My 6 Tidbits of Advice for Dietetic Interns

Last year, before I started my Dietetic Internship, a girl in the class above me reached out to provide some advice and answer any questions I had about the dietetic internship that I would be starting.

She told me, “You will learn more about what you don’t like, rather than what you do like during the internship”.

This didn’t faze me as earth shattering advice at the time, but let me tell you, when 5 months of clinical rotations had passed and I couldn’t name a single area I really enjoyed, nor could I ever envision myself being a clinical dietitian, that advice was life saving. I still had a few moments of panic (I knew I still wanted to be a dietitian, but suddenly I had no idea what I wanted to do as a dietitian), but knowing that it is okay to not enjoy parts (or whole chunks) of the internship was very reassuring. There are so many areas of dietetics that you may not be exposed to in your internship, so there is still so many other opportunities to find where you fit in. And don’t worry- I’m still trying to figure out what that niche is for me.

Anyways, since I received that invaluable piece of advice prior to starting my internship, and now having completed an internship myself, I thought I would share a few pieces of advice for any RD2Be’s out there.

  1. Going along with the advice I was given, I would tell people to find an internship with tons of different rotations/areas of experience – especially if you don’t really know what area you want to go into. I worked in more than 25 different clinical areas during my internship, and although a didn’t love any of them, there were definitely some I liked more than others and I discovered interests that I didn’t know I had. Even if you do have a specific area of interest, gaining experience in a number of different fields will make you a better dietitian all around.
  2. Practice what you preach as a dietitian. Dietetic internships can be extremely busy and stressful, especially if you are also completing as masters degree at the same time (like me). It can be easy to slack off, skip workouts, and order pizza for dinner, but as future RDN’s, we all know that those choices aren’t the best for our physical or mental health. Make sure you have plenty of fruits and veggies to snack on and especially get a solid 7-8 hours of sleep every night.
  3. Ask lots of questions! I was terrified starting my first rotation because I felt like I didn’t know enough. Guess what…you aren’t supposed to know everything – that is why you are there. I never had a preceptor who wasn’t willing to answer my oodles of questions – especially regarding areas of nutrition that I didn’t learn a lot about in undergrad.
  4. Similarly, take advantage of all the knowledge your preceptors have to offer. This goes for nutrition knowledge (again, ask questions!), but I also liked to pick their brains about life and career advice. They all landed a job as a clinical dietitian and most had other jobs and experiences prior to their current job, so they have lots of valuable information to offer about careers in dietetics.
  5. I know I probably don’t have to say this to a bunch of type A, aspiring dietitians, but say on top of your work and manage your time well. I guess this mainly goes for interns who are also getting their masters at the same time (like I did), but you definitely don’t want to fall behind and let the workload pile up. Start your assignments early, chip away at them every day, and you will definitely still have time to enjoy life!
  6. Finally, your internship is the greatest study tools and experience to prepare you to be a dietitian. I remember worrying during the first few weeks of my internship that I needed to start taking notes or studying for the RD exam (this was when I still had 11 months of internship ahead of me!). Now, having passed the RD exam, I can confidently say that there is nothing to worry about. Those 1,200+ hours spent working during your internship aren’t for nothing and prepare you very well to be a dietitian and pass your exam.
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Back to the Beverage Basics

This week, I am going back to some basics. While I love writing about all the cool, new nutrition research I learn at work and at school, I sometimes forget that many people have a tough time making basic healthy choices – especially when it comes to what they are drinking.

In many of my rotations at the hospital, people overlook drinks as a source of nutrition. I have seen overweight patients who just can’t figure out why they aren’t losing weight while eating eggs for breakfast, a salad, for lunch, and grilled chicken for dinner. Guess what? These people also drink crazy chocolate-y, sugary Starbucks drinks, several glasses of orange juice per day, and bottle on bottles of pop/soda. I even had one patient who admitted to drinking over 2 liters of orange juice every day – that’s about 946 calories and 176 grams of sugar!! I know this is an extreme scenario, but it is so easy to lose sight of how easily those fluid calories can add up.

When I am working with patients who want to lose weight, my number one piece of advice is to switch to zero calorie beverages with no artificial sweeteners. Yes, diet coke is zero calories, but all the artificial sweeteners wreak havoc on your digestion and bacteria in your gut (more on this in a future post, but for now, avoid all artificial sweeteners).

So what type of beverages do I recommend?

Number 1 is always water! Hot, cold, with lemon, berries, or cucumbers…water is always the best option. I love mine ice cold with a wedge of lemon, of course!

If you aren’t a fan of water, try the unsweetened, flavored, sparking waters that are all over Instagram and Facebook, like LaCroix or Bubly. While these are all better options than pop or sugary drinks, I still encourage people to stick with fluids that aren’t sparkling. There is some newer research showing that all the carbonation can acid reflux and increase ghrelin levels (the hormone that makes you feel hungry).

You can also pick up a cup of coffee. No, not a double chocolate Frappuccino with umpteen pumps of flavor or even a cup with some Splenda…just a plain old cup of black coffee (maybe with a splash of milk). Two to three, 8 ounce cups of coffee per day has been found to decrease risk of many diseases and help you live longer. Unsweetened tea, hot or cold, is also a good option.

Ultimately, my top beverage recommendations are:
1. Water
2. Unsweetened tea
3. Black coffee
4. Zero-calorie flavored water
*1-2 glasses of milk each day (any variety) is also okay. There is lots of new and controversial research about milk, but I’ll save that topic for another day.

Stay away from:
1. Pop/Soda (diet and regular)
2. Juice (even the 100% natural kind)
3. Fancy, sugary coffee drink
4. Gatorade and other sports drinks (unless you are a competitive athlete)

I challenge you to cut out all fluid calories – that could add up to a few hundred calories per day or ½ pound per week!

 

Emotional Eating & Food as Fuel

This past Sunday was commencement at Case Western, and even though I wasn’t graduating, I still got to do a lot of celebrating because two of my best friends from undergrad were graduating. What I really mean by celebrating was going out to a lot of nice and yummy restaurants. My friends’ families’ were kind enough to include me at dinner on Saturday and lunch and dinner on Sunday.

If you know me, you know that I love a good meal out at a restaurant (especially if it is somewhere I’ve never been), but this weekend was a lot… I am not use to going out so much! I stuck with healthy choices (mostly protein and veggies) at my meals and shared some dessert, but the whole weekend got me thinking about how we view food as a culture.

In the caveman times, food was merely fuel to keep us going. Today, we eat to celebrate (graduations and birthdays, for example), we eat when we are sad (cue the break-up pint of ice cream), we eat/munch out of boredom (like the popcorn while watching TV), and we eat when we are stressed (you should see the university library during finals!).

As you can see, we strongly associate food with emotions and feelings…no wonder so many people struggle with emotional eating! If you think about it though, most of us are conditioned from a very young age to associate food (usually unhealthy food) with our emotions or actions. For example, say little Billy keeps crying as he gets a shot at the doctor so he gets a lollypop to cheer him up or his mom says he can have ice cream if he quietly and patiently waits while she buys the groceries. In these cases, Billy now associates (again, unhealthy) food with unhappiness/pain and with doing something good/behaving.

Why do we always use unhealthy foods as rewards? That’s because sweet and salty foods cause our brains to release dopamine, the hormone that makes you feel happy. While this sounds great (of course we all want to feel happy), dopamine is also the hormone that can create addiction – just one of the reasons why so many American’s are addicted to sugar and salt. Also, remember that although those foods may cause immediate happiness, sugar and salt are ultimately not good for you. They can lead to high blood pressure, inflammation, and even throw off all sorts of hormones that could cause anxiety or depression (the exact opposite of the initial feeling of happiness!).

So while almost everyone may struggle with emotional eating (including me!), it is important to think back to what food is really for – to fuel our bodies. I don’t think you would intentionally put fuel in our car that you knew would clog the pipes, so the next time you are reaching for the bag of chips or box of cookies, ask yourself, is this fueling my body with good, healthy nutrients that won’t “clog the pipes”?

And if you are a parent of little kiddos, try not to use food as a reward or use food to fill a need other than hunger. It is, of course, part of life to have cake and ice cream on your birthday (don’t give that up!!), but try not to use foods (especially sweet and salty ones) as bribes or treats for desired behaviors. It can help prevent some of those food-emotion associations later on.

Top 5 Healthy Springtime Tips

Even though spring has barely sprung outside, the spring semester is coming to an end. Tomorrow is my last day of class for the semester! Thankfully I don’t have any final exams, just one presentation on Wednesday and then I will no longer say that I am in school and working at the hospital at the same time. Now I’m taking a week of rest and relaxation until I hit the books again to start studying for my RD board exams (it makes me nervous just thinking about it!).

Since we are well into spring, I thought I would just share some of my 5 favorite things to do in the spring to stay healthy and happy!

1. Go outside! I know the cold weather is still lingering (especially up here in Cleveland), but getting fresh air and sunlight has been found to increase energy, decrease stress, improve digestion, and give your immune system a boost. Going for a walk is a great way to try to hit your 10,000 steps for the day and soak up some vitamin D.
2. Clean! Throwing out all the unnecessary stuff in your house/apartment/room has some surprising benefits. Living in a clean and uncluttered space decreases stress levels and makes you more productive. Not to mention, people who live in clean spaces are more likely to eat healthy, and cleaning can be a bit of a workout 😉
3. Check out a farmers market! The growing season is in full swing and farmers markets are the perfect for stocking up on produce. They are a great way to try out a new fruit or vegetable, see what is in season, and support local farmers. Plus you get the great to know exactly where your food came from and how it was grown.
4. Socialize! The longer days and rooftop restaurants & bars are the perfect excuse to spend time with friends and family. Spending time talking with other people can boost mental health and reduce your risk for dementia.
5. This is a big one…get ready…Put your phone down! It is so easy to get caught up in the virtual world of work and social media that it can be hard to disconnect (I’m guilty of it too), but try to unplug for at least an hour every day. Maybe put your phone in airplane mode an hour before bed, don’t check email or social media for at least an hour after you wake up, or leave your phone at home while you do my first four tips. It will help you be less distracted, more productive, more present, and you might even talk to someone and make a new friend.

Happy spring!

My Experience on Whole30

Don’t mind me just sitting over here indulging in a big bowl of ice cream.

The cycle of restricting foods (and dieting) and then binging on “unhealthy” or “forbidden” foods has never been as clear to me as it is right now. That’s because I just completed day 30 (the last day) of the Whole30 diet.

After my experiment as a vegetarian for a month, I thought I would try out another diet. The lucky winner- Whole30. Whole30 is a diet designed to “end unhealthy cravings and habits, restore a healthy metabolism, heal your digestive tract, and balance your immune system”. Sounds great until you hear what is involved. On Whole30 you aren’t allowed ANY grains, legumes, sugar, sweetener (including things like honey), dairy, soy, or alcohol. What does that leave you ask? I have pretty much spent the last month eating only meat, fish, eggs, fruits, and vegetables. It got real boring, real fast to say the least.

If you catch my drift, it was not an enjoyable experience. If you have read many of my previous posts or know me well, you know that I am not one to cut any foods out of my diet – you name it, I’ll probably eat it (yes, even as a nutrition student and future dietitian I eat (and love) chocolate, ice cream, buttered popcorn, and even a loose with chili cheese fries from Detroit’s Lafayette Coney Island), so having to cut so many things out of my diet was a challenge.

In theory, sticking to a diet made up of whole foods is great, but not allowing any wiggle room leads to overeating all of the “forbidden foods” later on (aka the big bowl of ice cream I am having). Cutting out foods can create an unhealthy relationship with food, it is restrictive, not sustainable, and most of all, it isn’t fun.

So, how was Whole30?

Like I said before, it is really boring because there wasn’t a lot of variety. It was also very difficult to go to restaurants or gatherings with food since there were so many things that were off limits.

Do I feel better?

Honestly, I don’t feel any different – aside from the fact that all I want to do is eat dessert, bread, and a big chipotle burrito bowl. But also remember, my diet was pretty rich in fruits, vegetables, and lean proteins before. It wasn’t like I was starting out eating McDonald’s on the daily.

Would I recommend Whole30?

That would be a big fat NO! I see no reason why you have to cut out things like whole grain bread that is packed with fiber, beans that are a good source of plant based protein, and dairy products that are full of calcium and protein. I actually think you end up in an even worse situation after Whole30. Think about the restricting and binging cycle I mentioned — after 30 days of restricting, all you want to do is overeat/binge on the foods you avoided for a month. (It has even been difficult for me, someone who is very aware of these restrict and binge patterns, to resist eating an entire pint of ice cream and a loaf of bread right now.)

On the other hand, I do think the emphasis of fruits, vegetables, and lean protein is great! Everyone could benefit from eating a few more of these and a few less sugary and starchy foods (since they make up the majority of a standard American diet). Note that I said “a few less”, not “eliminate” the sugary and starchy foods. There is no reason why pizza and chocolate can’t make there way into a healthy, balanced diet.

I think this pretty much sums up my thoughts on Whole30. Have you done Whole30? If so, what are your thoughts?

Healthy and Fast Meals with (almost) No Cooking Required

I’m not going to lie, I have slacked off a little (or a lot!) when it comes to cooking this year. Between school, work, trying new workout classes ;), and trying to get a decent amount of sleep, cooking just hasn’t been a priority. But don’t get me wrong, this doesn’t mean I’m having frozen meals or fast food – it just means my meals are a little more simple and don’t take much time to make.

Whether you are a student like me, a working professional, home taking care of kiddos, or have other responsibilities, time is always the number 1 excuse for not eating healthy, so today I thought I would share my tips and tricks for fast and easy, healthy meals.

1. Cook ahead of time – I typically only turn on my oven and stove one or two times a week. I’ll make some chicken, roast some veggies, brown some ground turkey, and cook some rice or quinoa. From start to finish, it usually takes me no more than an hour. I keep everything in separate containers in the fridge so it’s ready when I get home from a long day at work.

2. Build a meal – Now that you have all the food is cooked and ready to be eaten, all you have to do is put it together. Think of it like an assembly line…add some rice, chicken, broccoli, and sauce to a bowl, pop it in the microwave and voila, dinner is served.

3. Oh, wait – there is no step three 😉 It is so easy there are only two steps! See, no excuses!!

Here is a little cheat sheet for building a healthy meal:

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  • Tricks if you are really short on time:
    Choose canned tuna, buy a pre-baked chicken, or try canned beans which don’t require cooking for your protein sources
  • Use frozen veggies that you can steam in the microwave – no baking or chopping required.

Now that you have the “recipe” to build your own healthy meal, I thought I would share some of my favorites. Some might sound strange, but I promise they are tasty! Also, lots are vegetarian since I was experimenting with being a vegetarian for a month.

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No excuses now! What are your favorite meals to build?

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.