Silly Fruits

Just a fun little picture for your Tuesday reading pleasure, sent to me by my wonderful friend Tara, who just got her MPH*.

I've been sitting in on a lot of sessions with eating disordered patients lately. From what I've observed, EDs generally develop as a means for a person to exert control when other parts of life feel out-of-control. But I still feel like this message hits home. Who hasn't fretted that their body was too big/small/skinny/fat/fill-in-the-blank? I think I'll frame this precious little image and hang it in my [future] office.

*and is looking for a job in NOLA, for all you employers who read this blog...

Of Vampires and Dietetic Interns

As I sat outside the other day, shielding my eyes from the June sun, my skin blindingly white, I realized: I have become a vampire.

whoops - not a vampire, just Kristen Stewart

Just kidding (well, only sort of). I’m actually just fresh out of an intensive 5-month clinical rotation, the first part of my dietetic internship (DI). For the last few months I’ve been reading medical charts, giving diet instruction, writing hundreds (literally, I counted) of nutrition notes, running up and down five flights of stairs to the kitchen and back, pushing Ensure like whoa, calculating tube feeds and total parenteral nutrition (TPN), shouting above the bleeps and the ringing in the ICU, shouting above the din of nurse chatter everywhere else, and driving to work in the dark to arrive by 7:00 am. But! I am alive – even better than alive – thrilled to finally be doing the work I knew I wanted to do. For all the times I doubted my career choice – and there were many (ahem: organic chemistry) – I’m so glad I stuck with it.  Sincerest thanks to everyone who believed in me.  I owe you one, or one thousand.

In exchange for your undying support, I would like to share some lessons I learned at the hospital.  Some are medically/nutritionally related, some not. Bear with me.

1.     Stop smoking. Really. The vast majority of patients I saw who had cancer of any type had a history of smoking.

2.     Prevention is key. By the time you land in the hospital, a lot of damage has already been done. Make it easy on yourself and don’t get there in the first place.

3.     Get preventive screenings. Again, really. Get a colonoscopy. One day of misery is far better than the alternative. Don’t pretend you don’t know what I’m talking about. Colorectal cancer is not something you want, but early detection makes all the difference.

4.     Be nice to nurses. They’ll give you better care.

5.     Be nice to RDs. Duh.

6.     Medical and health professionals: we all play on the same team. Everyone’s input is valuable; none of us can see all or do all.

7.     If you need help, ask for it. One day I got a consult from a patient who, based on our nutrition screening protocol, was low risk (RDs are usually consulted for high risk patients). Because she asked to see a dietitian, however, I was able to meet with her before she got discharged. As it turned out, this woman had a long and complicated history with food, dieting, and emotional health. I gave her information relating to emotional eating and general healthful nutrition, as well as a list of resources where she could get further information and/or counseling. She was very grateful for the information, and I was glad to have made a difference. And to think, none of this would have happened had she not asked for help!

So now I’m onto the other requisite rotations of a DI: community, pediatrics, and foodservice.  These will take me through to the end of July, and then I’ll be done.  Done done.  And then? Besides embarking upon my a mission to look like I stepped outside once or twice this year tan, ¿quién sabe? Stay tuned.

scrubbin' it down at the pharmacy, aka The Only Place Where People are Paler Than Me

How not to stuff yourself on Thanksgiving

Do you heart Turkey Day?  I sure do.  What’s not to love?  It’s the only time of year where it is acceptable to cover what would otherwise be a perfectly legitimate vegetable with miniature marshmallows^*.

http://www.theinertia.com/comedy/happy-thanksgiving/. 20 Nov 2011.

I will never  become one of those people that prattles on about how the average person consumes a billion calories in one dinner alone.  That’s not the point.  The point is to enjoy a beautiful meal in the company of the people you love (and, ok, probably some of the people you hate).  Not that I ever advocate “going on a diet,” but Thanksgiving especially is no time for food restriction.  If, like me, you wait all year to have your piece of dark meat turkey (crispy skin and all), then shouldn’t you enjoy it?

But let me ask you this: is it enjoyable to eat till the point of bursting?  To have indigestion for the next two days?  If you are so bold, is it enjoyable to step on the scale the next morning and see that you’ve gained 20 pounds (thus beginning the “oh well, I already blew it” downward spiral into the holiday season)?  No, friends.  It is not.

Our culture would have you believe that it’s impossible to have a good Thanksgiving without having to change into elastic-waist pants midway through dinner.  Stop the madness!  Not only is it possible, but with these easy tips to avoid overdoing it, our nation’s only most famous culinary holiday will be even better.

1.     If you can, exercise in the morning.  Not only will this give you a pre-emptive calorie burn; it will also put you into a healthy mindset for the rest of the day.  Plus, exercise feels good.

2.     Eat something before dinner.  Year after year, so many of you refuse to eat anything all day before dinner is served.  This is setting yourself up for disaster!  When you deprive your body of fuel, you become so hungry that when the food is finally on the table, your animal brain takes over and you obey an evolutionarily-embedded command to eat everything in sight.  This is not a lack of willpower; it’s a physiological mechanism to protect you from famine in the land.  Only thing is, there's no famine.  So, eat a small breakfast, and 3-4 hours before dinner, eat a snack or small meal.  Try a couple whole grain crackers with reduced fat cheese and an apple, or a cup of low-fat yogurt with ¼ cup of granola and half a banana.  The idea is to roll up to the table feeling moderately hungry, not famished and/or faint.

3.     Leave some space on your plate.  You’re probably eating off of the good china anyway; why not appreciate it?  Take a portion of everything you want; just make sure that you can still see some of the plate underneath.  Your portions will be smaller this way; this is good.  You can always take more later if you are still truly hungry.

4.     Drink water as you eat.  Water takes up space in your stomach, thus expediting satiety (“I’m full”) signals.  I’m going to be honest here: this is like the blind leading the blind.  When I have a choice between water and wine, guess which one I choose?  (I never said I was a perfect eater!)  If you figure out how to do this, please let me know.  My liver will very much apreesh.

5.     Focus more on the conversation and less on the food.  Yes, we are thankful for the food, but we are not only thankful for the food.  We are also thankful for the amazing anecdotes about cousin Lisa’s poor life decisions .

6.     Stop when you begin to feel full.  This may happen before dessert or even second helpings.  That’s OK.  This is not the last meal you will ever eat.  In fact, you’ll probably be eating the same meal for the next 3 nights in a row.  If, for some reason, it looks like the pies will not live to see the morning, choose one or two and take a small bite of each.  I don’t want you regretting that you didn’t get to taste something that you wanted to.

7.     Slow down.  Savor each bite.  You are not a plow, and your fork is not a shovel.  Take small bites and chew thoroughly.  Converse.  Sip some wine water.  Look at you, so civilized!

        After all this, you might be the only one of your relatives to not pass out 30 minutes into the game from a food coma, top two buttons undone, Rolaids on the coffee table.  I give you permission to feel righteous about this.

Friendsgiving 2010

 

*God Bless America.

Why I use real mayo

Yeah, I said it – real mayo.  Open my fridge and you’ll find a small jar of original Hellman’s.  Not “light.”  Not Miracle Whip.  I’m talking the good stuff.

Does this surprise you?  After all, mayo is, like, pure fat, amiright?  (I am!  I am so smart.)

Seriously though, poor fat.  It’s been so maligned over the years.  But the fact is, we need a certain amount of dietary fat for energy, vitamin transport, and other important functions.  In fact, some types of fat may actually reduce the risk of heart disease.  The key is knowing which fats to choose:

Trans Fat: Public enemy #1 of the nutrition world.  Trans fats are added to foods during hydrogenation, a process in which fats are made more shelf-stable by switching the position of hydrogen atoms.  Trans fats are uniquely bad because they raise LDL (bad) cholesterol and also lower HDL (good) cholesterol.  Try not to eat anything that lists hydrogenated or partially hydrogenated oil as an ingredient.  (Note: the FDA does not require products to be labeled as containing trans fat if they have less than 0.5 g/serving.  For more information, visit the FDA website on trans fat labeling.)

Before hydrogenation

After hydrogenation -- note diagonal hydrogens

 

Saturated Fat: The majority of research to date demonstrates that high intakes of saturated fat, which is mostly found in animal products like steak, bacon, cheese, eggs, and whole milk, raises LDL (bad) cholesterol.  High levels of LDL cholesterol cause plaque to accumulate in your arteries, raising your risk of heart disease, high blood pressure, and stroke.  Some lucky folks don’t appear to be affected by high sat-fat intakes, but some have exaggerated responses to the stuff.  If you don’t know what kind of person you are (your parents generally serve as a pretty good reference point), it’s probably best to assume you’re somewhere in the middle.  At least until you get your cholesterol tested at the doc’s office.  (Really, go do it.)

The USDA recommends getting no more than 10% of your daily calories from saturated fat.  Gosh, that’s helpful. 

[Sarcasm]

In plain terms, if you eat about 2000 calories a day, try to keep your sat fat intake under 22.2 g. (Math: 0.1 x 2000 = 200 cals; 200 cals x [1g fat/9 cals per g] = 22.2 g fat)

Bottom line:  Don’t swear off steak.  Just choose a leaner cut, keep your portion reasonable, and don’t get it topped with cheese and/or eggs and/or bacon.

(And from the Dept. of Interesting but Practically Useless Information: Crisco consists of trans fats; lard consists of saturated fats.  Lard, therefore, is the healthier choice.)

Mono- and Polyunsaturated Fats: Yay, these fats are good for us!  Monounsaturated and polyunsaturated fats (MUFAs and PUFAs, and yes you can pronounce it like that) occur naturally in some animal products but mostly in nuts and high-fat fruits like olives and avocados (MUFAs), and salmon, eggs, soybean oil, flax seeds, and walnuts (PUFAs). 

So what the heck are these things?  Quick chem lesson (quick, I promise!):

1 double bond in the chain

A MUFA is a fatty acid with only one double bond.  If a fatty acid doesn’t have any double bonds, it is saturated with hydrogen atoms.  This makes the molecule stiff, which is why butter is solid at room temperature.  With a double bond, fatty acids become unsaturated because they lose some hydrogen atoms (2 per double bond, to be exact).  Double bonds add kinks to a fatty acid chain, which makes the molecule more fluid.  This is why oil is a liquid at room temperature.

more than 1 double bond in the chain

A PUFA is a fatty acid with two or more double bonds.  PUFAs include omega-3s, omega-6s, and omega-9s.  These three PUFAs are called essential fatty acids because our bodies cannot synthesize them; we must obtain them from the diet.  Like MUFAs, PUFAs are liquid at room temperature. 

Generally speaking, we all could use some more omega-3s in our diet.  These guys are so awesome because they lower LDL (bad) cholesterol and raise HDL (good) cholesterol.  Omega-3s are like the opposite of trans fats.

As for omega-6s and 9s, don’t worry too much about them.  Chances are you’re getting plenty without even trying.  Definitely don’t buy omega-9 supplements -- biggest waste of money ever!

</lecture>

So where were we?  Oh, yes – mayo. 

Hellman’s Real Mayonnaise contains: soybean oil, water, whole eggs and egg yolks, vinegar, salt, sugar, lemon juice, calcium disodium EDTA (used to protect quality), and natural flavors.

Soybean oil is a healthy PUFA.  Egg yolks contain omega-3s.  The other ingredients are nutritionally negligible.  Of the 10g of fat per tablespoon serving, only 1.5g are saturated.  6g are PUFAs and 2.5g are MUFAs.

For comparison’s sake, Hellman’s Light Mayonnaise contains: water, soybean oil, vinegar, modified corn starch, whole eggs and egg yolks, sugar, salt, xanthan gum, lemon and lime peel fibers (thickeners), (sorbic acid, calcium disodium EDTA) used to protect quality, lemon juice concentrate, phosphoric acid, dl alpha tocopheryl acetate (vitamin e), natural flavors, beta carotene.

That’s a lot of ingredients there.  Most of the additions are thickening agents used to make up for the loss of texture from fat.  Not bad, but you might have to use twice the amount of light mayo to achieve the same mouthfeel as regular.

Best bet?  Buy mayo with the least amount of ingredients you can find (or, if you’re superhuman, make your own).  Then, use half as much as you would of the light stuff.  And enjoy, for God’s sake – the real stuff is so much better!

Welcome Home Chicken

In case you missed it, I moved.

I hate moving.  I’ve done it so many times that you think I’d be used to it by now, but the week before every move still finds me up all night, crippled by thoughts of worst-case scenarios.  What if my movers don’t show up?  What if the keys to my new apartment don’t work?  What if I can’t figure out how to drive the U-Haul?  I get tension headaches.  My entire body becomes stiff with dread.

But happily, my movers arrived right on time, the keys worked, and I successfully piloted the truck through some of the worst traffic I’ve ever seen (did you know that the entire city of Boston moves on September 1^st?).  In fact, everything went as smoothly as I had never imagined.

And now my life looks like this:

It’s hard to say which is worse, packing or unpacking.  Packing, you realize how much useless crap you’ve accumulated; unpacking, you realize how much useful stuff you’ve either lost or misplaced.  Either way your hands get ragged and covered in newspaper ink.  Either way, you’ll probably suffer through a week or so without internet.

Which is how, stumbling out of a [wifi-equipped] café several nights ago, I realized that I hadn’t really eaten a proper, home-cooked meal in a long time.  I suddenly hungered for one, desperately, down to the bones.  And I knew exactly what I wanted to make.

every good dish starts with garlic and onion.

 I made a variation of this dish several weeks ago.  It was the first week of our annual family vacation to the Outer Banks.  We always drive -- a venerable feat in and of itself -- but this trip was made extra special by the fact that our van's A/C went on the fritz a few days before we left.  Although I'm usually the designated meal planner, all of my mental energy was spent thinking how best to maximize ventilation to the back seat.  Having thus dropped the ball, we simply picked up a family pack of chicken breasts and 5 lbs of ground beef—a package so grotesquely large that my brother Sam promptly deemed it the “meat pillow”—and hoped for the best.

(I still shudder at the the thought of that much ground beef.)

I don’t have much experience with improvisational cooking, but that night I produced one of the most delicious dinners I’ve ever made.  (Never mind the fact that I found myself in front of a hot stove not three hours after a 14-hour car ride in what was essentially an encapsulated rainforest.)  Not knowing where things would go, I started with a base of garlic and onion.  I added the chicken and opened a bottle of white wine to take the edge off.  The wine inspired me, and I added a good splash to the pan.  Cooking with wine is très French, I thought to myself proudly.  And then it came to me – thyme!  It’s the quintessential French herb.  I rifled through the cabinets and pulled out a bottle of dried thyme, triumphant.  It wasn’t long before my travel-weary family started to take notice.  There's something about the scent of these ingredients simmering together that whets the appetite.  Around the dinner table, we ate heartily and spoke little – the happy silence that comes from a good meal at the end of a long day.

This moving business -- not unlike a family road trip -- is one of the most exhausting things you can do.  Last week I relied far too heavily on my parents' goodwill and crashed in various friends’ apartments, availing myself of their patience, generosity, and couches while I gathered my belongings and bit my nails in preparation and fear of the blessed day.  To everyone who helped me, thank you, thank you, thank you.  I hope that one day, when I acquire a table and chairs, you will all come over and let me make you dinner.

Welcome Home Chicken

ed. note: the beauty of improvisational cooking is that you’re not using a recipe; you’re free to use as much or as little ingredient as you wish.  This recipe doesn’t give exact amounts or cooking times.  If it makes you nervous, I suggest a glass of wine.

Ingredients:

1 package bone-in chicken thighs, between 2-2.5 lbs (or about 1.25 lbs boneless skinless breasts)

1 small yellow onion, sliced

1-2 cloves garlic, minced

1-2 Tbsp. extra virgin olive oil

Dried thyme -- a couple teaspoons?

S+P

1 bottle light to medium bodied white wine, for cooking and drinking.  Extra points if it’s French.

Heat [new] stove to medium-high.  Add oil.  Add onion and garlic.

Turn heat down to medium.  Cook until onions are soft and translucent.  Add chicken to pan.  Sprinkle with salt, pepper, and thyme.  Pour about ¼ cup of wine over chicken.

the wine lived up to its name

Cook chicken 10-15 minutes, then flip.  Add more wine and seasoning as needed.  Cook another 10-15 minutes, or until chicken is cooked through.  Serve with steamed rice and sautéed spinach, and be sure to scoop up some of the pan juices.

Eat wherever you can find space among the boxes.

Eating well while crazy-busy: an iphone picture story

A lot of people are very busy.  Too busy, they say, to eat healthy.  What they mean is that they're often on the go and may not have consistent access to a kitchen or even a fridge.  From August 30 to September 1, I fit these criteria.  I slept on friends' couches and ate grab-'n-go meals for 2 days straight while packing and moving.  Throughout it all, I took pictures of everything I ate to show you that it is possible to make healthy choices when you have no time or means to cook!  So without further ado, here is everything I ate:

Breakfast: plain lowfat yogurt with granola, fruit and coffee -- Crema Cafe in Harvard Square

Lunch/snacks: I picked up these items at a Russian market to have on hand while packing.  I didn't really know what the pastry would turn out to be...

It was a sour cherry danish - delish, but definitely a splurge!  I rounded it out with an apple, some almonds, and plenty of water.

I crashed at Jeanine's that night.  Before we went out to dinner, I snacked on some black grapes she had set out.  I was famished!

Dinner was shabu-shabu, or Asian hot pot.  It's kind of like fondue!  I ordered beef, veggies, and vermicelli rice noodles.  I ate half of the beef but everything else.

I also required a beer.  Packing is hard work!

Later on I had to go back to my previous night's residence to pick up some odds and ends.  I couldn't resist cuddling with Rebecca and Alex's dog!

Moving day!  Breakfast was a yogurt parfait with granola and coffee at Blue State Coffee.  The yogurt was not reduced fat, but it sure was good!  Plus, I knew the higher fat content would keep me full for a while.  I ate about 3/4 of it.

Snack: my other apple and a handful of almonds.

Lunch, finally!  I knew I needed some good fuel for moving later on, so I got a chicken burrito with cheese, salsa, rice, black beans, and guacamole, all in a whole wheat flour tortilla -- at Anna's Taqueria.  It was so big I could only eat about 2/3 of it.

Victory dinner!  After the move, I took my hungry movers out to Sunset Grill and Tap in Brighton, where I ordered some nachos for us to split as an appetizer.  Even though it was only a half portion, it was so huge that we only put away about 1/3 of it -- come on, guys!

My portion of nachos (multiply it by 2), and a Sierra Nevada

Kyle and Willy thought it was hilarious that I, an [almost!] nutrition expert, was chowing down on a burger the size of my head.  I ate about half, plus a few chips, before throwing in the towel.

Thanks, guys!

So there you have it!  While this is not how I would like to eat all of the time, I managed to keep my energy levels high by snacking wisely, making reasonable menu choices, and stopping when full.

Want to health-ify your crazy-busy days?  Be sure to stock up on healthy snacks to have on hand (like fruit and nuts), replace sugary drinks with water, and choose lean meats, low-fat dairy, and whole grains whenever possible.

What are your secrets for eating healthy on the go?

Oh, the Irony

Ladies and gentlemen, I am a record-breaker.

I’m not kidding – prepare to be astounded.  You might want to sit down.

You see, I was the only student ever to win the Home Economics award 3 years in a row at John Jay Middle School (home of the Statesmen, née Indians, which was later determined to be politically incorrect).  I know.  It’s a lot to take in.  Perhaps you should take a minute?

There.  Feeling better?  I’ve often wondered why I was the love object of the Home Ec. department.  So far, the answer seems to be: I was probably the only student who didn’t absolutely hate it.  Because certainly there are more precise cross-stitchers out there.  Better ironers, absolutely.  I recall my 8^th grade pillow project turning out a little lumpy.  And don’t tell, but once I think I packed the flour while making baking powder biscuits.

But it’s true, I never hated home ec. – maybe I even enjoyed it a little.  And why not?  In other classes I sat there, quiet and obedient, cramming my brain with facts about the War of 1812, how Density = Mass/Volume, and blah, blah, blah.  In Home Ec., I didn’t have to think.  This was basic stuff!  How to fold a shirt?  Are you joking?  Who raised you?

Well apparently you were all raised by wolves, because I won the Home Ec. award every single year of middle school. 

You can imagine how embarrassing this was.  The Home Ec. teachers were all a motherly mix of frumpy and sweet, and while I’m sure they thought they were honoring my excellent performance, little did they know they were actually ruining my social standing for the next 5 years, and maybe my entire life.  Year after year I sat in the windowless, overheated gymnasium at the end-of-year awards ceremony, praying that I wouldn’t get the Home Ec. award.  And year after year I was obliged to march from the back of the gym to the front, where the principal and the Home Ec. teachers stood on a collapsible platform, and accept my award to a chorus of snickering pre-teens and their families.  Even my parents snickered.  (Yes, I saw you guys.  Thanks for the support.)  One year they reported that upon the announcement of my award, a man sitting nearby chortled, “Is she gonna bake us a pie?”  I waited for my parents to explain how they valiantly defended me in front of this thug, but instead they spent the car ride home imitating the way he put a Southern accent on the word “pie.”  “Hey Becca,” they laughed, “are you gonna bake us a pa-ah?”

I’d like to make it clear that I won other awards besides Home Economics.  Lots, in fact!  The English award.  The Spanish award.  The… something… award.  I was inducted into a society for women in science, which at the time sounded like a membership I would have preferred to decline.  There were probably others too, but the point is that nobody remembers them.  They only remember the Home Ec. awards, and they remember all of those.

Fortunately, life moves on.  I graduated and began high school.  The next year, the middle school determined that award ceremonies were politically incorrect.  Later, I attended a highly competitive private school where I was never again subjected to the humiliation of being recognized for achievement, in anything.

Still, even after all these years, it is not without a touch of irony that I’ve spent most of this summer working at a well-known women's lifestyle magazine that is the veritable bible of the Home Economics movement.

it's either a bible or a cookbook

The office is like my old Home Ec. room raised to the 100th power.  We have labs for testing sheets and towels, vacuum cleaners, and stove-top oven ranges.  While I’m often busy researching the latest findings from the nutrition world, writing blog posts, contributing to magazine articles, and coordinating taste tests, I would be remiss to omit the fact that I’ve also done a fair amount of recipe development.  And you know what?  There’s still something comforting about stepping away from my stack of journal articles, putting on an apron, and breaking out the measuring cups.  So nice, in fact, that – dare I say it? – maybe I deserved those Home Ec. awards after all.

I just have one thing to say:

Make your own f%*&ing pie.