Ever hear of the term "Freshman 15"? This is an informal term which refers to the average amount of a weight many new college students gain in their first year of school. The quarantine 15 is a similar concept...15 pounds in the first year of a pandemic! While this is not technically an actual medical term, this weight gain phenomenon is the most common complaint I hear from patients, friends, and co-workers. It's not surprising. Our lives have been disrupted in major ways, which means normal routines have changed including eating and exercising patterns.

Although studies on the impact of COVID 19 on weight gain or weight loss are just starting, it appears that for many, this is a real concept. According to Yale Medicine, this year is especially challenging for people who struggle with their weight. John Morton, MD, MPH, MHA, medical director of bariatric surgery at Yale New Haven Health System, says he has seen patients in telehealth appointments who have gained five, 10, and even 30 pounds. 

• Routine. Our routines have been drastically altered; many more people are working at home while their children are also at home trying to learn. Additionally, it's easy to get out of routine when home is considered a place to relax and let go. There is no better time than now to create a new routine. Plan a consistent time to wake up, go to bed, for meal times and/or meal preparation, and exercise.
• Sleep. According to the National Sleep Foundation "Numerous studies have suggested that restricted sleep and poor sleep quality may lead to metabolic derangement, weight gain, and an increased risk of obesity and other chronic health conditions". ​It is recommended to try to get at least 7 hours of sleep each night for adults. Here are the recommendations for all age groups:

               > Newborn (0-3 months):  14-17 hours                 > Teen 14-17 years old 8-10 hours
               > Infant (4-11 months):  12-15 hours                     > Young Adult (18-25 years): 7-9 hours
               > Toddler (1-2 years): 11-14 hours                        > Adult (26-64 years): 7-9 hours
               > Preschool (3-5 years): 10-13 hours                    > Older Adult (65 and older): 7-8 hours
               > School-age (6-13 years): 9-11 hours

• ​Mindfulness. Being aware of what you are eating and why is important. Are you eating because you are bored? Anxious? Sad? Are you truly hungry? Once you have identified what is driving you to eat that extra bag of chips or your kids' halloween candy, you can take the necessary steps to combat it:
          > Eating out of boredom? Try to divert your attention to activity. Go for a walk, jump rope, do
             some jumping jacks or perhaps you just need a drink of water. 
          > Anxious? Sad? Stressed? Try to identify the root cause and address it. If unable to directly,
             find another outlet; write in a journal, color in a coloring book, do yoga, or go for a walk are a
             few ideas.
• Exercise. Perhaps you've noticed a theme in the previous recommendations. They all include a component of exercise. The American Heart Association recommends at least 150 minutes of moderately intense activity per week. This means you need to get your heart pumping!

With a pandemic in full effect, you may be wondering about other ways to protect yourself besides thorough hand washing and using disinfecting products. Keeping your body as strong as possible through nutrition and exercise is important now more than ever. Here are four tips to keep your immune system top notch.


1. Eat colorful fruits and vegetables. The deeper and richer the color, the more antioxidants that particular fruit or vegetable packs. The thought is that antioxidants may prevent damage to immune cells by neutralizing free radicals – agents in the environment that may damage your cells and reduce your immunity. Having a hard time finding fresh produce? Frozen and canned fruits and vegetables count too! Examples of fruits and vegetables loaded in antioxidants include those that represent the colors of the rainbow such as:
-raspberries
-sweet potatoes
-yellow bell peppers
-spinach
-blueberries
-eggplant


2. Eat vitamin rich food. Foods that are high in antioxidants are also rich in vitamins. Eating vitamin C rich foods provides your body with more benefits than taking a vitamin C supplement because food provides other vitamins and minerals that a supplement alone may not. Additionally, taking supplements with large doses of vitamin C is a waste of your money because the body will excrete excess vitamin C in the urine. Vitamin C acts as an antioxidant and plays a role in cartilage development and wound healing. Vitamin C rich foods include:
-citrus foods
-potatoes
-tomatoes
-green and red bell peppers
-Brussel sprouts
-kiwi


3. Eat lean protein. Protein plays a role in the body's immune system, especially for healing and recovery. There are a lot of beans missing from grocery shelves recently, but do you know how to use them? My favorite way to use beans is in what I call a “Power Bowl”. Here is what I include in mine:
-1/2 cup cooked quinoa or brown rice
-1/2-3/4 cup beans (my go-to beans are black beans and/or garbanzo but you can use any kind)
-1/2 of an avocado
-3/4-1 cup sautéed red, yellow and orange bell peppers (I sauté mine in olive oil)
-2 Tbsp salsa ( I like mango salsa)
-1/4 cup shredded cheese


This is one of my favorite meals because it’s quick and easy and packs protein, fiber, monounsaturated fats (the good fats!), vitamin C, calcium and iron. Protein sources such as meat and eggs are pretty limited in grocery stores right now so don’t forget about other protein sources like nuts and nut butters, dried beans, quinoa, soymilk, tofu, tempeh and yogurt.


4. Get your vitamin D. Vitamin D deficiency is associated with increased susceptibility to infection. With some counties ordering residents to shelter-in-place it can be hard to get adequate sunshine. Try to get at least 15 minutes of sunshine by sitting on your porch, in your yard or taking a walk while social distancing. It’s also good to breathe in some fresh air!


Stay strong and healthy everyone!
Aftan Bryant, RDN

Mary Purdy, MS, RDN

​During this trying time of concern over COVID-19, commonly referred to as coronavirus, recommendations from the Centers for Disease Control and Prevention and other state and federal organizations have centered around washing hands, avoiding touching your face, and staying home.
However, not much press has been given to a key concept that dietitians know plenty about when it comes to staying well: tapping into the power of diet (and supplements) to fortify the body’s immune function. RDs have an incredible opportunity to leverage their knowledge and experience and potentially play a vital role in helping to reduce the spread and severity of COVID-19.
As dietitians know, there are numerous dietary and supplemental strategies that can offer support for a more resilient immune system. No matter your place of work, you can offer the following helpful advice to clients.
1. Consume immune-protective herbs and spices. Ginger, garlic, onions, oregano, rosemary, and thyme all have properties that help fight off viruses and harmful bacteria and give the body’s defenses a natural boost. Suggest clients whip up garlicky hummus, sip raw ginger tea, and throw oregano and rosemary into salads and roasted vegetable dishes or even a chickpea/tuna salad. Or go for an all-in-one elixir with my flu buster.
2. Munch on more orange foods. Carrots, sweet potatoes, and winter squashes all are rich in beta-carotene, which has been shown to protect lung function and act as a strong defender against less favorable bugs. Beta-carotene also gets converted to vitamin A, which is critical for immune function. Bright-colored fruits and veggies in general offer all kinds of antioxidant protection and bolster the body’s infection-fighting mechanisms.
3. Eat vitamin C–rich foods. Citrus, red peppers, broccoli, and kiwi all are great sources of vitamin C. Suggest clients start their day with a grapefruit or an orange or throw sliced peppers on their sandwich. Studies show that consuming vitamin C can help prevent illness. For extra insurance, I suggest a supplement of 500 mg/day. Recommend clients read supplement labels to look for accompanying flavonoids, which help improve absorption and utilization of this important nutrient.
4. Zap it with zinc. Zinc is key for immune function, and it tends to be lower in those who are older, who take antacids, and in some vegetarians and vegans. Clients can find high amounts of zinc in meat and seafood and in moderate amounts in sunflower and pumpkin seeds. A low-dose supplement of 15-25 mg/day (taken with food) can offer clients an additional immune-system boost. Remind clients that supplement quality matters, and suggest they look for zinc supplements in the form of zinc picolinate, which has been shown to be best absorbed.
5. Pop a fortifying supplement. I swear by elderberry syrup or tinctures. Research shows elderberry can protect against flu and fortify the immune system as well as be an effective treatment for upper respiratory infections. This supplement can be found in natural food stores and even in some drugstores. Trusted brands clients can look for include Sambucol, Gaia, or Garden of Life.
6. Get your vitamin D. At this time of year and for those living in more northern locations, serum levels of this critical vitamin can decline. Vitamin D is essential for optimal immune function and has been shown to help address respiratory infections. Supplementing is an easy way to get 1,000 IU/day, a safe amount for most people and one shown to raise low serum vitamin D levels (ie, those below 30 ng/mL). Vitamin D also can be found in mushrooms, fatty fish, and eggs.
7. Give the magic of mushrooms a try. These fungal gems can offer an excellent boost to the immune system and provide some food (in the form of beta glucans) for beneficial gut bacteria, which help fend off infection. Suggest clients toss them into salads, stir-frys, and soups or, if mushroom ain’t their thang, there’s a supplement for that. My personal fave: MyCommunity, a collection of different mushrooms for immune support in a simple capsule.
8. Minimize alcohol, sugar, and processed foods. Not only can the consumption of these foods increase the risk of suppressing the immune system, but eating them often means that healthful and supportive nutrients are displaced. Getting clients and patients to focus on a whole foods diet instead of heavily processed foods and try a seltzer with a splash of juice or a few drops of bitters instead of a cocktail can be helpful advice.
Think dietitians can’t also be superheroes in the COVID-19 outbreak? Just watch us!
— Mary Purdy, MS, RDN, serves as adjunct faculty at Bastyr University where she earned her master’s degree. She has provided clinical nutrition counseling for the past 12 years, hosts the podcast Mary’s Nutrition Show, and speaks regularly at a variety of conferences.
reprinted from: https://rdlounge.com/2020/03/06/8-ways-to-boost-immunity/

What are Registered Dietitians Nutritionists?
 

• Registered Dietitian Nutritionists are the food and nutrition experts who can translate the science of nutrition into practical solutions for healthy living.
• Registered Dietitian Nutritionists have degrees in nutrition, dietetics, public health or a related field from well-respected, accredited colleges and universities, completed an internship, passed an examination and maintain continuing education.
• Registered Dietitian Nutritionists use their nutrition expertise to help individuals make personalized, positive lifestyle changes.
• Registered Dietitian Nutritionists work throughout the community in hospitals, schools, public health clinics, nursing homes, fitness centers, food management, food industry, universities, research private practice and more.
• Registered Dietitian Nutritionists are advocates for advancing the nutritional status of Americans and people around the world.

Modified from the Academy of Nutrition and Dietetics. National RDN Day.

​You may have started to notice that the Nutrition Facts Label, found on the back of food packaging, appears different. That’s because the U.S. Food and Drug Administration (FDA) published new rules for the label back in 2016. These rules are finally coming into effect. All food manufactures must change their label by January of 2021. This is the biggest makeover since the Nutrition Facts Label’s inception in 1993.
What are some of the new changes?

• Serving sizes have been updated to reflect more REALISTIC portion sizes and depict what people are actually eating and drinking.
  • Old label, “You’re trying to tell me, I’m only supposed to eat ½ cup of ice cream?”
  • New label, “2/3 cup of ice cream is a more realistic portion.”
• New fun & fresh design. The type size for “Calories” and “Serving size” are bigger and bolder making it easier for people to read and navigate.
•  Have you noticed the extra section under Total Sugars? ADDED SUGAR must be noted on the label. Added Sugars include table sugar, sugar from honey, syrups, and concentrated fruit or vegetable juices. It is recommended to aim for 10% or less of your total calorie intake to be from added sugar.
• Daily percent values of different micronutrients are shown. Vitamin A and C are no longer required to be shown on the label because nutrition deficiencies of these vitamins are rare among Americans today. Vitamin D and potassium are now required on the label because evidence shows many Americans do not consume enough of these nutrients.

Overall, the new design and requirements will help you make more informed food choices that encouraged healthy eating habits. If you want to learn more about the Nutrition Facts Label changes, see resources provided below.
Resources:
Changes to the Nutrition Facts Label
FDA New and Improved Nutrition Facts Label
Side-By-Side Comparison of New vs. Old Label
Written By:
Gabrielle Vandergriff, RDN



Recipe of the Week - Drop the Beet 😊
 
Beet and Goat Cheese Quinoa Salad
Serves 4
Ingredients
1/2 cup dry quinoa
1 cup cold water
1 T olive oil
2 tsp lemon juice
1/4 tsp kosher salt
Freshly ground black pepper, to taste
1 cup cooked, diced beets
1/4 cup crumbled goat cheese
Directions
1. To prepare the quinoa, place in a small to medium saucepan and add water. Bring to a boil over high heat, then reduce heat, cover, and simmer gently for 10 to 15 minutes, until all the water is absorbed.
2. Transfer cooked quinoa to a large bowl and let it cool. Add olive oil, lemon juice, salt, and pepper to taste. Toss to coat the quinoa.
3. Add beets and goat cheese and fold into the quinoa mixture. Serve at room temperature or chilled.
Nutrient Analysis per serving
Calories: 218; Total fat: 12 g; Sat fat: 5 g; Cholesterol: 27 mg; Sodium: 354 mg; Total carbohydrate: 19 g; Sugars: 3 g; Dietary fiber: 2 g; Protein: 10 g
— Recipe by Jessica Levinson, MS, RDN, CDN, culinary nutrition expert and recipe developer. Find more of her recipes at JessicaLevinson.com.

1. Fuel Your Body throughout the day


Eat three meals and two snacks. Incorporate a source of protein, fat, and carbohydrate to form a balanced meal so that your blood sugar remains stable. Optimally, you will eat every 3-4 hours. If you wait longer than 4 hours to eat, your blood sugar may get low, which can cause irritability, anger, and mood swings. When you are starving, you are more likely to overeat at your next meal.
 
2. Hydrate, Hydrate, Hydrate


Drink at least 64 ounces of water daily. Of course, if you have a medical condition that limits your water intake, then follow the recommendations of your physician or other healthcare providers. You need adequate water for your body to function correctly. When you are dehydrated, you may become sluggish, irritable, and may affect mood swings. Some people can mistake hunger for thirst and overeat. If you do not like the taste of water, you can add sliced oranges, lemons, or limes for flavor. It's best to choose non-caffeinated beverages. In certain people, caffeine can cause anxiety and a reduced ability to handle stress.
 
3. Avoid processed, sugary foods.
 
When you eat high sugar foods, it rapidly creates a spike in your blood sugar. Because simple sugars digest quickly, your blood sugar can plunge back down to being low creating a roller coaster effect, which can manifest itself in swings of energy and mood. Low blood sugar can create a craving for more sweets, which continues the roller coaster cycle of blood sugar of ups and downs.
 
4. Omega 3 Fatty acids


Omega-3 Fatty acids are essential in the diet. Omega 3 fatty acids have been showed to reduce the symptoms of depression. Fatty fish such as sardines, tuna, and salmon are good sources of omega-3 fats. Plants also contain omega-3 fats such as flaxseeds and avocados. If you are taking blood thinners, consult your physician before adding a fish oil supplement. You can always start with eating foods high in omega-3 fats and contact a dietitian for personalized supplement recommendations.
 
5. Choose nutrient-dense foods for adequate vitamins and minerals.


Your body requires adequate vitamins and minerals to support the production of energy and neurotransmitters. Without these nutrient building blocks, you may lack sufficient neurotransmitters, which may contribute to low energy and depression. Nutritional deficiencies of iron, calcium, magnesium, vitamin D3, thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, and tyrosine can also lead to low energy and depression.
 
Iron: Asparagus, bok choy, dark green leafy vegetables (collard greens, turnip greens, spinach, etc.), lentils, red meats, and turmeric.
 
Calcium: Cheese, yogurt, tofu, sardines, milk, fortified non-dairy milk
 
Magnesium: Black beans, navy beans, soy, pumpkin seeds, and quinoa
 
Vitamin D3: Egg yolks, salmon, mackerel, tuna, and fortified foods

Thiamin: Lentils, oat, barley and beans
 
Riboflavin: Broccoli, cheese, chicken, beef, almonds spinach
 
Niacin: Meats such as beef, chicken turkey, salmon, sardines, and lamb

Vitamin B6: Tuna, turkey, salmon, sardines, beef, chicken, lamb
 
Folate: Dark green leafy vegetables, lentils, broccoli and beans
 
Vitamin B12: Yogurt, shrimp, scallops, salmon, eggs, cod, chicken, and beef.
 
Tyrosine: seaweed, chicken, salmon, turkey, swiss cheese, pumpkin seeds, white beans, eggs

In the beginning, the best way to get started is to start by improving your diet. Food is nourishment, but it is also an instruction manual that activates DNA to produce hormones, enzymes, and neurotransmitters. There are far more phytochemicals and even unknown beneficial ingredients found in food and not in vitamins that affect our health.
 
Supplements should supplement the diet and not be the main course. Concerning supplements, taking more is not always better. Excessive supplementation may cause body imbalances and toxicity, which can be as harmful as a nutritional deficiency.

​Jeremy Thararoop, DCN, RD

February can be a time of cold and snow, especially in Denver, Colorado. Many of us crave warm meals during the winter months after a long day. I work with patients with chronic kidney disease and end stage renal disease. A renal diet can seem very restrictive and many of my clients feel they can no longer enjoy the “winter” foods (such as soup) they once enjoyed due to concerns for high sodium, potassium, and phosphorus. A crowd favorite soup has always been chicken noodle soup. Below is a recipe I like to recommend to my clients that can be enjoyed by most people in the family.
Portions: 10 Serving Size: 1-1/4 Cups
Ingredients
· 1 prepared rotisserie chicken
· 8 cups low-sodium chicken broth
· 1/2 cup onion
· 1 cup celery
· 1 cup carrots
· 6 ounces wide noodles, uncooked
· 3 tablespoons fresh parsley
Nutrients per serving
Calories 185
Protein 21 g
Carbohydrates 14 g
Fat 5 g
Cholesterol 63 mg
Sodium 361 mg
Potassium 294 mg
Phosphorus 161 mg
Calcium 22 mg
Fiber 1.4 g


Preparation
1. Remove chicken from bones and chop into bite-sized pieces. Measure 4 cups for the soup.
2. Pour chicken broth in a large stock pot; bring to a boil.
3. Chop onion; slice celery and carrots.
4. Add chicken, vegetables and noodles to stock pot.
5. Bring to a boil and cook approximately 15 minutes until noodles are done.
6. Garnish with chopped parsley.
Recipe: https://www.davita.com/diet-nutrition/recipes/soups-stews/rotisserie-chicken-noodle-soup
​By Liz Graham, RDN
 

30-Minute Workouts for Any Schedule
By Heather Mangieri, MS, RDN, CSSD, LDN
Published February 3, 2020
Reviewed January 2020

​
Even with the best intentions, it's easy to let a busy weekly routine crowd out regular physical activity. Yet, the beneficial effects of exercise are undeniable. Current recommendations suggest that in a week, adults get at least 150 minutes of moderate-intensity aerobic exercise such as such as brisk walking or cycling, and two to three days of muscle-strengthening activities.
It doesn't have to be done all at one time. The 150 minutes can be spread out throughout during the week, and even broken into smaller chunks of time throughout the day. Research suggests that small bouts of exercise throughout the day compared to one prolonged bout can be equally beneficial to one's health. In addition, smaller bouts may be easier for people to implement and maintain. So, if you can't seem to find 30 consecutive minutes in a day for your workout, you can still fit it in by splitting up the time.
To help keep exercise a priority, schedule it into your calendar like any other appointment or task. Scheduling is a straightforward way of converting an intention or activity into a long-lasting habit.
10-Minute Mini-Workouts
Try taking 10 minutes in the morning, afternoon and evening to do some form of activity. This can include 10 minutes of body weight exercises (push-ups, crunches, lunges, squats, etc.) in the morning, a 10-minute brisk walk during your lunch break at work and 10 minutes of yoga-inspired stretching in the evening.
Involve the Family in Daily Fitness
Thirty minutes will fly by if you get the kids engaged in something that they, too, can enjoy. Grab the family and head out for a walk, game of tag or bike ride.
Clean with Purpose
Don't just sweep the floor, scrub the floor. Don't just unload the dishwasher, dance with the dishes. Minutes add up fast when you move more during your clean-up time.
Look for Opportunities to Walk
Suggest work meetings on the go. Moving while meeting can foster creativity and communication often is improved when conducted side-by-side compared to face-to-face. Outdoor air also improves mood and enhancing collaboration. If your job has you hanging out in airports on a regular basis, make that an activity for you, too. Walking while waiting in the airport can easily add thousands of steps to your day.
Thirty minutes of activity accumulates quickly when you seek out opportunities, such as taking the stairs, parking far away or doing yard work.
If you can't seem to find the self-motivation needed to make it happen, consider recruiting a workout partner or hiring a fitness professional. Knowing that someone is expecting you at a certain place or time can help to enhance accountability for being more active.
Heather Mangieri, MS, RDN, CSSD, LDN is a spokesperson for the Academy of Nutrition and Dietetics based in Pittsburgh, PA.
https://www.eatright.org/fitness/exercise/workout-ideas/30-minute-workouts-for-any-schedule
​____________________________________________________________________________________________________________

​Valentine’s Day
My coworker and fellow dietitian, Aftan,  told me about a Greek Yogurt Chocolate Mousse she made for a cardiac class.  I thought that sounded like a great recipe for Valentine’s Day so I gave it a try.  I decided I like a stronger chocolate taste and made some adjustments.
 
2 T Hershey’s sugar free chocolate chips
¼ c Skim milk
2 c Fat free plain Greek yogurt
1 t vanilla extract
1.5 t Lakanto Monkfruit sweetner or sugar
3 T Unsweetened cocoa powder
1 c Raspberries
Reddi Whip Dairy Topping (fat free)* optional
 
Melt the chocolate chips in a microwave safe bowl for 1 minute, then stir.  If not completely melted, microwave for another 30 seconds and stir. 
In a mixing bowl add the Greek yogurt and whip with an electric mixer until fluffy.  Add the skim milk, vanilla extract, cocoa powder, and monkfruit sweetener or sugar.  Beat until incorporated into yogurt.  Next add the melted chocolate a little bit at a time beating in between additions.
Divide the mousse into 6 portions and top with raspberries and whipped dairy topping.  

Adapted from diabetesfoodhub.org  greek-yogurt-chocolate-mousse

​By Jen Leone
_____________________________________________________________________________________________________________

Motivation is a Fickle Friend

​​Motivation and Determination

Motivation and willpower are fickle friends.  They come on strong and propel you into action.  Until something bumps you off track.  Could be the cold weather or long day at work and then you find motivation and willpower are nowhere in sight.  How do some stay on track when their motivation leaves them high and dry?  What gets them to the gym or out for that walk or keeps them on track with their plan on the days that they lack motivation and willpower?  Determination!
 
They have a determination that drives them.  A force of feelings that won’t distract them from their goal or new way of life.  Determination will drive you into action more so than motivation.  Don’t get me wrong, motivation is essential but being determined will help you stay on course.  But how does one become determined.  Here are some steps to take to develop your determination. 
 
Create a strong and specific goal.  I am determined to ________.   Your decision is now set and this will help motivate you through difficult and stressful times.  Mentally brush away doubts or excuses and stay focused on your goal. 
 
Don’t let fear crush your determination.  Fears can drain your energy, destroy your creativity, and can blast away your concentration.  Face your fears head on and you will be more determined.  Have positive affirmations on hand to help wash away pesky fears.  Your affirmation could be as simple as “I can do this!”
 
It’s important to know your “why”.  Why did you choose this goal?  To feel better?  To avoid diabetes or a heart attack?  Having a strong “why” will keep you focused.  Make sure your “why” is strong so it holds up against days you are feeling less motivated.   Your why will help create your determination and your determination will drive your motivation and willpower. 
by Jen Leone
 

Another year has ended, which means it’s time for New Year’s resolutions in the hopes of making the next year better than the one before.
New year new me…right?
 
Studies have shown that in the first 30 days of the year less than 25% of people stay committed to their New Year’s resolutions.  One of the most common resolutions millions of people set every year is to exercise more and lose weight. Many people fail to create a plan to achieve these goals and get discouraged when they don’t see immediate results. One of the most helpful tools in planning for weight loss is to use SMART goal setting framework.
 
Specific- Make a clear statement about what you’re trying to achieve. For example, lose weight for my health is more specific than be healthy.
Measurable- Make your resolution quantifiable. For example, I will lose 10% of my body weight.
Attainable- Set a realistic goal for yourself that is still challenging. I will exercise for 1 hour
7 days/week is likely not attainable and will cause stress when not achieved. I will exercise for 30 minutes 5x/week is more realistic.
Relevant- Make sure losing weight and exercising more is a goal that is truly important to you and not dictated by a friend, family member, or spouse.
Time-sensitive- Give yourself a deadline to create urgency and so that you can look forward to celebrating your success.
 
Now that you’ve thought of some goals, write them down! We live in a world full of distractions and it can be easy to get distracted or forget your resolutions throughout the year. Writing down your resolutions helps you clarify what it is you want to achieve, establishes intention, and will act as a guide throughout the year.
 
Many of us tend to be over eager and ambitious when it comes to resolutions. It’s important to break up big goals into smaller goals. For example, if losing 100 lbs is your end goal, it can be hard to set a deadline. Break it up into smaller goals such as I will lose 15 lbs by my birthday in 4 months. This way you can celebrate small successes, which will motivate you to meet your big end goal.
 
Find a friend or family member that shares the same resolution or wants to support you in yours. Telling someone about your goal will hold you accountable and give a sense of obligation. Having a partner also makes exercise and weight loss more fun. Going for walks together, to the gym, or to an exercise class will feel like a fun day with a friend.
 
Prepare yourself for the possibility of mistakes and setbacks. Setbacks happen, especially when on a weight loss journey. Weight loss can be hard through holidays, birthdays, busy work schedules, and unexpected life events. Avoid thinking of a mistake as defeat such as “I missed going to the gym 3 days in a row, I’m never going to lose weight anyway”. Instead, own the mistake, and make up for it the next day and move forward with your schedule and goals you have set.
 
Here’s to a new year of health, happiness, and success in 2020!

Happy New Year!
     I love the week between Christmas and New Year’s Eve. I tend to relax and spend time with family and friends. Lots of food and fun too. Of course, having Type I Diabetes makes me plan and reflect more than most folks without diabetes.
     The holidays in general are challenging when it comes to food, cocktails, parties, etc. I have an insulin pump, but it does not give me free rein on food choices. I do taste and indulge more than usual, so after I’ve had all the deliousness and usually higher blood sugars for a couple of weeks, how do I come back. What tools do I have available to help get back on track?
     The most valuable is my glucometer. I make sure I am keeping a log of blood sugar readings so I can take the appropriate amount of medication for my food intake before and after meals if needed. Everyone follows a different routine, but I count carbohydrates and I use insulin to combat the rise in blood sugars. Knowing how certain types of carbohydrates affect me is determined by using my glucometer one or two hours after I have consumed something. Knowing what will happen gives me more freedom in my choices and not having to fight highs and/or lows.
     Another tool I have is reading labels. Knowing what is in something gives me freedom to by-pass one brand versus another brand of the same type of product. It is surprising how big a difference there can be. Carbohydrates come from many sources meaning more eventual glucose breaking down into my system. Added sugars are in most foods that have been processed and reading the label will help me know how much per serving. If I want to eat more than recommended I can. I just need to count my carbohydrates so I can then medicate for the correct amount.
     Probably the best tool I have available is exercise. I have never been an athlete but love to play sports like bowling, tennis, golf, and softball. As I age, I find it more difficult to actually get out and do these sports so I am finding walking, swimming, extra movement when cleaning house can meet my needs. I also like simple yoga and stretching routines. Making sure I get my heartrate up is a good idea but not my entire focus. I just want to make sure I am moving! Some days I do better than others, but I know my blood sugars reflect when I have made an effort! I also just feel happier and healthier. I can have an extra snack too when I am exercising! I love my snacks.
     Exercise is a stress reliever. Like meditation or prayer works on the mind, physical exercise helps relieve bodily stress. My muscles will feel stronger, my bowels work better (always important as I get older), my blood pressure lowers, food tastes better to me. A mind body connection I use to make me more efficient and happier is something I can get behind.
      Finally, a tool very under rated is just giving myself a break. I am not perfect and having Diabetes is a 24/7 endurance of constant maintenance. My mental health is affected by my physical health. My physical health is affected by my mental health. Hand-in-hand every moment of every day. So sometimes I just allow myself the freedom to feel normal. I allow myself to not think about my blood sugar for a few hours every day. I have found gratitude helps. I am grateful I have tools to keep me on track and just go about my day. I am grateful I have a support team of family, medical professionals, and nutrition specialist to keep me motivated when I struggle to find balance.
     I am looking forward to a new year and a new decade to enjoy my life with family, work, hobbies, and things to keep my mind and body occupied. I am willing to accept I have diabetes, but diabetes does not have me. I alone determine how I chose to use my tools for myself.
Have wonderful New Year,
Elizabeth
(Wife, mother, grandmother, friend, chef, artist, and administrator)

12/20/19
Healthy Holiday Eating
Holiday meals are meant to be enjoyed! Spending time with family and friends, sharing traditions and remembering the tastes and smells of times gone by. But it is all too easy to overindulge and make yourself miserable by over-eating or drinking. This year try slowing down, savoring the flavors, smells, colors and textures of the foods. Put your fork down and talk with friends. Enjoy the season and experiences, not the stretched out waistband. Remember, you only have taste buds in your mouth, not in your stomach, so relish the flavor of the food instead of wolfing it down. Bon Appetite!

Cabbage Rolls Made with Turkey
Portions: 6       Serving Size: 2 cabbage rolls
 Ingredients

• 12 cabbage leaves
• 1 pound ground turkey
• 1/2 cup uncooked rice
• 1/4 cup onion, finely chopped
• 2 eggs
• 1/2 teaspoon black pepper (divided use)
• 1/4 teaspoon dried basil
• 2 teaspoons dried parsley
• 1-1/4 cup water (divided use)
• 3 ounces tomato paste
• 2 tablespoons lemon juice
• 1 tablespoon sugar 

 
Nutrients per serving
Calories 219
Protein 17 g
Carbohydrates 26 g
Fat 6 g
Cholesterol 96 mg
Sodium 112 mg
Potassium 581 mg
Phosphorus 190 mg
Calcium 80 mg
Fiber 3.5 g
Preparation

1. Carefully remove 12 cabbage leaves from a whole cabbage and wash them.
2. Boil a large pot of water. Add cabbage leaves and cook for 2 minutes to soften. Drain and set leaves aside.
3. In a large bowl, combine ground turkey, rice, onion, eggs, 1/4 teaspoon pepper, basil, parsley and 1/4 cup water.
4. Place 1/4 cup of the turkey mixture on the cabbage leaf and fold sides of leaf over turkey mixture.
5. Place rolls close together, seam side down in a baking dish.
6. Combine tomato paste, lemon juice, 1 cup water, 1/4 teaspoon pepper and sugar to make a sauce. Top cabbage rolls with sauce. Cover and bake at 375° F for 1-1/2 hour. Uncover and bake 30 minutes longer.

Helpful hints

• Cabbage rolls can be cooked in a slow cooker on low setting for 6 to 8 hours instead of baked in the oven.
• If you are following a low-potassium diet, be aware 2 cabbage rolls are equal to 2 vegetable servings. Consuming extra servings of fruits or vegetables can cause high potassium levels.

 


11/8/19- Positive talk.
Use positive self-talk. Instead of thinking poorly about yourself, start finding ways to think positively. When we talk negatively about ourselves, it feeds that demon and supports the downward spiral.
Change how you think about food. Instead of using the terms “good” and “bad” as it relates to food, use words like “treats” or “snacks”. The more negatively you talk about your food, the more guilt, shame, and regret you will create and the sabotage cycle will continue.

Butternut Squash Ravioli

​INGREDIENTS
FOR THE PASTA
2 1/4 c. all-purpose flour, plus more for surface
1/2 tsp. kosher salt
4 large eggs
FOR THE FILLING
1 (10-oz.) container butternut squash puree
1 c. freshly grated Parmesan 
1/2 c. ricotta
1 tbsp. packed brown sugar
Kosher salt
Freshly ground black pepper
FOR THE SAUCE
1/2 c. (1 stick) butter
2 cloves garlic, minced
1 tbsp. freshly chopped sage
2 tsp. freshly chopped thyme
Freshly grated Parmesan, for serving
GET INGREDIENTS Powered by Chicory
 
DIRECTIONS

1. In a medium bowl, whisk together flour and salt. Pour flour mixture out onto a clean surface. Using your hands, make a well in center of flour. Crack eggs into well and use a fork to slowly whisk flour into eggs until a shaggy dough forms. Use your hands to knead dough until smooth and no longer sticky, about 5 minutes. Add flour to surface as necessary to keep dough from sticking. Wrap dough tightly in plastic wrap and refrigerate for at least 1 hour. 
2. When ready to roll pasta, cut dough into quarters. Wrap all but 1 back in plastic wrap and place back in refrigerator. 
3. On a lightly floured surface, roll uncovered dough into a long rectangle about 1/4” thick. Set pasta maker to widest setting and pass the rolled out dough through 2 times. Fold short ends of dough to meet in center of rectangle, then fold in half so that the dough is in quarters. Roll out again so the dough is 1/4” thick, then pass through pasta maker 2 more times. 
4. Reduce setting by one degree. Repeat process of folding and then rolling through machine 2 to 3 times before going to the next setting. Repeat this process all the way to the thinnest setting. If your pasta sheet becomes too long to work with, cut it in half. Repeat with remaining dough in refrigerator. Keep rolled out dough covered with a clean kitchen towel. 
5. In a large bowl, combine butternut squash puree, Parmesan, ricotta, and brown sugar. Season with salt and pepper. 
6. Lay one piece of dough out on a lightly floured surface. Spoon about 1 tablespoon of filling every 1 inch. If you pasta sheet is wide enough, make 2 rows of filling. Using your finger, lightly wet in between each pile of filling with water. Gently lay a second piece of dough over top and press between filling to seal, making sure there is as little air in pockets as possible. Using a pasta cutter or pizza wheel, cut between each pocket to make individual ravioli. Repeat with remaining dough and filling. Refrigerate until ready to cook. 
7. In a large skillet over medium heat, melt butter and cook until foamy. Reduce heat to medium-low and continue to cook until butter starts to smell nutty, turns a deep golden, and the bubbling starts slowing down, about 4 minutes. Add garlic, sage, and thyme and cook until fragrant, 1 minute, then remove pan from heat. 
8. In a large pot of boiling salted water, working in batches, add ravioli and cook until tender, about 1 1/2 minutes. Use a spider to remove from water and place directly in brown butter. Gently toss to coat. 
9. Serve warm with Parmesan. 

How to distinguish between true, physical hunger vs. emotional hunger
Do you often find yourself eating when you don’t feel hungry? Not sure why you are eating? Use the tips below to help distinguish between physical hunger and emotional hunger. Identifying and decreasing emotional eating is one of the first steps to achieving your health and wellness goals.

1. Emotional hunger is sudden. It comes out of nowhere it seems. Physical hunger is gradual. Your stomach rumbles, later it growls. Physical hunger gives you steadily progressive clues that it’s time to eat.
2. Emotional hunger is for a specific food (ex: cake) while physical hunger is open to different foods.
3. Emotional hunger is “above the neck”. An emotional based craving begins in the mouth and mind. Physical hunger is based in the stomach. You feel gnawing, rumbling, emptiness and sometimes pain in your stomach with physical hunger.
4. Emotional hunger is urgent and demands that you eat now. Physical hunger is patient. It prefers you eat soon but does not command that you eat right this very moment.
5. Emotional eating is often paired with an emotion, which can either be an upsetting emotion or even a joyful emotion. Physical hunger occurs out of physical need.
6. Emotional eating often involves automatic or absent-minded eating. You look down and the food you were eating is gone and you don’t really remember tasting each bite. Physical hunger involves deliberate choices and awareness of the eating.
7. Emotional eating sometimes does not notice, or stop eating, in response to fullness. Emotional overeating stems from a desire to cover up painful feelings. Physical hunger allows you to stop when you are full.

Source: Virtue, Doreen. Constant Craving A-Z. (Carlsbad, CA: Hay House, 1999)



                                                                                                    Chicken Fajitas
Ingredients:
4 boneless skinless chicken breasts, cut into strips
8 oz.  Italian salad dressing
12 whole wheat flour or whole grain corn tortillas
1 small onion, cut into strips
medium bell pepper, also cut into strips
16 oz. favorite salsa
8 oz. non fat cheddar cheese
4 oz. nonfat plain yogurt
2 whole tomatoes, chopped
1/2 head lettuce, chopped
Directions:
Cook strips of chicken in small amount of water until tender, add Italian dressing, onion and bell pepper strips and cook until liquid is gone.  Place chicken, onions and peppers on tortilla, top with 1 T. yogurt, salsa, cheese, lettuce and tomatoes.  Serves 12.
Nutrition Information:
Total calories            Total grams protein   Total grams carbohydrate           Total grams fat
215                          18                                            20                                                            7
Significant source of the following vitamins, minerals and other nutrients:
Vitamin C, Niacin, Potassium, Calcium and Lycopene
On your diet this counts as:  2 oz. protein, 1 grain and 1 veggie

Exercise motivation:
Are you having trouble getting started on, and keeping up, an exercise routine? Do you feel motivated one week, then not motivated the next? Follow these tips towards building an exercise routine that truly lasts.
 
1.Find activities that you enjoy
                Some forms of exercise may have stronger benefits than others, but the best form of exercise is the one you enjoy doing because you will end up doing it more often and more consistently.
 
2. Focus more on intrinsic motivations
                Research shows the strongest and longest lasting motivation is intrinsic. This means motivation that comes from inside of you such as the “runner’s high” after a hard workout, or noticing that you have more energy during the day, or overcoming physical challenges you didn’t think possible such running that extra mile.
 
3. Make exercise part of your schedule
                Having times for exercise built into your schedule will not only help you make time for exercise, but also limit demotivating hurdles such as trying to decide when you will be exercising and telling yourself you’ll do it later. If exercise is a regular part of your schedule, you’ll barely have to think about it except when you’re doing it.
​

​Black-strap Molasses Salmon
Heart healthy salmon with a tasty new twist.
Ingredients:
·         1 (16 oz.) salmon filet
·         2 Tbsp. black-strap molasses
·         2 Tbsp. low sodium soy sauce
 
Directions:

1.  Preheat oven to 375 degrees.
2. Lay out a large piece of aluminum foil long enough to double up and create an aluminum foil pocket.
3. Lay the salmon filet on ½ of the aluminum foil.
4. Drizzle the molasses and then the soy sauce over the filet.
5. Fold the other half of the aluminum foil over the top of the salmon and roll the edges to create a sealed pocket.
6. Bake for 20 min or until salmon is just tender.  Do not over cook as salmon dries out rather quickly. 

  
Tips:
 Leftover salmon makes an excellent topping for a spinach salad the next day.
Make enough to snack on as a heart healthy treat with a few multi grain crackers. 
 
Number of Servings: 4
Serving Size: 4 oz. 
 
Nutrition facts per serving: Calories: 220, Fat: 5g, Saturated fat: 1g, Polyunsaturated fats: 0g, Monounsaturated fats: 4g, Carbohydrates: 8g,Sugar: 8g, Fiber: 0g, Protein: 31g, Sodium: 780mg, 
Significant source of EPA and DHA, 4 oz. contains 1518 mg.