Athletes need protein, but do they need protein supplements?
Our body uses protein to build and repair tissues, to make enzymes and body chemicals, and to build muscles, tendons, skin, hair, nails, among other things! Protein is especially important to you as an athlete because it helps you to recover after a tough workout.
By Dolapo Balogun MA, BS
Protein supplements have become uber popular within the last decade, but it’s important to know that you can easily hit your protein requirements just through your diet! In this blog we will discuss what protein does for your body in relation to sports and where you can get them on a budget!
You’ve heard it before in your elementary science class, but we will remind you: protein breaks down into amino acids, which are the building blocks of our body. Proteins are the building blocks of our muscles and without them we would not get the most out of our workouts.
How much protein do athletes need?
For the average adult, 10%-35% of protein per day is adequate; however, as an athlete your protein needs are a bit higher.
When you workout and lift weights, the protein in your muscles are broken down, and this is why your muscles feel sore (this is how muscles are built and grow, by a tear and repair system). For athletes, optimal protein consumption is important to provide our bodies with amino acids that the muscles need to continually rebuild themselves. Without the proper fuel for your muscles, you can risk injuries.
Protein has gained a lot of traction over the past few years as the body’s preferred energy source. However, if you read our lowdown on carbs you’ll already know that the body prefers carbohydrates for fuel, and the body still needs carbohydrates after a workout to refuel. Protein is not the body’s preferred energy source for workouts, but is very important for rebuilding muscle *afer*. Timing of protein is important, too. It’s not the end-all-be-all, but you should try to have protein within 60 minutes of your workout to start that muscle protein synthesis process at an optimal time.
The recommended protein intake for the average adult is 0.8g/kg of body weight, but for athletes it is 1.2-2g/kg. Surprisingly, this is simple to reach and incorporate it into your diet.
Protein is important as an athlete. Luckily, you do not have to buy (literally!) into diet culture and waste your money purchasing the latest on-brand protein supplements.
How do I get enough protein to build muscle?
Humans are unable to naturally produce some amino acids so the rest must be consumed; therefore quality of protein matters. You can find quality protein in fish, meats and poultry, eggs, milk, beans, nuts, and whole grains. For vegan and vegetarian athletes, you can find quality protein in quinoa, beans and rice, tofu, chickpeas, lentils, and seitan.
Here are some budgeting tips regarding protein:
Freeze the protein you are not using for immediate use! Thaw it when you are ready to prepare it to avoid wasting it. Buying in bulk is also a great way to save money.
Buying canned beans can be a great way to save money - they are usually less than $1 at some grocery stores and have a long shelf life!
Get creative about your protein sources. Preparing some energy bites is way more cost efficient than buying a protein supplement! Use Pinterest to find creative recipes that are low-cost and easy to make!
Energy bites can be made to fit your favorite flavors
Dolapo Balogun was a Division I basketball player at the University of San Francisco and is currently a dietetic intern at UC San Diego Health. She aspires to be a registered dietitian that focuses practices in sports nutrition and become an advocate for cultural awareness and diversity within the field of dietetics.
Best fats for athletes
By Dolapo Balogun MA, BS
Contrary to popular belief, fat is an essential part of our diet! There’s no need to be scared of it!
Why do athletes need fat?
Fats are important because it is a macronutrient that helps provide your body with energy and support your cells by providing structure and cushion to prevent damage. Dietary fat is found in a variety of sources that are easy additions to your diet. Fats are also vital for absorbing fat-soluble vitamins. Did you know that fat also helps to protect your organs and insulate your body to keep you warm?
Fat plays so many important roles in the body like protecting the organs, cushioning joints, and helping the body absorb vital nutrients. During lower intensity activity and activities performed for an extended period of time, the body uses fat as energy.
It is important to note that not all fats are created equally.
Healthy fats for athletes
Saturated and trans fats are found in fried foods, margarine, fatty cuts of meat, hydrogenated vegetable oil, and pastries, just to name a few. Compared to carbs & protein, fat takes the longest to digest. These foods may make you feel sluggish and bloated, especially right before exercise. Eating too much of these saturated fats can increase cholesterol in your body. Saturated fats can still be enjoyed from time to time in moderation! Eat that cookie and treat yo’ self!
Unsaturated fats are mostly found in oils from plants and fish. There are two types called monounsaturated fats and polyunsaturated fats and both play a role in protecting your heart against inflammation. They can be found in nuts, plant oils, avocados, and fish.
Want to try more fish? Pair salmon with BBQ sauce and bake for 30 minutes at 375 degrees. Yum!
An easy way to remember the difference between saturated and unsaturated fats is to know that most unsaturated fats are liquid at room temperature while saturated fats are solid at room temperature.
Some fats have better benefits than others! As an athlete it’s important to know the difference. The average adult needs 25%-35% of their calories coming from fat. Just like protein and carbohydrates, quality fat sources are most important. You should focus on monounsaturated and polyunsaturated fats, and it’s very easy to incorporate them into your diet with ways such as:
Eat more fish such as tuna or salmon
Cook with olive oil or canola oil
Add peanut butter to your oatmeal
Snack on some almonds or walnuts
Add avocado to your sandwich.
Here are some great budgeting ideas when it comes to incorporating fats into your diet:
Make your own nut butters! Nut butters (anything other than peanut butter, honestly), can be super expensive, especially if you eat it often. You can buy nuts in bulk and create your own! YouTube offers so many easy DIY recipes to do so!
Nuts and seeds are a tasty addition to salads and a good source of monounsaturated fats.
Shopping for fats, like avocados, in season are key! Shopping in season allows you to save money! There’s nothing worse than produce going bad before you have a chance to use them!
How you store your fats matter. Store your oils in a dark, cool place to stop them from going rancid. Have too many avocados on hand? Store them in the fridge and pull them out a few days before you want to use them so they become perfectly ripe for that Insta-worthy avocado toast you’ve been craving!
Need more information about fats? Shoot us a message and let’s talk more about it!
Dolapo Balogun was a Division I basketball player at the University of San Francisco and is currently a dietetic intern at UC San Diego Health. She aspires to be a registered dietitian that focuses practices in sports nutrition and become an advocate for cultural awareness and diversity within the field of dietetics
Do athletes need carbs?
By Dolapo Balogun MA, BS
Carbs, carbs, carbs.
Let’s just nip this one in the bud, shall we?
Carbohydrates are the most efficient (and preferred) source of fuel for the body and athletic performance. This is because the energy from carbs, which is called glucose, is released into our muscles at a super fast rate!
How does our body use carbs during exercise?
The way carbs function can be easily described is like this: you wouldn’t put crummy gas into your car and expect it to run smoothly, would you? Then how can you expect your body to do the same if you rely mainly on candy and soda to get your carbs? Carbs are the fuel that makes your engine run smoothly. You can find *quality* carbohydrates in fruits and veggies, whole grain breads and cereals, oatmeal, and dairy.
Carbs have gotten a terrible rep over the years, but it’s time to bust some myths. This week we will break down scientifically why carbs are the main choice of energy that your body prefers and where to find it on a budget!
One last thing … yes, you CAN enjoy pasta and bread - just wanted to get that one out of the way!
Who’s ready for the Spark Notes version on carbs? Quality carbohydrates are what your body needs and thrives on.
Carbohydrates are actually a vital part of a person's diet. It is recommended that the average adult consumes 45%-65% of carbohydrates daily and there are 4 calories in 1 gram. Carbohydrates are the body’s main source of energy, and as an athlete you N E E D to eat carbs in order to have the endurance you need to get through a practice, race, or game. Every athlete needs it to perform adequately.
When you eat carbs, it is broken down into glucose and transported to your cells to be used for energy. Our body also converts and stores the carbs we eat into our muscles and at this point, it is called glycogen (it’s stored in our muscles and liver). Think of it as money in the bank to use later. Glycogen is there and ready to help power you through your workouts! Carbohydrates also help to delay fatigue by allowing you to perform at a high level for a longer time. Your brain and central nervous system also use carbs for energy, allowing you to make quick decisions on the court and field.
What carbs are best for athletes?
Now that we understand why we need carbohydrates, we can talk about where to find them! You can find *quality* carbohydrates in fruits and veggies, whole grain breads and cereals, pasta, oatmeal, and dairy!
Incorporating them into your diet is fairly simple. In terms of budget here are a few tips:
Buy frozen! Frozen fruits and vegetables are often cheaper and sometimes higher in nutritional value as they are picked and packed at peak ripeness. This also goes for canned food, too! Just be aware of added sugars in syrups.
Seasons matter! The seasons often determine the price of fresh fruits and vegetables. To save money, shop in season. For example, strawberries and avocados are cheapest in the summer vs the winter months.
Storage makes a difference! How you store your foods can determine how long they last. It’s annoying having to throw out perishable items before you have the chance to eat them. Google or Youtube how to properly store food so that you are not throwing away money - literally!
Getting the picture? Carbohydrates are nothing to be scared of, as we need them to thrive! Got any more questions? Drop us a message!
Dolapo Balogun was a Division I basketball player at the University of San Francisco and is currently a dietetic intern at UC San Diego Health. She aspires to be a registered dietitian that focuses practices in sports nutrition and become an advocate for cultural awareness and diversity within the field of dietetics
How To Shop For A Personal Trainer: Know What You’re Buying
By Candice Luciani, B.S., C.S.C.S., USAWL-1
With the holidays hitting us full force now, people are going to approach the New Year with resolutions. Typically, those resolutions are related to health and as any gym goer knows, the New Year brings more people into the fitness industry looking to be healthier for the up and coming year.
And as someone who wants to become healthier, there are a few things to consider when approaching this new resolution:
Weight-loss is a common goal and usually the first reason people set foot into a gym. Because of that, it is a typical goal with novice gym goers. Novice gym people usually go to a gym that they think they would be comfortable going to, but they don’t really know how to go about effective weight loss. So to anyone starting a New Year’s fitness resolution, here are things to consider:
Do you need a personal trainer?
Some trainers are certified, but the facts in the field of exercise science is that it isn’t a regulated field. Because of that, most certifications don’t have significant backing and almost anyone can call themselves a certified personal trainer. So how do you know which ones are reputable? The two gold standard certifying bodies are ACSM, which stands for The American College of Sports Medicine and the NSCA, which is the National Strength and Conditioning Association. Anyone with those certifications has a solid grasp of key points like anatomy and physiology, contraindications towards exercise, and how to scale and progress movements.
One key thing to do when choosing a fitness professional is to do research and look on the United States Registry of Exercise Professionals at: www.usreps.org and see if your trainer is in fact currently certified and registered. This will tell you that everything is good to go and before you train with them, ask if they are insured. Go to several gyms and get business cards and see if you can set up consultations to talk to trainers and feel them out. You can even check for personal trainers online. They will be motivating you and guiding you on your fitness journey, and it’s something that should be a good fit and feel like you want to come to the gym and get the work in.
Do you have any limiting injuries or health conditions?
If you are going to find a gym, you want to make sure that it is your kind of gym. If you have limiting injuries, you would want an exercise professional that has access to gym equipment for special populations or machines, as they are a great place to start as a beginner. They might also have a certification for special populations. Some things can be scaled and trained differently, and reputable trainers will know how to quickly change up something so it is right for you. Also, in general, beginners that haven’t trained with resistance training usually have a dominant side that is stronger than another. Because of this, they shouldn’t be trained with predominantly bilateral movements or use strictly barbells right from the start. It takes time, discipline, and consistency to progress into intermediate programming. According to the NSCA, it takes at least 6 months for a beginner to progress into intermediate training, so it’s definitely a goal, but not a starting point. It’s also a matter of building body queueing along with training your body to move collectively and safely with proper form in order to prevent injury.
Do you want to build strength or mass, or even compete?
If you want to get into bodybuilding, powerlifting, Olympic weightlifting, or even CrossFit, there are starting points for all of those concepts as a beginner and as such, you wouldn’t dive into complex movements, programs, or concepts that you see fitness enthusiasts doing, who may or may not be trained professionals. The last thing you want to do is go to a gym and try something that you saw someone do on social media without doing research. With that said, if you are a beginner, find a registered fitness professional.
Are you ready to change your lifestyle in order to change the body of your lifestyle, or do you just want a quick fix?
Realistic and lasting weight loss takes time. Healthy weight loss that you can keep off and doesn’t diminish your lean body mass only equals losing 1% of your bodyweight a week. Even when you’re doing everything correctly, your metabolism may not always completely agree with the idea. Because of that, it takes time to lose 50 pounds if that’s a fitness goal, for example. People typically start too late and finish too early without structuring their fitness routine correctly. Also, switching up your routine is key too. A program will typically work for 4-6 weeks and then if you plateau, it will no longer be effective for change. Your body is smart, it will figure out how to adapt and become more efficient.
There’s another key point on the flip side to programming. You should have some structure to your program and not just do something entirely different every day and every week since this doesn’t train and strengthen specific movements and muscles. Trainers that don’t have structure to their programs aren’t going to build a trained movement with their client. It takes time and instruction to teach a movement. It’s been said that mastering any art takes 10,000 hours, so anyone in the gym that looks well versed in gym movements has likely been working on it for many years. And if they are new but look like a bodybuilder, it’s 9.8 times out of 10 probably too good to be true-naturally. Only take advice from registered exercise professionals.
I wish everyone a safe and happy holiday and New Year! And best of luck with your fitness resolutions in 2020!
Candice Luciani, B.S., C.S.C.S., USAWL-1 has a bachelor’s degree in exercise science, is a master personal trainer and is a certified strength and conditioning coach. She is a nationally qualified 71kg Olympic weightlifter and fitness based yoga instructor.
Roasted Gingerbread Pumpkin Seeds
The poor pumpkin: It’s a shining star of October and November, but come December 1st… well, pumpkins take a backseat to all the other holiday goodies. While I love to bake cookies and make other holiday treats, by the time mid-December rolls around I’m really not looking for yet another sweet treat. If you want to make something with your kids or just for yourself that’s a more savory option, give pumpkins some love this December with this recipe for Roasted Gingerbread Pumpkin Seeds.
Melted butter makes the base of your seed coating.
While some people think green pumpkin seeds are the inside of a typical pumpkin seed, green pumpkin seeds called pepitas grow inside certain varieties of pumpkins. Pepitas can be found raw in the bulk food section of many grocery stores.
This recipe is easy for kids to make and the cinnamon smell from baking these is better than any holiday candle you can purchase.
Like most seeds, pumpkin seeds are high in minerals such as magnesium and zinc. They’re also a good source of fiber.
Always fun sharing a new recipe!
You can make this recipe using regular pumpkin seeds if you still have some pumpkins left over from the last two months. Pumpkins can last up 8 to 12 weeks. You’d want to dry the pumpkin seeds though before using this recipe and go with the smaller pumpkin seeds as the larger ones can be more woody.
Check out the fun we had on Good Day PA talking about pepitas!
https://www.abc27.com/good-day-pa/kid-eats-roasted-gingerbread-pumpkin-seeds-recipe/
Roasted Gingerbread Pumpkin Seeds
These holiday spices should still be easy to find from Thanksgiving!
1.5 Cups Green Pumpkin Seeds (Pepitas)
2 Tablespoons Butter
3/4 teaspoon cinnamon
1/8th teaspoon powdered ginger
1/8th teaspoon salt
Pinch of cloves
Pinch of nutmeg
For after baking: 2 Tablespoons sugar
Preheat oven to 300 degrees.
In a medium size bowl melt the butter. Mix in cinnamon, ginger, salt, cloves and nutmeg. (Don’t add the sugar.) Add pumpkin seeds to bowl and toss well to coat.
Enjoy the warm aroma of gingerbread pumpkin seeds roasting!
Spread seeds evenly on a baking pan. Bake for 40 minutes. Set your timer and stir the seeds every 10 minutes.
Once toasted, transfer the seeds to a medium sized bowl while still hot. Add the sugar to the seeds and toss well to coat. Pour the seeds back on the baking sheet to cool. Store seeds in the refrigerator up to 2 weeks.
Does Your Child Need a Sports Drink?
Like any mother of an athlete, I try to guide my son on how often to pick water versus a sports drink. Competitive athletes need carbohydrates to replace what their muscles burn, especially as an event passes the 60 minute mark. When you check out what the athletes are chugging down at athletic events, it’s often a sports drink. They may honestly need a special re-hydration beverage in order to replace the fuel they’ve just used up while sweating through an intense game or practice.
But what about the parents or the siblings on the side lines? Do they need a sports drink? Rehydration beverages were originally developed for use by competitive athletes DURING athletic events. Somehow though, sports drinks have earned an undeserved rep as being a healthier option than other sweetened beverages.
I recently got to share some helpful recommendations with Good Day PA regarding kids and sports drinks. Check out my segment at this link: https://www.abc27.com/good-day-pa/kid-eats-beware-of-sports-drinks/
Here are a few twists of the truth when it comes to the average person’s need for a sports drink.
“But they’re full of electrolytes.”
What exactly is an electrolyte? Electrolytes are elements in the blood that can dissolve into structures called ions. They are vital for chemical reactions and electrical impulses in our body. Sodium, potassium, chloride, calcium, and phosphate are all examples of electrolytes.
We get lots of electrolytes in the foods and beverages we consume every day. If your body isn’t losing sodium or potassium through losses like heavy sweating or diarrhea, there is not a health benefit of adding extra electrolytes into your body. If you’re hanging out watching TV or sitting at your desk, your health is not going to benefit from a sports drink or added electrolytes.
Let’s check out a typical label for what ingredients are actually in a sports drink. Ingredients often include: Water, dextrose (a form of sugar), sugar itself, citric acid, natural or artificial flavor, salt, sodium citrate (another form of salt), monopotassium phosphate (a source of potassium) , red 40, blue 1 or another artificial color, modified food starch, and glycerol ester of rosin. Sound healthy?
The American diet provides most people with at least 4,000 to 6,000 milligrams of sodium per day. That’s double or triple the amount recommended for most Americans to take in. If your doctor has told you to cut back on the salt in your diet, a sports drink is just another source of sodium.
But what about the potassium?
If you’re including some fruits and vegetables in your diet (especially the brightly colored ones) it’s likely you’re getting more potassium than a bottle of sports drink. The amount of potassium in a 16 oz bottle is only 2% of our daily needs. That’s the same amount you would find in only 1.5 ounces of orange juice or half an orange. The other electrolytes? They’re just not present in the average sports drink.
Would you like a pinch of salt with that sugar water?
A child, sitting on the sideline watching a sibling play, is not going to benefit from a sports drink. A 20 oz bottle of a typical sports drink contains 8.5 teaspoons of sugar. Children typically don’t need more than 6 to 8 teaspoons of sugar per day. The same goes for women who only use up 8 teaspoons and men, who only need 10 teaspoons per day. Athletes on the other hand, need sugar to fuel muscle cell work.
Still, even athletes can over do it. Sports drinks are not needed unless the exercise is going to last more than 90 minutes or it’s extremely hot out. Sports drinks especially are not needed for children who have played just a fun non-competitive soccer game or sat in the dug out for several innings.
What does your dentist think of sports drinks?
That steady source of energy? In addition to the sugar, it can be a significant source of acid which can lead to irreversible damage to tooth enamel, the sparkly white outer layer of the tooth. Dentists recommend to steer clear of sports drinks as a frequent drink option.
Certainly if you’re a heavy sweater who works hard in a hot environment, opt to alternate a re-hydration beverage like a sports drink along with water. For most of us, sugar sweetened drinks are not a necessary part of an everyday diet. Rather than buying another case of sports drink, opt for a refillable water bottle. An infuser bottle even allows you to add a little fresh fruit for flavor without the thought of sucking down a chunk of cucumber or melon. Staying hydrated is important, but most people don’t need a fancy product in order to do it effectively.
Veggies Love to Be Grilled Too!
I not only love to eat, I love to cook. Cooking outside over leaping flames though? Nope, I’ve never been a griller. The grill master in our home, my husband, unfortunately works as a nurse on second shift. So what’s a woman to do when she wants the taste of grilled goodness? For me, it means learning how to do it yourself of course!
Nutritionally, meals prepared on the grill can be lower or higher in fat and calories compared to boiling, baking, or frying. Cuts of meat which do well staying moist and juicy over flames often have a higher fat content like steak compared to chicken breasts. Steer clear of too many processed meats which can be extremely high in sodium and other additives. Too much of the blackened charred parts though (my favorite) is considered a possible carcinogenic risk by some experts in cancer prevention so it’s best to not consistently burn your food to a crisp.
If you’re trying to eat healthier you can balance your plate better, decrease the calories in your meal and up the nutritional quality by adding some vegetables to your grill. I love grilled veggies in all their smoky goodness. In one of my recent grilling experiments though, two of my sliced zucchini slipped though my clutches to end up totally done for in the bottom of the grill.
Obviously my technique needed help. So I went straight to the one person that makes the best grilled veggies I’ve ever tasted. My neighbor, grilling wizard Chef Luc St. Onge was happy to offer his advice on how to save my poor zucchini from its fiery fate at the bottom of the grill.
Grill first, cut later.
This is definitely where I went wrong. For zucchini or yellow squash, slice them just in half. Keeping the squash in a bigger piece allows you to get good grill marks and flavor without it getting overdone. Add a light coating of olive oil, seasoned salt and ground pepper before grilling. Luc offered a warning to avoid lathering on too much oil as it can cause the flames to flare up and burn the food. Keep a squeeze bottle full of water handy to squirt the grill if the flames get crazy. Grill it until it has nice marks, normally three minutes on each side. Slice it after it’s done for a better appearing presentation and no runaway skinny ones slipping through the grill.
Hot grill, medium heat.
Chef Luc recommended choosing ripe vegetables but not over ripe, so that they hold their firmness on the grill. For vegetables it’s important to avoid having the grill too hot. Medium heat works best. In my personal opinion, Luc’s grilled asparagus completed with a balsamic reduction is near heaven in flavor.
What I didn’t realize was how tricky asparagus is too grill. Luc shared, “It’s easy to burn the tips while the rest of it is cooking. The key is to turn down the heat on the other side of the grill to prepare asparagus perfectly.”
Don’t turn your back.
Keep an eye on your veggies since they’re done so quickly. Be sure to move vegetables up to the second part of grill if you’re going to do something else. Turning your back on them will end in a charred mess pretty quickly. Obviously if you’re grilling something thin in shape, position the veggies perpendicular to the grill tines or use a grill pan so that they don’t slip through the spaces in the grill.
Seasoned grill = more flavor.
One key Luc also emphasized was to have a seasoned grill for flavor. Covering all of the grill with aluminum foil decreases the flavor of the food. When I asked Luc whether he ever had a “grill fail” with a fruit or vegetable the only one he could even think of was a grapefruit idea gone awry. Other than that Luc and I had a hard time even thinking of a vegetable you couldn’t grill.
Here are a few veggie & fruit ideas for your next grilling adventure:
Carrots are a tasty addition to the grill that most people don’t think of
Bell peppers can be cut length wise in half to grill and cut afterwards
Pineapple, mango hold up well to grilling
Eggplant- Luc recommends cutting lengthwise, leave skin on to keep it together
For Smaller vegetables like grape tomatoes or peaches you can use a grill pan and even finish it in the oven.
Sweet potatoes- Cut in halves length wise, coat with a little olive oil or butter.
Romaine hearts- coat with a little olive oil and pepper, Place on grill on high. Will be done VERY quickly!
I’m hoping with my new found advice I’ll have all my veggies survive so there’s enough for leftovers!
Grilled romaine with shaved Parmesan
Helping the Most Selective Eaters
Shawn wasn’t your typical four year old. Extremely thin and unable to communicate verbally, his entire diet consisted of infant oatmeal cereal with pureed fruit mixed in. For three meals a day, that was it. No meats, no vegetables, no solid food whatsoever. During his first visit to the feeding clinic, staffed by a registered dietitian, occupational therapist, and speech language pathologist, Shawn screamed and banged his head on the floor when chicken nuggets were simply brought into the same room. Beyond simple picky eating, this type of response can be common among children on the Autism Spectrum.
It’s now believed that 1 in every 68 children meets the criteria for autism spectrum disorder. Common behaviors include problems interpreting social interaction cues, repetitive patterns of behavior, and interests. Gastrointestinal difficulties are common, but the cause and preferred treatment for issues such as constipation, diarrhea and reflux disease hasn’t been fully determined. Problems with communication skills can make it difficult for caregivers to interpret food preferences when attempting to feed, prepare or serve food to their child. Basically meals are a battle.
Call it what you will- Food selectivity, sensory integration with food, or problem feeding behaviors, children with ASD are five times more likely to have feeding behavioral issues. A child may refuse to accept certain textures — rejecting those that are more complex than a smooth, purée for instance or completely rejecting anything other than crunchy foods. Smooth vanilla yogurt may be accepted, but offer them a pink yogurt with tiny pieces of strawberry and suddenly that yogurt is a complete no go.
Children with sensory disorders often will not touch foods which are wet, slimy, sticky etc., and may adamantly refuse to have those types of foods on the same plate as their preferred food. In extreme cases, there may be only five items in a child’s entire food repertoire. New textures and tastes are often rejected, despite multiple attempts at positive reinforcement, encouragement and repeated introduction of the foods.
Preferred foods often lean towards snack foods, starches such as french fries, processed foods which consistently appear the same to the child’s sensitive perception, or easily chewed, processed meats such as chicken nuggets or hot dogs. Children, especially high functioning on the spectrum, may show significant brand specificity choosing only “nuggets from McDonalds” or certain types of crackers.
Despite the fact that there is help for problem feeding behaviors, it’s still common for pediatricians to offer the advice to worried parents such as “They’ll grow out of it,” or “They’ll eat when they get hungry,” Unfortunately variety is key when it comes to getting enough vitamins and minerals on a daily basis. Children with such limited palates may need key nutrients supplemented to ensure they receive sufficient building blocks for their immune system and growth.
But what can parents do? In the next few blogs we’ll be expanding on these tips with some great places to start.
Begin by avoiding forcing or fighting at meals. Expanding a child’s diet relies on careful exposure to new foods in a non-threatening way.
Work on establishing a meal time routine by eating at the same location, using the same plates and utensils.
Increase pleasant interaction with non-preferred foods by placing a disliked food on the table, on their tray or even on their plate if they will tolerate it, but avoid prompting them to eat it.
Seek out help from a registered dietitian nutritionist, qualified occupational therapist or speech language pathologist with experience in treating feeding disorders. Don’t worry- They won’t judge you! You’ll find a sympathetic ear from a trained practitioner who knows how to help.
Picky Eating or Sensory Defensiveness?
When the dietitian reviewed the referral, it seemed pretty cut and dry. A ten year old boy with a high BMI, elevated LDL cholesterol, and mild anxiety. As the family dynamics were investigated at the nutrition appointment though, it was discovered that Adam can’t sit with the family at mealtimes. The smell of other family members food causes him to gag, he hasn’t eaten a vegetable since 11 months of age, and he tends to gravitate towards only crunchy foods. His interpretation of sensory input was effecting his ability to eat a wide variety of healthy foods.
Addressing feeding issues falls in the overlapping realm of Occupational Therapists, Speech Language Pathologists and Dietitians. Thanks to my friends & coworkers Gabby Spangler OTD, OTR/L, Leah Tingley MOT, OTR/L of Leg Up Farm in Mt. Wolf, PA along with Jaime Smetana MS, OTR/L and Katie Hein-Schultz, MS, CCC-SLP of WellSpan Health in York, PA for helping out with this blog.
Practice getting messy can help
We explore food with all of our senses, especially new foods. Fear of new foods or their sensory characteristics is sometimes referred to as food neophobia. It’s not always the case, but in interviewing parents of children with autism many pinpoint the age of approximately 15 - 18 months as a time when food variety significantly dropped. Hein-Schultz explained, “There is a great deal of gross motor and fine motor development that occurs between 10-18 months of age. Children with autism can struggle in these areas from language to sensory regulation. As their brain develops and learns, sensory triggers can become more overwhelming. Feeding is a skill that requires all five senses to work together simultaneously and can be quite challenging when one is unable to regulate the constantly changing system during tasks such as eating.”
For children with sensory issues, the advice to simply make them eat a non-preferred food or to offer it when they’re extremely hungry simply won’t work. Food selectivity can lead to significant food jags in which less than 5 to 10 foods total are consumed. A child may avoid all choices from the fruit or vegetable group or consume only one item from an entire food group. Caregivers whose children have severe negative reactions to the sensory characteristics of food sometimes give up hope of ever introducing new foods. Some adults and teens on the autism spectrum have never had these sensory issues with food fully addressed and finally the issue rears its head when high cholesterol or excessive weight gain must be addressed.
Along with significant food selectivity, other signs of sensory integration issues can include problems with loud noises, bright lights, bathing and grooming tasks, particular preferences with clothing such as issues with tags or socks, and many other triggers. For individuals not on the autism spectrum, oversensitivity to sensory input can still impact food choices.
Here are a few things to look for to identify possible sensory issues with food and the need for a referral to a feeding specialist-
Sight
How a food looks including the color, appearance of wetness, or lack of a perfect or expected appearance can be a cause for refusal or a complete meltdown. Children may closely examine new foods and gag at even the sight of non-preferred foods. Choosing only one brand of food is also very common. Children can often identify certain brands by the sight, taste, or texture.
Smell
Identifying and overreacting to smells that sometimes seem very minor or gagging at the smell of non-preferred foods and other people’s food can be an issue. Children may run out of the room when someone is cooking or eating.
Touch
Children may avoid touching new foods or wet foods with their bare hands. In our feeding clinic you would commonly see children quickly wipe their hands on their shirt or pants after finally touching a non-preferred food. And let’s face it- If a child is unwilling to touch a food with their hands, they’re not going to put it in their mouth.
Hearing
Yes, even sound can play a role in food selectivity. A food when chewed such as hard pretzels may cause a lot of internal noise. While some children may crave that sensory input, other children will be totally turned off by the sound and the feeling of crunching down on a hard food item.
Taste
There can still be negative overreactions even when a person decides to put a new food in their mouth. Spangler suggests examining whether there are certain characteristics that a child avoids completely, “Look for a pattern in all sensory aspects of preferred foods such as a preference for bland or strong/spicy, a certain color, shape or texture. Consider the original texture but also as it is chewed (ex – apples may be crunchy to bite into but then creates a lot of juice as chewed).”
When a caregiver finally gets connected with a provider who understands the challenges of sensory issues, it can bring significant relief and hope to the family. Smetana agreed, “Obtaining help provides families with a sense of someone who is aware of what they are going through, that their child is, in fact, picky and not just a behavior problem. Families can obtain a support system, someone who is listening and providing assistance as a starting point to increase the child’s desire to sit at the table, begin to engage with new foods, and eventually begin to consume new foods.”
To find a feeding specialist in your area who may be able to help with sensory issues, check out: https://www.feedingmatters.org/providers
All things Keto
How I love to clear up keto misinformation. I decided to put all my advice I’ve given regarding the ketogenic diet in one place. What do you find most confusing about keto?
The Keto Meal Plan for Beginners
Everything you need to know to get started with this high-fat, low-carb diet.
SHAPE
https://www.shape.com/weight-loss/tips-plans/keto-meal-plan-beginners-high-fat-diet
8 Common Keto Diet Mistakes You Could Be Getting Wrong
Here's what keto experts want people to know about the crazy-popular (but often misunderstood) eating style.
SHAPE
https://www.shape.com/healthy-eating/diet-tips/common-keto-diet-mistakes-misinterpretations
Ketogenic Diet May Increase Risk for Type 2 Diabetes, Early Findings Suggest
The study, which was on mice and not humans, found that the high-fat, low-carb diet appeared to trigger insulin resistance in the rodents.
https://www.everydayhealth.com/diabetes/diet/can-keto-cause-diabetes-study-on-mice-suggests-maybe/
Paleo Vs. Keto: Which Is Best For You?
How cutting carbs or eating like a cavewoman could affect your health.
https://www.healthyway.com/content/paleo-vs-keto-which-is-best-for-you/
Here’s the skinny on the ketogenic diet: What it is, how to follow it properly
Tampa Bay Times
What is the keto diet — and is it right for you?
The eating philosophy is getting a lot of buzz, but it may not be right for everyone.
NBC News.com
https://www.nbcnews.com/better/health/what-keto-diet-it-right-you-ncna847256
The Keto Diet and Diabetes: Is It the Right Pick for You?
Taste of Home
https://www.tasteofhome.com/article/ketogenic-diet-and-diabetes/
8 Healthy Rules to Steal From the Keto Diet- Even If You’d Never Actually Follow It
Family Circle
10 Things to Know Before Trying the Ketogenic Diet
My Fitness Pal
https://blog.myfitnesspal.com/10-things-to-know-before-trying-the-ketogenic-diet/
6 Mistakes Every Keto Beginner Makes (and How to Avoid Them)
Greatist
https://greatist.com/eat/keto-diet-mistakes-to-avoid
Ketosis and Ketoacidosis: They May Be Sisters, but They’re Certainly Not Twins
ADDE in Practice
https://journals.sagepub.com/doi/abs/10.1177/2325160318798640
This Is What Happens to Your Body When You Stop Eating Carbs
Reader’s Digest
https://www.rd.com/health/diet-weight-loss/what-happens-to-your-body-when-you-stop-eating-carbs/
6 Tips For Staying In Ketosis Through The Holidays
Vitamin Shoppe
https://whatsgood.vitaminshoppe.com/keto-thanksgiving-survival-guide/
Very Low Carbohydrate Diets In Diabetes
https://eatrightpa.org/members/blog/very-low-carbohydrate-diets-in-diabetes/
Feeding Therapy Meets the Ketogenic Diet
Recently I discovered that an article I wrote on guidelines for speech therapists to use in dealing with children on the ketogenic diet is no longer available online. This article was published in ADVANCE for Speech- Language Pathologists & Audiologists a few years ago. Due to the publication no longer being available I'm sharing it here.
When parents first learn about the principles of the ketogenic diet for seizures, many are surprised that the preferred food choices on this plan exist in complete opposition to the American food guide pyramid. The building blocks of this effective therapy for intractable seizures in children include fats such as heavy cream, butter, oils, and even avocados. Common foods such as milk, bread, rice, cereal, and pasta are noticeably absent from meals and snacks composed of roughly ninety percent fat. Through the manipulation of the amount and types of nutrients provided, seizure control may be improved. For speech therapists, working with a child on the ketogenic diet can lead to increased challenges when utilizing standard interventions.
What Is Ketosis?
Without sufficient carbohydrates present in daily food choices, the human body must switch to breaking down fat for energy. This conversion to a back-up fuel system induces the presence of ketone bodies in the blood. Although the complete action of the ketogenic diet remains under investigation, the increased levels of blood ketones, often correlates with a reduction in seizures. Even if seizure activity is not greatly reduced, neurologists are sometimes able to reduce the number or dosage of seizure medications. For some children, parents and healthcare workers have witnessed improved development in language and motor skills while closely following the diet.
The ketogenic diet is a delicate balance between fat, protein, and minimal amounts of carbohydrate, calculated and prepared by weight to achieve what is known as the ketogenic ratio. On a typical 4:1 ratio, each meal and snack provides approximately one part protein plus one part carbohydrate for every four parts fat consumed. While the average slice of bread may contain fifteen grams of carbohydrate, a child on the ketogenic diet may receive an allotment of less than five grams of carbohydrate for the entire day.
Due to the structured nature of the diet, every child must be closely followed by a ketogenic diet team including a neurologist, registered dietitian, and nursing personnel. Serum levels of nutrients are closely monitored and vitamin and mineral supplements are mandatory while children are following the diet.
Unlike low carbohydrate diets utilized for weight loss, children’s calorie and protein needs are calculated to provide sufficient nutrition for development. Growth and seizure activity is monitored closely by the keto diet team and nutrients provided are adjusted in response to each individual child.
While following the diet, even a small amount of carbohydrate can create an imbalance. For this reason, carbohydrate is restricted in the form of medications, supplements, toothpastes, and even lotions. Therapists must be careful to adhere to approved products to prevent introduction of excess carbohydrates.
Newer approaches to diet therapies for seizures include the modified Atkins diet and the Low Glycemic Index diet. Both of these diets focus on the restriction of dietary carbohydrate to a certain level, but food is not weighed on a gram scale and the allotment of carbohydrates is slightly higher than the ketogenic diet. These diets are often used for teenagers and adults as opposed to the ketogenic diet.
Typical Interventions Can Negate the Diet
For children with dysphagia, the simple addition of a commercial thickening agent or rice cereal to their liquids can have adverse consequences when trying to maintain high levels of ketosis. For this reason, traditional thickening agents cannot be offered due to the carbohydrate content. Unlike thickening agents based on modified corn starch, thickeners such as guar gum or xanthan gum are incorporated due to their incomplete absorption by the body. Pure forms of these gums can be purchased through some health food store or via the Internet. One commercial example of this type of thickener, Simply Thick, a xanthan gum based liquid, can also be incorporated into the ketogenic diet when a thickening agent is needed.
According to Beth Zupec Kania, RD, CD owner of Ketogenic Seminars and consultant for The Charlie Foundation, “success in maintaining good seizure control during both testing for swallowing issues and upgrading the ketogenic diet is found by working closely with the registered dietitian who is monitoring each child. Due to the fact that the typical first foods used for swallow studies and therapies are severely restricted in type and amount on the ketogenic diet, foods such as applesauce, must be paired with a source of fat calculated by the dietitian to maintain ketosis.”
Some children may begin the ketogenic diet receiving all or nearly all of their calories from a ketogenic tube feeding such as Ketocal, manufactured by Nutricia or Ross Carbohydrate Free formula by Abbott. For some children, if seizures decrease and development improves, more calories may be an option from oral sources in the form of snacks or meals. Small snacks of heavy cream which has been whipped and paired with pureed fruit can be calculated by a child’s registered dietitian. As children begin to consume greater amounts of intake by mouth, enteral feedings can be reduced if excess weight gain occurs.
Although fruits juices are typically avoided, beverages which are carbohydrate free such as certain flavored waters or a few approved caffeine free diet sodas can be used for oral stimulation. These beverages can also be frozen and presented at the temperature desired. Many products labeled as sugar free, including lollipops, still contain carbohydrates which will interfere with ketosis. Even sugar free gelatin, which contains protein, must be paired with whipped heavy cream to maintain appropriate levels of ketones in the blood. Zupec Kania states, “One misconception I have encountered is when parents have allowed their kids to taste a food by licking it, thinking that since they are not ingesting it, that it doesn’t contribute calories. They often experience a problem with either ketones and or seizures.”
For swallowing and motility studies calculated snacks should be provided by the family to help prevent immediate cessation of ketosis which can precipitate a seizure. The radiologic product added to the child’s food should also be free of all forms of carbohydrate.
Heidi Pfeifer, RD, LDN clinical dietitian specialist with Massachusetts General Hospital emphasizes that every child is an individual and items that are typically used in assessing children by speech therapists need to be modified. Pfeifer is fond of trying different flavors to provide oral stimulation or increase the volume of food consumed, “Even if a family is not familiar with using spices, the addition of a very small amount of hot sauce to an item such as mayonnaise or ketogenic chicken fingers can help to change the flavor and boost a child’s intake.” Although commonly used foods may need to be avoided during feeding and speech therapy, using a little creativity and being knowledge about the guidelines of their diet can make a big difference in working with these children and helping to maintain their seizure control.
Food Options for Therapy
The following foods according to Beth Zupec Kania, RD, CD should not be offered on their own, but can be paired by the ketogenic dietitian with a calculated source of fat for feeding therapies. Children who have a feeding tube can receive their fat source enterally.
Soft
Cooked or canned green beans, carrots, or squash, avocado.
Ripe kiwi with the seeds removed.
Firm
Honeydew melon, nectarine, papaya, peach with the skin removed. Popcorn with the hull removed prior to weighing.
Dark meat chicken with the skin removed.
Crunchy
Plain cheerios, Rice Krispies, All Bran- although these are very high in carbohydrate, a few pieces can be worked into a meal or snack.
List of resources
Time for Winter Veggies to Take Their Turn
With temps still dipping into the single digits and the arrival of garden fresh vegetables months away, it’s likely you’re missing out on some servings of fresh fruits and vegetables. Combining too many hours of indoor sedentary activities along with less than healthy food choices often adds extra pounds to many waistlines before Spring finally arrives.
Dear Future Doctor...what's the best nutrition advice for your patient?
Psst. Hey you! Yea, the one in the short lab coat with the big brain. Recently I referred a friend to the primary care doctor you’re currently training under. You see, my friend had been complaining about a lot of uncomfortable gastrointestinal symptoms which she had never discussed with a doctor. Rather than just starting her on a diet for IBS (which as a registered dietitian I very well could have), I sent her in for an appointment to make sure all other medical causes of her symptoms beyond diet were ruled out. Without even asking her what she was actually eating (and prior to seeing the doctor), you promptly diagnosed her with Irritable Bowel Syndrome and provided a handout from the Internet on the low fermentable oligosaccharide, disaccharide, monosaccharide and polyol diet or FODMAP for short. Helpful? Maybe not.
The FODMAP diet has gotten great media attention recently and for good reasons. For individuals who have IBS it may be the key to finding relief from bloating, diarrhea, gas and other uncomfortable GI side effects which occur when consuming certain foods. In this situation though, applying a complicated, although well researched diet to a person whose food intake you haven’t actually assessed? There may be a better approach.
Is it simply lactose intolerance?
Poor digestion of lactose, or the sugar in cow’s milk, is prevalent throughout the U.S. If your patient’s diagnosis is simply lactose intolerance you’ve now advised her to avoid multiple vegetables, fruits, wheat, beans, and various sources of fiber. Does she really need to limit her portion of avocado or pistachios when she simply needs to swap her two daily glasses of cow’s milk for a lactose free option?
What’s in that bar?
What if the real problem is that every morning at breakfast she’s eating a bowl filled with 15 grams of chicory root fiber or a bar with inulin as the second ingredient? Could the source of gas and bloating be her sugar free ice cream with both mannitol and sorbitol as ingredients? Without assessing her actual food intake and symptoms there would be no way to know that she simply needs to stop consuming those particular products, rather than restricting her intake of more than one hundred food items.
Water, water everywhere?
Could the fact that her caffeine habit, a can of soda twice a day (a source of high fructose corn syrup) along with a fruit smoothie is the cause of the diarrhea? Fructose intolerance can occur in the same way as lactose intolerance, but is often ignored as a source of GI problems.
Unknown Antibodies?
What if the real problem is celiac disease? By handing her the fodmap diet without testing for celiac antibodies you have now rendered this mode of testing completely inaccurate. This is the number one reason I ask a primary care physician to check for anti-gliadin antibodies BEFORE we implement a gluten free diet. Her choice to avoid wheat, rye and barley prior to testing for autoimmune disease will result in a false negative as she has now removed the trigger for an immune response. But why does this matter if she’s feeling better? Knowing you have an autoimmune disease versus simply avoiding gluten because you feel better will have significantly different influences on someone’s attitude and future decisions when presented with Grandma Susie’s famous gluten-laden chocolate cake.
There are other organs of digestion?
A few years ago a client that had been struggling with significant abdominal pain for 15 years told me she was sent to my office as a “last resort.” Seriously? During so many years of suffering, seeing a registered dietitian was never suggested by her physicians. And guess what? Fodmap didn’t fix her. We tried three different approaches to her diet and I played food detective for several weeks until we discovered the answer. In the end, a low fat diet was the perfect match for her undiagnosed bile reflux and persistent nausea. Her message thanking me for helping her escape the abdominal pain that had been plaguing her for 15 years was truly a blessing. Could I have resolved the issue without assessing her food choices and symptoms? Probably not in the next 15 years.
No diet will work if someone isn’t equipped to follow it. Inevitably if someone doesn’t truly understand and apply the diet guidelines accurately they won’t feel better. And if they don’t feel better they typically won’t continue with any of it. Six months later you’ll encounter someone who is still having issues. Is handing someone a paper a good substitute to reviewing food and beverage choices thoroughly with a client for 30 minutes? The answer is no.
As the only healthcare providers that extensively study food science along with medicine and evidenced based nutrition guidelines, registered dietitians understand thoroughly the subtle differences in how foods are digested and in this case, how they affect gastrointestinal symptoms. Medical nutrition therapy doesn’t center on handing someone a paper or pulling a diet out of a hat. In that hour that I spend with a patient I will assess, evaluate and educate on the most appropriate foods to choose based on that individual. I’m not a gambler, but I would put money on the fact that my training and experience may just trump your google search.
As a future physician you will be the authority figure among healthcare professionals. You will also be the gateway to comprehensive care. If you only have five minutes to truly help someone, why not hand them information about making an appointment with a registered dietitian nutritionist? Have them see an RDN and let us collaborate with you to truly help your patient. That’s what we’re here for!
Anyone can consult with and find a registered dietitian nutritionist at http://www.eatright.org/find-an-expert
Better your breakfast with some easy swaps
What’s your go-to breakfast option? Maybe it’s a doughnut or other sweet pastry. Puffed colorful cereal with milk? Or perhaps you’re someone who opts for nothing at all.
Research continues to support that having a meal within 1 to 2 hours of getting up from sleep is a healthy habit with many benefits including less snacking at night, better weight control, and increased focus on mental tasks compared to breakfast skippers.
But let’s face it- that sugary pastry is never going to stick with you until lunch. And that raging physical hunger from a poor choice or skipping all together? You’re probably not going to make a healthy choice at lunch. You may catch yourself tossing in the towel, ordering a greasy burger and fries and vowing to do better tomorrow.
Newer research continues to support having breakfast, but several studies have shown promising results on both appetite, weight loss, and eating habits when 20 to 30 grams of protein are included as part of that healthy breakfast. Protein does not turn into blood sugar until about 1.5 hours after you’ve eaten it, offering a more long lasting energy source than just carbohydrates alone.
These are a few combinations below which equal 20 to 30 grams of lean protein:
· 3 to 4 eggs or 6 to 8 egg whites would provide 21 to 28 grams protein. Everything has protein though (Fruits only have a tiny amount) so pairing the eggs with veggies or whole grain toast would also contribute protein without getting it all just from eggs.
· 8 oz of low fat Greek yogurt equals 20 to 22 grams (many small cartons are only 5 to 6 ounces). Pair with 1 cup of seasonal berries and 2 tablespoons chopped nuts or flavored pumpkin seeds.
· Four to 4.5 ounces of any meat or fish would provide 28 to 31.5 grams of protein. What differs is that a chicken breast with 4.5 ounces meat would provide 210 calories while the same amount of steak, depending on the fat marbling, may offer up 310 calories.
· Peanut butter or other nut butters are actually fats that contain protein. To reach 30 grams of protein from just peanut butter or any other nut butter you’d need to eat a whopping 8 Tablespoons! You’d use up a big chunk of your calorie budget with 840 calories worth of nut butter! Although you may not reach the protein goal with only a tablespoon of peanut butter the high fat content may help you feel just as full when paired with a banana or whole grain waffle.
· If you’re a cereal fan consider having less cereal and a small amount of protein with it. Some turkey sausage links have 10 grams of protein per serving. Choose low sodium if you have heart disease.
· For vegetarian options consider hummus, tofu in your smoothie, or other bean recipes for a protein addition to the morning.
If you’re not used to eating within several hours of getting up a liquid breakfast like a shake containing protein or a Greek yogurt is a good way to start training your stomach to tolerate food.
Looking to prep ahead for the week? Try this tasty, low carb and high protein egg breakfast recipe.
Egg Cups- Makes 12 muffins
Ingredients: 12 eggs or 1 carton egg beaters
· Splash of milk
· Vegetables of your choice to add to egg mixture—recipe analyzed with 2 cups chopped, raw baby spinach and ½ to 1 chopped red pepper
· (can use fresh chopped salsa, or other vegetables instead like mushrooms, onions or broccoli)
· Salt and Pepper, to taste
Directions
Heat your oven to 375F. Spray a 12-cup muffin tin with non-stick cooking spray REALLY WELL (these will stick!). Beat eggs and add the splash of milk. Season with pepper and salt if desired. Put vegetables into each muffin cup. Then pour the egg mixture on top of vegetables equally among the muffin cups. Bake for about 20-23 minutes, or until the egg cups are well set. If a tester/toothpick inserted in the center comes out clean they’re done! Keep in a closed container in the refrigerator. To freeze egg cups, let cool completely then wrap each egg cup individually in plastic wrap and place in large container or freezer bag. Freeze up to one month. Reheat each cup in the microwave. Remove from the plastic wrap before placing in microwave! Three egg cups will normally heat to the right temperature in less than 1 minute.
The nutrition facts are using eggs, chopped raw spinach leaves and red pepper with no cheese. Each egg cup is 75 calories, 1 gm carb, 6 grams protein, 5 grams fat. A small amount of shredded cheese can be melted on top when microwaved.
Egg cups are super easy to prep ahead. Keep in a container in the refrigerator until time to reheat in the microwave.
Don't Go Gluten Free Before You Consider This
May is celiac awareness month. Celiac disease (CD) is an autoimmune disease once thought to be rare in occurrence. Even just ten years ago, anyone diagnosed with celiac disease was rushed into the dietitian’s office for appropriate counseling A.S.A.P. on label reading, food options, mineral supplementation and emotional support to tackle this significant change. The rarity of the diagnosis necessitated a full workup on vitamin and mineral levels in the blood and clear direction provided by licensed professionals. A friend of mine who was recently diagnosed with celiac disease was simply told over the phone by a doctor’s office staff member that she had CD with no direction on the next step forward. While it may seem more commonplace within the medical community and more individuals may know the word gluten, CD is a chronic medical condition and is no less serious than it was a decade ago.
No one is born with celiac disease, but it can occur at any age. Like other autoimmune diseases, the body decides to overreact and attack itself with an immune response. In susceptible individuals, damage occurs to the small intestine in response to consuming gluten. Gluten, a protein found in wheat, rye, and barley is obviously a common food ingredient in the United States. Gliadin, a part of gluten, cannot be fully broken down by the intestine in those with CD, and may pass through the barrier of the intestinal wall causing an inflammatory response. Over time as damage to the small intestine occurs from ingesting gluten, the ability of the small intestine to absorb nutrients is decreased. Experts believe that many cases of celiac disease remain undiagnosed, but according to studies in the United States and other countries, the prevalence is approximately 1 in 80 to 1 in 300 individuals.
Although physical problems related to CD can vary, signs and symptoms may include abdominal pain, abdominal bloating, diarrhea, constipation, gastrointestinal reflux, or vomiting. . Lactose intolerance can occur for many reasons, but it is often present in undiagnosed celiac disease due to the damage the body has inflicted on the area of the small intestine that produces enzymes which help us break down and absorb our food.
If the gluten free diet is not closely followed it may lead to nutrient deficiencies, specifically calcium, vitamins D and B-12, iron, folate, and zinc which can lead to poor growth in children, anemia, irregular periods and fertility issues, along with low bone density. More than 50% of people with CD have been found to be vitamin D deficient which effects both immune system health and increases risk of weak bones.
Testing for CD focuses first on blood markers of an immune response while on a diet that contains gluten, specifically high levels of IgA and IgG antibodies. The gold standard of testing though is a tissue biopsy of the gastrointestinal tract done by a doctor specializing in gastroenterology. Genetic testing is also available which also may help tell the difference between CD and a gluten intolerance. If an individual goes on a gluten-free diet prior to testing, the results of any blood or tissue tests are completely invalid. Celiac disease is actually the only autoimmune disease where the trigger for the disease is known and can be avoided. Once a person has one autoimmune disease or certain medical conditions it is likely that another may occur. This is why it is recommended that certain people with diagnoses of Type 1 diabetes, rheumatoid arthritis, Down syndrome, Turner syndrome and others routinely be screened for celiac disease.
Medical nutrition therapy for CD is vital as this currently is the only known treatment that helps to decrease damage which occurs when the small intestine is exposed to gluten. Patients must avoid all sources of gluten including wheat, rye, and barley including small amounts such as malt flavoring and cross contact in the home or in processed food items. Vitamin and mineral supplementation may be needed to correct deficiencies. Life time compliance with the gluten free diet is essential for health.
You would think that the increased awareness of gluten would be a helpful to those who truly need to avoid gluten. In many ways it is as there are many more food products available. On the other hand, well-meaning individuals may not realize how careful one must be to avoid allowing any gluten from coming in contact with gluten free food. Those with celiac disease can not eat a salad that once had a handful of croutons resting upon it or “cheat” on their gluten free diet every now and then. An immune response can’t be felt. We don’t feel our white blood cells attacking a cold or doing their awesome immune magic, so for individuals with celiac disease consuming even small amounts of gluten can have effects on the body without a physical outward sign. The root of what causes the signs and symptoms in celiac disease is the damage that has occurred because of the immune system attacking the gastrointestinal system, not the gluten itself
There are many items in food and especially highly processed options with amped up fiber counts that can lead to poor digestion. If you have GI problems such as bloating, diarrhea, or heartburn it is a poor choice to start a completely gluten free diet prior to being tested for celiac disease. Once gluten is removed the body will stop producing antibodies against gluten and a test for celiac disease would come up negative. It’s important to know the truth about your diagnosis as celiac disease is one medical condition in which mineral supplementation is often needed, bone density can be effected, and the gluten free diet must be adhered to 100% of the time, 365 days a year, for a lifetime. Not knowing celiac disease is present may encourage someone to not be as vigilant at sticking to gluten free choices.
Dear dieter....
Dear dieter,
I hope you’re well! Just wondering how that miracle diet is going? You know, the diet you started New Year’s Day that was going to fix every one of life’s issues, including your emotional eating? Oh, not so good?
Despite how we try to feed it, mental stress does not actually require any additional calories. Food does not really fix the boredom, sadness, sleepiness, or anger that is the true underlying challenge. Eating (or not eating) for emotional reasons still leaves behind the trigger for negative feelings often along with guilt for trying to soothe the emotions with food. Strict diet plans don’t address the fact that a contributor to the weight gain was eating for emotional reasons rather than hunger.
Following a fad diet can impact social interactions and family events.
Everyone has different habits and interaction with food. Everyone also has stress, daily activities you’d rather not do, and emotional ups and downs. What differs though is how individuals justify their behavior and also their rewards in the form of food. How often are your rewarding yourself for daily activities you’d have to complete anyway? Do you find yourself saying, “I completed that work” or “I had a hard day” so I deserve this ice cream?
The first week in March is part of eating disorder awareness week. Disordered eating comes in many forms. Sometimes the strength of the relationship between eating behaviors and emotions aren’t strong enough to classify it as a true eating disorder, but many habits are not conducive to a healthy relationship with food. In 2013, the American Psychiatric Association (APA) formally recognized Binge Eating Disorder as a diagnosis making it the most common eating disorder in the United States.
If most of your weight gain came from eating from grief, sadness, or anxiety a strict diet is not going to take away those emotions. It will just prolong the time frame until you turn to food again for comfort. If you feel like you don’t know where to start, then seek out professional help. A licensed behavioral counselor can help you address the emotional aspects of your eating and develop alternative coping methods for your stress.
If you feel like your habits could improve when it comes to your eating and emotions consider these tips to get started.
Start by listening to your body and trusting it. Our stomachs try to send us signals that we’re full. Eating an entire, oversized portion at a restaurant and adding on a dessert because it’s offered has very little to do with our feelings of fullness. We eat because it looks good, smells good, and tastes good. Those are all important parts of enjoying a nice meal, but is your stomach actually full? Consider wrapping up part of your food at a meal. You can enjoy it twice, save money by not having to eat different food later, and decrease your overall calorie intake by spreading out the food. Start by serving less on your plate, but in your mind consider thinking “I’ll start with this,” rather than “This isn’t going to fill me up.”
Consider eating for your health and not just your weight. Remember all those fruits and vegetables you keep hearing about? Consider adding servings in every day because they provide good building blocks for our immune system and help our cardiovascular system, not just because they are on every diet plan. Skip the lemonade, iced tea, and soda because there’s more sugar in each cup than your body possibly needs for energy.
Plan your food. No, it doesn’t have to go to the extreme of one of those photos on Pinterest with twenty-one meals all neat and tidy in a million, itty bitty containers. A human body typically needs to refuel every four hours. If you don’t feel yourself and allow yourself to get overly hungry you’re likely to grab something quick and overeat. Take some food with you that will last without refrigeration like a banana, a pouch of nut butter, and a granola bar with minimal ingredients.
Move your body. And ENJOY it! For some dieters exercise is only done as a punishment or during complete deprivation. Being hungry and pushing through another few steps on the tread mill is a sure way to suck all the enjoyment out of physical activity. Formal exercise programs certainly have their place, but if you haven’t stuck to an exercise routine, just try to move more. Put on music and get a groove on! Exercise is an anti-depressant backed by multiple studies showing positive effects on mood and attitude.
And last, but not least- Skip the awful self-talk. Don’t say things to yourself in the mirror that you wouldn’t say to your best friend. Love your body and start to acknowledge all the wonderful things it can do!
Never Eat Out of a Box of…..
Researcher Brian Wansink, relays some important findings about how Americans eat in his book Mindless Eating. Through Wansink’s experiments (some rather funny, like the ever filling soup bowl) researchers determined that basically, if there’s food in sight- we’ll eat it, the bigger the food container, the more we’ll eat out of it, and if the food keeps coming, we’ll keep on eating.
Everyone is born a “mindful eater.” A child normally stops eating when their stomach is full. As we grow older we learn to eat for reasons other than hunger and to follow other cues when it comes to stopping. When we make food choices based on habits or emotions, whether it be boredom, stress, or sadness, we can end up eating more than our bodies actually need.
Food is everywhere and if you’re not skilled at passing it by sometimes, it’s bound to end up as unwanted weight gain. Whether it’s in your office or your own home, fight back against mindless eating by setting a few rules for yourself.
Start by eating on a better schedule. Eat sensibly and drink water at set intervals throughout the day. Most people need to eat every four hours. Chaotic eaters don’t make time for regular meals and then overeat when they do take time to eat.
Set a specific time for 1 snack between meals if you need it. Watch the clock or set an alarm on your phone for snack time. Until then, look forward to eating, drink a big glass of water and tough it out for another 30 minutes or an hour until you can have that one snack. When snack time does come, check with your stomach and see if you are actually physically hungry. Get comfortable with not eating as an activity.
Hide food from yourself. If you are prone to eating just because food is available, having tempting foods in sight will make it much more likely for an overindulgence to occur. Ditch the candy jar, doughnut box, or big plastic tub of pretzels in the office. If you don’t see it you won’t want it as much.
If you’re going to bring a treat to work, bring one portion, not the entire bag. Keeping your favorites in your desk can be really tempting if you’re trying to avoid a deadline or are stressed out. If you’re not getting anything done anyway, take a brief walk to get refreshed rather than grabbing another snack.
Never eat out of a box of…..fill in the blank. Maybe for you its crackers, or cookies, or M & M’s, or even dried fruit. The bottom line is --don’t eat directly out of a food container that contains multiple servings. If your brain sees more food it’s not as likely to cue you to stop. Snacking does not lead to weight loss if you’re eating more than what your body needs. Get out a set portion and hide the rest away for later.
Focus on today’s eating. Many people indulge today, justifying the choice and saying that tomorrow will be different or the “diet” starts next week. Cutting down on mindless eating today can help your health tomorrow.
What To Do With That Leftover Veggie Tray
Got pumpkins?
On my front porch, there are three sad looking Jack O'Lanterns and one large pumpkin hanging out from Halloween. If you've got pumpkins too, don't toss them into the trash. There’s still a lot you can do with your fall pumpkins!
Pumpkin is somewhat of a magical character in menus. It can be savory, sweet, or just give a health boost to a recipe without even knowing it’s there. Cinderella certainly knew how versatile a pumpkin could be!
Like many dark orange vegetables, pumpkins are jam packed with a plant form of vitamin A called beta carotene. At only 50 calories per cup, this true super hero of nutrition is a great source of potassium, vitamin A, and fiber. Dark orange vegetables like butternut squash, sweet potatoes, and pumpkin can meet your full day’s Vitamin A needs in only one half cup serving. Canned pumpkin has no added sodium and requires no cooking. You already know there’s pumpkin flavored everything, but there are lots of ways you can use real pumpkin.
So how can you tell whether it’s decorative or edible? With more than 40 varieties, most pumpkins are actually edible, but can vary in their flavor and texture. Jack O’Lantern pumpkins are developed more for size and shape, not taste. Complaints about cooking that variety include that it can be flavorless and watery. As long as it’s not a decorative gourd (which really contains no flesh) you can try to use pumpkins you’ve already spent money on. Don’t try using a pumpkin though that you’ve already carved and sat outside with a candle in it.
Whether meal or snack, there’s a pumpkin recipe that will fit. If you take time to make pancakes or muffins from scratch, pumpkin is a super easy, tasty edition. For more savory options utilize pumpkin puree for a thickener for soup or chunks of pumpkin in a chili.
If you have little ones at home you can make an ooey, gooey mess having kids sort through the pumpkin guts for the precious seeds. Remove as much of the pumpkin strings as possible. Put about 4 cups of water on to boil. Add the seeds and boil for 10 minutes. Drain and spread on a clean kitchen towel to dry. Seeds usually toast best if you toss them with a little oil or melted butter. After heating the oven to 250 degrees, spread on a shallow pan or cookie sheet and place in heated oven. You will need to toast the seeds for about 35 to 45 minutes. Stirring every 10 minutes can help them toast evenly.
You don’t necessarily have to remove the skin before you tackle roasting the pumpkin. Give your pumpkin a very through bath using dish soap. After you’ve gutted the pumpkin you can cut it into large chunks which can be roasted, microwaved or boiled. Roasting takes the longest time at up to 60 minutes, microwaving or boiling will take about 10 to 15 minutes. You can also use a slow cooker but it will take about three to four hours to get rid of the crunchy bite of uncooked pumpkin.
Pumpkin puree can be used for all sorts of dishes. To make pumpkin puree, you simply have to scoop the flesh from the skin after cooking and then run it through a blender or food processor. You will get roughly 1 cup of puree for every pound of pumpkin. Make it easy by freezing the pureed pumpkin in 1 cup servings. It will last about six months in the freezer and a week in the refrigerator.
If you think you don’t like squash, but you like pumpkin pie you might be in for a surprise. Canned pumpkin is typically made using blends of butternut, hubbard, and other squash as it is less stringy and more flavorful than pumpkin alone. The term pumpkin can be used loosely to include over forty different varieties of pumpkin and squash.
And if you don’t want to eat your pumpkins? Toss the pumpkin somewhere where it can grow in the spring. Squash family plants don’t like to be disturbed so be sure to toss it in a spot where it can break down, release it’s seeds, and turn into a glorious vine in the spring.
