Monday, December 30, 2013

Frozen Produce: Get the Facts

Frozen produce gets a pretty bad wrap. I'm not totally sure why, but a recent article from the Wall Street Journal has a few ideas.

Maybe it's the idea that is conjured up when I mention a "frozen dinner"-- something bland, covered in some kind of sauce, and probably fairly salty, chewy meat. Not a lot of color, kind of a greyish-brownish mix of things.

Maybe it's the idea that if I didn't slave away over the stove for hours then it doesn't really "count" as a home-cooked meal, or I'm not taking proper care of my family.

But the reality is -- when you're going for produce, frozen is just as good as fresh. And at times, it can be even better than fresh -- like now, in the dead of winter, when fresh may have spent a fair amount of time in transit before I ever see it in the store. During transit, storage, purchase, and (ultimately) sitting on my counter or in my fridge until I'm ready to use it, my produce is losing nutrients. Some of these nutrients start to break down with exposure to the air (oxygen), or if they get battered and bruised a bit along the way.

And - bonus - especially out of season, these fruits and veggies are often cheaper than fresh.

Now, I know what you're going to say -- but the berries are mushy, and... no thank you. Well, you're right. There is absolutely nothing in this world that can compare to a fresh strawberry at peak season. Certainly not a frozen strawberry on a chilly January day such as this. But there are ways around this. So here you have it -- tips for getting the most out of your frozen fruits and veggies!

- Frozen fruit is great for smoothies! You really can't tell the difference here, I promise. And, bonus, they are already chilly so you don't even need to add ice!
- Looking for some crispness in your veg? Look no further than your skillet. Microwaving frozen veggies (while delicious) may not be what you're after, texturally. So try heating them up in a skillet to help maintain some of the texture.
- Frozen fruit is good for cooking! making compote or jellies for waffles and pancakes can help you use the softer texture of fruits to your advantage. They are also great for home-made pie fillings (easier than you'd think).
- Frozen veggies are great to toss in soups! Many types come without sauce and already chopped into the perfect sized bites for soups.

For the complete WSJ article, please go here.

-- Les, MS RD LD

Wednesday, December 18, 2013

An ode to B12

Maybe "ode" isn't the best word, since I'm not much of a singer/song-writer, but I still think today is a good day to talk about B12 -- what it is, what it does, and why we should care.

B12, or Cobalamin as it's called in more science-y circles, is one of the B-complex vitamins. This also includes B1, 2, 3, 5, 6, 7 and 9. They each have alternate names like thiamine (1), riboflavin (2), niacin (3), pantothenic acid (5), pyridoxine (6), biotin (7) and folate (9). It may sound like a lot to remember but here's basically everything you need to know about the B vitamins. Are you ready?

They are all water soluble (meaning the body doesn't really store them very well). They help you break down the food you eat to get energy. So that's why we call them energy vitamins. Energy drinks and little magic "3 o'clock feeling" caffeine-free energy supplements are loaded with B vitamins, and B12 in particular. (In case you're wondering, vitamin C is also water soluble. Vitamins A, D, E & K are all fat soluble).

What's interesting, though, is that if your body doesn't have the energy available, such as a carbohydrate, protein or fat source (i.e. food), then the B vitamins don't get used. And because they are water soluble, the body will flush them away along with the rest of your... fluids. You will literally flush these vitamins down the toilet.

B12 Myth Busted: B12 burns belly fat! Or any kind of fat. Looking at the above, you can understand how someone may make this mistake. B12 is not a calorie-free energy source. In fact, calories are the body's energy source so... no calories, no energy. Makes sense, right?

However, studies have shown that in people who are B12 deficient, weight loss will occur when adequate B12 levels are achieved. This is due to the body being able to more efficiently break down the energy in the food you eat when it has enough of the vitamin available.

So then, how do you know if you are B12 deficient? B12 is produced by animals (but not humans, sadly), and is therefore found in animal products, such as meat fish and dairy. Strict vegetarians may require B12 supplementation, since they won't get it from the diet. Other at-risk groups include people with digestive alternations, such as having had gastric surgery or removal of parts of the intestine that absorb B12.

B12 requires activation in both the mouth and stomach to be sufficiently absorbed. Additionally, since B12 is found in animal protein sources, stomach acid is important to help break everything apart so the body can get access to the B12.

What's the lesson here? B12 is a pretty phenomenal vitamin. In addition to its role in metabolism and breakdown of energy sources, it is also plays a part in cardiovascular and neurological health & function. B12 is a pretty cool vitamin.

-- Les, MS RD LD

Tuesday, December 10, 2013

Beyond the Basics of Sodium

We hear a lot about Sodium. It's all over, really. Sodium takes credit in popular media for increasing blood pressure and causing fluid retention. It also takes credit for enhancing flavor (especially in processed foods). As a result, when sodium is conspicuously absent from these foods, they are advertised with a big shiny label that says "No Sodium Added!" or "Low-Sodium!".

But what does it actually do?

In terms of taste, yes, it makes things taste salty, but it also enhances the flavor of sweet things and can add depth to savory foods. So removing salt from a food doesn't just keep it from being salty, it may also completely change the flavor profile.

In the body, sodium is pretty important, and it does a lot of things. Yes, that includes influencing blood pressure (in some people, but not everyone) and can cause fluid retention. 

But why? And how?

Well, as it happens....

Sodium and water get along just beautifully. Specifically, NaCl (sodium [Na] chloride [Cl]) really likes to be around water. Have you ever put salt on an avocado? Or noticed the way a salad will wilt if you leave salad dressing on the leaves for too long? Sodium actually pulls water to come with it. Chemists will call this "osmolality" but really it just means sodium and water love to hang out.

As it happens, this is pretty important in human physiology. Humans are somewhere between 60-80% water (we are born closer to 80% and dry out as we age). That's a LOT of water to keep in the right place. Sodium helps us do that. In the case of water retention, all it means is your body will hang on to a bit of that water until it has time to flush out the excess sodium. Excess water can influence blood pressure for some people (meaning your blood has more water in it, which means more pressure by your heart to pump, thus higher blood pressure). This can also be the case for people with difficulty maintaining sodium balance, such as those with renal disorders.

Sodium is also important in nerve transmission, and it moves frequently in-and-out of the cells to help maintain water balance and electrical current.

So, in essence, what does this all mean? Sodium is pretty important! We have requirements for Sodium each day, and for the most part, the body can take care of a little fluctuation in one direction or another. In general, the Institute of Medicine recommends no more than 2300 mg daily of sodium. Naturally, certain conditions, such as blood pressure, kidney issues and diabetes, will have other recommendations for sodium intake. Be sure to ask your physician about your specific needs before you make any changes in your own diet or exercise routines.

The more you know!

-- Les, MS RD LD

Monday, December 2, 2013

Caffeine: Yes No and In Between

The Journal of Clinical Sleep Medicine released a study this week examining the effects of caffeine on sleep. Specifically -- are timing and dose important?

If you must know -- yes, timing and dose matter -- but first I want to just explore what caffeine is.

Caffeine, at it's most basic, is a nervous stimulant. That is to say, it stimulates the nervous system, getting all of your neurons firing and excited. For some people this could be a jittery effect, others may feel more alert, and some others may not even notice a difference (I would direct you to read more about the study below). Tolerance to caffeine can occur over time. This means that you are more likely to notice the impact of caffeine if you do not regularly drink coffee and then one day have a rather large dose.

The study, (you can read the abstract here) examined a few different doses (0, 400 or 600mg), at a few different times - either at bedtime, three hours before bed, or six hours before bed. They found that yes, indeed, consumption of caffeine -- even six hours before bed -- can impact your sleep. In fact, the participants that had 400mg of caffeine (equivalent to about 2-3 cups of coffee) six hours before bed lost an hour of sleep! What's more -- subjectively, the participants didn't even seem to notice that they had lost that precious hour!

The study itself was small, only 12 participants, and very short term, only 4 days, but the findings are interesting, and certainly grounds for thought (excuse the pun), especially if you enjoy a cup of coffee on your way home from work or with your dessert.

What's the take-away here? Caffeine can impact your wakefulness and sleep cycles, even if you don't notice it. So if you choose to do so, make sure you have plenty of time before bed, lest you disturb your sleep cycle.

For a press release about the study, please see the American Academy of Sleep Medicine website at

- Les, MS RD LD

Tuesday, November 26, 2013

Thanksgiving, Stuffing and Food Safety!

There's more than one way to cook a turkey. Though, I guess it really depends on who you ask.

Most people will probably tell you there's only one way to cook a turkey. And even then, people will disagree on what that one way is.

You can bake it. You can fry it. You can smoke it. You can grill it. You can roast it. You can stuff it before you bake it. You can stuff it after it's cooked. You could not stuff it at all and serve the stuffing separate. you can go the vegetarian route and do any of the above to a Tofurkey.

It's a heated debate. And hopefully it's always heated to 165F, right in the center.

This Thanksgiving (and always, really), be sure you're using proper food safety in your kitchen to keep your holiday safe! Follow these simple tips for stuffing your turkey this (and every) year!

- Internal probe thermometers are best! The "pop" on a turkey can be a really great way to alert you when it's time to check your bird, but for the best results be sure to use an internal thermometer. This will allow you to check the temperature at the center of your bird. If you choose to stuff your turkey, make sure the center of the stuffing AND the center of your bird are both at 165F. Probe thermometers will generally run about 5-10$ and can be purchased at any kitchen store, Publix or IKEA.
- Don't remove the stuffing before it is fully cooked! Undercooked stuffing can become a hotspot for contamination, even if your bird as already reached 165F.
- Use proper thawing techniques for your bird. Best technique is to thaw in the refrigerator, generally allow about 4 hours per pound for this technique. If you have a 16lb bird, it will take about 64 hours to thaw completely.
- If you are running short on time, you can also submerge your turkey in enough cold water to cover your turkey completely. Change the water every 30 minutes to keep the turkey properly chilled. This method will take about 30 minutes per pound.
- NEVER fry a frozen turkey! Be sure your turkey is COMPLETELY thawed before frying. Frozen turkeys hold a lot of water and as it fries, this water can rapidly heat and turn to water vapor. As the water vapor escapes, it can cause oil to spatter, with potentially injurious results.

What about the leftovers?
- Refrigerate after 2 hours to prevent the spread of food-borne illness.
- Cover leftovers with wrap or seal in air-tight containers to make sure everyone plays nice in the fridge.
-  Sunday is the absolute deadline! Leftovers can be kept (below 40F, properly sealed) for up to three days. For Thanksgiving, that means cleaning out the refrigerator before you head back to work Monday morning.

Happy Thanksgiving!

- Les, MS RD LD

Tuesday, November 12, 2013

In the News: Trans Fats

It's probably easiest to start at the beginning: What's a trans fat and where does it come from?

Trans fats are a type of solid fat (think butter or lard -- AKA saturated fat). They are found naturally in the food supply, namely meat and milk, in very small amounts. This is not the type that has the FDA concerned enough to remove the GRAS label (more on this later) from trans fats.

The type that concerns most people is what results from partially hydrogenated oils. What's the difference? Chemically, not much. But in terms of supply, hydrogenated oils are much more abundant than the minimal amount that can be found naturally.

Trans fats aren't a new concept by any means. The hydrogenation process was discovered in the early 1900s, and it was used as a way to turn a liquid fat (vegetable oil, which is cheap) into a solid fat (which has a longer shelf-life and is easier to store and transport) by blasting oil with hydrogen. So now we have a fat that is easy to store, easy to transport, lasts a long time AND is cheap. When they were first introduced, it was widely held that these types of fats were less damaging to the body than saturated fats, and even than natural trans fats.

We now have more information which tells us that trans fats are harmful to the body (particularly the vascular systems, think cholesterol and arteries). This isn't good news, especially since prior to about 2000, they were very prevalent in the food supply. Coupled with this is the recognition that saturated fats (and fats in general) aren't really the super-villains they are made out to be. Maintaining cell integrity, coating neurons and boosting immunity are only some of the things fats do for us!

So, what is the FDA really doing here? Ultimately, this is a matter of labeling and classification. GRAS, or "generally recognized as safe" is a label for manufactured food products and additives that indicates to the public that items are safe, so long as they are used the way the manufacturer intended. In the case of trans fats, this means that they are safe to eat. Or did, until last week.

This is a fight that's been happening for awhile, and all across the globe. In 1994, CSPI (the Center for Science in the Public Interest) called for the labeling of added trans fats in food products (this happened in 2003, and took effect by 2006). In 2003, Denmark passed legislation that essentially banned their use. In the US, various states and municipalities (including NYC, California and Washington State) have passed different types of legislation banning or regulating their use in restaurants.

What's next? Well, as it happens, the use of trans fats in food is down -- by over 50% -- since 2000. Additionally, other retailers, including Wal Mart, McDonalds, Burger King and KFC have all either elimintated trans fats or have current timelines in place for the removal from their products. In the next sixty days, the FDA will be accepting comments about this initiative before handing down a final decision. If the GRAS label is indeed removed, a deadline will be established to remove additive trans fats from processed foods.

To view the FDA press release:

- Les, MS RD LD

Tuesday, November 5, 2013

Dietitian's Lunchbox - Lunch with Les

Since we've spent the last several weeks sneaking around the office and peeking in everyone's lunchbox, I suppose it's only fair I share my lunch with you, too.

My favorite lunch is borrowed from Mellow Mushroom's hoagie menu -- the Tempeh Hoagie. Served up with fresh fruit and a cup of yogurt this balanced meal keeps me going through the afternoon! The best part? This sandwich is delicious hot or cold, and my husband loves it too!

It starts with sauteed tempeh, onions and green peppers marinated with Teriyaki sauce and piled high into a hoagie roll with feta cheese, pesto, lettuce, tomato and sprouts. For a hot sandwich, it can be toasted for just a few minutes, or it's delicious right out of the fridge.

This delicious and wholesome meal keeps me going straight through the afternoon. No "3 o'clock feeling" in this office!

-- Les, MS RD LD

Wednesday, October 30, 2013

Tips & Tricks in the Grocery Store

It's no secret that food marketing is big business.Big grocery chains (including Wal-Mart and Costco) make the list as well as food and beverage companies such as Coca-Cola and PepsiCo.

You can scarcely open a magazine, turn on the tv, or read a facebook feed without coming across at least one reference to health, food and nutrition. Eat more this, less this, avoid this at all costs, you've never lived if you haven't eaten this... It can all be a bit much.

Last week, we looked at some new research that's being done to determine if there's an effective way to use marketing strategies to increase the amount of fruits and veggies found in the grocery cart. As promised, this week we are going to look at what the Big Companies are doing to market their goods, and how their items end up in your cart, even if they aren't first showing up on your grocery list.

1) We rarely venture to the center A pretty cool study hooked up GPS units to grocery shoppers to track their movements through the store. While we may think of grocery shopping as an up-and-down type pattern, the truth is, we rarely do this. Most often, people will move along the perimeter of the store, venturing into aisles, and often, only to what they need and straight out again.
Why does this matter? Products placed at the center of the aisle will receive less foot traffic, so this isn't a high-priority area for popular items. Instead, retailers will often utilize the end-space to feature profitable items.
Wouldn't it be cool if oatmeal toppings, such as bananas, raisins or nuts were featured on the ends of the cereal aisle? (I referred to this last week, Publix does this on occasion)

2) Fresh stuff is on the outside! The perimeter of the store usually houses the fresher, less processed items, such as bakery, deli, butcher, produce and dairy. Packaged foods, such as crackers, cereals, snacks and canned goods tend to be on the center aisles.
This makes sense especially if you consider that the fresh-areas require more space and personnel, especially in the deli, bakery and butcher shop!

3) Look high, look low. Eye level is key to getting you to notice things. Think about this when you take a kid to the store with you -- younger kids have a lower eye level, and often products marketed to them will be placed lower on the shelves. This is also important for pricing -- higher profit margin items will often be right where you see them, and are likely to go for them first.
Seriously, though, look all over the shelves, and not just at the items staring straight at you! Often you'll be able to find comparable items with a friendly price tag if you look across the shelves.

4) I meant it when I said don't shop hungry! Get your ideas together, make a list, and stick with it! Humans are not happy when they are hungry, and research shows people are more likely to purchase more energy dense foods when hungry. For a June 2013 article published by JAMA,  go here.

5) Primates respond to Red, and we are the only mammals that can even see it. As it happens, not only do we see red, we have a pretty interesting response to it. Why? This article can tell you more, but a large piece of this amounts to our ability to spot ripened fruit on a tree. The red shines out like a shining beacon. The Publix sale tags are a great (if blurry) example.

6) Bulk isn't always cheaper. If you are buying flour and you opt for the bigger bag to help save a few bucks, be sure to double check the "unit price" on the aisle price marker. Generally, it's true that a bigger bag will shave off a couple cents per ounce (which can add up to big bucks), but to be sure, check and compare. Some items are the same price regardless of the size of the container (I'm looking at you, Brummel & Brown), others can actually go up in price for a larger container, such as some brands of chocolate sauce.

7) There's an app for that. Publix now lets you digitally clip coupons and attach them to your phone number. At the check out, you can enter your digits to submit your coupons. There are other coupon apps you can use and scan at the store -- not only to build your grocery list but to clip coupons and aid in on-sale-meal-planning for the week.

Is there another thing you've noticed influences the way you shop? Let us know!

-- Les, MS RD LD

Wednesday, October 23, 2013

Marketing Produce

How many ways are there to grocery shop? You can check what you have at home, make a menu, make a list, and then go. You can peruse cookbooks for ideas and see what strikes you when you get there, or you can go in without a list and see what looks good.

You can follow your list to the letter, or you can deviate slightly, depending on the mood. Or you can even make a list with genres "some kind of pasta or rice" and grab what you feel like when you get there.

I'm sure we've all heard some of the general rules about the grocery store and how to be successful -- don't go when you're hungry, make a list and stick to it -- but this can be easier said than done, especially if you didn't have time to make a list, or left the list at home, or if you arrive at the store with kids or family members that didn't help write the list.

Grocery stores can be a good learning experience for kids, and it can be a great way to get them involved in food preparation at an early age. Especially as children grow into adolescents and adults, teaching them to grocery shop and how to build cohesive, balanced meals is important.

But what happens at the cereal aisle when you don't see eye-to-eye, or you're waiting in line staring at the perfectly-eye-level candy bars engaging in the conversation about whether or not candy was on the list. Or, just walking through the aisle to get to the deli case or produce department when the giant cereal/cookie/whatever display distracts you from your original task?

More and more, researchers are recognizing some of the grocery-store tactics used by companies to market their products and wondering if similar techniques can be used to market produce.

Every day, I come across at least one reference (often more like 5 or 10) to the recommended intake of fruits and vegetables and how our actual intake. Are there ways to market produce when you're already in the store? Can you make bananas an impulse buy?

Well, we don't really know, but there are a few good ways to find out! Some techniques that are being used and studied include the use of arrows on the floor to point people in the direction of the produce department. Other tactics (which I see frequently at Publix stores here in Florida) involve placing produce strategically around the store -- such as bananas at the endcaps of the cereal aisle, or onions and peppers at the meat counter with recipe cards for fajitas.

What would help you balance your grocery cart? In El Paso, it certainly wasn't the arrows on the floor -- they actually caused produce sales to fall.

Next week, we'll give you insight into ways companies effectively market to you when you're already at the store.

For more on this topic, look no further.

-- Les, MS RD LD

Wednesday, October 16, 2013

Dietitian's Lunchbox - Holly's

Holly Pudwill is a busy dietitian. She sees clients individually, serves as nutrition coordinator for Blue Horizon, facilitates groups, meal experiences and nutrition education, and goes home each day to play with puppy Duke to make sure he gets the exercise and play time he needs each day.

How does she do it?

"Private Practice can get hectic! Two days each week I'm here for both lunch and dinner -- I need to make sure I'm packing complete meals... balance is key when I'm getting so much of my nutrition at work!"

A favorite of Holly's is pita with spiced chicken, cheese, lettuce, tomato and dressing. It's quick and easy to make, especially if chicken and rice is on the menu the evening before. And added bonus -- this meal keeps fine in a cooler-pack and is delicious hot or cold! And to round out her meal? Carrots and pita chips with a side of hummus lends a nutriitonal boost and enhances both the visual and textural appeal of her lunch.

"It's such a breeze to pack, too. That's so important, because honestly, I'd rather be playing with Duke than stressing over my lunchbox each morning!"

-- Les, MS RD LD with Holly Pudwill, MS RD LD

Thursday, October 10, 2013

The Culture of Picky Eating

Recently, I came across an article about the origins of the children's menu. I was intrigued, probably because I'd never really thought of this as being a thing that "started", more like it was always there.

Naturally, I started thinking about my own dining experiences, in particular the children's menus. From what I understand about them (which is very little), there are certain universal truths about the children's menu, at least here in the US. 

1) They come with activities. Usually a few crayons, a word find, maybe coloring pictures. Sometimes these activities are food centered, though I would venture to say usually they are not.
2) They are kid friendly foods, meaning typically there's not much cutlery required, and I don't recall having ever seen an octagon-style cage fight over peas between parents and kid at a restaurant.*
3) The menu includes hamburger, chicken fingers, hot dog and/or macaroni and cheese, even in restaurants that do not serve these items for adults. Or, even more interesting, that serve a gourmet mac-and-cheese for adults and the powdered box variety for kids.

All kid's menus are not created equal. That's not to say that there aren't ever any options available for the 12-and-under with a more refined palate. Certainly, there are Italian places that offer spaghetti, seafood restaurants with a fish finger or shrimp of some kind and steak places that... you get the picture. However, I will tell you I have never, in all my years of menu perusing come across vichyssois or steamed mussels over arugula on a kid's menu.

My point is this - there seems to be a universal understanding that kids eat different foods, and people tend to go along with it (even if, in my earlier research, I learned this was not a customary practice until the early 1900s). At the same time, we recognize there is a growing need to introduce foods to fruits and veggies at a young age, to incorporate healthy, balanced eating practices regularly. There's also a bounty of cookbooks and recipes available about everything from hiding veggies in sauces and pasta, to featuring veggies in a way that your kid might actually like to try.

Still in other ways, we've moved beyond the idea of "kid-friendly" to the idea that children can participate in the more mature culinary experiences of their parents. We are merging these ideas to send conflicting expectations -- you must eat your peas at home, but as soon as you walk through the door...all bets are off.

That's not to say some kids won't be picky, or that loading asparagus onto a kid's plate is a sure-fire way to get the kid to love asparagus (it doesn't work, by the way), but there are ways to make fruits and veggies approachable without side-stepping the issue all together by providing baby carrots at every meal. Kids will meet your expectations. If you expect for a child to love chicken fingers and hamburgers, he will probably eat a lot of chicken fingers and hamburgers. If you expect your child to try new things (even just once), he probably will -- provided you give him the opportunity.

*There is never any need for an octagon-style cage fight over veggies. There are much more civil ways to engage a child in balanced eating.

For an actual historical account of the origins of the children's menu, check this out.

-- Les, MS RD LD

Monday, September 30, 2013

Dietitian's Lunchbox - Karen's Favorite Meal

The President of Nutritional Guidance, Inc. has a pretty busy schedule. Between mentoring dietitians here at NG, acting as Clinical Director for Blue Horizon Eating Disorder Services, LLC, reaching out and collaborating with the medical community here in Central Florida and serving on the iaedp board, it's a wonder Karen Beerbower can fit in time for her lunch every day.
"Lunch is a top priority." Karen is sure to clear out time for her lunch each day, not just for herself, but for her staff as well. She makes time for a lunch meeting each week to go over cases, answer questions and give the benefit of her 20-plus years of experience to the dietitians under her tutelage.
What does Karen look for in her lunchbox? A variety of temperatures, textures and colors in the meals she brings to work each day helps keep her satisfied with her meals.
On today's menu -- "My absolute favorite lunch!" A meatloaf sandwich complete with sliced tomato, a side of pasta salad, a banana and a bottle of water. A quick round in the microwave for her sandwich, and her lunch is good to go! And the clean-up is easy, since the pasta salad fits easily in a reusable bowl, and the banana comes in its own wrapper.

"The secret is that ranch pasta salad -- tricolor pasta, cucumber, petite peas, carrots, yellow tomato, sweet bell pepper and of course, ranch dressing! It's absolutely delicious and carries me through until dinner at 7pm!!!"
Next, we'll catch up with Holly and peek in her lunchbox to see how she fuels up for her day here at NG!

- Les, MS RD LD

Wednesday, September 18, 2013

Eat like a Caveman

The Paleo diet is by no means a new way of eating.

One may go so far as to say it is the oldest diet in human history. Advocates of this lifestyle will often cite the new-age diseases that we suffer from -- diabetes, cancer, irritable bowel syndrome -- and point to our food supply as the main culprit. What about our modern diet causes these problems? Too much processed food, too little fruits and veggies, too much fat, too little nutrition.

To some degree this is true. There are certainly more processed foods available today than back in the days of the caveman. And I'm certainly not looking to debate the merits of a processed vs a largely whole food diet today. But the question here is really, is there a way to find balance with this diet? Is it better to look back on our ancestors for nutrition advice?

Rather, my mission is to answer a few basic questions: What is a paleo diet? Is this how our ancestors ate? Is there any merit to eating this way today? For the sake of simplicity, we'll look at these ideas in general, rather than the geographical differences between cavemen and what foods they may have had available. It's important to remember that Neanderthals were very much at the mercy of their environment when it came to food (and pretty much everything else), but I digress.

What is the Paleo diet? Is this how our ancestors ate?
Modern renditions of the paleo diet started in the 60s and 70s. Today, as then, the diet was marketed as a way to get lean, fit and stave off disease. It is predominately meat based, with vegetables, seeds and nuts. This diet has no dairy, beans or legumes and limited grains and fruit. There are, of course, variations of this diet, but the principle is the same: more meat, less wheat. The diet emphasizes whole foods rather than anything processed.
My caveman friends didn't follow this diet to get fit, they followed it because they ate what they had. Mammoth hunting is (probably) hard work. I say probably, because I've never done it myself, but I can scarcely catch a fish without modern technology, let alone hunt down a massive beast. Small game is another story. Rabbits, squirrels and deer are much easier to hunt. And, being wild, they are a much leaner source of meat than our modern farmed cows (grass fed or not). Chicken breast? I think not. If you are going to go to all the trouble and hassle of hunting down a bird, you are probably going to make it worth while - organs, marrow and all. (There's even evidence of harvesting marrow from bones in the fossil record!)

It's interesting to note the aversion to many grains in the diet, especially as we have fairly strong evidence of the use of grain by our ancestors. We know milling of grains occurred because we have found mortar and pestles at archaeological sites. Additionally, food as we know it today was very much created by our more recent ancestors. Genetic Engineering is by no means a new concept. While we are able to do it in different ways (in a lab) than before (cross pollinating plants), the technology isn't as new as we like to think. Many vegetables and fruits would be unrecognizable should we hop in a time machine -- bananas have smaller seeds, carrots no longer have tough, woody, bitter root systems, berries are bigger, and avocados are certainly more fleshy than ever before. This isn't a bad thing, it's just different.

So different that today's Paleo isn't really what my Neanderthal cousins would have eaten, if for no other reason than our plants have changed, too.

Is there any merit to eating this way today?
No. Yes. I don't know!

There are plenty of good, wholesome things about the Modern Paleo Diets that I think we can learn a thing-or-two from. More veggies? Of course! Emphasis on whole foods? Absolutely!

Elimination of grains? Uhm... Our ancestors didn't eat this way, and I don't think it's advisable for most of us modern-day folks as well. Grains are an important (and nutritious!) part of the diet. Remember, this is a fabulous source of carbohydrate (brain food, I call it), fiber, vitamins and minerals. Many grains today are fortified with iron and folic acid, in addition to the selenium, magnesium, mangenese and B vitamins they naturally contain.

What about dairy? Dairy is an awesome source of protein, calcium, vitamin D and riboflavin. Many coaches will even use a low-fat milk as a post-practice supplement for their athletes, so good are its benefits to the body. What's interesting to note is that many proponents of this diet will assert that our bodies are very much the same as they were 10,000 years ago, and that if they didn't drink milk we shouldn't either. Lactase -- the enzyme that allows us to break down lactose (milk sugar) -- evolved in humans over the course of some 6,000 years. So we could (and I will) argue that while our basic physiology is very much the same, we have had plenty of time to evolve (just a bit), and that as a result, our diet can, too.

In conclusion...
There are some good ideas at work with the Paleo diet. In the end, balance and variety will help us ensure we are meeting our needs every day -- both for our physical well-being as well as for mental maturity and growth.

"Our species was not designed to subsist on a single, optimal diet. What is remarkable about human beings is the extraordinary variety of what we eat. We have been able to thrive in almost every ecosystem on the Earth, consuming diets ranging from almost all animal foods among populations of the Arctic to primarily tubers and cereal grains among populations in the high Andes.” - William Leonard, Northwestern University, 2002

For more information on this topic: 

-- Les, MS RD LD

Monday, September 9, 2013

Dietitian's Lunchbox - The Moran Family

As a part of our new series, we are peeking inside the lunches here at Nutritional Guidance, and finding out what the Dietitian's are doing at home to make sure they are getting their needs met each day at the office.

This week, we're checking in with Meghan to see what works for her family.

"Packing lunches is definitely a family affair -- Nate and I both eat lunch at work, and we like to make sure Lucas has everything he needs! You'd think it would be tough with a toddler at home, but it's actually a great time for us to wind down in the evening and spend time as a family."

Meghan and Nate share tastes which works out great, since they can prepare larger meals to share the next day. "Last night, we had some leftover baked chicken, so we tossed it together with grapes, walnuts and mayo for a quick chicken salad. Since Nate is usually on the go during the day, sandwiches are a go-to for his lunchbox." With some cut-up melon and a bag of sun-chips, this lunch is ideal to meet Meghan's needs during the day. "It's great having the chips on the side, since they add that satisfying crunch -- I'm big on texture, and it really helps me enjoy the meal!"

As for baby Lucas? "He loves the melon since he can poke at it on his plate, and feed himself. He's not quite ready for the chicken salad sandwich yet, but he likes the chopped bits of chicken with a few crackers."

In the Moran household, lunch is a family affair, even when they aren't together.

Thursday, August 29, 2013

Food Records!

Ah the food journal. Not that I've done any amount of formal research on the subject, but I would hazard a guess that it's far and away the most irritating part of a Dietitian appointment. Most sessions start out something like this:

Quick check in, how was your week? Step up on the scale for me... any challenges this week? Okay, let's get out that food journal. Cue cold sweats. You know, I had it, but I must've left it in my car (this may or may not be accompanied by some light rummaging if there's a bag present)... or on the counter... Maybe the journal is there, but oops, it's not complete. Missing a meal or two here, or perhaps entire days, maybe just yesterday was filled out haphazardly in the waiting room.

That's not to say that no one does it. Plenty of our clients here at NG fill it out. Some without complaint, others ask within seconds -- again? Can I stop this yet? So where does this resistance come from? Maybe it's annoying, having a little book to carry around. Maybe you just forget, after all, Morgan Spurlock taught us all about the 28-days-to-change-a-habit-rule (recent research out of the UK suggests as little as 12 days with high motivation, though the anecdotal evidence says much longer). So, in my own non-scientific way, I've compiled a list of barriers to filling out the food journal, and hopefully, a few ideas on how to overcome them:

Reason 1: I don't have time - I've done a food journal in the past, it's usually a pretty standard part of the education experience to become a dietitian. Some of us do it in a counseling class, or even in nutrition education, but human nutrition 101 will usually involve keeping a journal for anywhere from 3 to 7 days, followed by use of a nutrient analysis software to help us analyze the data. I gotta say, I wasn't the best about it the first time around (neither were my subjects, usually a friend or family member that's willing), but once you get past the initial resistance, I don't think I've ever spent more than about 5 minutes (total) on a food journal during the day. Maybe 2 minutes per meal just to get it all down, if I'm being particularly verbose about what was going on that day. So while it may feel like a lot of time and energy, it really doesn't take too long.
Solution:Get it done when you finish your meal. It doesn't take as long to do, especially since you aren't racking your brain -- was that 1/2c broccoli or more like 3/4? Did I butter my toast this morning? And 30 seconds later you'll be out the door and on your way!
Bonus: It'll be more accurate too, all the better for you to turn in to your dietitian.

Reason 2: I forgot I'd say for most people, especially in the beginning stages, this is probably true. I've been eating meals for well over 20 years now. And I have a particular formula. Decide what to eat, grab a plate, prepare the food, put it on the plate, grab some silverware, eat it, put away dishes, move on with my day. That's a long time to make a routine, and suddenly start changing the steps. So what do you do? How can you possibly remember that there's this new step in your meals?
Solution: Put your food journal somewhere memorable.On the kitchen counter, where you'll see it. Integrate it into your routine. Do you cook and follow a recipe? Great! What better time to jot it down. As you line up the ingredients, make a few quick notes about what's going to be on your plate. Go out to eat a lot? You can keep a small journal in your pocket to take quick notes on, and if needed, transfer the information to your regular journal. Pack a lunch? You can slip the journal in with your lunch, or even fill it out as you prepare your food. Eat at the same time every day? Set an alarm on your phone, it will ping to remind you -- time to journal!
Bonus: Making this habit early in the process gets you moving along with your dietitian, and that means you can move on with your nutrition that much quicker!

Reason 3: I left my journal at home. I go-go-go-go!! If the tiny pocket journal from #2 isn't something that appeals to you, there's another option. As a dietitian, I prefer for my clients to have a separate food journal. I like it because it physically separates it from everything else going on, but again, any food records is better than no food records.
Solution: Some clients really click with using their phone. It's a pretty genius idea, it's always with you, and using a note-taking app affords you all the advantages of writing time, type, quantity, preparation method and even feelings (hungry, full, tired, etc) that were going on at the meal.
A word of caution: I love the note-taking apps. There are dozens out there, free, paid, and they can do all kinds of fancy things. Most phones even come with one built in. Seriously, go for it. But many apps specifically made to be a food journal can be overwhelming. They allow you to log all kinds of things, which may or may not be relevant to your course of treatment with your dietitian. There is such a thing as too much information, so if you choose to use one of these apps, discuss it with your dietitian and see what's a best fit for you.
Bonus: Some apps, such as Rise Up or Recovery Record give you the option to connect with your dietitian on a digital level. You may even find that the phone helps develop the habit, and then you can move to a written journal for a bit more freedom in the way you log your meals and interact with your dietitian.

What's your biggest barrier? Anything in particular that makes this an annoying daily task to complete? Let us know, and we'll crowd source solutions in the NG office!

- Les, MS RD LD

Thursday, August 15, 2013

Dietitian's Lunchbox

Here at Nutritional Guidance, we work hard for our clients. Helping each and every person that walks through our door meet their nutrition needs, answering questions, and providing education and information. We don't simply provide a meal plan, or an "eat this" guide, but rather we work together, with both individuals and families, to make sure that they are able to meet their goals and be successful.

As the school year kicks into full gear, we are here to answer your questions about how to provide a diet that meets our four main criteria: balance, adequacy, variety and moderation. Believe it or not, there are ways to get each of these things into the lunchbox and out the door every morning before the bus arrives.

In the coming weeks, we'll be sneaking a peek into the lunch boxes here at Nutritional Guidance, and sharing what we find.

In the meantime, here are a few tips about putting that lunch together -- not only for kids going back to school, but for those long days at the office where you'll be bringing lunch in with you, or just for packing a picnic for a day at the beach.

- Where are you going? Is there a refrigerator where you can keep you lunch chilled? Are you going to have access to a microwave? Remember, not having a fridge doesn't mean you can't bring chilled foods! Freezer packs can be picked up at the grocery store -- many for less than a dollar. An insulated lunch box will go a long way in helping keep your food chilled -- and safe -- until lunchtime. We'll be checking with both hot and cold meal options to help you and your loved ones meet your needs at the office and at the school cafeteria.

- What do you like? Especially for younger children, lunch may not be the time to introduce a new food or to attempt one of the 35 trials it takes for acceptance of a new (or oft-rejected) food. Instead, pick from foods that you know will go over well in the lunch box. Carrot sticks, fruit and other finger foods can be a great way to pack in fiber, vitamins and minerals at lunchtime. Get creative!

- Pack it together! Having your child help pick out foods for the lunch is a great way to get them involved. Sit together and make a grocery list -- providing options such as banana, apple or berries, can help your child take a bit of responsibility for the contents of the lunchbox, as well as help them learn what makes up a great meal. Children are also more likely to eat and enjoy foods that they helped prepare!

- No cleanup required! Remember, even with a 30 minute lunch break, often times on 15-20 minutes of that can really be used for the meal. Keep it simple and neat! Spaghetti and meatballs can be a part of a great meal, but it can be hard to eat (and keep clean!) at the lunch table, especially if this is a meal for a younger child. Complicated wrappers are to be avoided, and cutting up fruit or veggies in advance can help maximize the time that can be spent eating and enjoying the meal.

What challenges do you face packing meals each night?

We'll be checking in with our dietitians in the coming weeks to get some great ideas for planning, prepping and packing those lunches, so stay tuned!

- Les, MS RD LD

Wednesday, August 14, 2013

What does it all mean?, Taste, pt 7

Together, we’ve been (more or less) reviewing the tastes, where they come from, what they mean to the body, and what the body might be telling you when you crave a certain food. Sometimes you may not recognize the craving, but you may just feel hungry, sometimes even after having eaten. Your brain might be saying, “Hey! You just ate, you really shouldn’t be hungry.” But at the same time, you just feel like eating, or maybe you’re getting hungry but can’t really tell why. If your meal (or your diet) isn’t in the right balance, your body may be trying to signal that it is missing something. This could be energy, vitamins, minerals or protein. Sometimes you can tell which – let’s review:

Sweet – energy
Bitter – danger, or perhaps nutrient rich
Sour – pH balance
Salty – electrolyte balance
Savory – protein

Sometimes you can’t, it may just be a general hungry feeling. But no fear, there’s a simple way to make sure you’re getting everything you need, and I’ll tell you my secret because I’m feeling particularly generous today – keep a balanced diet. Get plenty of grains, fruits, veggies and protein. This will help ensure that your body is getting everything it needs – energy, vitamins, minerals and nitrogen (protein) to keep the body running smoothly and efficiently. In turn, this will help you stay healthy so you can keep up your busy active life.

Monday, August 5, 2013

Prescribing Weight Loss

Recently, we wrote about the AMAs decision to label Obesity as a disease, and some of the benefits that this may have for patients; namely, that this decision could potentially lead to insurance reimbursement for programs and medications promoting healthy weight. With insurance reimbursement comes incentive for research and ultimately, pharmaceutical development. In fact, within the last year, two medications have been released on the market specifically for this purpose – Qysmia and Belviq.
Belviq has shown some promise – trials have shown only slight (and not statistically significant) increased risk for issues with heart valves over placebo (not even .5%). While it does hold some potential for recreational use, that is minimal as well, as those side effects only occur at high-doses and seem to be minimal (1).
Qysmia, which is actually a combination of phentramine and topiramate, was released earlier in the year, is the first diet-pill approved by the FDA in over a decade. Sales have thus far not been promising, and the drug has not passed muster world-wide – the EU did not approve its sale or use. As for the drug itself, both components have known issues, particularly for women of child-bearing age, but the FDA did approve it, and it could be a valuable tool in promoting weight loss.
These medications must be prescribed by a physician, and they work in combination with a balanced diet and exercise plan. They are not intended to be used for a pesky pound or two at beach season, but only for patients with a significant amount of weight to lose. Typically, significant means BMI >35, or BMI >30 with related medical issues, such as type 2 diabetes, or high blood pressure.
There are plenty of other weight loss drugs, supplements, pills and herbs available on the market. Many lack any real research to back up the claims. Others may be more sinister in nature – marketed as an all-natural product or herbal supplement, all the while containing less friendly ingredients. Sibutramine and Phenolphthalein are common offenders (2).
Sibutramine has been shown to suppress appetite – hence its diet-pill marketing. However, it can also cause damage to the heart and undesirable alterations in blood pressure. This is of particular concern for individuals who already have an existing heart condition, or who are at risk, such as those who are overweight or struggling to control blood pressure. Phenolphtalein is a laxative, and there are concerns about its safety, particularly as related to its potential carcinogenicity.
There’s a lesson here: Be a critical consumer, do your homework to determine potential risks. Consult with your physician before taking any medications or supplements. And remember, even FDA approved medications are intended for use with a balanced diet and exercise.
- Les, MS RD LD
For more information:

Monday, July 15, 2013

Savor the Flavor, taste, pt 6

Savory flavor was first described in 1908, though there are records of the use of this flavor back in the 1800s, even though the chef’s in question weren’t quite sure what was responsible for the taste. By 1985, Umami (as it is called today) was first recognized at a symposium in Hawaii. While the flavor certainly isn’t new, our understanding of it is.
Savory flavor comes from nucleotides and glutamate. Glutamate may sound familiar – it’s a key component of monosodium glutamate or MSG. MSG is used as a food additive because it rounds out and balances the other flavors in a very complimentary fashion. You may recall that salt is often used in a similar manner. Savory flavor gives that special something to what you’re eating, and though you may not know it, you are certainly capable of craving it.
But usually we just call it meat.
Meat is mostly protein. And protein is pretty important. It would make sense then that the body would have a fairly reliable mechanism for telling you when you need more of it. After all, protein is in your DNA. Also your hormones, signaling pathways, enzymes, blood, bones… everywhere. It gets under your skin. And in your hair and nails. Protein is what makes it all possible.
Protein is made up of amino acids, hooked up into chains (we call ‘em peptides). When you get a bunch of them together (polypeptide) they start to form funny shapes. They swirl (alpha helix) and flatten out into sheets (beta sheets, specifically). These shapes are very specific, and can only happen when you have the right amino acids hooked up together and in the right order. Sickle cell anemia is actually a protein disorder. Hemoglobin is made up of 147 amino acids. The sixth in this chain is usually a glutamate. In this disease, however, it’s a valine. And that’s all it takes.
In human nutrition we only care about 20 of these amino acids. We can make about half of them (some of them you may not be able to make enough of if you need extra for some reason, such as when you’re sick). The rest need to come from your food. But fear not – animal products have everything you need and plants have most of them. But the good news is different plants have different pieces, so if you don’t eat meat, but you have a healthy balance of different veggies, grains, nuts, seeds and legumes (beans), you’ll get everything you need.
There are recommendations for protein out there, some are from the USDA, others are from various body building websites, but if there’s one thing to take from this, it’s that eating protein won’t make your muscles big. But it will make your immune system (and just about everything else) stronger, and provide your body with the ingredients it needs to for cell growth, repair and maintenance. And the cells are happy, every body’s happy.
If you’re really curious about your protein needs, I’d direct you for general recommendations to the RDAs at For more specific recommendations, you can meet with a dietitian to determine what your needs are. But one thing is certain – with balanced intake you can be sure you’re getting enough of everything you need, protein included.

- Les, MS RD LD

Wednesday, July 10, 2013

Obesity -- A disease?

If you’ve been paying much attention to the news the last week or so, you have probably heard something about the American Medical Association (AMA) officially terming obesity as a disease. There are arguments both for and against this notion, and both sides of this argument were present at the AMA meeting in Chicago. In fact, the committee that studied this matter recommended that Obesity not be defined as a disease, but this motion was outvoted.
The argument goes back several years. In 2008, a study published in the Obesity Journal used several approaches to review the literature and found that, yes, the benefits of classifying obesity as a disease would far outweigh the drawbacks (1). In 2004, Medicare removed all references to Obesity as not a disease, though they continue to not cover weight-loss medications on the Part D prescription plan.
I don’t know about you, but this sounds like an awful lot of mixed messages to me. So let’s start at the beginning – What is obesity?
Traditionally, Obesity is classified using weight as a function of height. It has a medical code, which means that paperwork documenting this can be submitted to insurance for reimbursement by your healthcare providers. The formula typically used is BMI, which is calculated by dividing your weight by your height (squared) – kg/m2. Anyone with a BMI >30 is considered “Obese” by this calculation.
The theory is that if you are X height, and you weigh more, you are likely carrying a disproportionate amount of body fat, and you are therefore more likely to have certain medical complications as a result – elevated blood lipids, high blood pressure, diabetes, to name a few. However, this calculation does NOT take into account actual body fat. This means that if you have a high proportion of body fat, and are therefore at risk for these complications, but your BMI happens to be in a healthy range (generally considered to be right around 22), then you are not obese, even if you have the aforementioned metabolic complications. BMI may be a useful tool, but it is only one of many when evaluating a patient for certain risks, and this finding is the primary reason the AMA committee did not recommend classifying Obesity as a disease.
Further, there is plenty of research to show that healthy lifestyle (including proper nutrition and regular physical activity) independent of body weight are better predictors of risk than weight alone. Meaning, if you are technically overweight or obese, but you exercise and have a balanced diet, you are more likely to be healthy than if you are of a “normal weight” but do not include balanced meals and exercise in your everyday.
So, why then, are we bothering with this question at all? As it happens, the AMA does have some amount of clout. If this group of physicians makes a declaration, insurance companies are likely to follow suit, which means they will begin to cover and reimburse programs (and medications) aimed at promoting healthy weight and resolving the Obesity issue. Reimbursement by insurance is a pretty good incentive to create and market medications and treatments, and so pharmaceutical companies are more likely to begin developing medications to help achieve and/or maintain a healthy weight.
Is there a lesson here? Maybe, maybe not. Like so many things in life, there’s no clear right or wrong in this situation, it simply is. Maybe the best we can do for now is to promote a healthy lifestyle, loaded with balanced meals and regular physical activity. After all, research has shown us time and again, that’s the easiest way to ensure you achieve metabolic balance – regardless of the number on the scale.
For more information:

- Les, MS RD LD

Wednesday, July 3, 2013

Break out that Grill!

Summer is upon us, bringing with it the sunshine and late afternoon thunderstorms Florida is famous for. And of course, the grill. The summer holidays are full of friends, family, and open flame, charring meats, vegetables and even fruit (yes, fruit) to smoky perfection. But these gatherings may bring some stress to your holiday, so to help ensure the thunderclouds stay in the late-afternoon sky (and not hanging over your head), NG is here to help with a few tips and tricks to food safety, managing balance and reducing stress so you can get down to business – and enjoy your day off!
Food Safety
  • Clean that grill!! Whether it’s the grill behind your house or one down at the park, be sure to scrub it with warm soapy water before each use
  • Take a spare plate! When taking meats to your grill, make sure to take a clean plate to transfer the meat to after cooking. Never reuse a plate that previously held raw meat. The same goes for cutting boards, counters and knives/utensils. Be sure to wash anything that comes into contact with raw meat to help prevent cross contamination. Including your hands!
  • Cook it through! Use a thermometer to check for internal temperatures.
  • Steak – 145°
  • Ground meat (including burgers) – 160°
  • Chicken - 165°
  • Keep an eye on that clock! Be sure to keep hot foods hot to prevent contamination with potential pathogens that can cause foodborne illnesses. After two hours, be sure to cover, label (and date) and refrigerate all leftovers. Cooked foods can be frozen for up to 2 months (watch for freezer burn) or left in the fridge for 2-3 days. When you decide to reheat, make sure that temperature reaches 165°.
  • Chilled favorites, such as potato salad or spinach dip, can be kept and displayed on ice. This will help them stay cool and safe at your parties. You can also switch out items every hour to ensure that they get plenty of time in the fridge to cool down.
Managing Balance
  • With friends and family often comes food. Take a plate to the buffet table to get all your food together. Not only will this help you choose portions to help you meet your needs, it can also give you a clear idea of what (and how much) you are eating.
  • Be sure to get some of those fruits and veggies on your plate, too! Grilled peaches and watermelon are popular this time of year, and tossing peppers, mushrooms, tomatoes and onions on skewers can add a pop of flavor to your favorite grilled meat.
  • Aunt Betty’s apple pie and a blueberry crumb cake? Remember, there’s always tomorrow! Any leftovers can be saved (see above for tips!) and used at a later meal. It’s a great way to bring the spirit and camaraderie of the 4th to your entire week!
Managing Self
  • Gatherings can sometimes be stressful. Be sure to take time for yourself. If you need a breather from the party, take a walk or step back to a quiet place to gather yourself or allow for a bit of downtime on an otherwise hectic holiday.
  • Balance your time visiting family and friends with downtime to help keep yourself centered. Using weekends and holidays to spend time with loved ones can be great fun! Make sure you take care of yourself in-between to really get the most out of your holidays.
Do you have a favorite marinade or recipe you'd like to share? Have a question you’d like answered? Have another grilling/party idea? Like us on Facebook and join the conversation!
Happy Grilling!

- Les, MS RD LD