Internship Update: Finally Time for Clinical

Last Friday marked a very exciting day…the last day of my food service rotations in my Internship. After 2 long weeks in the kitchen cutting fruit and making sandwiches, 1 week in the storeroom and purchasing, and 3 weeks working with a patient meal service manager, I am finally on to my clinical rotations!

As much as I don’t enjoy food service and could never see myself working in the field, I did have some valuable experiences. I learned just about everything there is to know about what patients can order, how patients order, where their food comes from, how it gets to them, and everything in between. As a dietitian, I can definitely see why it might be important to know what options the patients have while they are in the hospital.

Having my food service rotations first gives me good background knowledge on how the nutrition and dietary departments run, and I think I am well equipped to give patients meal recommendations based on their individual diet needs. I guess that I one perk of getting food service out of the way at the beginning (and I am glad I never have to put on another hair net again!).

Now, I have just finished day 2 of my clinical orientation. Day 1 was learning a lot about the electronic medical record and how the healthcare system works, but I am quickly getting the hang of it. My preceptor covers telemetry, general medicine, and adult cystic fibrosis floors so I have seen quite the variety of patients so far. I got to do my first note on my own today, and diagnosed a patient with moderate malnutrition. The patient’s doctor agreed with my diagnosis, which means the hospital gets reimbursed for my patient visit. I also feel very official (and old/not smart enough) wearing my white lab coat around 😉

That is pretty much all that is going on in the hospital. October is my busiest month with class work so I have been a busy beaver working on all my assignments every day after work. That unfortunately leaves me little time for any new recipes, but I have been enjoying a super simple (and of course, healthy) spaghetti squash bowl for dinner. I just mix spaghetti squash, steamed broccoli, peas, and chicken or ground turkey with some pasta sauce and wah lah… dinner is served.

Internship Status: Week 9/49

Advertisements

The Westside Market

IMG_9990Ever since my freshman year of undergrad, making a trip to the Westside market in Ohio City, Cleveland (a big market where you can find everything from fruits and vegetables to honey, meat, cheese, and bread) has always been an exciting adventure. A few times every year, my friends and I would wake up early on a Saturday morning and head over to the market to indulge in some fresh fruit that we could never find in the dining halls. Strangely enough, I have now lived just a 5-minute drive from the market for the past 2 months and haven’t had a chance to go yet.

Saturday morning I decided to change that. Last week in class we had a discussion about different cultural fruits and vegetables, which got me wanting to eat some exotic fruits that I wouldn’t buy on a regular basis. So, Saturday morning my alarm went off at 6:30am (yes, I love fruits and veggies that much) and headed to the market before it got too crowded and overwhelming.

I gave myself a $20 limit otherwise my entire paycheck could have quickly disappeared. With my 20, I got 2 mangos, 2 spaghetti squashes, strawberries, blackberries, bananas, a pomegranate, and a carton of eggs (and I had some change to spare). Not bad if you ask me.

FullSizeRender 69

I found that not only is it a bit cheaper to get produce at the market, but it is also so much more exciting. Seeing all the bright colored fruits and vegetables lined up makes you want to buy all of them! So if you are having trouble motivating to buy (or eat) your fruits and veggies, maybe going to a farmers market can help. It creates a change of pace and scenery that can make you more excited about eating those fruits and veggies.

If farmers markets aren’t your thing, try going to a different grocery store than usual. We often get stuck in a routine of going to the same store, walking through it in the same direction, and buying the same products, but going to new places and seeing foods presented in different ways can change the way you think about them…hopefully for the better! Even if its not fruits and vegetables, changing up anything in your diet provides variety meaning different vitamins and minerals you maybe weren’t getting before. Win!

Tempeh Pizza

Usually, I can’t wait to eat the veggies on my dinner plate, but every now and then, I want food that isn’t so healthy. Last night was one of those nights. After having fish, chicken, salads, and tons of veggies throughout the week, pizza sounded good for some strange reason (I am usually not much of a cheese or pizza fan). So, instead of ordering pizza (which is super unhealthy and costs more than making my own), I went to the store to get some ingredients. You probably can guess that I got sauce and cheese, but no bread or flour were needed for my pizza crust… I used Tempeh.

Tempeh is a vegan protein made from soybeans (sometimes used as a tofu alternative). I like it much better than Tofu because it is more patty/cake like and doesn’t have that strange mushy tofu texture. It is high in protein, potassium, and unsaturated fat (the good kind of fat)…and it makes for a great pizza crust ;).

The trickiest part was cutting the tempeh into thin slices, but other than that, this recipe is very simple. I like my tempeh crispy on the edges so I put it in the oven for a while before adding the sauce and cheese, but tempeh can be eaten raw, so feel free to put it in the oven for as short as you would like.

Also, remember, it is tempeh and not any sort of bread so it does have a little different taste and texture than traditional pizza…but it is filled with a lot more nutrients!

tempeh pizza.png

Whole Grains

Five weeks (holy cow-I can’t believe it has already been 5 weeks!) of my DI complete and I am finally getting into the swing of things. I have my daily routine down, feel a lot less overwhelmed, and still have time to explore Cleveland and spend a few hours at the grocery store ;).

The highlight of last week was working an outreach table at the outpatient pediatric clinic in the hospital. I spent the day educating patients about the importance of whole grains. I made a poster (which I don’t think I have done since high school), a handout, compiled some recipes, and played a whole grain game with some of the kids. Having quality conversations with some of the parents definitely made me feel like I was making a difference, but playing games with the kids continuously put a smile on my face throughout the day. And even better, not only did I have fun playing with them, they were also able to learn what whole grains were and be introduced to new food items to try! Win-Win!

Since I had the opportunity to teach so many people in the clinic about whole grains, I thought I would share the knowledge here.

Whole grainFirst off…What is a whole grain? You have probably heard of them, but do you really know what they are? A whole grain means that the product contains all three parts of the grain- the germ, endosperm, and bran. White or refined grains only contain the endosperm. The bran and germ are important because they have vitamins, minerals, fiber, and healthy fats, whereas the endosperm is made mostly of starch.

Whole grains have also been found to prevent stroke, heart disease, type 2 diabetes, obesity, and constipation. I don’t know about you, but I think those reasons alone are enough to want some whole grains in my everyday meals.

Ok, now that I hopefully have convinced you to eat some whole grains, you have to find them at the store. This can be the tricky part. Lots of packages slap phrases like “100% wheat” and “multi-grain” across the front to pull you in, but these phrases do not mean it is a whole grain. Here’s what you should look for:

  • Check the ingredient list on the box. If a food is a whole grain, the very first word on the ingredient list will be “whole” (ie. Whole wheat flour, whole grain oats, etc.).
  • Words like “brown rice” “bulgur” “quinoa”, “oats” and “wheat berries” listed first in the ingredients also always mean it is a whole grain.
  • Even if the front of the box says “5g of whole grain”, check the ingredients. While it might have some whole grain, if it is not the first ingredient, then the majority of the product is a refined grain.

There are lots of other whole grains including bulgur, millet, farro, barley, amaranth, buckwheat, and rye, which are great for adding to soups and salads or as a side dish. Those sound a little foreign? Try oatmeal or whole grain cereal (like Cheerios) for breakfast. Air-popped popcorn and whole grain crackers (like Wheat Thins) are perfect whole grain snacks. Even using whole grain bread on your lunch sandwich is a step in the right direction.

Making the switch to whole grains can be hard, but small steps can make it easier. A good rule of thumb is the make at least half of the grains you eat each day whole grains. You can also use this as an opportunity to try some new foods!

Here are some pictures from my outreach in the clinic!

Put it on a Plate

Ever get home after a long day and the last thing you want to do is put together a meal? If there are no plans to eat anytime soon, I can guess that your first move is to open the fridge or the pantry and just start picking at whatever looks good. The problem? There is not limit. You have the whole bag, container, or package at your disposal.

The amount of food you eat is just as important as the type of food you are eat. We often load our plates way too high or dig our hand in the snack bag a few too many times leading to overeating and that uncomfortably full feeling.

So, my number one tip for portion control is putting everything you eat on a plate (or in a bowl). Sounds easy enough, right? But think about how many times you have eaten straight out of the package. Maybe it was the whole bag of popcorn on the couch or standing in front of the fridge, fork in hand, eating straight out of the Tupperware container (I am frequently guilty of this one).

Instead of bringing the whole bag of popcorn with you to the couch, pour a reasonable amount into a bowl. Even if your “reasonable” amount is more than the recommended serving size, I’ll bet you it is a lot less than what you would eat if you ate straight out of the bag.

The same goes for meals… When you sit down for dinner, put a scoopful of each item on your plate at the beginning. Then you can visualize all the food you will be eating. If you put each item on your plate after you have finished the previous item, you can’t tell how much you ate in total.

See, if you can visualize the total amount of food you are eating in a given sitting, you are more likely to make more realistic decisions when it comes to portion sizes. Even if you just want some nuts, fruit, and a slice of bread for a snack, putting it on a small plate allows you to pick out a serving size that you think is reasonable.

In my opinion, eating healthier portion sizes is worth the 2 extra minutes and few extra dishes.

Diet & Exercise, etc.

As promised, I have a Dietetic Internship update and some other goodies to share. These first two weeks have been dedicated to orientation at the hospital. I, along with the four other interns, have sat through lots of HR trainings, lectures about hospital policies, gone on more hospital tours than I can count, and even had a few homework assignments already. Aside from that boring stuff, we did have some sessions that were more interesting and applicable to dietetics, like an intro to the Nutrition Focused Physical Exam, a taste test of the various supplements the hospital can supply to patients, and we did some patient-clinician role playing to prepare for talking with patients.

IMG_9871In other very exciting news, I officially can check “run a half marathon” off my bucket list. At 9:58am this morning, I crossed the finish line of the Rock and Roll Half Marathon in Cleveland. Miles 10-12 were definitely a struggle and required a little walking, but I ran the first 10 and the last 1.3 without stopping. Considering my longest training run was 10 miles and I wasn’t planning on running the full 13.1 until October, I am pretty happy with how I did. I decided to run it two months early because I quickly realized, during week 1 at the hospital, fitting long runs into my busy schedule was not realistic.

Now, I am home, have eaten more food than I thought possible (Note: running 13.1 miles makes you very hungry!), and my legs are officially jello. Since getting up off the couch is not really an option right now, I thought I would also add something to this post that is maybe more relevant to you (as opposed to just leaving it as an update on my life).

Since I’m in the half marathon spirit, talking about workouts seems appropriate. While workouts and healthy eating are usually two peas in a pod, I have stayed away from writing about them too much because I have no background or credentials surrounding fitness or exercise. But, I do know a thing or two about the relationship between diet and exercise, which I can share that emphasize the importance of a quality diet:

  1. I’m pretty sure we have all heard that “You can’t outrun a bad diet” and “Abs are made in the kitchen”. While these phrases may seem silly, there is a little bit of truth to them. We, as a society often underestimate how much we eat and overestimate how much we burn during a workout (the cardio machines that give false calorie readings don’t help). So, it can be really hard to burn enough calories in a workout to compensate for the two extra cookies last night. Personally, those two extra cookies aren’t worth a whole ‘nother hour at the gym (see the graphic below)…I’ll stick to one cookie.

    food calories to workout convesion

    Calories in food equivalent to workouts (I think these workouts are a little but underestimated, but you get the point)

  2. Surprise! It isn’t all about the number on the scale. Maybe those extra hours in the gym are worth it to you (or you naturally have a fast metabolism) and you eat anything and everything you want. Just because you fall into a healthy weight category doesn’t make you immune to sodium increasing you blood pressure or saturated fat clogging your arteries.
  3. Diet and exercise are not one or the other. They are both important and you need to find a balance. Here are just a two examples… exercise can increase HDL (good cholesterol) which diet can’t do, and fruits and vegetables provide antioxidants that can reduce your risk of cancer and heart disease.
  4. A poor diet often leads to low energy, poor sleep, and negative mood meaning your workout (or any part of your daily life) probably won’t be that great or productive if your not eating well.

These are just a few examples of why a healthy, well-balanced diet are so important. Now, I’m not ragging on exercise (see #3), While the “diet pea” might fit very nicely in that pod with the “exercise pea”, sometimes they need to stand on their own and be recognized for their individual benefits. Trust me, after training for a half marathon, I get that after a good sweaty workout you feel like you deserve a giant chocolate bar and a bag of chips, but in reality, that isn’t going to work (not for losing weight or for overall health).

I hope this helps, eat more veggies, and stay sweaty!

Overnight Oats

I can’t believe it has already been two weeks since moving back to Cleveland! I am officially done with 1 week of my Dietetic Internship (48 more to go!) and have been very busy. Hopefully this weekend I’ll have some time to write a full update on how it is going, but for now, I thought I would share one of my favorite breakfasts.

While oatmeal is definitely one of my go-to breakfasts in the morning, it isn’t easy to take on the go. Now that I am waking up early to get to work at the hospital, I need something that I can take with me in the car. The solution? Overnight oats!

It took some trial and error to get the recipe just right and a few tries before I got use to the texture, but now I love ‘em! I can throw all the ingredients in a jar at night, pop it in the fridge, and wa-lah – breakfast is ready to go when I wake up.

IMG_9376

All the ingredients for my recipe

If you aren’t familiar, overnight oats are made by putting raw, rolled oats in a jar with yogurt or milk. While the oats soak overnight, they absorb the moisture and soften up. The first time I tried making overnight oats, I was expecting them to taste and feel like cooked oat (which they don’t). They still kind of feel raw…like I said, it takes some getting use to.

Anyways, I love that you can make so many different flavors. My favorite is banana and cinnamon (see the recipe below), but I have done strawberry peanut butter, chocolate coconut, and pumpkin spice (the options are endless). Here is the step by step of what mine look like.

 

  1. oats       2. yogurt       3. banana       4. cinnamon     5. chia seeds      6. mix!

I like my overnight oats to be pretty thick so I don’t add any liquid but you can always put in a splash of milk, almond milk, or egg whites if you like it runnier. I also add chia seeds, which absorb moisture and give it a thicker, pudding texture. Again, you can add more and less chia seeds than I do to give it the texture you like. It might take a few tries but there is no wrong way.

Let me know what your favorite overnight oat mixtures are. I am always looking for new ones to try!

Screen Shot 2017-07-06 at 10.18.51 AM.png

P.S. I have found that the oats stay good for 3-4 days in the fridge so you can make a bunch of jars to have for the week (no excuses for not eating breakfast!)