Is washing dishes stopping you from preparing food?

     Many people are reluctant to cook or prepare food because of the dirty dishes that will result. Some people are very busy and don't have time for another task, and other people find that they continuously put off washing the dishes, and the dishes just pile up. Here are a few tips. 

• Use disposable cutlery and containers for packing your food for lunch or work
• prepare one-pot or one-pan meals to limit the amount of dishes you need to wash
• Cook in disposable pans and throw them away when you are done cooking
• Line washable pans with parchment paper to limit the mess and make washing them easier
• When you use pots or pans, immediately soak them in the sink to make cleaning them easier when you do get around to it
• fill a dish basin with soapy water and add your dirty dishes and silverware to it after eating so they can soak and make washing them easier

Tips for healthy eating with executive functioning challenges

• Have the same structure for dinner every week. For example, Sunday is pizza, Monday is chicken, Tuesday is fish, Wednesday is pasta, Thursday is ground beef, Friday is vegetarian, and Saturday is beef.
• Choose simple recipes. For example, chicken, beef, or fish topped with a store-bought seasoning mix or jarred marinade or  and baked. 
• Make partially prepared foods a part of your meal routine. For example, use frozen vegetables or instant/quick-cook grain mixes as sides. 
• Prepare breakfast the night before to be grabbed on your way out in the morning. For example, add the ingredients for overnight oats to a container or spoon yogurt or cottage cheese and fruit into a container. Put a spoon on top of the container in the fridge to have one less thing to remember in the morning. 
• You don't need to eat "breakfast foods" for breakfast or "dinner foods" for dinner. Do what works for you. For example, scrambled eggs and whole wheat toast can be dinner or leftover chicken and rice can be a filling breakfast. 

Vacation nutrition

    Sometimes my patients raise concerns about their nutrition over a vacation or another time when they are off their typical schedule. My instinctual response is to assure them that vacation represents a small minority of their life, and to not give it too much importance. But that answer does not really address the core fear. The bigger worry behind this is the fear of loss of control. When you are on your routine, it is easier to stay in control. You can set up your life to make sure you always have the specific food you need when you need it. You can avoid every triggering situation. You can avoid people who might have "forbidden" foods or talk about disallowed topics. It seems that the real work is to be open to all possible circumstances and the real human likelihood of imperfection. 

Reasons my patients want to make healthy lifestyle changes

• so I can be around to play with my grandchildren
• to lower my risk of a heart attack
• to improve my blood sugar
• so I can have an easier time climbing up the stairs
• to have more energy
• to improve my mood
• to have less nausea
• to have less bloating
• so I don't eat until I am uncomfortably overfull
• to feel better
• so I can walk further without getting out of breath
• to improve my blood lipid levels
• to feel stronger
• to feel good
• so I can take care of myself
• because only I can do this for myself

I want to lose weight!

     "I want to lose weight!" This is the most common goal of people who I speak to for a nutrition consult. If there is one thing I have learned through my years of being a dietitian, it is that I can't guarantee weight loss. My patients can tell you better than I can tell you that weight loss is really hard to achieve and even harder to maintain. Generally, in the best case scenario, diet alone will lead to 5-10% weight loss, which is often not enough to meet the patient's goal. Fortunately, nutrition changes, even with no weight loss, can lead to real improvements in health and health risk reduction. 

Fear of deprivation

     One of concerns that my patients have is that once they change their eating habits, certain foods will become forbidden, and they will constantly feel deprived of these foods. This fear leads to the "last supper" phenomenon that precedes a diet. The thought is, "I will never be allowed to eat donuts again, so I better get them all in now before they become banned in my next diet." In reality, the idea of prohibited foods is a concept we create ourselves. The extension of that thought, that deprivation is inevitable, is also self-created. 

    I would like to point out the fallacies in both statements. First, we do not have to outlaw foods. I am not even talking about promoting the "everything in moderation" theory. I am simply talking about the black and white/all or nothing thinking that goes into banning foods. The "never again" mindset. Regarding the fear feeling deprived, there are a few other possibilities. Some of that fear stems from the fact we decide foods are forbidden. It is human nature to want what is not allowed. Easing up on the rules can help us avoid the feeling of deprivation. Additionally, there are other helpful and more accurate thoughts we can have. Perhaps a more accurate thought might be, "Let's see what happens if I have oatmeal for breakfast today instead of a donut. I don't need to make plans for the rest of my life right now. I am just deciding about right now" Or the thought could be, "I want to eat a donut when I can really enjoy it, like on a relaxed Sunday morning when I can sit down and savor the taste. Now I am rushing to work and will scarf it down and barely taste it." Or the thought can be, "I would like to sit down and enjoy a donut now. Not because I earned it or because I was good. But because right now I am choosing to eat and enjoy a donut." 

    Remember, knowing these ideas does not immediately translate into feeling and living these ideas. It takes a lot of effort, practice, and reminding ourselves of the perspective we prefer to have. Bumps in the road towards this are just moments to notice what happened. Each new moment is a new opportunity that does not have to depend on the past. 

Non-hunger reasons we eat

• tiredness
• boredom
• anxiety
• restlessness
• pleasure-seeking desires
• habit
• social setting that encourages eating
• location
• eating customs
• "last supper" mentality
• rebound from food restriction

    Which of these have you experienced recently? 

Hunger and Satiety: When to eat and when to wait

     Many of us have grown out of touch with knowing when to eat. Babies tend to be good at crying for milk when they are hungry and stopping to eat when they are satisfied. As we get older, other influences encourage us to eat. We are coaxed to finish our dinners, offered sweets as rewards, and we start using pleasurable foods to calm our nerves. It takes a lot of relearning to get back to that "baby" state of eating when hungry and stopping when full.

    One way to reteach ourselves this skill is with the use of a hunger and satiety scale. With this scale, we can rate our current state and have prespecified points that correspond to "time to eat" and "time to stop eating." We will use a 10 point scale. Let's put "starving" at 1 and "uncomfortably full" at 10. If you at a 1, you have waited too long and allowed yourself to be too hungry. If you are at a 10, you might have stomach discomfort or pressure in your abdomen from the quantity of food eaten. At the midpoint, near 5-6, is where you are neither hungry or full. You could eat without making yourself uncomfortable, and you could wait longer and not be too hungry. Around 3 on this scale is where you feel hungry and ready to eat, but not ravenously hungry. This is a good time to seek out something to eat and begin a meal. The meal can continue until you reach about an 8 on the scale. At this point you are comfortably full, but not overstuffed. Based on this scale, we want to remain in the range of 3-8. This prevents us from getting too hungry or uncomfortably overfull. 

    At first, knowing when to eat out of hunger and stop when full will be a conscious effort. It will take effort to remember to check in with your inner hunger and satiety cues. You might sometimes forget, and then later notice that you allowed yourself to get ravenously hungry or uncomfortably full. With practice, you will remember more frequently to notice your inner hunger and satiety signals to help you remain in the 3-8 range. And with even more practice, it will become second nature. 

How to improve your eating with mindfulness practices

• When you are deciding what to eat, take into account how you will feel after the meal—what you think will help you stay satiated, how much you need to eat to be satisfied but not overfull, and what will be comfortable in your stomach without GI discomfort.
• Sit down while you eat.
• Don’t multitask while you eat. Don’t watch TV or videos, don’t read.
• Focus your attention on the eating experience. Note the different sensations: the aroma, what the food looks like, the taste, the texture, the mouthfeel, the temperature.
• Consciously slow down your eating. Put your utensil down between bites. Allow yourself to taste every bite.
• Once you are finished your portion of food, give yourself 15 minutes to allow the satiety signals to get to your brain. Then you can make a decision if and what you should eat next.
• When you have an urge to eat, notice if it is driven by hunger, boredom, stress, loneliness, habit, socializing, or another cause.

Grocery List: Some of the Cheapest and Most Nutritious Foods

• Beans (dry beans have no sodium while canned beans do)
• lentils
• chickpeas (dry chickpeas have no sodium while canned beans do)
• oatmeal (the large canisters are cheaper and do not have added sugar, unlike some of the individual oatmeal packets)
• popcorn kernels (air popping is a no-fat added method to prepare)
• milk
• yogurt (the store brand will be cheaper, plain yogurt will not have sugar added)
• cottage cheese (the store brand will be cheaper)
• eggs
• peanuts or natural peanut butter (choose the peanut butter that only has peanuts and salt as the ingredients)
• canned tuna fish
• cabbage
• potatoes
• sweet potatoes
• summer squash (green or yellow zucchini)
• winter squash
• beets
• onions
• tomatoes
• apples
• bananas
• in-season fruit
• frozen berries, strawberries, etc
• lettuce
• carrots
• canned tomatoes
• frozen mixed vegetables, broccoli, cauliflower, carrots, spinach, kale, etc (the ones with sauce will have added fat and sodium; the plain ones are just that—plain vegetables)
• brown rice
• while wheat pasta
• water

In the comments section, let me know which foods you have found to be inexpensive. 

Tips for Healthy Holiday Eating

                Happy post-Thanksgiving! Many people struggle with healthy eating on holidays. Often, they decide that it’s a holiday and they will just enjoy it. That usually means eating many foods in larger quantities. As a dietitian, I wonder what to advise my patients on this topic. Should I just say, “it’s a holiday, it does not happen often, just enjoy?” Or, should I encourage my patients to continue to make healthy choices every day?

                Somehow, a holiday is not just one day. The holiday has become holiday season, and the holiday treats are eaten for weeks in advance of the actual special day. It ends up becoming a challenge during the entire month… But in truth, it is the same challenge the whole year. We are always inundated with treats, snacks, and yummy food. It is hard to stay away from tempting food when it is right in front of us.

                Here are some strategies on making healthy choices all year round...but especially when the holidays are here.

• Don’t buy it! If it’s not in your house, you won’t eat it
• Stock up on healthy foods
• Check out restaurant menus before you dine, and see if you can find some healthier choices; some places post their nutrition facts online
• Split your restaurant meal with someone
• Share your plate of dessert
• Plan ahead and choose the treats that you’d like to eat rather than tasting some of everything
• Start your day with a healthy breakfast; saving your calories for a big meal usually does not work
• Choose water, flavored water, and flavored seltzer rather than soda
• Don’t stop your healthy routines such as exercise
• Bring a healthy dish to a potluck

In the comments below, please share your healthy eating strategies for the holiday season.

Healthy Potatoes?

                Somehow, potatoes have gotten a bad rap. In the United States, potatoes are the most commonly consumed vegetables[1]. Yes, potatoes are technically a vegetable, although from a macronutrient standpoint, they are a carbohydrate food, with 15gm of carbohydrates in ½ cup. They are high in vitamin C and potassium, like many other vegetables. Sweet potatoes have an added bonus of vitamin A. 

Are potatoes healthy? They definitely can be part of a healthy diet for most people. We all need carbohydrates, and potatoes are definitely an option there. Just keep an eye out for the portion size…and how they are prepared.

Nutrient Content of Various Potato Dishes[2]

	Calories	Carbohydrate (g)	Fat (g)	Fiber (g)
Small white potato, with skin (138g)	134	37	0	4
Small sweet potato, no skin (138g)	105	24	0	3
½ cup mashed potatoes, made with oil (115g)	121	15	6	2
Medium size fast food serving  French fries (117g)	378	50	18	5

                Now you can ask, “which are better: white potatoes or sweet potatoes?” You will notice some nutrient differences. Overall, I would say to just have a variety of carbohydrate foods. Maybe today’s dinner will have sweet potatoes, tomorrow’s dinner will have white potatoes, the next night winter squash, and another night a whole grain pita. Yes there are some nutrient differences, but they are minute in the scheme of an entire diet. Choose a carbohydrate, and more often than not, choose the carbohydrate that has fiber and less added oil or fat.

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[1] State of the plate: 2015 study on America’s consumption of fruits & vegetables. Produce for Better Health Foundation. Accessed November 8, 2017. <https://www.pbhfoundation.org/pdfs/about/res/pbh_res/State_of_the_Plate_2015_WEB_Bookmarked.pdf>

[2] USDA Food Composition Databases. United States Department of Agriculture Agricultural Research Service. Accessed November 8, 2017. < https://ndb.nal.usda.gov/ndb/search/list>

What is the Point of Pasteurizing?

                The goal of pasteurizing is to reduce the amount of bacteria in food and make diseases caused by those bacteria less likely. There are a few types of pasteurization, and the main differences between them are the temperature and the length of time needed to complete the process. The higher the temperature, the shorter the time needed for the food to be at that temperature to kill sufficient bacteria. Pasteurization also extends the shelf-life of foods because there is less bacteria to grow and cause the food to spoil.

One of the most common foods that are pasteurized is milk. Unpasteurized milk, more commonly called raw milk, has recently been in the headlines. While some promote supposed health benefits of raw milk, the medical community warns people not to drink it due to the risk of contracting diseases from bacteria in it. While there are some vitamins that can be degraded by heat and pasteurization, these are not the vitamins that are found in large quantities in milk to begin with.

As an aside, there are some vitamins in fruits and vegetables that are degraded from heat, and therefore are found in fewer quantities in cooked fruits and vegetables. Don’t worry though! There are still plenty vitamins and minerals in produce. Go ahead, eat fruits and vegetables raw, cooked, grilled, steamed, or however you like them. As long as you are having a variety of fruits and vegetables, it is quite unlikely you will develop a deficiency by cooking your produce.

Let me know if you have questions about specific foods that are pasteurized. 

Snacks

                What is a healthy snack? What is a snack anyway?  Any food can be a snack. Strictly speaking, a snack is something we eat between meals. Remember, though, that we don’t necessarily need to be eating between meals. Sometimes we eat between meals out of habit. For example, every day I eat a cheese stick at 10am, so today I will also eat a cheese stick at 10am. I may or may not even be hungry. From a nutrition standpoint, the goal of a snack is provide necessary energy and nutrients between meals. Snacks can also prevent us from getting too hungry before the next meal. This is important, because when we are too hungry, it becomes very hard to make good decisions of what to eat and how much to eat at the next meal.  A general guideline is that most people need to eat every 3-4 hours or so. If your meals are 4 hours apart, a snack between them is likely not necessary. It is generally a good idea to have a snack if you would be going 6-8 hours between meals.

                Now I can move on to what a healthy snack is. (As a disclaimer, this may not apply to you if you have a medical condition that changes your nutrition requirements.) In general, a healthy snack will have protein or fiber in it. That is important because both of those nutrients help us stay full. Usually a snack is fairly low in calories so it does not become a meal by itself.  

                Below you will find a list of suggested ideas for snacks. Notice that they all contain different amounts of nutrients and calories.

	Calories	Carbs (g)	Fiber (g)	Protein (g)	Fat (g)
1 hardboiled  egg	70	0	0	7	4
¼ cup peanuts	207	6	3	9	18
½ cup almonds	207	8	5	8	18
½ can tuna fish with ½ Tbsp mayo on 2 rice cakes	195	80	3	18	7
1 Tbsp nut butter on 1 slice whole grain bread	177	18	3	8	9
6oz low fat plain Greek yogurt	125	7	0	17	3
6oz low fat plain Greek yogurt with 4 strawberries	140	11	1	17	3
1 low fat cheese stick	50	1	0	7	3
1 cup 1% milk	102	12	0	8	2
½ cup low fat cottage cheese	81	3	0	14	1
1 cup carrot strips	50	11	3	1	0
1 cup pepper sticks	18	4	2	1	0
1 Tbsp hummus with 1 cup carrot sticks	75	13	4	2	1
10 cherry tomatoes	31	7	2	2	0
¼ packed cup raisins	123	33	2	1	0
1 cup grapes	62	16	1	1	0
1 medium apple	95	25	4	0	0
1 medium banana	105	27	3	1	0
1 medium orange	62	15	3	1	0
2 cups air popped popcorn	62	12	2	2	1

                In the comments section below, let me know which snacks you are interested in learning the nutrition information for.