Big Girl Pants

So guess what? I actually grew up and became a real life dietitian. It only took me about 4 years and about $25K more than I had planned on, but here we are.

Since finishing my internship or dietetic residency as some would call it, I took and passed my RD exam. And after 5 years of studying, crying, whimpering, laughing, celebrating, whining, sweating, paying, breaking, rebuilding, panicking and all the seven dwarf's names, I became a gainfully employed dietitian.

For about the last year, I have been working in the bone marrow transplant unit of an oncology hospital whose name will remain anonymous lest I seriously bother someone with my nutritional musings. I LOVE my job and all the heartbreak, frustration and genuine friendships that come out of it. It is maybe the most satisfying thing in the world to help someone going through the battle of their life. I am continually amazed and inspired by my patients. It is also fairly terrifying.

The really good news, however, is that I will now be passing along some of my symptom management tips as well as ways to integrate supplements into cancer care.

It's maybe also worth mentioning that my dad was diagnosed with adenoid cystic carcinoma about 2 years ago, and a very, very dear friend of mine just lost her own father to a loooong and painful battle with esophageal cancer. So some of these posts will have some personal meaning.

I would love to welcome any of your own tips, tricks, questions, etc., if you or someone you know is dealing with cancer. One of the most valuable lessons I have learned being in oncology is that my patients teach me about as much as I teach them.

Oh and...

Year of the Snake

How was everyone's New Year's? What are the things in 2012 you'll be glad to leave behind? And what are the things you'll be sad to see go? I for one am pretty over 2012. 2013 will be better for two reasons: 1) it's the year of the snake and 1977 (the year I was born) is also the year of the snake-and look what an awesome year that turned out to be! 2) I'ts not 2012.

Did you make New Year's resolutions? We have all at one point in our life made a plan to do something to better ourselves and either succeeded or failed. If trying to eat better or get some more physical activity in your life made your list of resolutions, I have some tips for you.

The first step to eating better is not to overwhelm yourself with unachievable goal. As Lao-tzu said-"The journey of a thousand miles begins with one step. Many people feel very motivated at the beginning of the year to make a huge lifestyle change, which is great! But the way to keep that motivation going is to make ACHIEVABLE goals for yourself and track progress. Why set yourself up to fail? Oftentimes we try to be very regimented in restricting our diets and find we can only stick with our plan for a few weeks or months, but the REAL key to long term success is not to start with an extreme, restricted diet plan but instead aiming for a long term, lifestyle change.

Lifestyle changes work best by setting SMART goals. SMART goals are: Specific, Measurable, Achievable, Realistic and Time specific. For example ,instead of starting with, "I am going to eat better by not eating anymore sugar", start with something more achievable and specific like: “I am going to cut out soda and limit myself to dessert once a week." We have picked a smaller, achievable objective that we can track over time, and tracking your progress is important! It helps you celebrate your small successes and recognize your improvement. Document what you did to achieve your goal, how you felt about it (was it hard this day? easier another day?) and how you can continue to work towards your objective.There are some great apps for this like Nutrition Menu for your smart phone or just logging it in a small notebook that you can keep with you in your car, purse or work desk. Recognize that lifestyle change is fluid and will constantly be changing. In our previous example, after 2-3 weeks of not drinking soda and limiting dessert, it’s time for another goal. Once you realize that you are capable of making a change, the next change will seem easier. As you set new goals, don’t abandon your newer, healthier habits!

Remember; don’t punish yourself if you slip up. It’s much more important to stay with your goal for the long term and not get discouraged by mistakes.

Eating healthy isn't always about taking things away! It should also be about adding things to your diet like fresh fruits and vegetables, which most American’s don’t consume enough of anyway.

Stumped for a goal? Try these:

• I will eat one fresh piece of fruit and one vegetable every day
• I will limit red meat to once a month
• I will limit soda to once a week
• I will limit dessert to once a week
• I will add lean meats twice a week
• I will eat fish twice a week
• I will walk 30 minutes 4 days a week 

A recap of what we talked about:

• Aim for lifestyle changes NOT crash or fad dieting
• Set a SMART goal
• Track your progress towards your goal
• Set new goals often (aim for a new goal every 2-3 weeks)

Also, if you need help setting some goals for 2013 regarding diet and/or physical activity  message me and I will help you! 

Snoozin'

I have discovered Snooze in Hillcrest. And let me just say, it is amazing.

I went there the first time for a post-graduation brunch a few weeks ago. We didn't get off to the best start, Snooze and I....

 They have an absolutely ridiculous policy of not accepting reservations-even for a party of ELEVEN. Even when one person in that party is breastfeeding and needs to eat. Even when one person in that party is an infant. Even when everyone in your party is starving. Even if you call ahead to let them know there is a party of ELEVEN on their way. I can only assume this policy is because the original restaurant is in Colorado and they probably don't have quite have the San Diego thing down just yet. However, despite waiting almost two hours for a table, the food was excellent and so was the service. We also got fairly toasty while waiting from their assortment of tasty cocktails including a lemonade mimosa and bloody marys that have an option of adding pickle juice!! Or you can just order the shot of pickle juice on the side and drink it plain if you are obsessed with pickle juice like me.

Some of our group post-cocktails, pre-ordering

This was the farmer's benny and the marscapone stuffed french toast-as delicious and decadent as it sounds....


If you go, try their pancake flight because that way you can get three of their delicious pancakes to try. We went for pineapple upside down, red velvet and blueberry. Another little trick is you can actually do half orders of any of their items-which is awesome because you'll definitely want to try everything on their menu.

Yum!

Beet this.

There are lots and lots of ergogenic aids out there which tout the ability to help enhance your athletic performance. Anjee what is an ergogenic aid?! you ask. It's basically anything that has the ability to increase your capacity for physical performance. This can be caffeine or steroids.

An article in the Summer edition of Food and Nutrition magazine had an interesting blurb about beetroot juice and its benefits for middle distance and endurance athletes.

Seems there is some research out there that indicated beetroot juice may delay time to exhaustion. Yep. Looks like our beety friends are rich in nitrate which has two effects on the body during exercise:

1. It reduces VO2max which is means it reduces the demand for oxygen during exercise. Obviously the lower the demand for O2 the more efficiently (and longer) you are able to place demands on the body before exhaustion. 
2. Increases muscle efficiency. Muscles are able to utilize O2 more efficiently thus delaying the time to fatigue. 

The acceptable daily intake of nitrate is 3.65 mg/kg/d and the amounts used in the studies are usually about twice this amount so it remains to be seen how safe it is to supplement with beetroot juice but interesting stuff nonetheless. 

Would you drink beet juice to increase your performance? I may have to try it on my next long run......

Remember me?

Hello there.

You may or may not have noticed I've been out for a bit. Well, I'm back.

Let's see. Let me just sum up the last few months here. I finished my thesis, defended my thesis much to the chagrin of my PI, faculty, staff and students of SDSU. FINALLY took surfing lessons much to the chagrin of all involved. I am no longer terrified of the ocean. That's a lie. Celebrated my 34th birthday. Oscar and I broke up. I moved out. Was placed in a dietetic internship which I start in July. I have joined a climbing group. I only go because we go out for beers at Smallbar after every Wednesday. I deleted my face book (no I didn't defriend you I just am over FB right now). And I think that about does it. Oh and I graduated last Friday.

So now that we have that out of the way, let's get updated on the nutrition world, because really, isn't that the more exciting thing here?

The American Dietetic Association is now the Academy of Nutrition and Dietetics. I am not sure why although I assume it's because they feel it sounds fancy to call themselves the Academy of Nutrition and Dietetics. I'm not sure they thought this one through however because the acronym is going to be AND. Doesn't sound fancy when you see it like that does it? Anyway, that is the new institution and that is how they will be addressed. I have been paying extra special attention to AND lately and it's position on the new health care laws; it has been very interesting watching how this whole health care reform business plays out in regards to nutrition professionals. Many of the billing codes are going to be changed to limit certain nutrition related therapies or remove them all together. Obviously this is a concern moving forward and has a lot of us wondering what exactly our careers will look like in the future. Time will tell I suppose.

But onto a little blurb from my Food and Nutrition magazine. This month had an article on juicing and I thought I'd pay it a little mind since everyone from my new roommates to my brother are juicing these days and it's something I get asked about quite a bit.

Juicing is the process of using a juicer to separate fruits and vegetables from their peels, pulp,fibrous materials, etc., into a purely liquid form. It's different than blending since the juicing process actually removes the other components of fruits and vegetable whereas blending them uses the entire fruit and/or vegetable. 

Juicing has also been getting a ton of attention lately. Many hail it THE a way to lose weight and others insist it is the best way to consume fruits and vegetables. Movies, movie stars and fitness advocates alike seem to be hopping on the latest industry trend. 

In an attempt to figure out what the fuss was about, I made a few juices of my own. Tasty, diarrhea looking things from kale, ginger, lemon, parsley and carrots. I juiced a whole bag of oranges one time and got two whole glasses of juice out of it. After a particularly rigorous week of post break up drinking I juiced for what was supposed to be ten days but was chiseled down to six after I just about got fired from my job for being so darned cranky from being so darned hungry. Don't get me wrong, my juices were tasty!! Seriously they were so good. And I actually felt pretty good too after drinking them. I didn't get the fit of hypoglycemia I assumed would follow a strict juicing diet. My main concern wasn't what was in the juice, but what wasn't in it.

After I reduced a weeks worth of produce to a glass of liquid, all the fibrous material (the stuff that contains almost ALL the fiber) was still in my juicer. One time I tried adding it back into the juice but to be honest it was pretty gross, but I digress.

I think this article from Food and Nutrition Magazine gives great tips on how to be a smart juicer and hopefully get the most benefits from juicing. A few main points:

1) There is no advantage to consuming juice over whole fruits and veggies

2) Juice-only diets which severely restrict calories may result in short term weight loss (and later to weight gain) but the lack of protein won't sustain muscle mass

3) Other deficiencies like fiber, fat soluble vitamins D and E, essential fatty acids and B vitamins may result

4) Always thoroughly wash fruits and veggies and consume juice immediately

5) Aim for a 3-to-1 vegetable to fruit ratio

And it's important to remember juicing really shouldn't be replacing meals and its hold no benefit over consuming fruits and vegetables in their raw, whole form but can be a great way to incorporate fruits and vegetables into your diet if you have a hard time doing so. 


Do you juice? If so what's your favorite recipe?

Pizza is a vegetable. Great call Congress.

I have not blogged in a very, very long time; and I know for the 4 of you who look at this blog it must have been a heartbreaking few months. This article on how corrupt and stupid our governing agencies are when it comes to food brought me out of my thesis writing stupor long enough to put up this snazzy post. Just another fine example of the almighty dollar coming before the general good of the people. I'll be back soon with more rantings and ravings, just you wait.

Chocolate: good for the soul, good for the heart

Heart Disease, Diabetes and Stroke: More Chocolate, Less Risk? - ABC News

I really liked this article from ABC that that reported on a new review of published research on chocolate.

The review looked at 7 studies and controlled for age, diet, physical activity, body mass index and smoking and discovered that chocolate consumers had reduced risk for heart disease, diabetes and stroke.

I really like this article because instead of jumping to unfounded conclusions like a lot of the media tends to do, it merely points out that habitual chocolate intake and lower disease risk are correlated; but that it doesn't necessarily mean that that chocolate is the sole cause of the lower risk. Other factors weigh in as well. For example, a there was a study that reported that people that prayed lived longer than people the didn't. But that could also be because people who pray go to church more, are more social and therefore have a social outlet and support. Or perhaps people that pray more experience less tress because of praying. So you can never really say that correlation implies causation, but the research is interesting nonetheless and seems to support past research that has implied similar benefits of chocolate.