- 26 July 2016
- Nutrition Blog
By: Marissa Martino, RD
Type 2 diabetes has been on the rise for the last decade, with a whopping 1.4 million Americans diagnosed each year. This accounts for adults and children. The most disheartening concept about this statistic is that type 2 diabetes, unlike type 1, is actually controllable and even preventable. Diabetes is when your body can’t regulate blood glucose- or sugar- properly, causing all sorts of harmful and long term effects. Type 2 is the form of diabetes that develops from insulin resistance. Insulin is the hormone that allows the sugar from the food that we eat into our cells, which is then converted into usable energy. If we eat too many foods high in carbohydrates and simple sugars, our blood sugar skyrockets. Insulin is then released in an attempt to lower and regulate our blood sugar. This feedback mechanism causes blood sugar to be lowered, which is the “crashing” feeling we get about 45 minutes after a sugary snack such as a muffin or donut. This rollercoaster effect of constant high and low blood glucose wreaks havoc on the body, and eventually leads to insulin resistance. Our cells become less sensitive to insulin, causing an influx of glucose in the bloodstream. Uncontrolled high blood sugar over time causes the blood to become sticky and viscous. This leads to damaged blood vessels and nerves which affects eye sight, hearing, lack of feeling in hands and feet, chronic inflammation and dehydration.
After being diagnosed with type 2 diabetes, the goal is to regulate blood sugar levels with diet before resorting to medication and insulin injections. The difficult part about this is, most of us are already comfortable with a certain type of lifestyle- which is usually filled with some unhealthy habits. And habits, as we all know, are not so simple to break. Our lives are hectic and busy, with the majority of the country constantly eating on the run. When we think about what foods are “convenient”, almost all of those options are carb based. Bagels, granola bars, soft pretzels and even food items we deem healthy, such as yogurt or smoothies can be culprits.
A large part of diabetes education is first understanding the vast amount of hidden carbohydrates entangled in our food system. Once we learn how to look at a food label and understand about how many grams of carbs we should be eating per sitting, it’s becomes less challenging to adhere to a diabetic friendly lifestyle.
An attainable goal is to stay under 200 grams of carbs a day. We should aim for no more than 30 grams for a snack, and average between 30-60 grams at meal time. The “diabetic exchange list” is a convenient source that lists all popular food items and the total carb count. A simple rule of thumb is to remember that 15 grams of carbs is roughly 1 slice of bread, 1/3 cup cooked rice or pasta, or 1 cup of fruit.
One of the most important guidelines to stabilize blood sugar, is to make sure that protein, fiber, or a healthy fat sources are combined with any carb. This is because fiber, protein and fat are slower digesting nutrients, meaning they will delay the rate carb digestion, preventing the high spike in blood sugar. It has also been shown that saving the carb portion of a snack or meal for last can also help slow down the rate of absorption. For example, if your snack is a handful of almonds and an apple, eat the almonds first and then the apple. The simple sugars from the apple will be more slowly digested thanks to the fiber, protein and healthy fats from the almonds.
By making sure that there is always fiber, protein and or healthy fat every time we eat, we are ensuring that blood glucose levels are stabilized. Even if it is a “complex carb” still try to add a protein. If you like oatmeal in the morning, add a hardboiled egg or a handful of walnuts. Also, rather than the sugar packed instant oatmeal, use plain or steel cut oats and add a drizzle of local honey or fresh berries. If you like a yogurt as a snack, make sure it doesn’t have more than 15 grams of sugar! (My favorite brands are Siggi’s, Chobani Simply 100 or Oikos Triple Zero).
Exercise is also a very important and useful tool in lowering and stabilizing glucose levels. The cells present in muscle are actually very sensitive to insulin, so the more muscle mass we have, the more our bodies will respond to insulin.
Changing habits takes time, focus and dedication. Registered dietitians can guide and support you to a healthier lifestyle, helping you to make achievable and sustainable adjustments.
- 30 June 2016
- Nutrition Blog
By: Angela Luciani, RD
July is national ice cream month … As temperatures heat up, many of us are looking forward to cooling down with a summer treat. When you head to the frozen section of the grocery store – you may get brain freeze just looking at all the new and different options out there… light, low fat, slow churned, coconut milk, Greek yogurt… the list goes on. The good news is you can have your ice cream and eat it too – remember, it is how much and how often you enjoy ice cream that can become problematic.
So how do you navigate through all of these options and which ones to choose? It is important to keep in mind that a single serving of ice cream is a half cup. The pint of ice cream you see at the store has a total of 4 servings! Instead of eating straight from the carton, measure out your serving size and put the rest back in the freezer. If you’re going out for ice cream – ask if you can have the kid’s size or only ask for one scoop.
When choosing which type of ice cream to purchase, choose brands whose ingredients you can recognize, and compare the fat and sugar content before deciding which one to go with. Traditionally – ice cream is made with cream; therefore, you will find that the “ultra-premium” ice cream brands, such as Ben and Jerry’s or Haagen-Dazs, will have more calories and saturated fat per serving than others (up to 50% more than regular ice cream). While they certainly are delicious –there are many alternatives you can choose that can provide less calories and less fat, making it a treat that you won’t feel guilty about! Halo Top ice cream is a great option as it provides 240-280 calories and 24gm of protein per pint! They offer flavors including chocolate, mint chip, birthday cake and many more! Edy’s slow churned ice cream contains more milk than cream which can make it a better choice. Frozen yogurt has less calories than ice cream, but still can pack in a lot of sugar, leaving you craving more – self-serve Fro-Yo can lead us to overeating –so you must continue to be mindful of your serving size. For a “lighter” premium option, try choosing the Ben and Jerry’s fro-yo version. Still craving more, or realizing that half serving isn’t going to cut it? – instead of going for that extra serving – add berries or nuts as a topping to make it more filling!
If you can’t have dairy or are looking for dairy-free options – Ben and Jerry’s has come out with a new ice cream product that is made with almond milk.
Don’t be afraid to try making your own! There are plenty of recipes all over the internet on how to make healthier homemade ice cream options. See below for a relatively simple and easy to make recipe!
Banana Nutella Ice Cream – makes 3 servings
- 6 ripe bananas – frozen
- ½ tsp vanilla
- ¾ cup Nutella
- Cut bananas into 1-inch slices and transfer to food processor.
- Blend until smooth consistence.
- Add vanilla and nutella – Pulse until combined.
- Eat right away or store in airtight container.
- 27 April 2016
- Nutrition Blog
By: Angela Luciani, RD
May is stroke prevention/awareness month. Each year, about 800,000 people suffer from a stroke (1). Anyone can have a stroke, including children. Having a stroke can be scary for many people because it is often an unpredictable event; however, up to 80% of strokes are preventable (2). There are some factors that increase your risk for a stroke that you cannot control such as age, gender, race as well as family/personal medical history but there are some steps you can take to modify your lifestyle in order to help reduce your risk.
- Incorporate a heart healthy diet – Diet plays an important role in reducing your risk for stroke as well as many other chronic diseases. Both poor cholesterol levels and high blood pressure are risk factors for having a stroke but can be improved with nutrition. Choosing a heart healthy diet includes the following:
- Incorporate a variety of fruits and vegetables
- Choose whole-grain, high-fiber foods
- Limit saturated fat and trans fat which can be found in items such as butter, cheese, fried and processed foods, red meat and other animal-based foods
- Choose lean meats and poultry such as chicken or turkey without the skin
- Incorporate fish at least two times a week for added benefits of omega 3’s
- Aim for a healthy weight – Obesity increases your risk of having a stroke. A normal BMI of 18.5-24.9 is recommended. Losing weight can have a significant impact on your stroke risk.
- Exercise daily – Exercise is one of the best ways to stay in shape as it can not only help you maintain or achieve a healthy weight but it also helps lower cholesterol levels and can keep blood pressure at a normal level. (It’s also a great way to de-stress!)
- Cut back on the alcohol! – Consuming too much alcohol can lead to high blood pressure and/or trigger an irregular heartbeat – both of which also increase your risk for a stroke. Alcohol can also tend to be high in calories, so regular consumption can make it difficult to maintain a healthy weight.
- 28 March 2016
- Nutrition Blog
Have you ever had a really stressful day at work, then decided to take a jog, attend your yoga or kickboxing class, or even go lift some weights at the gym? Chances are you felt much better afterwards, and the stress from earlier that day melted away. This is because exercise actually has both short term and long term effects on mood. Research shows that moderate exercise enhances mood within just 5 minutes of activity. Many studies have also shown that exercise can help and prevent anxiety disorders, also known as fight-or-flight responses. Those who participate in exercise have a decreased response to anxiety sensitivity than those who are sedentary.
Some have the idea that exercise will wear them out and be tiring, when actually the opposite is true. Exercise boosts energy. During exercise, blood flows more freely throughout your body, delivering oxygen and nutrients to important organs, tissues and muscle. Your body also releases chemicals called endorphins during moderate exercise. Endorphins interact with the receptors in your brain that trigger a positive feeling. Ever felt a post workout high, or general sense of well being and confidence after exercise? That is your body responding to these feel-good chemicals being released during your workout.
If you don’t belong to a gym, or don’t know where to start in regards to exercise- first and foremost, get outside! Take advantage of the beautiful weather and walk or jog along a trail. Incorporate some jump squats or walking lunges to increase heart rate and blood flow. If you are at home, you can create your own plyometrics or HIIT (high intensity interval training) circuit. Sprint up the stairs in your apartment building, hold yourself in a plank position, use your body weight for wall-sits, squats or pushups. The options here are endless.
In conclusion, the benefits of daily exercise are remarkably valuable in so many ways- including weight control, improvement of mood and sleep, boosts energy and combats health conditions such as diabetes, heart disease and high cholesterol. Need any more convincing to get up and move? Remember, sweat is free!
- 29 February 2016
- Nutrition Blog
By: Marissa Martino, RD
Our bodies are composed of over 60% water, which means that this essential nutrient is vital to our health. Water plays many roles and has a variety of functions, along with maintaining a certain homeostasis in each of us. A deficiency in water can result in noticeable symptoms, such as dry mouth, eyes and nose. But it can also affect parts of our body on a cellular level that we can’t necessarily detect right away- such as carrying nutrients and oxygen to our blood. Water regulates our body temperature, lubricates and cushions our joints, aids in digestion by preventing constipation and also helps to put less of a burden on our kidneys and liver by flushing out our systems.
A very generic number for water intake is 64 oz a day. This number changes in regards to how physical our job is, our sweat rate, and the temperature of the weather. It’s important to make sure we are at minimum, replenishing the amount of water we lose each day. More than 1.5 liters of water are lost just by perspiration, breathing and urine output. This amount is before any physical activity! If we are dehydrated during physical activity, we don’t sweat as much which can cause our body to overheat.
Some simply forget to drink throughout the day, and others just don’t prefer to drink plain water. There are many ways to fix these problems! First, go out and splurge on a nice water bottle. This will give you an initiative to have it with you throughout your day. Place your water on your desk and set little goals for yourself- for example, by 10 am you will have drank the first half of your water bottle, and by 12pm you will have finished your first bottle and refill at lunch time. There’s also unlimited ways to flavor your water without adding sugar or artificial flavorings. Fruits such as citrus, berries, even mango and pineapple infuse awesomely in water bottles to give a little natural sweetness and vitamin boost to your water. Or you can go the herbal route with mint, lemongrass, rosemary, basil, or sage which mix very well with veggies like cucumbers. You could try a refreshing blend like citrus, mint and cucumber or you could energize your afternoon with raspberry and black tea infused water. If you are craving a bit more sweetness, a drop or two of stevia will do the trick. If bubbles help quench your thirst, add these flavorings to carbonated seltzer water. The combinations are endless!
- 29 December 2015
- Nutrition Blog
Obesity rates have more than doubled in adults and children with an estimated 64% of women being classified as overweight or obese (NIH, 2009). Obesity is measured by the body mass index (BMI) which takes into account one’s height in relation to their weight. A BMI greater than 30 is considered to be overweight.
Being overweight can increase your risk for developing many diseases including but not limited to the following: coronary heart disease, Type 2 diabetes, hypertension, sleep apnea and respiratory problems, joint disease, gynecological problems such as infertility and more. Weight loss can be the cure for many of those diseases, so it is important to take control of your health and seek help and treatment when it is necessary.
Many diet programs advertised online, in magazines or on television are available at your fingertips, but do they really work and if they do, how long can you keep that weight off?
The weight management program at Rittenhouse Women’s Wellness Center is designed to help educate you on the right way to lose weight for the long-term. Whether or not you have a chronic disease or could just stand to lose a couple pounds, our program is available to individually tailor your needs to meet realistic weight loss goals.
The program consists of 6 months of nutrition counseling with Angela, one of our Registered Dietitians, who will do a formal assessment that includes an analysis of your current diet, nutrition education, and meal planning advice. The program also includes 2 comprehensive follow up appointments with Catherine, one of our Nurse Practitioners, who will monitor your weight, blood pressure, and any laboratory work as needed, in order to help you see the progress in your overall health as you lose weight.
Unlike fad diets that can be restrictive and difficult to maintain, RWWC’s weight management program will focus on three essential components: healthy eating, lifestyle modifications, as well as ways to incorporate physical activity into your daily routine that will help you lose weight and keep it off.
If you are interested in losing weight, have chronic conditions like PCOS, diabetes, or high blood pressure, or have a BMI over 30, please contact the front desk or your provider to see if this program is right for you.
- 29 December 2015
- Nutrition Blog
Hypertension, also known as high blood pressure, is when the blood flow through your blood vessels and arteries is too strong. As your heart beats, it pumps blood through your arteries to the rest of your body. As our blood pressure rises, the blood pushes harder against the walls of your arteries. This is natural during certain periods of your day, including when you first wake up and during exercise. However, prolonged high blood pressure strains the heart, damages vessels and kidneys, and increases risk of a heart attack and stroke. Heart disease is the leading cause of death for both men and women; however, it can be controlled and even prevented with a healthy diet.
The most common regime you will see for hypertension is called the DASH diet, or Dietary Approach to Stop Hypertension. This diet focuses mostly on limiting salt intake. The reason we monitor salt in regards to high blood pressure is because salt retains water. The more water we have present in our blood, the higher the volume of blood. Thus, more pressure is put on our vessels to transport the blood. The average recommendation for salt intake is <2,300 mg a day, but the DASH diet recommends <1,500 mg daily. This means inspecting our food labels since salt is added to the majority of processed foods. The DASH diet also includes eating more fruits and vegetables, whole grains and fiber, along with limiting saturated fats, cholesterol and trans fats, and sweets. It’s also important to make sure that there is enough potassium in the diet since this vitamin balances the salt in our bodies.
You may also notice that the DASH diet suggests the consumption of fish. This is because fish contain Omega-3’s, which are healthy fatty acids. These type of polyunsaturated fats help lower our bad cholesterol (LDL), and raise our good cholesterol (HDL). DASH is almost identical to the Mediterranean diet, which equates to a high consumption of fruits, vegetables, beans, nuts/seeds, and whole grains, and little to no red meat or dairy products.
Helpful tips on controlling blood pressure include following the DASH diet, maintaining a healthy weight, increasing physical activity, learning how to read a nutrition label and consider keeping a sodium diary to monitor your daily intake. Cooking and preparing your own foods is always better than eating out since you have complete control over the amount of sodium being added. You can also use spices and herbs rather than salt to flavor your foods. Be sure to have your blood pressure checked by your doctor and work with a dietitian to assess what behavioral changes are benefitting you so that you can improve your health and feel your best.
- 25 November 2015
- Nutrition Blog
By: Marissa Martino, Registered Dietitian
Anyone can be affected by the negative habit of stress eating, whether it’s more prevalent during the holidays, or even all year around. There are many reasons why we binge eat because of stress, but luckily there are also many ways to confront this destructive behavior. First, is to understand exactly why we stress eat. Biologically, our bodies are regulated by hormones, many of which control and greatly affect our weight. Cortisol, the “stress hormone” can actually create cravings and make it physically harder for our bodies to drop fat. This hormone is important to be aware of since it can create nervous energy and make us “orally fidgety”, causing nail biting, teeth clenching and also eating without being aware. To grasp stress eating, we need to first understand that for many people, emotions become tied to eating habits, which makes weight and anything related to, such as food, a very emotional subject. It’s important to recognize what emotion is driving us to eat, and realizing that the end result is always the same- guilt, along with the same emotions from before eating lurking close by. This is why the first step to combating stress eating is to figure out what your triggers are.
What emotion prompts you to crave foods, and what caused that emotion? The next step is to become comfortable with confronting that emotion and learn how to openly communicate with whomever or whatever the trigger is for that emotion. Another trick is to keep a food journal. As a dietitian, I recommend this for everyone- whether you’re dealing with stress eating, want to lose weight, or even just become a healthier version of yourself.
Documenting everything that you consume will make you much more aware of your selections. You can also assess your hunger levels each time before you eat or drink- are you physically hungry (grumbling), or are you just bored? After you eat or drink, then document your satiety level. If you were actually hungry, the result of eating should be satisfying. If you ate or drank due to stress or boredom, your satisfaction level will be much lower.
Another important key is replacing a stress eating with a healthy habit. Once you understand what your trigger is, tame that stress by engaging in something that interests you, whether it’s yoga, going to the gym, meditation in a quiet place. Fight boredom with whatever hobbies interest you and don’t forget to do a hunger check before eating or drinking. If you are concerned with weight loss, keep temptations out of the house to avoid any mishaps. Battling stress eating is a journey to understanding ourselves better and becoming healthier physically and also mentally. Also remember that we are all human, and if we fall off track, don’t wait until the next day to get back on track. Learn from your setback and move past your obstacles as quick as possible. Believe in yourself and be a part of your own support system!
- 01 October 2015
- Nutrition Blog
By: Angela Luciani, R.D.
You may know that good nutrition can help you feel good on the inside, but does it affect how you look like on the outside? Yes! The foods we choose to consume can directly impact our skin just as much as the products we use ON our skin. Studies suggest that certain foods affect your skin. A well balanced diet is key to keeping skin looking healthy and feeling great.
Here are some tips to help you find your way towards healthy skin.
Drink plenty of fluids
Drinking plenty of fluids ensures that your body stays hydrated. Dehydration can often can cause fatigue and lead to aging. Water is the best choice for healthy skin. Drinking more water also promotes cleansing, flushes toxins out of your system, reduces bloating, and increases your skins moisture level. Don’t forget to drink up!
Avoid refined carbohydrates or consuming too many carbohydrates in one sitting
Your skin contains collagen and elastin fibers which allow connective tissue to remain firm and keep its shape. When you consume foods that are high in sugar, you cause your blood sugar to spike and as a result, the sugar is broken down into molecules that stick to elastin and collagen, which makes them less flexible. It also disrupts collagen turnover.
Incorporate antioxidants into your diet
Antioxidants work as a defense system against free radicals that harm our skin leading to wrinkles, dry skin and tissue damage. There are many different types of antioxidants which help protect from various types of damage to your tissues. Choose a wide variety of fruits and vegetables to pack the most punch - bell peppers, tomatoes, dark leafy greens, berries and citrus fruits are all great choices!
Include “healthy” fats in each meal
Fat is a structural component of your skin, so it is important to eat a diet that incorporates healthy fats to maintain healthy and elastic skin. Remember: Not all fats are created equal. High intakes of Omega 3 fatty acids reduce inflammation and have been found to be protective again UV rays and sunburn. Adding these healthy fat sources can help keep your skin smooth and soft, naturally, while new skin cells replace old cells.
- 18 August 2015
- Nutrition Blog
By: Angela Luciani, Registered Dietitian
Most of us have been there before – We want to eat healthy, so we go to the grocery store, purchase a ton of healthy foods/ingredients: vegetables, fruits, poultry or seafood and maybe even some snacks. We get home, we make lunch or dinner for a few nights but then reality sets in. By Wednesday, we either are sick of the food we have or we don’t have the right ingredients to make what we wanted. Plus, it’s the middle of the week/almost the weekend, so what do we do? Eat out of convenience because it seems faster and easier. So, when life gets busy, how can you stay on track? Whether you’re trying to get fit, lose weight, or just eat healthier in general, one of the keys to success is PLANNING.
1. Start small.
If planning out every single meal for the week sounds overwhelming, start with planning dinners so you know you have at least one balanced meal for the week.
2. Set time aside.
Find 15-30 minutes out of your busy schedule where you can sit down and plan your meals for the week. Maybe you can make use of that 30 minute train ride into the city or on your way home can or perhaps an afternoon over the weekend when your husband is watching football.
3. Choose recipes with a purpose.
There is an endless amount of blogs, magazines, cookbooks to choose recipes from for the week.
Try to select recipes that will overlap so that you can minimize how much you have to purchase. I like to compile my recipes -When I find a recipe I like, I print it out or write it down on a piece of paper and keep it in a folder. This way, I always have a fresh recipe dish to choose from so that my meals for the week don’t get repetitive or boring. Keep an eye on the nutrition facts and keep in mind serving sizes - choose recipes that are healthy and will help you meet your goals.
4. Make a Master Plan
Choosing a format to create your meal calendar is up to you. A simple notecard, a printable template, an excel spreadsheet or using an electronic version are all great ways to help you stay organized – whichever you choose, it is always a good idea to keep a paper copy for a visual. This helps hold yourself accountable for what you are supposed to eat for the week – and you can plan ahead for those nights you have business dinners or happy hours. Hang it on the fridge to remind yourself of your plan.
5. Plan your grocery list.
Save yourself some time and do this in conjunction with writing out your recipes/calendar meal plan. If you are unsure of what you have in your fridge, freezer or pantry, now is the time to check. Do an inventory before you leave and cross off the ingredients you do not need to purchase. Nothing is more frustrating than starting to make your meal and realizing you don’t have one of the ingredients.
6. Get the prep work over with
Don’t just unload the groceries from the car when you get home – Prep the ingredients for your week, dice up the vegetables, cut up the fruit and portion out your snacks. Prepping your meals and snacks ahead of time will make it more likely for you to grab these foods when you are hungry.
Using these tips can you set yourself up for success! Eating meals and snacks spaced out every three to four hours throughout the day will help maintain your blood sugar and will also prevent hunger before meals, which often times can lead to overeating.