Being Vegetarian

Exactly four weeks ago I decided to become a vegetarian…temporarily. Yep, I have officially been a vegetarian for one full month. I had been pondering the idea for a while and I had finally used up all the chicken and turkey in my freezer, so I thought it would be a good time to start. (Oh, and I guess I should include that I just cut out all meat and fish. I still ate eggs and dairy.)

By no means did I plan on being a vegetarian forever, but as a future dietitian I thought it would be a good experience to walk in the shoes of vegetarian patients and clients that I will work with.

Anyways, I thought I would share some things I have learned from my experience with you this week.

The good, the bad, and the indifferent

The first question I have gotten from all my friends and family is, “how do you feel”, and honestly, I can’t say that I feel much different. Prior to my vegetarian experiment, I didn’t each much red meat at all; I mostly stuck to chicken, turkey, tuna, and salmon. Research has shown that there are a lot more benefits to cutting out red meat compared to other lean meats, so I don’t know if that has anything to do with the lack of change I have felt.

People are also very concerned about protein, so I’ll also mention that I was keeping track of my food intake using MyFitnessPal at the beginning to make sure I was getting enough protein. While I could easily meet my protein needs for the day, I had to be a lot more conscious of including it at every meal and snack than I was before.

With that being said, eating out was a struggle– not because there aren’t any vegetarian option (you can get pasta and potatoes pretty much anywhere), but because restaurant menus lack vegetarian protein sources. I especially had a hard time in the cafeteria at the hospital. After the first week I started bringing a container of tofu and beans to add to salads and soups to make sure I got my protein in.

So while it may have been a little difficult at times, I actually am really happy that I gave vegetarianism a shot. I had to get super creative in the kitchen, and find new ways to incorporate tofu, tempeh, beans, and eggs into my meals to make sure I got enough protein in for the day (which means lots of new vegetarian recipes and food combination to share in the coming weeks!). I also now have a good basis of vegetarian recommendations for any patients or clients who come to me with questions.

And finally (skip this section if you don’t want to hear about flatulence and bowel movements), vegetarianism has made me very regular. Vegetarian diets tend to be a lot higher in fiber which kept everything moving smoothly. The first week I was a little gassy (probably due to all the beans I was eating), but my body got use to it and I have been fine ever since.

Overall thoughts

I think a lot more good came out of this experiment than bad. I have cooked up some new things in the kitchen and have had experiences that will help me be a better dietitian. Meeting protein needs can be tough but definitely manageable if you plan ahead.

While I think going completely vegetarian isn’t really necessary (unless you would like to, of course), there are lots of benefits to being a vegetarian. Plant-based diets usually have a lot more fiber, vitamins, and minerals. There is also lots of research showing that decreasing meat intake can help prevent chronic diseases, aid in weight loss, and save the environment.

If I were to give any recommendations, I would say that it is always beneficial to cut back on red meat intake (Eat it no more than 1x per week) and increase you fruit and veggie intake. You can also try Meatless Mondays or another modified version of being a vegetarian to get some of the benefits (such as meatless lunches during the week).

Looking forward

This week I am planning on including a lot of fish and meat to see if I feel any different (I give you any updates in next weeks post). After that, I’ll definitely be adding fish and meat back into my diet but probably not in the same quantities as before. I am going to continue to include vegetarian meals on a regular basis because they both healthy and – more importantly – they taste good!

Considerations

If you are or decide to become a vegetarian or vegan long-term (longer than 1-2 months), I suggest seeing a dietitian (or sending me an email, I’m happy to help!) since there are some vitamin and mineral deficiencies that can occur if you aren’t taking supplements.

“Should I be eating dairy?”

 

When people find out I am studying nutrition the questions immediately start pouring out, and the topic of dairy is one of the most popular. There is tons of research on both sides, so I’ll try to sum it up for you.

Evolution and Intolerance

The number 1 argument against dairy is that it isn’t “evolutionary” for humans to consume the milk made from other animals. While it is true that humans are the only species to do this, people have been consuming animal dairy products for hundreds of years, and some research shows that our genes have changed and adapted to accommodate the dairy products we consume.

While some genes may have changed, over 75% of the world’s population is still intolerant to the natural sugars in dairy (also known as lactose intolerance). This is likely due to reduction of lactase production (the enzyme used to digests those sugars) that naturally occurs as we age. Why does it decrease with age? Probably because in distant human history, people didn’t have much dairy in their diet after they stopped breast-feeding.

Calcium and Bones

Because dairy is the optimal food for growing animals, it is packed with beneficial nutrients like calcium, vitamin D, protein, phosphorus, and some B vitamins. Dairy products often get the spotlight for calcium content and bone health – which they should since it can be extremely difficult to meet our daily calcium needs from food without dairy. Several studies have shown that people who consume dairy have improved bone mineral density, and have lower risk of osteoporosis and bone fractures. But, other studies have shown that people who are lactose intolerant often have higher bone mineral density and lower risk of osteoporosis. Confusing, right?

More and more research is showing that we should really be focusing on vitamin D when it comes to bone health, but I’ll save that post for another day.

Healthy Fat

While the research on bone health is still “up in the air”, it is pretty well proven that dairy can provide a lot of healthy fats that can decrease heart disease and stroke risk. But there is a disclaimer that comes with this one. The nutrient composition of dairy can differ depending on what the dairy producing animals eat. We only see these healthy fats when dairy comes from animals that were grass fed or pasture raised. And don’t forget, you only get these healthy fats if you buy dairy products with fat in them – low fat and skim won’t have them.

Hormones and IGF-1

Finally, the infamous hormones that people are concerned about. Dairy has been shown to increase a hormone called insulin-like growth factor (IGF-1). IGF-1 is responsible for cell growth – which can be a good thing and a bad thing. It is great for healing damaged tissues and building muscle, but it also means it might help the growth of cancerous cells (that’s why so many people say that dairy causes cancer). While there are few and inconclusive studies showing dairy may increase prostate cancer risk, there are several studies showing dairy can decrease colorectal cancer risk.

In addition to cancer, IGF-1 is also the suspected hormonal link between dairy and acne, headaches, low energy, inhibited weight loss, and many more.

Conclusions

So back to the original question “Should I be eating dairy?”

Do you have digestive symptoms (like abdominal pain, flatulence, and diarrhea) after eating dairy? If you do, avoid it. You can try lactose-free dairy products be those can also cause trouble sometimes.

Do you have any symptoms of hormone imbalances (like acne, headaches, low energy, inhibited weight loss, or mood swings)? If you do, try eliminating dairy and see how you respond. Maybe it will help, maybe not, but it is worth a try.

Other than that, it is really personal preference. While there are some potential health risks, the evidence isn’t conclusive and none of the studies were gold-standard clinical trials. If you aren’t sure, maybe you try to eliminate it for a week or two to see if you feel any different and then make your decision. Remember, everyone is different so just because your neighbor won’t touch a piece of cheese doesn’t mean you shouldn’t have any either.

However, nutritionally, if you choose not to eat dairy, I would suggest a daily calcium + vitamin D supplement, especially if you are under the age of 30.

Meatless Monday

If you thought hospital cafeterias were full of healthy food options, you thought wrong. Unfortunately, even in the building where heart disease is being treated, it is also being served on a plate in the form of fried chicken, onion rings, French fries, pizza, and deli sandwiches. Since those are the main options, I resort to the salad bar daily for my lunch, filling my bowl with romaine, kale, tomatoes, peas, mushrooms, and chicken. But it is only now, after almost 12 weeks, that I realized the cafeteria does “Meatless Monday’s”. I just thought every now and then the salad bar was out of chicken, but I have now realized it happens to be every Monday…the same day they don’t serve chicken fingers or BBQ chicken pizza.

With research linking meat consumption to cancer, cardiovascular disease, diabetes, and obesity, at least the hospital is on the right track one day a week. Meatless Monday’s is a concept used to both reduce health risks, but also reduce our carbon footprint since there is so much water and fuel used in meat production.

After the Meatless Monday realization I had, I decided I would try something other than a salad this past Monday. In a cafeteria where most of the food looks slightly suspicious, my meatless lunch was actually delicious – stuffed sweet potato with a kale, quinoa, and cranberry salad and a quarter of a roasted acorn squash. It was also nice to switch things up and have something other than a salad.

I have never participated in Meatless Monday’s before, but I think I might try to continue Meatless Monday’s through dinner at home. It is great motivation to get creative in the kitchen, try something new, and get some health benefits.

Worried you won’t get enough protein by going meatless? No need to worry! 85% lean ground beef has 10.4 grams of protein per 100 calories and broccoli has 8.5g per 100 calories… Pretty close, huh? Plus broccoli is full of fiber, vitamins, and minerals that meat doesn’t really have. And of course, there’s always quinoa, tofu, lentils, yogurt, beans, and nuts which are all good sources of protein.

Sure, meats have lean protein, vitamin B12, and iron, but you don’t need to have it everyday to reap the benefits. Give Meatless Monday’s a try! If anything, it is a good excuse to fill your plate with extra veggies, which never hurts.

Up for a challenge? In doing some google-ing about Meatless Monday. I also found there is a campaign called #NoRedOctober encouraging people to cut meat for the entire month of October. I know October is almost over but you can try it any month. Think you could do it? It would be tough, but even a meatless day or week is better than nothing.

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!

The Scoop on Salt

Sitting at the Father’s Day dinner table last night, somehow the topic of salt came up. Everyone was discussing the difference between table salt, kosher salt, sea salt, etc. Low and behold, the most common myth about sea salt came up.

Does sea salt have less sodium and is it better for you than regular table or kosher salt?

The simple answer is no. All types of salt are about 40% sodium (by weight) meaning that sea salt has about the same amount of sodium as an equal amount of any other type of salt. So, don’t think that swapping sea salt for your regular table salt will work wonders on your blood pressure.

But here is the catch- when measuring salt with measuring spoons, 1 teaspoon of sea salt may have less sodium than 1 teaspoon of table salt. This is because sea salt is typically larger crystals so fewer will fit in the measuring spoon (compared to the finely ground table salt). This is the basis behind the common myth that sea salt is “better for you” and contains less sodium.

With that being said, there are some differences between the various types of the most commonly used salts.

  • Sea salt is usually less processed and will contain small amounts of minerals (like potassium, magnesium, and calcium) from the ocean.
  • Table salt is processed to a fine texture (good for mixing into recipes) with impurities and minerals removed.
  • Table salt is usually iodized (it has added iodine) to prevent iodine deficiency which can lead to hypothyroidism and goiter.
  • Kosher salt is coarser and flakier making it good for sprinkling on top of foods for lots of flavor
  • Pink Himalyan salt has lots of minerals giving it more flavor and makes it popular for skin and spa treatments.
  • Check out this link for info about 12 different types of salt http://www.wideopeneats.com/12-different-types-salt-use/

Which type of salt should you choose? You should leave that up to your taste buds. Some may say the minerals in sea salt make it superior, but the amounts are so small that it is almost insignificant. You can get all those same minerals from nutrient dense fruits and vegetables.

Just keep in mind, regardless of the type of salt, they all have almost the same amount of sodium, which one of the largest contributors to high blood pressure and heart disease in America.

The American Heart Association recommends an ideal limit of 1,500mg of sodium per day (max of 2,300mg per day), but the average American has over 3,400mg per day! Watch out though because more than 75% of the sodium most people consume comes from packaged foods like chips, muffins, crackers, cereal, microwave dinners, and canned goods (not from the salt shaker).

Here are some tips to cut back on sodium and prevent high blood pressure:

  • Choose the low sodium or sodium-free version of popular snacks (especially broths and condiments) at the grocery store
  • Buy the “no salt added” canned goods, or rinse your canned veggies and beans off with water before eating them
  • Use spices to add flavor when cooking as opposed to salt
  • Avoid foods with the words pickled, brined, cured, and smoked – this usually means high salt
  • Potassium has the opposite effect on blood pressure than sodium (it can help reduce blood pressure) so incorporate foods like sweet potatoes, bananas, yogurt, and other high potassium foods into your diet

How my Senior Capstone has solidified my decision to be a dietitian

As a nutrition major, I get to have a very unique experience for my Senior Capstone project. Instead of writing a long research like most students, I have the opportunity to teach a nutrition education class, along with four other students majoring in nutrition, to older adults at a local YMCA. Over the course of the semester, we teach six different classes on various nutrition topics. The topic this week- diabetes. We chose to teach about diabetes because over 25% of older adults have it and many cases go undiagnosed or unmanaged.

Before we gave the presentation, our advising professor thought it would be a good idea for us to learn how to check your blood sugar since that is a major part of living life with diabetes. She gave each of us our own blood sugar meter and got to check our own blood sugar. Since needles don’t freak me out, I was pretty excited about the opportunity. Our professor walked us through the process and I got my first ever blood sugar reading: 97mg/dL which is perfectly normal :).

 

testing-blood-sugar

Overall, it was a pretty eye opening experience. While it didn’t hurt that much, it is definitely not something I would want to do every day. (Diabetics may have to test their blood sugar up to eight times a day depending on how well-managed their blood sugar is.) I found it even crazier that people with diabetes can make so many dietary changes to prevent uncontrolled blood sugar and having to test blood sugar every day, yet many people don’t make the changes they need (usually because they don’t know what they need to do or how) and end up suffering the consequences.

While we taught the class, my classmates and I discovered that many of the participants had diabetes, but they couldn’t even identify what foods had carbohydrates in them (the main contributor to elevated blood sugar). I had a little bit of a light bulb moment during the class; I realized just how little the general public actually knows about nutrition, and that I often find myself assuming that people know so much more than they actually do, which can make my job as a (eventually) dietitian a lot harder.

That being said, this is just another reason why I want to be a dietitian. The fact up to 40% of premature deaths can be prevented by changes in health behaviors like diet and exercise makes me feel like my job as a dietitian will be meaningful and will hopefully have a positive affect on the people I work with.

Say Ta-Ta to Trans Fat

New research is always coming out telling us what we should and shouldn’t eat. From red meat giving us cancer to avocados making us skinny, the information we get about food can be confusing. One thing that hasn’t changed is the research regarding trans fat (the type of fat in partially hydrogenated oils). Trans fats are the worst of all the fats in our food and are strongly linked to causing cardiovascular disease.

Fortunately, just about one year ago, the FDA removed partially hydrogenated oils from the GRAS (Generally Recognized as Safe) list. That means, from that date, companies have three years to remove all trans fats from their products. Currently, trans fats can be found in products like margarines, fried food, non-dairy creamers, cookies, and crackers.

Until 2018 when trans fat is removed from our food, you should still be checking food labels and preventing consumption of trans fats. It is also important to make sure the ingredients do not include any partially hydrogenated oils. That’s because companies can legally label their product as having zero grams of trans fat as long as they have less than .5 grams per serving. Meaning, there can still be trans fat in a product even if the label says there is none.

Read more about the ban on trans fats here.

Read more about how different types of fat affect the body here.

Decoding Dietary Fat

Screen Shot 2015-10-07 at 9.58.41 PMEver look at a nutrition facts label and have no clue what it means? Is trans fat going to kill you? Should you avoid saturated fat? Which is better: polyunsaturated fats and monounsaturated fats? It can be confusing, but I’ve got you covered. Get ready for a crash course on fats.

Some background:

There are four different types of fat: trans fat, saturated fat, monounsaturated fat (MUFA), and polyunsaturated fat (PUFA).

The main factor that determines “good” vs. “bad” fats is their contribution to the development of cardio vascular disease (CVD). Cardiovascular disease can develop as a result of various things, but the most common is cholesterol build up in the arteries. The two main types of cholesterol carriers that influence cholesterol levels are HDL and LDL. HDL is usually called the “good” carriers that removes cholesterol from the body and brings it to the liver. LDL does the reverse; it takes cholesterol out of the liver and circulates it throughout the body where it can get trapped in the artery walls.

When LDL cholesterol gets trapped in the artery walls, inflammation and hard plaques can develop. This inflammation makes it difficult for blood to move and plaques can break off and block arteries leading to a heart attack.

How Do Fats Impact Cholesterol?

Trans Fat: Trans fat is the worst type of fat. When trans fats are consumed, your LDL levels increase and your HDL levels decrease. That means a huge increase in CVD risk. Compared to a person who eats absolutely no trans fat, a person who gets 2% of their calories from trans fat has at 23% greater risk of developing cardiovascular disease!

Saturated Fat: Saturated Fats increase HDL and LDL cholesterol. That means they aren’t the best, but they aren’t nearly as bad as trans fats.

Monounsaturated Fat: Monounsaturated fats have not been found to have a huge link to cardiovascular disease. Some studies have shown that they decrease risk, but most studies show that they do not impact CVD risk at all. Though, they do have some connection to increasing LDL particle size. This is a good thing because when LDL particles are bigger, it is less likely they will get trapped in the arteries.

Polyunsaturated Fat: Polyunsaturated fats (PUFAs) come in two forms: omega-3 and omega-6. Omega-3 PUFAs have anti-inflammatory effects, can decrease LDL cholesterol, and increase LDL particle size- all good things. Omega-6 PUFAs, on the other hand, are pro-inflammatory and can cause blood vessels to narrow making it harder for blood to circulate. It gets complicated because both omega-3 and 6 are required for survival. Therefore, it is important to eat both, but omega-3 should be eaten in slightly larger quantities.

So which ones should I eat??

Increase omega-3 polyunsaturated fat intake. These are going to have the greatest impact on cardiovascular disease risk. Just 250mg/day of fish high in omega 3 can decrease your CVD risk by 36%!
Sources: flaxseed, salmon, and fresh tuna.

Watch your omega-6 polyunsaturated fat intake. These are still an essential part of the diet and are needed for survival. In fact, they are required to prevent learning deficits, skin lesions, and impaired vision, but swapping some omega-6 for omeg-3 every now and then will decrease your risk of CVD.
Sources: nuts/seeds, vegetable oils, and many processed foods.

Don’t worry about monounsaturated fats. Keep eating these guys with no worries. It might be a good idea to swap saturated fats (like butter) for some MUFAs (like olive oil) when you are cooking.
Sources: olive oil, avocados, and nuts/seeds.

Consume saturated fat in moderation; a little bit won’t kill you.
Sources: cheese, butter, whole milk, and red meats.

Avoid trans fat at all costs. Keep trans fat consumption as low as possible (absolutely none is ideal) and chose any other type of fat before eating trans fat.
Sources: fried food, margarine, non-dairy creamers, and processed cookies and crackers.

Don’t forget, eating fat won’t necessarily make you fat. Fat is essential for the body to function so it is important to consume enough (20-35% of your calories should come from fat each day).

Copenhagen, here I come! + blood sugar

Three weeks into school and I am knee-deep in homework, reading, and tests, but today was a surprising break from the daily grind. As I sat in my human nutrition class learning how various types of fiber influence blood glucose levels, an email notification popped up on the side of my computer screen. I usually ignore my emails during class, but this one couldn’t wait. The subject read “DIS Spring 2016 Registration Information”, and I nearly jumped out of my seat.

I was accepted to study abroad at the Danish Institute for Study Abroad in Copenhagen next semester!

It has been a stressful two weeks since they received my application, waiting to hear their decision. Every time my phone vibrated this week, I anxiously hoped that it would be the email with my admission decision. Finally the anticipation is over and the countdown until I leave begins (Only 126 days, but who is counting?).

With all of the excitement, I could barely comprehend what the professor lectured on, but I did catch a few things about fiber. In many of my recipe posts, I discuss how high fiber foods are good at keeping you satisfied for long periods of time, but fiber also has other benefits. The one we focused on in class today was fibers impact on blood sugar.

I’ll try to keep this simple, but here is how it works:

  1. Food is consumed and the sugars are absorbed from the digestive system into the blood (blood sugar goes up)
  2. Insulin binds to the sugar in the blood and brings it into the cells (blood sugar goes down)

Having consistently high blood sugar (from eating lots of sugary foods) causes lots of insulin production. Too much insulin all of the time can cause the cells to become desensitized to insulin. This is a form of diabetes because the insulin is not able to reduce blood sugar levels.

How do you prevent this from happening?

One option is fiber (especially soluble fiber)!! When consuming a high fiber diet, nutrient absorption is slowed down, which means there are lower amounts of sugar in the blood after eating a meal. This also means less insulin is needed to absorb the sugar.

So make sure you get your daily dose of 28-35 grams of fiber per day (the average American eats less than half of that). Keeping blood sugar low is the key to managing the insulin response and reducing your risk for diabetes!

Here are some good sources of soluble fiber:
Broccoli
Carrots
Beans
Peas
Sweet Potato
Apples
Plums
Berries

*Note that intake of fiber does not cure diabetes, nor does it allow you to eat unlimited sugar, it just allows your body to have a healthier response to high sugar foods.

P.S. Look out for posts about my study abroad adventure as we get closer to my departure!