BusyBusyBusy

I'm going to go ahead and state the obvious...my blog has been on the back burner. Between finishing projects for rotations, putting together my capstone portfolio, cleaning up my resume, and applying for jobs on the other side of the United States, I haven't really even thought about blogging. Graduation is right around the corner and I could not be more ready. Now the hard part...finding a job. Wish me luck! 

Over the past few weeks I have been all over the place. I completed two weeks in school foodservice, 1 week at the Northern Kentucky Health Department, and I am now at Meals on Wheels. Yes, at the beginning of the year I was there for a few weeks creating their cycle menu but now I get the opportunity to see the menu being implemented. Today was a little rough since I had to be there by 4am. Kudos to those who do that everyday, I'm not so sure I could do it. I worked the tray line putting together 1,300 meals and was first put on spaghetti duty but was then quickly demoted to scoping sauce. Let's just say I wasn't the fastest and I looked like Lucy and Ethel on the chocolate factory episode. Thankfully, the rest of the week does not require me to work the tray line. Only a few more rotations left so I'll do my best to keep everyone updated. 

Enjoy the chilly but beautifully sunny day!

Weight Management

The first week of the last quarter on my journey to be an RD has ended. I was at an amazing facility that dealt with surgical and nonsurgical weight loss. On Wednesday I was able to observe two weight loss surgeries, a bypass and lap band. Quick overview: bypass makes the stomach smaller and causes the food to bypass part of the intestine. Lap band does not require any cutting or stapeling of the stomach. An adjustable band is put around the top of stomach causing a restriction on the amount of food you are able to eat. Both of these surgeries also help you feel fuller faster and stay fuller longer.  


Everyone has their own opinions about weight loss surgeries and I'm not here to spark a debate but, it's truly remarkable the hundred's of ways there are to lose weight. I have now had the opportunity to see weight management in children and adults, both surgical and nonsurgical, and I have to say I love weight management for either population. I should have seen the signs earlier since 99% of my blog is about weight management. Unfortunately, that was my only week with them and next month I move on to schools, health departments, and meals on wheels. 


Tomorrow is the last day of National Nutrition Month. I hope everyone had the opportunity to get involved or get into eating healthy and exercising. Now...we begin the countdown for next year!

Portion Distortion

This post is inspired by an experience I had yesterday morning that I am still racking my brain about. It all started when Nolan and I were headed out to get our day started. We were hungry and decided to stop on our way out to get a breakfast sandwich and some coffee (I'll keep the name underwraps). We get there and I order a breakfast sandwich and a small iced coffee. I was then informed that if I order a medium (a size BIGGER than I wanted) it would be cheaper. I quickly said no thank you, I only want a small and then thought to myself...what the heck?! how on earth does that make sense? They just offered me something more for less money...I don't get it, and I still don't get it. My second thought was no wonder everyone in America is gaining weight. The concept of portion sizes is all wrong. I understand everyone is pinching pennies left and right, myself included but, when it comes to food/my health I don't settle. Here's an example: The small coffe I got was 120 calories the medium they offered me is 200 calories. doesn't seem like a huge difference is calories but heres where my thought process is going...


I am not a big coffee drinker but I imagine people out there that would choose the cheaper medium coffee over the small the 5 days a week they work. If this is the case that is an extra 1,000 calories a week, 4,000 calories a month, meaning you would gain a little over 1 pound a month because of this coffee (or about 12 pounds a year). You then spend money dieting etc. all because you  didn't want to spend the extra 20 cents (or whatever it was) just to buy the smaller size. It's a vicious cycle, I know. So next time someone offers you a bigger size for less, I know it may be tempting but think of the overall picture. The amount of food you eat and drink plays an important role in energy balance and choosing smaller portions can help you lose weight and keep it off.

Here are some ways to control portion sizes:


1. Downsize your dishes. I've said it once and I'll say it again. Use smaller plates and bowls. We tend to fill up the plates we use and then eat it all. When you use a smaller plate your brain will think you are getting more when the same amount of food is put on a smaller plate
2. Use visual cues. A tennis ball is about the size of a piece of medium fruit, a deck of cards is one serving of meat etc.
3. Split an entree with a friend. Most restaurants serve more than the amount of food one person needs to eat in a day. Share with a friend (and it will be less expensive!) or, ask for a doggie bag to save it for lunch the next day.
4. Don't mindless eat. If you eat in front of the TV, put the amount of food you want on a plate instead of eating out of the package. It's easy to overeat when your focused on something else.
5. Figure out how big your portions really are. Measure the amount your plates, bowls, glasses actually hold.
6. Measure out a fixed amount. Measure out a serving size (check the label!) to see what it looks like in your dishes. Also, make your own 100 calorie packs of your favorite snacks (again, check the label for calories per serving). 






check out www.choosemyplate.gov for more information on decreasing portion sizes and a daily food plan to help manage your daily intake. 

The End is Near(er)

This week was a big week. I ended my 7 week rotation at Children's (so sad to go!). This week was my obesity rotation and I have to say, I really loved it. As we all know, obesity is on the rise and is considered an epidemic in this country. According to the CDC, about 17% (12.5 million) children, ages 2-19, are obese and the prevalence rate since 1980 has tripled. More than 1/3 (35.7%) of U.S. adults are obese resulting in countless medical problems. 


I worked with a group they have called HealthWorks! that teaches overweight kids and teens how to eat healthy and exercise. I was also in the bariatric center for those who are either in the decision making process or in the treatment phases of bariatric surgery. On top of those, I spent a day in the lipid and hypertension clinic. During this rotation I did feel bad for some of these kids but, I was also so grateful that they were getting the help they need. The largest patient there this week was a CHILD with a BMI of 70 (morbidly obese). I got to sit in with each person on the team so I really got a good sense of who the patient was and what was going on in their life. This week I learned such a great lesson...you never know what someone is going through. The perspective I had of some of these patients during the nutrition interview was so different than when I went in with the social worker. Even though someone may put up a good front, they may really be struggling inside. But, thats what my job entails...helping people get healthy and love who they are.

Today I presented my big project for the year. My partner and I's topic was eating disorders and for our seminar we gave a presentation for the first hour and had a dietitian that works in eating disorders come and speak for the second hour. Man o man am I so happy to have that over with!! So, let's go through the check list for the year....Lunch and learn-check, case study during acute care-check, intern forum-check, case study during peds rotation-check, intern seminar-check. From here on out it's smooth sailing (I hope)! 


It's hard to believe that there are only 2 1/2 months until I complete my dietetic internship AND graduate. Two huge chapters are quickly coming to an end. For now, time to enjoy what's left and finally get some R&R during spring break in one week. 

Get Your Plate In Shape

The first day of March has arrived which can only mean one thing...It's national nutrition month! For those of you who don't know, national nutrition month (NNM) is a nutrition education and information campaign that was created by the Academy of Nutrition and Dietetics (AND). It  "focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits." 


A drum roll please....the theme for this year is....get your plate in shape.

This is a great theme for this years NNM since the pyramid guidelines are no longer and it is now MyPlate. The new MyPlate guidelines and NNM encourage everyone to take a look at what your putting on your plate and focus on getting the recommend amount of portion sizes, fruits, vegetable, grains, protein, and dairy each day. A press release about NNM from AND stated "each year, National Nutrition Month provides us the opportunity to remind consumers of the basics of healthy eating. By focusing this year's theme on the new MyPlate, we can help people make the simple changes to their daily eating plans that will benefit them for a lifetime."


Take a look at whats really going on your plate and check out some suggestions below from the food and nutrition experts from AND on how to get your plate in shape. 

• Make half of your plate fruits and vegetables: Eat a variety of vegetables, especially dark-green, red and orange varieties. Add fresh, dried, frozen or canned fruits to meals and snacks.
• Make at least half your grains whole: Choose 100 percent whole-grain breads, cereals, crackers, pasta and brown rice. Check the ingredients list on food packages to find whole-grain foods.
• Switch to fat-free or low-fat milk: Fat-free and low-fat milk have the same amount of calcium and other essential nutrients as whole milk, but less fat and calories. For those who are lactose intolerant, try lactose-free milk or a calcium-fortified soy beverage.
• Vary your protein choices: Eat a variety of foods from the protein food group each week, such as seafood, nuts and beans, as well as lean meat, poultry and eggs. Keep meat and poultry portions small and lean. And be sure to choose seafood as the protein at least twice a week.
• Cut back on sodium and empty calories from solid fats and added sugars: Compare sodium in foods and choose those with lower numbers, and season your foods with herbs and spices instead of salt. Switch from solid fats to healthy oils like olive and canola oil. Replace sugary drinks with water and choose fruit for dessert.
• Enjoy your foods but eat less: Avoid oversized portions. Use a smaller plate, bowl and glass. Cook more often at home where you are in control of what’s in your food. When eating out, choose lower calorie menu options.
• Be physically active your way: Adults need at least 2 hours and 30 minutes of physical activity every week. Choose activities that you enjoy, and start by doing as much as you can.

There are tons of activities that happen during NNM so check out your local community to see what's going on. If your in the Cincinnati area, this weekend is the Nutrition Council Food on the Run 5k and 10k fitness run/walk downtown (I'll be starting off NNM by running in the 5k!) and for the first 4 friday's in March from 10am-12:30pm there are children's activities and display booths at the Museum Center. This Friday I'll be helping out and we will have the kids "complete their plate" and lead a movement activity.  



For more information, games, reading list, eduction resources etc. check out http://www.eatright.org/nnm

Cookies for Breakfast

I am a big advocate of eating breakfast, just ask anyone near and dear to me. Whether they want it or not, I'm always preaching how important it is to not skip meals and eat breakfast. The biggest complaint I hear is "I don't have enough time" which I can fully relate to. My day starts early and ends late (if I haven't fallen asleep by 10pm) and when my alarm goes off the next morning, I'd rather squeeze in any extra minutes I can than eat breakfast. This is where a new food product comes into play. This new product is Belvita, a breakfast biscuit or as they like to call it "a new kind of breakfast". They are like cookies, very convenient and portable as they come prepackaged. There are 4 biscuits in a package and they are packed with whole grains, B vitamins, and fiber. All 4 biscuits contains only 230 calories, 8 grams of fat, 35 grams of carbohydrates (18-20 of these are whole grain carbohydrates), and 4 grams of protein. Another added bonus: they contain NO high fructose corn syrup, no partially hydrogenated oils, and no artificial sweeteners. I have only tasted the golden oat (they also have blueberry and apple cinnamon), in fact I had them for breakfast this morning. The taste is comparable to graham crackers but sweeter and crunchier. I paired it with a glass of milk to give myself a little more protein because I knew I would be having a late lunch today. I was surprised to find I stayed full until about 1pm but I'm usually starving by 11am.  Other breakfast pairings with Belvita could be fresh fruit with greek yogurt, an apple, or a banana with the one (or two) cups of coffee we need in the morning. So, along with the new breakfast biscuits and other breakfast tips and tricks there are literally no more excuses. 

What's Your Poo Telling You?

Today marked the end of my 3rd week in peds and the end of my GI rotation. I spent all week talking about none other than poop, or to put it lightly 'output'. Most of the patients I saw had Crohn's disease or short gut syndrome. 


Here's a little bit about each of those: 
Crohn's- A form of inflammatory bowl disease that usually affects the intestines. People with Crohn's disease have chronic inflammation anywhere along the GI tract. With chronic inflammation you can imagine that it wouldn't be too fun to eat. So, we work with them on 'safe' foods, what their eating patterns should be, or if they are on enteral feeds we adjust their feeds to best fit their needs 
Short Gut- This name has a literal meaning...these kids have a short gut. This is because their intestines are not working correctly, usually exhibiting significant malabsorption and they have had some type of bowel resection to correct this problem. To get nutrition, these kids are usually on enteral nutrition and sometimes TPN. We work with their feeds to make sure they get the proper nutrition they need. 


To know if the kids are tolerating their feeds and their intestines are working correctly we had to focus on their output. How much, what did it look like, etc. that way we can make adjustments if needed. Sounds like fun, right? It's amazing how much your poop can tell you. Here are a couple of fun facts:


1. Poop should sink- Floating stools can indicate a high fat content, which can be the sign of malabsorption (your not absorbing enough fat and other nutrients from the food your eating). 
2. Shape matters- The perfect stool is an S shape. This shows that your getting enough fiber in your diet (fiber helps bulk up your stools and keep them together).
3.75% of your poop is water
4. The average human poops 2 pounds a day. 


So, the next time you hit the john check out what your poo is telling you.