Micros and Macros

In this post, I thought I would take it back to some basics: micronutrients (the little guys) and macronutrients (the big guys).

Micronutrients

Micronutrients are all your vitamins and minerals, like iron, zinc, vitamin D, and vitamin E – just to name a few. They are called micronutrients because you only need a little bit of them each day. Your fruits and vegetables are packed with tons of these, but they are also in lots of other foods.

Micronutrients are responsible for things like eye sight, bone health, thyroid function, blood pressure, and many, many more.

Right now, on the nutrition fact labels you will always see vitamin A, vitamin C, calcium, and iron. That is because back in 1990’s when the label was designed, those were the nutrients that people often did not get enough of. Now, you may know that there is a new nutrition fact panel coming out, which will be mandatory for manufacturers to use by 2021. On this label you will see vitamin D, calcium, iron, and potassium since these are the micronutrients that most people are low on now.

Macronutrients

Macronutrients are your carbs (including sugar and fiber), proteins, and fats. They are called macronutrients because – you guessed it – you need large amounts of them each day. Protein rich foods include fish, animal meats, and soy products (like tofu and tempeh). Fats come from foods like avocados, nuts, seeds, oils, and butter. Carbs come from grains (quinoa, bulgur, rye, rice, wheat) and foods made from grains like bread and pasta, corn, peas, and fruits. There are also lots of “combination foods” like beans, eggs, and cheese that provide a good mix of 2 or 3 of these macronutrients.

Macronutrients are our main sources of energy, growth, and building blocks for muscles.

Why does this matter?

Micro and macronutrients are both crucial for survival. We can’t live healthfully if any single one within these two groups is missing. I wanted to talk about this because many food products market themselves as “healthy” because they have extra whole grain or protein. For example, I love Kodiak Cake pancakes, which are “protein packed” and made with 100% whole grains. While it is great to have a little extra protein and whole grains these pancakes don’t have many micronutrients. Now think about broccoli and carrots – super healthy right? Yes, they may be packed full of micronutrients but they have very few macronutrients.

See – that’s why variety is important and eating only vegetables all day isn’t really a good thing. There is no single food that can provide all the nutrients we need. Mix things up, try new foods, and maximize your nutrient intake!

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Med-Surg, Outpatient, and Change, Oh My!

Boy has this semester flown by! I am officially 1/3 of the way done with my Dietetic Internship and Monday is my last day of class for the semester. Last week marked the end of my general medical-surgical (med-surg) rotations in the hospital, which were a total of eight weeks: two weeks in cystic fibrosis and telemetry, two weeks in geriatrics and trauma step-down, two weeks in cardiac, and two weeks in bone marrow transplant. While I liked some rotations better than others, I honestly didn’t love any of them. Most of the time I was seeing patients due to unintentional weight loss and decreased appetite (both of which are major issues in the hospital). Unfortunately, the standard of practice for these patients is to recommend using high calorie/high protein supplements (which are filled with sugar) and encourage high calorie foods. I also didn’t feel like seeing a patient for 10 minutes, one or two times during their hospital stay really made an impact on their health. I wasn’t encouraging them to eat healthier or make better food choices in their daily life, I was just trying to manage symptoms and ensure they could be discharged as soon as possible. Besides all these dislikes, I did learn that I loved doing calculations for enteral and parenteral nutrition (feeding via a tube or IV) in patients that couldn’t eat food orally.

The past week I have been in my adult outpatient rotation, and I have absolutely loved it so far (which is very reassuring after not loving my previous eight weeks). My preceptors are amazing and I definitely see it as an area I am interested in working in in the future. You get to spend so much more time with the patients and it is exciting to see them learn and make progress with improving their diet. I have also learned a little bit about integrative and functional medicine, which also sparked my interest. It is a growing field and focuses on a mix of different eastern and western medicine techniques, plus uses food as a method of healing different types of diseases.

With all of my experiences this past week in outpatient, I thought I would share a few words of wisdom (per usual). It has been exciting to see all of these patients be so eager and motivated to make change (which is definitely different from the patients in the hospital). But, at the same time, change is difficult and it requires work. You can’t expect to just show up and meet with a dietitian and, poof, you start losing weight or controlling your diabetes. The same thing goes for reading my blog. While I love that people are reading my posts and I am able to share information, reading doesn’t translate to results. In fact, we only remember about 10% of the things we read. In order to make positive changes, you have to take the information you read and hear, and put it into action.

Since this post is getting a little lengthy, I’ll leave it at that for now, but I’ll share more about making changes in my next post!

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

Summer Plans and Future Blogging

As promised, I am back with a summer plans update. (If you want to know what I have been up to the past 5 months, check out my last post.) Being that my Dietetic Internship (DI) starts August 7, my summer is cut a bit shorter than usual…and it is probably my last summer ever since my DI/grad school will run from August 2017-December 2018 without much of a break. That means I am planning to have a very exciting and busy summer, hopefully with some relaxation involved too!

If you know me, you know traveling is obviously #1 on my to do list. Here are the plans so far:

  • Two days after commencement, my family is going to Peru for 10 days of adventure
  • We have a long weekend in New Jersey for my cousin’s graduation
  • A girls, long weekend trip planned in Chicago with my mom and cousins
  • My grandma and I are spending a week in San Francisco and Napa in July
  • I have a trip to Boston in the works with a friend
  • And hopefully I will also be able to squeeze in a weekend visit to see my friends in Cleveland and Columbus

I’ll also be working and coaching gymnastics here and there, cooking up some new recipes in the kitchen (my goal is to make 1-2 new recipes each week, which I will share…if they turn out well, of course), trying new Detroit restaurants while I am home, and getting ready to move into my first solo apartment. I will be living in Downtown Cleveland for the duration of my 18-month program. I am excited to not only live downtown close to all the good restaurants (obviously food is #1) but also experience Cleveland from a new angle. Since I want to move to Downtown Detroit when I graduate, I think this will be a great way to make sure I enjoy living in a growing urban area.

This brings me to my plans for future blogging. Part of the reason I took a little break from blogging is that I started to run out of ideas. Between gathering images, information, and trying to figure out what the lesson from each post should be, it was just a little too time consuming and began to feel like a chore.

With that being said, I still love writing these posts and sharing my experiences with you. That means, I am still going to be posting (hopefully even more now!) but the posts won’t be so much about sharing information and research or trying to teach a lesson. I will probably be writing more about healthy (and yummy) new things I find at the grocery store, healthy and cool new restaurants I try, and my travel adventures (which obviously will include a lot of food). I’m sure there will still be tips for making healthy choices and probably some interesting food facts here and there, but those won’t be the focus of the posts.

Honestly, I’m not sure how it is going to work out so I guess we will find out together 😉

Dana

Back & Better Than Ever

I guess senior year got the best of me and The Lemon Wedge took the back seat. But no worries, I am back to blogging. I thought I would use this post to update you on what I have been up to this last semester and what I have planned for the future.

As I have talked about before, in order to make my dreams of being a Registered Dietitian (RD) come true, I have to complete a Dietetic Internship (read more here). Soooo last summer and fall took the GRE, narrowed down the list of programs I would apply to and began working on my applications. The process to apply is similar to a residency after medical school where you apply to many programs but are only “matched”/accepted to one program (or you don’t match at all and have to reapply the next year). Deadline for applications was February 15th so I kept busy over winter break and the first few weeks of my semester writing, revising, and re-revising my personal IMG_7271statements over and over and over again until I could practically recite them to you by heart. Finally, on February 14th, with trembling hands, I clicked the infamous “submit” button. From there, it was a big waiting game until “Match Day” when you find out the results.

I ended up applying to 6 different Dietetic Internships, all which were combined with a Master’s degree program: University Hospitals (Cleveland), Veteran’s Affairs Hospital (Cleveland), Cleveland Clinic (Cleveland), Ohio State (Columbus), Rush Medical Center (Chicago), and Tufts Medical Center (Boston).

Finally, Match Day (April 2) rolled around and at 7pm on the nose I logged into my online application to find out that I had matched with my first choice- University Hospitals (Cleveland) and I would stay at Case Western Reserve University to get my Master’s in Nutrition! It was quite an exciting day and I felt a huge weight lifted off my shoulders…I was officially and “RD2Be”!

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Celebrating with Tacos and Sangria

In other exciting news from this semester:
-I had my first research paper published in the Current Nutrition Reports journal. It was a paper that I co-authored as part of my independent study class last semester about dietary supplement use in older adults.

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President Snyder and I 🙂

-I also was selected to be one of the students who decided which professor at the university receives the Excellence in Mentoring award. Being on this committee got me an invitation to Barbara Snyder’s house for a fancy reception…exciting!! (She is the president of the university and basically a celebrity around here!)

That brings us to today. I am currently writing this blog post, as it seemed like a great way to procrastinate studying for my last final exam as an undergraduate (#senoritis). I have one last exam in Pathophysiology next Wednesday before I am done. Then there is a week and a half of lots of food and fun activities with my fellow graduating seniors before commencement.

Now that you are up to speed on the past 5 months, and this post is getting long, I am going to call it quits here. I should get back to studying, but in the next few days I will be writing another post about my summer plans and my future plans for The Lemon Wedge.

Glad to be back!

Dana

Drink Your H2O

Over the summer, a friend and I made a bucket list of a bunch of things we wanted to do during our senior year of college. Four weeks into school, we are slowly checking things off the list. One check mark I got to add Tuesday was donating blood. I’ve wanted to do it for a while but for some reason, it just never happened. When “Blood Drive” was listed as an upcoming event in last week’s university email, I knew I had to go for it. I registered with the Red Cross and signed up for a time slot. I was feeling pretty good about it until I was walking to the donation site. I started to get a little freaked out, praying that I wouldn’t pass out. Once I got there, I calmed down a bit. I had to read a big information packet, get a brief physical done to test my blood pressure and iron levels and then answer a bunch of questions. The nurse wasn’t too happy with me since she had to type in all the countries I had traveled to in the past year (it ended up being 13!) and the amount of time I spent in each one. After that long process it was finally time to stick the needle in me. Shockingly, it didn’t hurt, nor did I even get the slightest bit light headed. I got a banana, some apple juice, and was sent along my marry way. Hopefully you don’t mind the graphic pictures!

How does this story relate to food and nutrition?
Well, if you have ever given blood before, you know that you have to drink lots of extra water both before and after you donate to increase your blood volume and keep you hydrated. But even if you aren’t donating blood, water can do tons of amazing things for the body. Here are some of the top reasons why you should always have a water bottle by your side (if you didn’t guess, mine usually has lemon it in 😉 )

  1. Water is crucial for our survival. The body is made of 60%-70% water and every system in our body requires water to function properly.
  2. It can improve your mood. Being thirsty is never a pleasant feeling. Dehydration can also affect your mood and make you grumpy and confused. Drink more water to be happy and think clearer.
  3. It regulates your appetite. Sometimes when we feel hungry, we actually just need something to drink. Try a glass of water before reaching for the munchies (this can help you lose weight too!).
  4. Water keeps your skin glowing. Skin is the largest organ in our body and water helps it continue to build new cells, which can improve the color and texture of your skin. Staying hydrated also helps your skin maintain your internal body temperature.

How much water should you be drinking?
There are lots of opinions on this one. The old fashion recommendation is 8 glasses of 8 ounces per day (64oz total). Now, new research is saying that more wouldn’t hurt. A good rule of thumb is to take your body weight in pounds and divide it in half. That should give you the number of ounces you should aim for per day.

Drink up!

What I Learned From Losing My Fitbit

Last week, I had a very traumatic event happen…I lost my Fitbit (okay, maybe traumatic is an exaggeration but I digress). Thankfully, my mom had one that she didn’t use at home and could send to me at school. Still, this left me Fitbit-less for about a week. One day that week, I had the strangest thought while walking to class. I felt like walking wasn’t worth anything because I had nothing to show for it (ie. No big green star at the end of the day when I hit my step goal). I quickly had to shake myself out of that crazy thought. It blew my mind that losing this little piece of technology and not being able to see how many steps I had taken made my walking feel useless.

I did, though, get a good lesson out of this crazy thought of mine: My life is constantly a numbers game: how many steps I take, how many ounces of water I drink, how many calories I eat, how many minutes I exercise for, and the list continues. I can have a few OCD tendencies at times; I like to keep track and make sure everything is neat and organized and I guess counting all these things can bring a little bit of organization to my life. Even if you aren’t someone like me who is obsessed with counting steps, calories, minutes, and ounces, it seems like that is what we are recommended to do. The US Food and Drug Administration recommends we consume about 2.5 cups of vegetables, 2000 calories, 5.5 ounces of protein, and 64 ounces of water each day.

My point is that we are a numbers and counting driven society even though that is not the recommended way to lose weight or create a “healthy” diet. Counting and recording everything has been proven to be an ineffective way to have long-term weight loss – it is just not a sustainable behavior. Instead, listening to your body and making logical decisions about what and when to eat and exercise is the best way to go. This crazy thought during my Fitbit-less walk showed me that I need to do a better job of just listening to my body and not worrying about the numbers- especially when it comes to physical activity.

Is your stomach growling? Go get something healthy to eat. Are you full? Stop eating- you don’t have to finish everything on your plate. Craving chocolate? Break a few squares off of the big bar, enjoy them, and leave the rest for later. The same goes for exercise. Sitting at a desk all day? Get up and go for a walk. Sore muscles and exhausted? Take a rest day. Feeling unmotivated? Remember that exercise will make you feel better so go get it done!

Your body knows exactly what it needs, you just have to learn how to listen and understand the cues it gives you. I know it isn’t as easy as it sounds. It takes time and work to be “on the same page” as your body. Setting number driven goals (like 10,000 steps per day) might be beneficial to working towards a target weight or activity level, but in the end, it is all about how you feel. Whether you meet those goals or not, if you aren’t feeling good all the calories and steps you counted don’t mean anything. You should always try to feel healthy, not hungry, tired, or deprived.

Dietetic Internship Search Update
The beginning of senior year means the hunt and application process for a Dietetic Internship (DI) has begun. A DI is a 1200-hour supervised practice program a student must go through to in order to sit for a board exam to become a Registered Dietitian (read more about the process here). I am looking at DI’s that have a master’s degree program combined, so that narrows down my options but there are still lots to choose from.

Step one in applying to any of these programs is taking the GRE (Graduate Records Exam), which I just took in August. I got my scores this week and thankfully I did well enough that I don’t need to take it again!

The next steps are figuring out exactly where I am going to apply and starting my personal statement. Stay tuned for more DI updates 🙂