the topic and now realize that higher protein intake actually leads to a higher absorption of calcium.  Very cool!

So how much is a lot?  Well, it seems that those who get ~800mg of calcium/day AND who eat high amounts of protein (85+grams/day) seem to have the lowest risk of developing a fracture.

If you don’t have higher intakes of both (800mg of calcium and 85+grams of protein) you  may be a greater risk for poor bone health so it is important to think of protein and calcium together when meal planning.

So eat up…enjoy those lean animal proteins and get some calcium.  You’ll be helping your bones as well as your muscles!!

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References:

1.  Shapses SA, et al.  Hormonal and dietary influences on true fractional calcium absorption in women: role of obesity. Osteoporos Int. 2012

2.  Sahni S., et al.  Protective effect of high protein and calcium intake on the risk of hip fracture in the Framingham Offspring Cohort.  Journal of Bone and Mineral Research 2010.

Image:  http://www.cookinglight.com/eating-smart/nutrition-101/calcium-magnesium-vitamin-k-00400000055855/page2.html

Never Too Old to Play…With Your Food

Yes, you read correctly, the title of my post this week is encouraging you to play with your food.  What I really mean is I want you to get excited about food!

This year’s Older Americans Month slogan is “Never Too Old to Play.” I think for most of us the slogan conjures up ideas of exercise, playing with kids and playing games.  I think we’d all agree that these are great ways to play, but we must not forget the role of good nutrition as we “play” and that we can also “play” with our food.

Eating throughout life should be fun and involve some play.  Here are a few ideas to help you:

1.  Try pairing foods together that you’ve never thought of before.  I recently put cottage cheese on oatmeal and LOVED it!!  I got some extra protein and the slight saltiness made my somewhat boring oatmeal delicious.

2.  Eat like a kid.  Kids are notorious for making finger foods fun.  Ants on a log, apple peanut butterflies, and vegetable creatures are just some ideas.  These same ideas work great with folks who may want to eat on the go, wander due to dementia or who need an activity that is healthy that will involve the grandkids.

3.  Take easy to prepare snacks with you on the go.  Dried cherries mixed with white chocolate chips and walnuts, cheese cubes and whole grain crackers, celery with Nutella.  These are just a few ideas of quick snacks that can add protein to your diet.

4.  Eat in a new/different location. Try moving away from eating near the TV and enjoy eating outdoors or in a new room.  You’d be surprised how much more you can enjoy your meal.  Adding natural light and fresh air can help wake up your senses.

5.  Try different types of protein.  I know, I know, I’m always talking about protein…but it is important when you are over 70!  Here are a few of my favorites:  dry milk (1-2 tablespoons) mixed into smoothies, peanut butter on frozen fruit and cottage cheese with strawberries.  Yum!

Enjoy the month of May as you remember we are “never too old to play”… outside or with our food.  Have a great week!

What’s in your starting line-up? ACC Tournament and National Nutrition Month

March is an exciting time of year!  Not only is it National Nutrition Month but there is a little bit of basketball going on…

When I saw the image of the tournament (featured to the left) I couldn’t help but notice that the cute, little orange basketball had been made to  look like a Georgia peach.  Did they have a Dietitian working for them?  🙂

Each team has a starting line-up.  These guards, forwards and centers are at the core of the team and possess the most talent and skill.

On your plate, you also have great players…shall we call them “your plate’s starting five?”

Starting at point guard: vegetables, they are key to distributing nutrients and energy to your body.  Include those  vegetables that are bright in colors.  Foods like carrots, kale and beets.

Like a good three-point shooter, fruits are tasty, exciting and fun to be around.  Try to add more of those fruits to your plate that are deep in color like strawberries, blueberries and blackberries (and peaches, of course).

Every good team has a center to anchor the inside game. Protein can help add B12 to your diet and help you feel fuller longer.  Include lean proteins in your diet like non-fatty meats, fish, beans and lentils.

Forwards are key to being able to move all around and fill in many different roles on the court.  You can use 100% whole grains to add fiber to your diet.  Of course, anytime you add fiber you should also be aware of your fluid intake to prevent constipation.  Be sure to try to drink 8-10 cups of water a day.

Oh, and be sure to limit sugar sweetened beverages as a way to prevent fouling out.  🙂

Here is a good picture from Tufts to help you plan your starting line-up:

You too can find your way to a champion’s diet and peak health!!  (Go Heels!!)

A special thanks goes to my husband, @robreports for  making sure I had all my basketball lingo correct.  🙂

References:

1.  Tufts Nutrition:  http://now.tufts.edu/news-releases/tufts-university-nutrition-scientists-unveil-

Balancing the Bread: Carbohydrate Counting 101

Balancing the Bread: Carbohydrate Counting 101

In the past thirty years, carbohydrates have experienced a drastic rise and fall in popularity. There has got to be a balance between the high-carb low-fat diets of the eighties and nineties and the low-carb high-protein diets of the 2000s.

For folks with diabetes, finding that balance is especially important.

Carbohydrates, such as breads, pastas, fruits and vegetables, are broken down to glucose during digestion. After a carbohydrate rich meal, blood glucose levels rise. Cells take up the glucose from the blood to use for energy or convert it to fat for storage. Aging is associated with a decrease in glucose tolerance, which means that cells can’t take up the glucose from the blood as efficiently2.  Type II diabetes is diagnosed by high blood glucose levels and occurs in 23.1% of adults 60 years and older3. The American Diabetes Association has published a position statement that supports managing blood glucose levels for type II diabetes4.

Carbohydrate Counting: A Way to Balance Blood Glucose

One way to manage blood glucose levels is carbohydrate counting5. Carbohydrate counting is a little like balancing a check book. It takes some work, but when it comes down to it, it’s just simple math.

  1. Decide on a carbohydrate budget for each meal. You dietitian is your financial advisor in this case; he or she can help you decide what is best for you.  A good place to start is 45-60 grams (3-4 servings of 15 g each) per meal for women and 60-75 grams(4-5 servings of 15 g each) per meal for men.
  2. Find out how many carbohydrates are in the foods you eat. The nutrition facts label is your price tag in this case. Look at the serving size first. All of the information pertains to that serving size. Then look at the grams of total carbohydrates. You can adjust your portion sizes based on how many carbohydrates are in the food and what your carbohydrate budget is.

Carbohydrate counting isn’t for everyone. If you don’t have diabetes or insulin resistance, it’s unnecessary. If you have diabetes but find that carbohydrate counting does not work well for you, you can try the plate method (http://www.diabetes.org/food-and-fitness/food/planning-meals/create-your-plate/).

Carbohydrates are an important part of everyone’s diet. If you have diabetes, it’s especially important to eat balanced meals, so you’re your blood sugar does not go too high. Carbohydrate counting is one way to achieve this balance. If you don’t have diabetes, it unnecessary to use carbohydrate counting, but you should still try to have balanced meals with carbohydrates, proteins and fats.  To estimate how many carbohydrates you need each day, you can use a carbohydrate calculator (http://www.wfubmc.edu/patientsAndVisitors/healthCalculators.aspx?cid=7).

The Who, What, Why and When of Carbohydrate Counting

Who: Adults with diabetes who decide this will be a useful strategy for them

What: Count your carbs and try to stay within a certain range

Why: For better glycemic control

When: At each meal

Guest Blogger:  Kaitlyn Jongkind

Sources:

  1. Balance: Street Vendor Turkey. Sol Algranti Photography.
  2. Meneilly, G. Pathophysiology of Diabetes in the Elderly. Clinical Geriatrics 2010; 18; 25-28.
  3. http://www.diabetes.org/diabetes-basics/diabetes-statistics/?utm_source=WWW&utm_medium=DropDownDB&utm_content=Statistics&utm_campaign=CON
  4. American Diabetes Association: Position statement: Implications of the Diabetes Control and Complications Trial. Diabetes Care 23 (Suppl 1): S24-26, 2000.
  5. GILLESPIE SJ, KULKARNI KD, DALY AE. Using Carbohydrate Counting in Diabetes Clinical Practice. J Am Diet Assoc 1998;98:897-905.

Pump Up the Volume: The Volumetrics Weight Control Plan for Older Adults

Pump Up the Volume: The Volumetrics Weight Control Plan for Older Adults

Whenever someone mentions a diet, the first thing that usually comes to mind is smaller portion sizes. According to Dr. Barbara Rolls, a nutrition researcher at Pennsylvania State University, reducing calorie intake does not mean reducing food intake.

Interested in dietary strategies for weight management, Dr. Rolls has found that those who are trying to lose weight are more satisfied when able to ingest the same amount of food, rather than the same amount of calories.[1] To place her extensive research into practice, Dr. Rolls has created a healthy eating plan—the Volumetrics Weight-Control Plan—that emphasizes eating foods low in energy density. What this means is eating foods that are low in calories but are collectively the same weight as foods previously eaten. By eating the same amount of food, those who are following this eating plan are able to still feel full, but fewer calories will be consumed. Most of the foods that fall into this low energy density category are fruits and vegetables, whole grains, beans and foods high in fiber and water content. [2]

For an older adult, this eating plan may prove beneficial not only for losing excess weight, but also for maintaining a healthy diet.  As we age, some of us find it difficult to stay hydrated, so increasing consumption of foods that are high in water content may ameliorate this issue. Additionally, this eating plan encourages the consumption of high fiber foods, which aid in proper digestion and may better manage constipation. Although most older adults do not need to worry about reducing calorie intake, abiding by this dietary plan may improve the intake of the essential nutrients necessary for graceful aging. When adopting this eating plan, it is important to remember to still eat three meals a day, incorporating a protein at every meal. Even though most of the recommended foods have a high water content, drinking plenty of fluids throughout the day is vital. Following these recommendations will lead to a healthy, well-balanced diet.

Want more information?  Download this helpful handout:  Patient HandOut_Lauren Brown

Guest Blogger:  Lauren Brown
 


[1] Rolls BJ. The supersizing of America: Portion size and the obesity epidemic. Nutrition Today. 2003;38:42-53.

[2] Rolls, Barbara J., and Robert A. Barnett. The Volumetrics Weight-control Plan: Feel Full on Fewer Calories. New York, NY: HarperPaperbacks, 2003. Print.

Photos found at http://www.buzzle.com/articles/healthy-nutrition-for-older-people.html And http://www.sparkpeople.com/myspark/groups_subcategory.asp?pg=2&strSearch=&strMethod=&selGroupType=&SortOrder=&CatID=34


2000 Calories in A Few Easy Steps

2000 Calories in A Few Easy Steps

Due to age-related changes in body composition, metabolism, and activity, older adults should have slightly different diets than the general population.

Here is a non-comprehensive list of some suggested dietary concerns:

  • Wet your whistle!— drinking 8 cups of water a day is crucial for older adults since dehydration is very common because of an age-related decreased sense of thirst
  • An apple a day keeps the doctor away[I1] —high fiber diets are essential to prevent digestive problems; great source of fiber are fruits.
  • Beef Up[I2] —high protein diets (about 100g per day) are recommended for older adults to prevent age-related muscle and function loss (sarcopenia)2. The dense calories from meat fats are also good to help older adults meet caloric needs.
  • Calcium and Vitamin D—due to decreased Vitamin D [I3] synthesis in the skin and decrease calcium intake, older adults are very susceptible to osteoporosis [I4] and bone fracture. Adequate intake of these vitamins and minerals is crucial3.

Designing a 2000 Calorie Diet

Aside from the age-related concerns mentioned above, older adults should also follow the general guidelines in designing a healthy diet:

  • Varied—eating a variety of foods helps ensure adequate micronutrient intakes.
  • Energy adequate—caloric content should match weight aims. For older adults, this will most frequently mean maintaining weight by increasing caloric intake to counteract sarcopenia and loss of appetite.
  • Medical Considerations—if any medical conditions exist, consulting a dietitian or doctor is recommended to ensure proper nutrition

With the general goals clear, using online caloric-nutrient counting tools is a great way to ensure adequate nutrition: My Pyramid Tracker and Spark People are two free options.

Attached, you can also find a handout with total servings of each food group to reach 2000 calories.

Example 2000 Calorie Diets

Day 1 Day 2
Breakfast
  • 2 medium eggs scrambled
  • 2 pieces of Wheat Toast
  • ½ cup of cooked Oatmeal with half a Bananas
  • 8 oz of Orange Juice fortified w Calcium
  • 1 multigrain bagel
  • 1 T. light cream cheese
  • 1 cup orange juice with calcium
  • 6 oz. low fat  yogurt
  • 1/2 cup fresh strawberries
Lunch
  • 1 Roasted Turkey (2 thick slices), Provolone (1 slice), Lettuce (2 leaves), and Light Mayonnaise (1/2 tablespoon) Sandwich
  • 8 oz of 2% Milk
  • 3 oz. lean hamburger, grilled or broiled
  • 1 T. ketchup
  • 1 hamburger bun
  • 1/2 tomato, sliced
  • 1/2 green pepper, sliced
  • 1 cup of skim milk
Dinner
  • 1.5 cups of Caesar Salad
  • 1 Piece of Vegetarian Lasagna (4×4)
  • 8 oz of Apple Juice
  • 2 cups of whole wheat pasta with meat sauce
  • 2 medium sausages
  • 1/2 cup cooked green beans
  • 1 slice of garlic bread
Snacks
  • At least four 8 oz glasses of water throughout the day

Calories= 2179 kcal 2055 kcal
Carbohydrates= 269 grams 279 grams
Proteins= 104 grams 103 grams
Fiber= 35 grams 31 grams

Also, download this helpful handout to be used when planning a 2000 calorie meal plan:  2000 Calorie Planning

Guest Blogger: Ignacio Cerdena

References and Photos

  1. Photo 1: ESL-to-go Blog. http://esltogo.wordpress.com/
  2. Kamel, Hosam. Sacropenia and Aging. Nutrition Review. May 2003, p157-167.
  3. Healthy Aging DPG (ADA) Newsletter: Bone Health: Physiology, Assessment and Prevention of Fractures. Summer 2008, pg 1, and 4-6.

[I1]Hyperlink to the “Fiber, Fluid and Alleviating Constipation” blog

[I2]Hyperlink to the “Protein and Sarcopenia” blog

[I3]Hyperlink to the “Vitamin D  (Dosing and Sources)” blog

[I4]Hyperlink to the “Osteoporosis:  What to do once you are a senior?” blog

1800 Calories A Day? No Problem!

1800 Calories a Day? No Problem!

Proper nutrition is vital for muscle function, bone mass, immune function, cognitive function, and wound healing and recovery(1) yet older adults are the demographic population most at risk for poor nutrition(2). By eating enough calories and protein each day and eating foods from all of the different food groups, you can make sure you get all the nutrients you need to maintain a healthy lifestyle.

Energy needs depend on many factors, including age, weight, height, gender, and activity level. Check out this site to see what is recommended for you:

http://www.mypyramid.gov/mypyramid/index.aspx

How much from each food group do you need to eat 1800 calories a day?

Protein: Choose 5 ounces of fish, poultry, lean meat, dry beans and nuts, and eggs

Grains: Choose 6 ounces of grains; look for whole grains such as brown rice and 100% whole wheat bread

Fruits: Choose 1 ½ cups of deep-colored fruits such as berries and melon

Vegetables: Choose 2 ½ cups of bright-colored vegetables such as carrots and broccoli

Dairy: Choose 3 cups of dairy, including low- and non-fat milk, yogurt, and cheese

Fats: These are ok! These foods, such as ice cream and butter, are fine in moderation but make sure these foods do not limit your intake of the other food groups.

Don’t forget about the importance of drinking enough water and getting enough physical activity- these are part of the food pyramid too! The most important point is that a well-balanced 1800 calorie diet involves food from all food groups.

Need More Ideas?  Check out these great handouts…5 sample 1800 kcal menus AND Mypyramid for 1800 kcals

Guest Blogger:  Jackie Geralnick

References:

1) Ahmed T, Haboubi N. “Assessment and management of nutrition in older people and its importance to health.” Clinical Interventions in Aging. 2010 Aug 9;5:207-16.

2) Brownie S. “Why are elderly individuals at risk of nutritional deficiency?” International Journal of Nursing Practice. 2006 Apr;12(2):110-8.

3) Lichtenstein AH, Rasmussen H, Yu WW, Epstein SR, Russell RM. “Modified MyPyramid for Older Adults.” J Nutr. 2008; 138:78-82.

4) “Meal Plan: 1800 Calories.” RD411.com. 2010. Web. 19 Oct. 2010. http://www.rd411.com/

5) “MyPyramid Plan.” MyPyramid.gov – United States Department of Agriculture – Home. Web. 18 October 2010. http://www.mypyramid.gov/mypyramid/index.aspx

Healthy Eating: 1500 calories

My doctor says that I need to follow a 1500 calorie diet.  What does that mean?

A calorie is a measurement of energy…and that just means how much food you are supposed to eat.  If we get too much energy, the excess is stored in our bodies as fat.  If we get too little energy, our bodies use our fat stores and muscles to make sure that we have enough energy to run on.

Both of these situations can cause complications for older adults making it difficult to stay active and healthy.  Being overweight can lead to a variety of chronic diseases that can be debilitating.  Too little weight and muscle can impair your ability to fight off disease and stay healthy.

Consider the kinds of foods to eat…in order to have a balanced diet.  As we age our bodies change in the way that we process and absorb the food we eat.  At the same time we usually need to eat less than we used to.  This makes it all the more important to get the most nutrition possible out of what we are eating 1.

Add it all up…what should my plate look like?

1/2 to 3/4 of your meal should be carbohydrate based foods:

-grains, fruits, vegetables

1/8 to 1/4 of your meal should be protein based foods:

-meats, poultry, fish, eggs, milk and cheese, beans and tofu and nuts

1/3 of calories should be from fat:

-oils that our foods are cooked in  and butter and cheeses we add to our plates.

Check out this sample menu to see how much food will give you 1500 calories…1500 calorie handout

Guest Blogger:  Jennifer Cantwell-Wood


References:

1. Dietary Guidelines for Americans, 2010. http://www.cnpp.usda.gov/DGAs2010-DGACReport.htm  p B1-4. accessed 10.16.10

2.http://www.brighamandwomens.org/healtheweightforwomen/eating/mealplans/1500_calorie.aspx  accessed 10.16.10