How do you keep variety in your diet during winter?

By Corinne Marti

To maintain a healthy diet, a wide variety of different types foods are ideal to get all the vitamins and minerals needed. This task is easy during the summer time, when produce is plentiful, and easy to get. What happens when the main growing season is over, and now much of the produce is out of season? This can cause problems, as the food becomes more expensive and the produce that is available is coming from places that are further away. You might be asking why it matters if our food has to travel a little further to get to the grocery store in the winter.  When our food has to travel from further away, say another continent instead of a couple hundred miles away, that means more money and fossil fuels were spent to get it here. That also means it had to be picked earlier and sat longer, causing the food to be less nutritious. For this reason (and to support your local economy) it is always good to shop local when possible; but what about during month that produce limited produce? There is an easy way to combat this issue, use frozen produce. You can even freeze your own local produce during the summer to use in the winter. All you have to do is place food how you want it prepared (whole, diced, without peel, etc.) in an airtight container like a Ziploc bag or a vacuum-sealed bag, and store it in the freezer. This is a more economical approach to keeping variety in your diet during the winter months. This way you can support local farmers, keep costs down during the winter, and also keep variety in your diet all year long. Below is a sample recipe on how to use frozen produce to make a meal. 

One Pot Stuffed Pepper Casserole

Image retrieved from: www.familyfreshmeals.com

Ingredients:

1 lbs. ground turkey/chicken

1 cup diced white onion (frozen)

3 cloves garlic, minced

2.5 cups diced bell peppers (frozen)

1/2 teaspoon pepper

14.5 can diced tomatoes, no salt added

2 cups chicken/vegetable broth

8 oz. can tomato sauce

1 Tablespoon soy sauce

1 teaspoon Italian seasoning

1 cup brown rice, uncooked

1 cup shredded cheddar cheese

                                                                                          Directions:

      1.  Over medium-high heat brown meat with frozen onions and garlic, cook for about 5-7 minutes, breaking into small pieces.

      2.  Add frozen diced peppers and pepper, cook for about 5-7 more minutes, until peppers are no longer frozen and have started to soften.

      3. Reduce heat to medium and add in tomatoes with juice, broth, tomato sauce, soy sauce and Italian seasonings. Stir until well combined. Bring mixture to a boil.

      4. Now add in uncooked rice. Return to a boil and then reduce heat to low. Cover and simmer for 35 minutes, until rice is tender.

     5. Remove from heat and sprinkle with shredded cheese and serve!

Halfway Through the Dietetic Internship: 5 Surprising Things I have Learned so Far

By: Maci Louwagie

Hello everyone! Happy New Year! This year is exciting for me as I will be (hopefully) completing my Dietetic Internship and Master’s degree in August! Yay! The new year got me reflecting a little bit about this past year and the past few months as a Dietetic Intern. I am over halfway through my Master’s program and have about 6 months left of rotations. I have learned quite a bit the past few months and have really enjoyed finally applying all I have been learning the past 4 years of undergrad. There were things I was expecting to learn and then there are always things that you learn that aren’t so expected.

I have gained so much knowledge from my classes and the rotations I have been in and that was expected. I expected to learn more about physiology and nutrition, how to educate on nutrition, and how to interact with a patient. I also expected to learn a lot about what the every-day life is like for a dietitian, and of course how to be an effective dietitian in the setting you are working in. I have learned a lot about becoming a dietitian and am gaining the knowledge, experience, and training that I need to be an effective one. After all, that is what this internship is all about. There are, however, things I have learned the past few months that I was not expecting to learn. I am sure every intern has their own list of surprising things they have learned during their internship but here are my top 5 halfway through: 

1. Every dietitian is different; I can be my own kind of dietitian

I have worked with a variety of dietitians in my rotations so far and none of them were alike. My fellow interns and I, we all share a similar passion for health but even working with them has shown me that everyone does things differently and no matter who you are, what qualities you have or don’t have, you can succeed and be an effective dietitian. Each dietitian writes their notes differently, has different day-to-day schedules, views their patients differently, prioritizes their goals differently, and is passionate about different health and nutrition topics. Just because one person writes their notes a certain way, or is passionate about kids or geriatrics, or interacts with a patient/client a certain way, does not mean that I or anyone else must do those things or be passionate about those things. I get to be my own dietitian. I get to take pieces from all the dietitians and places and experiences I have learned from, as well as my own qualities, passions, and quirks and build myself into being the effective dietitian I desire to be. I don’t have to be someone else. I don’t have to do things the way other people do them. I can learn from other people, but I don’t have to be them. I have learned and am still learning not to compare myself with others but to learn and grow from others in order to find my own success in what I do and become.

2. Many people don’t have the proper education they need to make healthful decisions

I grew up probably like a lot of my fellow interns: chugging mountain dews, eating out multiple times a week, and not having a care to what I ate as a child and teenager. Now looking back on all my bad choices, I want to be like “whyyyyy would I ever do that to myself” BUT, the thing is, I didn’t know. My parents didn’t know. I was not really educated on proper nutrition. But I was not and am not, the only one who grew up with lack of education about nutrition and many people grow up with a lack of education in general for numerous reasons. So,  how can we expect people to make healthful choices when they don’t know? How can we look at people and judge others by thinking “wow I can’t believe they are feeding their kids that” or “wow these people should’ve known better” when many people just don’t have the proper education they need? We cannot place expectations on people when we don’t know what kind of education they had or have. I have talked to many patients and coworkers and many things they say surprise me. Many people don’t know that pop (yes, it is POP when you are from MN) is loaded with sugar, or that “healthy” things such as yogurt and granola bars also are. Many people don’t know how much added sugar we are recommended per day, or what foods have certain vitamins and minerals, or that going on “detox” diets won’t fix all your problems. Many people hear things from the media or other people and just believe those things. Most people don’t know how to look at research and interpret it or to tell good sources from bad. Someone asked me the other day at a health fair, “I have heard that one egg a day is too many, is it okay if I have eggs sometimes?” Of COURSE! (one egg a day is NOT too many by the way). There is no such thing as a dumb question when it comes to nutrition and that is something I have learned. Don’t expect everyone to be as educated as you are. Most people are not and we cannot expect people to make healthful decisions when they just have no idea what that is or looks like. As dietitians, we can be the ones to give people credible and reliable nutrition education and that is exciting to me. 

(Exhibit A: people see things like this in the media or online somewhere and trust it without knowing that this is virtually impossible but how would they know?) 

3. Foodservice businesses are families

Before starting this internship, I was not looking forward to my foodservice rotations. As dietetic interns, we must get 8 weeks of experience in foodservice. I just wanted to get them over with to be honest. I thought to myself, “well I am not going to learn much or enjoy it. Just get through it.” Well, believe it or not, I have done 6 weeks of foodservice and leaving those rotations has been harder than leaving my clinical ones. Not because I became more passionate about foodservice itself, but because of the amazing people and foodservice families I met and became a part of. The strangers I met became the people that have been the hardest to say goodbye to. Foodservice workers become family and interact like family in a way. They fight, disagree, gossip, complain, get on each other’s nerves, but they also love one another, support one another, make each other laugh, fill in for one another, train one another, and get to know one another. They celebrate one another, write cards and collect a donation for someone if they have a parent or loved one pass away, ask one another if they are okay, and they take on newbies like me and welcome them into the family. These people cracked me up and welcomed me kindly and lovingly. They all work extremely hard, and no, foodservice employees are not perfect and they make mistakes but they have great intentions to do the best job they can. I became close with a lot of people and it was always so hard to say goodbye. I was at two different hospitals for my foodservice rotations and I felt like part of the family in both of them. This is something I did not expect. 

(me celebrating ugly Christmas sweater day with some of my foodservice coworkers!) 

4. Don’t judge a book by its cover

This one comes back to my number 2 a little bit. A simple but critical thing I have learned is that we cannot judge anyone as we don’t know their story. Sometimes, we can look at people, and as health professionals, we can make judgements about how people look, are shaped, if they are overweight and/or underweight, etc. The reality is though is that everyone has a story and we do not know it. We can’t assume someone is overweight because they can’t control themselves and eat too much. We don’t know their genetics, their household they grew up in, their economic situations, and what they have gone through to lose the weight. We cannot assume someone is underweight because they just are stubborn and won’t eat. We don’t know what is going on inside their head, the physiological processes behind their condition, their history or genetics, or the amount of times they have tried to gain the weight back but just can’t yet. We don’t know their education levels or how they grew up. So, don’t judge or make assumptions until you get to know someone. As future health professionals and future dietitians, this is a continual challenge for all of us.

5. We can make a difference in people’s lives if we tailor our nutrition interventions to the client/patient

Individualize, Individualize, Individualize. That is the key to being an effective dietitian. We learn in school all the physiological processes of the body, all the disease states, and all the nutritional interventions that should match each one. We learn what we SHOULD be eating and teaching others to eat. However, there is no one formula or right answer we can use for every person we are nutritionally counseling. And I had heard that we had to individualize before this internship but actually interacting with my own patients and clients has taught me that every person is different, even if they have the same disease or coming in for the same reason. Every person’s lifestyle, family situations, genetics, backgrounds, psychological state, motivation level, etc. are different. I cannot preach the same message or make the same nutritional plan for every person. The key to making a difference in people’s lives nutritionally is individualizing my plan and intervention to that unique person. We can, and we will have an impact if we focus in on what THAT person wants, needs, and is willing to do because not everyone is the same. We will not make a difference if we treat every person or disease state the same. I love this aspect of being a dietitian because this means that no day, no patient or client, no disease we encounter is ever the same.

I hope you enjoyed reading a little bit about what I have un-expectantly learned through my (almost) first half of my internship. It is a good reminder to keep your mind open in the dietetic internship and in life and you never know what you can and will learn! 

Making New Year’s Resolutions Actually Stick

By: Gillian Lewis

 

Have you already broken your New Year’s resolution? Well, you are not alone! On average, 80% of New Year’s resolutions fail by the second week of February. Health-related New Year’s resolutions are among the most popular types of resolutions. Some common examples include weight loss, healthier eating habits, and increasing exercise. Despite the emphasis on health, very few of these health-conscious resolutions are effective as only 8% of resolutions are maintained throughout the entire year.

There is some good news - breaking a New Year’s resolution does not mean all hope is lost. People like to look at New Year’s as a symbolic day to make significant life changes, but in reality, changes can begin on any day.  2018 can still be the year to make healthy changes!

Tips for Setting Nutrition-Related Goals that Last:

    1. Be SMART (specific, measurable, achievable, realistic, and timely).

Set goals that are specific, measurable, achievable, realistic, and timely. It’s easy to say, “I’m going to

eat healthier in 2018,” but what does that actually look like? There are several possible interpretations of healthy eating – eating more fruits and vegetables, eating less processed food, drinking more water. Such a vague goal doesn’t inspire action. Goals need to be specific, measurable, and timely enough so that an action plan can be developed. A goal to, “Eat 5 servings of fruits and vegetables every day” is clear cut about what needs to be done to succeed.

The problem with most New Year’s resolutions is that they are overly ambitious and too drastic. Quitting a habit cold turkey is rarely an effective method. Instead, it is important to set smaller, more realistic goals so that you have a chance to adjust to the behavior change. For example, if your overall goal is to stop drinking soda and you drink 5 cans of soda per day, it is more sustainable to gradually reduce your soda intake than to completely stop. Remember, behavior change is not a sprint!  

      2. Have a plan.

With goal setting, planning for change is just as important as setting the actual goal. Developing a specific action plan is important for sustainable behavior change. For example, if your goal is to, “Eat 5 servings of fruits and vegetables per day,” plan what each serving will be on a daily or weekly basis. When planning for nutrition-related goals, it is also important to plan in the healthiest way possible. Before making any significant changes, get expert advice from a registered dietitian and do your research from verified sources such as the Academy of   Nutrition and Dietetics (eatright.org) and the USDA (nutrition.gov).

      3. Moderation!

Especially with nutrition-related goals, moderation is key. When setting these goals, it is important to not completely deprive yourself of your favorite foods. As stated before, too drastic of a goal often does not lead to a sustainable change. If you are trying to limit your intake of junk food, give yourself some wiggle room when setting a specific goal. Allow room for a bowl of your favorite ice cream on occasion. Food is meant to be enjoyable after all!

   4.  Find a way to keep yourself accountable without being too hard on yourself.

Accountability and discipline are important aspects of accomplishing any goal. When setting nutrition-related goals, it is crucial to find ways that will keep you accountable. Some ideas include telling your friends and family about your goals to help keep you on track, using an app, or setting daily reminders and alarms. It is important to find what works best for you. With that being said, mistakes are bound to happen. In the behavior change process, it is crucial to take mistakes with a grain of salt and not get so down on yourself that you scrap the goal entirely. One mistake does not mean the goal is ruined. In fact, mistakes can be indicators as to what part of your plan is working and what is not. With behavior change, it is important to be persistent and adjust when mistakes occur.

Goal-setting is a continuous process. Even as a dietetic intern, I set health goals for myself. At the start of a New Year, I gave myself the goal of reducing the amount of sugar I put in my morning tea. While I want to keep my sugar intake low, I know it is not realistic for me to not add any sugar to my tea. At first, I reduced the amount of sugar by one quarter and it was a fairly easy adjustment. After two weeks of that, I reduced the amount of sugar even further, which was a little more difficult but still manageable. I am proud to say that I am not one of the many that have broken their New Year’s resolution! Following these tips when I set my goal is a major reason why I have stayed strong.

While these tips are not very flashy or exciting, this gradual, focused goal-setting method is the most likely to produce sustainable behavior change. As the saying goes, slow and steady wins the race!  

As a future dietitian, I strongly feel that these goal-setting and counseling skills are just as important

as the nutrition knowledge. As a profession, we strive to make people as healthy as possible through nutrition. People cannot be healthy unless they are motivated to do so - I wish I could have a dollar for every time I’ve heard, “I know what to do, I just need to do it” from a patient. For dietitians, nutrition knowledge and behavioral counseling must go hand in hand to achieve the desired healthy behaviors.

What healthy changes will you be making in 2018?

Sources:

https://www.forbes.com/sites/dandiamond/2013/01/01/just-8-of-people-achieve-their-new-years-resolutions-heres-how-they-did-it/#551ca4e2596b

http://www.businessinsider.com/new-years-resolutions-courses-2016-12/#exercise-more-often-1

http://maristpoll.marist.edu/1220-being-a-better-person-weight-loss-top-2018-new-years-resolutions/

Picture Sources:

http://www.stevensonfitness.com/5-5-new-years-resolutions/

http://www.teachhub.com/classroom-management-boost-learning-goal-setting

https://www.flintrehab.com/2015/goal-setting-for-stroke-rehabilitation/

http://agamefitandperform.com/2017-04-04-goal-setting-class

http://affirmyourlife.blogspot.com/2009/07/healthy-eating-affirmations.html

A Journey to Food, Cultural Competency and Nutrition

By Monique Lavalas

Mark Kurlansky once said, “Food is a central activity of mankind and one of the single most significant trademarks of a culture.” There are many things that connect people and cultures. One of those main things is none other than food. Food is one of the pentacles that make cultures so unique. Cooking reflects history. Food is also reflecting of family memories or memories of childhood. Food has a bigger value to what we can ever imagine. I know this because as an international student in this program, I have been exposed to many cultures, but two that I hold to heart are the Latino and afro-Caribbean cultures. To these two cultures, that I have been exposed to from being born and raised in Panama, I owe every initial knowledge that I have about food, which is tied to memories and causes us to reminisce old moments or create future one. Food is a key component of any to culture.

My Senior Year High School Folkloric Dance Presentation

Even though I have been exposed to these cultures that are second nature for me, I have also learned and submerged myself in other cultures as well. From a tender age, I was exposed to the American culture and was fortunate to see the European and South American cultures later in my life. But initially this was a challenge. It was a challenge to try and understand the cultural significance of the things that the people around me did, and why they did them, and not see it as a right or a wrong. Just to initially understand. By doing this, little by little did I understand people more and more, and I was able to reach my goal which was to identify and relate myself to them.

Ladies of the Ngäbe-Buglé community in Panama. Photo taken from Panama24horas.com.pa

One experience that I had in my own country was to volunteer at non-profit, non-governmental organization, in which they cater to prevent malnutrition in boys and girls from impoverished communities around the country. My task was to develop a booklet of recipes that parents could use for their children. But the challenge was we could only use a certain list of ingredients. Such list lacked ingredients such as flour, milk or even eggs, that as a Western society we are so used to having. This experience helped me submerge myself into understanding the core of such cultures in the native communities of Ñurum and Nole Duima, part of the provincial-level indigenous region of Ngäbe-Buglé in Panama. It helped me refocus my attention of the significant role that food and family have in not only their community, but in our world, and how gradually we have lost track of such practices since our Western society has become so individualized. In these communities, one could see a clear difference in details such as the kitchen location and the interpersonal relationship among parents and their children. Their kitchen was made of bamboo stakes and was located in the outer area of their mud house. Their stoves were also made of mud, and some of their cooking ware was metal or cast iron. Such an experience was inspirational to me, for I was able to see a story other than my own, which helped me have a change in perspective about the beauty of food, nutrition and culture, but more importantly, the beauty of people.

Photo collage of foods we made for the community of Nole Duima and Ñurum.

As future dietitians, we will encounter all sorts of clients or patients in our path, but there is nothing better than to have a deeper understanding of how culture creates a sense of cultural identity in the life of each person. By understanding and being culturally competent we can open barriers and grow to have a better relationship with such patients or clients. Having a good understanding of some’s culture goes beyond race or ethnicity. We must be understanding and acceptant of other’s values, beliefs, principles, or background and not just our own. But one may ask, how can we as future dietitians reach such a level of cultural competency? Some useful suggestions that I have been able to acquire from different professional in and out of the Nutrition & Dietetic fields, and from personal experience are:

1.First, examine your own cultural background. Ask yourself questions. Be reflective of what you are used to and your own culture.

2.Recognize that culture extends past the color of someone’s skin.

3.Find out about the patient’s background. Research and do not be afraid to ask certain questions. Ask questions about what they prepare at home, what are their favorite foods, what are their likes and dislikes. Be open to understand their food habits.

4. Wet your feet and engage in other cultural encounters.

5. Last, but not least, be genuine.

With this I hope we may all grow to be understand more of people and even more of ourselves.

“Culture is a window reflecting the history, culture and spiritual world of a nation, ... Cultural exchange is a bridge to enhance the mutual understanding and friendship between the people of different nations,” as said by Ju Hintao.