Nutrition

Low-Calorie Options for Adding Flavor to Water

By Melanie Pearsall RD, LDN, CDE
Sr. Clinical Nutritionist

Water is the healthiest drink for people of all ages. Drinking enough water is an important part of helping your body “detoxify,” and even mild dehydration can cause problems with concentration.  Americans tend to drink a lot of beverages other then water. Many of these drinks have a lot of added sugars and fat’s which are high in calories and cause weight gain. But the one thing these beverages have is flavor!   Many people know it’s important to drink water and stay hydrated but hate to drink “plain” water. Here are some suggestions to help even the pickiest water drinker succeed:

  • Flavor your water with orange or lemon slices, cucumber slices, berries or fresh herbs like mint or basil
  • Try flavored or plain seltzer waters! Sometimes that added fizz is enough to tickle your taste buds.
  • Herbal teas are a great way to flavor water. I often add an herbal tea bag to my cold water bottle and let it steep slowly, flavoring the water. Tea also provides an extra health benefit from anti-oxidants.
  • Add small amounts of sugar free type flavorings like Crystal Light to your water. I suggest people start off with just enough to add some flavor but without making it overly sweet.
  • Buy a water purifier for your home or individual bottle. This can make the water taste clean and refreshing as it removes some of the impurities that cause an aftertaste
  • If you like to drink pre-flavored water just double check the label to make sure it is low calorie (fewer than 10 calories per serving)
Article originally appeared in Summer 2013 DiabetesViews
Nutrition, Uncategorized

Other Whole Grains

By now you’ve probably heard about the many health benefits of whole grains (and hopefully started making half your grains whole grains).  Brown rice, quinoa and whole wheat bread are some of the go-to whole grain options but there are many, many other kinds to choose from.  Here are some other types of whole grains to try.

Barley

Barley is a really good source of fiber.  In fact, it has the most fiber of all the whole grains.  Barley has been shown to help lower LDL (“bad”) cholesterol and keep blood sugar stable.  When shopping for barley, look for hulled barley rather than “pearled” barley.  Although pearled barley cooks much faster (about 30 minutes vs. an hour for hulled barley), pearled barley has had much of the bran scraped off.  Without the bran, it is no longer considered a whole grain.

Serving ideas:  Barley can be eaten alone as a hot cereal, used to thicken soups and stews, or as a substitute for rice.

Buckwheat

Like quinoa, buckwheat isn’t really a grain (it’s a seed).  It’s also not a type of wheat – it’s more closely related to rhubarb.  Buckwheat is high in protein and gluten-free, making it a good option for people with Celiac or other gluten sensitivity.  The kernels (called “groats”) cook in about 20 – 30 minutes.  If you’re short on time, look for toasted buckwheat groats (called “kasha”) which typically cooks in 15-20 minutes.

Serving ideas:  Cooked groats can be eaten alone in place of oatmeal, or added to salads or soups.  Buckwheat flower is used to make soba noodles.

Oats

Oats are a good source of fiber and are known to help lower LDL (“bad”) cholesterol and blood pressure.  Some different types of oats you may find in the store include oat groats, steel cut oats, and rolled oats.  The difference between each of these is how they’re processed.  Oat groats are whole oat kernels.  Steel cut oats are oat groats that have been cut into smaller pieces, while rolled oats are groats that have been steamed and flattened.  Processed oats cook faster, but here’s the good news:  all processed oats are still whole grains!  Even instant oatmeal counts as a whole grain, but read the nutrition facts label very carefully and choose brands that do not have a lot of added salt and sugar.

Serving idea:  Make up a batch of this Be Fit Power Granola for a healthy snack

One final thing to remember:  whole grains are still high in carbohydrate.  While you’re trying out new whole grain options, remember to pay attention to portion size.

 Content reviewed by Melanie Pearsall, RD, CDE
recipes

Be Fit Basics: Black Bean Burger

Ingredients:
1 (2 ounce) hamburger bun, torn into pieces (can also substitute about 1 cup of breadcrumbs)
3 tbsp olive oil, divided
1 garlic clove, minced
1 can (15 ounces) black beans, low sodium, drained, can divided
¾ tsp chili powder
1 tbsp cilantro, chopped (can also omit or substitute another herb, like parsley)
¼ tsp kosher salt
1 large egg, lightly beaten PLUS 1 egg white, lightly beaten

Instructions:
Place bun in a food processor (or blender) and pulse until it turns into crumbs and transfer to a large bowl.  Add 1 tbsp oil, garlic and ¾ can of beans to food processor and pulse until mixture makes a thick paste.

In bowl with the bread crumbs stir in bean mixture, remaining ¼ can of beans, chili powder, cilantro, salt and eggs until combined. Divide mixture into 4 equal portions, shaping each portion into a patty. Heat sauté pan on medium heat; add remaining 2 tbsp oil.  Add patties to pan and cook about 4 minutes or until bottoms are browned. Flip and cook 3-4 minutes or until patties are cooked throughout.

Yield: 4 servings

Nutrition Information per Serving (per patty):
Calories: 250 • Protein: 10g • Sodium: 355mg • Carbohydrate: 25g •
Fiber:  6g • Fat:  13g • Sat Fat: 2g

Make it a Meal
Protein: 1 serving black bean burger (1 patty)
Starch: 1 bun (170 calories)
Vegetable: 1 cup carrot sticks or baby carrots (50 calories)
Burger Topping(s): ¼ avocado, sliced (60 calories) plus onion slices (5 calories)

Leftovers? Place black bean patty on ½ a whole wheat English muffin.  Add slice of cheddar cheese and place under the broiler (or in toaster oven) to make an open-face black bean burger melt. Pair with a side of mixed greens.

recipes

Be Fit Basics: Tomato Asparagus Whole Wheat Carbonara

Ingredients:
1 tbsp olive oil
1 pound asparagus, ends trimmed and spears cut into 1 inch pieces
2 garlic cloves, minced
1 pint cherry tomatoes
8 ounces (half a box) whole wheat penne pasta
2 ounces pecorino cheese (½ cup grated)
½ tsp kosher salt
½ tsp black pepper
2 eggs
¼ cup fresh basil leaves, roughly chopped

Instructions:
In a large saucepan, boil water for the pasta. In a large skillet, heat the oil on medium heat and then add the asparagus; cook for 3 to 4 minutes. Add the garlic and sauté for 1 minute. Add tomatoes and cook for about 5 minutes, or until the tomatoes soften, stirring occasionally.

When the water is boiling, add the pasta and cook until al dente (see the package for directions). Meanwhile, in a medium bowl, combine the cheese, salt, pepper, and eggs; whisk to fully combine. When the pasta is cooked, drain it, reserving about ¼ cup pasta water.

Add the reserved pasta water, egg mixture, and pasta back to the saucepan. Stir in vegetables and cook on low until the sauce thickens slightly (this will only take about a minute). Top with basil and serve.

Yield: 4 servings

Nutrition Information per Serving: Calories 340 • Protein 15g • Sodium 420mg • Carbohydrate 40g • Fiber 7g • Fat 9g • Sat fat 3g

Recipe adapted from Cooking Light
Nutrition, Uncategorized

Serving Up Satiety

By Elizabeth Daly
Dietetic Intern

In today’s society, we are constantly tempted by food. Whether we are commuting to work, out with friends or watching TV at home, we are influenced by messages encouraging us to eat more. Living in an environment surrounded by food can make it challenging for people to make healthy choices, lose weight and manage their diabetes. There are many different weight-loss diets advertised in the media, but dieting often leaves us feeling hungry, deprived and ultimately defeated. How can we better control our intake without feeling the need to eat all the time?

Satiety is the feeling of fullness that comes after eating. If we feel satiated after a meal, we are less likely to snack between meals or eat large portions the next time we sit down to eat.  Learning how to feel more satiated after a meal may help us better control how much we eat, aid in weight loss and better control blood sugar levels.

Feeling satiated takes time, often up to 20 minutes after eating a meal. It is controlled by a number of factors that begin once we take our first bite of food. When we eat, our stomach expands, we begin absorbing and digesting nutrients and the brain receives signals that lead to feelings of being full.

Not all foods produce the same level of satiety. Here are a few tips to help you feel fit and full:

  1. Add lean protein to meals and snacks

Adding protein to meals or snacks helps keep you full for longer and control blood sugar levels. Meals that only contain simple carbohydrates are digested quickly, spike blood sugar, and make you feel hungry again soon after.

~Ex.  1 oz low fat cheese or ¼ cup hummus or 1-2 tablespoons peanut butter or 1 oz nuts

  1. Add fruit and vegetables to meals

Fruits and vegetables are high in fiber and water.  Both of these help you feel full. They are also good sources of important nutrients and contribute to overall good health.

~Ex. Add a side salad with meals, add berries to cereal or yogurt, add vegetables in soup

  1. Limit sugary beverages

Sweetened beverages are high in sugar and calories but low in nutrients. They do not cause your body to feel as full as solid foods do, and can lead to spikes in blood sugar and weight gain.

~Try swapping sugar sweetened beverages with water at meals to curb your hunger!

 Content reviewed by Melanie Pearsall, RD, CDE
Health

Standards of Medical Care in Diabetes 2017: Diabetes Medications

Eileen B. Wyner, NP
Bulfinch Medical Group

Eileen Wyner, NP

I recently reviewed updates to the American Diabetes Association’s (ADA) Standards of Care for 2017.  In this post, I’ll review Section 8 of the standard that talks about different medications for treating diabetes. I will also discuss some of the newer medications used to treat diabetes.

Type 1 Diabetes is always treated with insulin, either through multiple injections or an insulin pump. Type 2 Diabetes can be treated with oral medications (pills by mouth), injections, or both.  The ADA recommends that people with Type 2 diabetes start patients start with the pill metformin, as long as it safe for them to take it.    Taking metformin for a long time may lead to not getting enough Vitamin B12, stomach symptoms, and can affect how well the kidneys work (your care team will monitor your kidneys to be sure they are working properly).

If someone is taking one oral medication at the highest possible dose but their A1C is still not at goal, providers should consider adding additional medications:  another oral medication, long acting insulin (injection), or a non-insulin injectable medication called glucagon-like peptide 1 receptor agonists (GLP-1 receptor agonists).

Examples of GLP-receptor agonists are exenatide (Byetta), liraglutide (Victoza), and dulagultide (Trulicity).  These medications cause food to move through the stomach slower so people feel full sooner. This leads to less glucagon (another hormone made by the pancreas) being released after meals and lowers appetite, which helps with weight loss.  These medications need glucose to work, so there is little chance of hypoglycemia.  Side effects include nausea, vomiting and acute pancreatitis. They may also cause medullary thyroid cancer in animals. It should be noted that these medications are expensive.

People with poorly controlled diabetes and atherosclerotic cardiovascular disease (ASCVD aka heart disease) may benefit from a new medication called empagliflozin (Jardiance), a type of medication called SGLT-2 inhibitor.  These medications work by preventing the body from reabsorbing glucose. This lets more glucose leave the body through urine.  People may have lower blood sugar values after eating and lose some weight.  Studies show empagliflozin helped reduce deaths caused by heart attack, stroke, and cardiovascular disease.  Empagliflozin is the only SGLT-2 inhibitor with these results, but other medications are being studied (liraglutide [Victoza] may have the same results, but other GLP-1 receptor agonists are not used this way).  Potential side effects include hypoglycemia, low blood pressure, dizziness, urinary tract infection, needing to urinate a lot, and increased LDL and creatinine (a waste product filtered out by the kidneys).  Again, these medications are very costly.

There are many medications available for the treatment of diabetes. These standards are general recommendations for medical care.  Always discuss questions about your care plan with your healthcare provider.

Nutrition

Plant-Based Protein

Alexandra Regalado
Dietetic Intern

What is Protein and How Much Do You Need?
Along with carbohydrates and fat, protein is part of a balanced diet and is essential for life. Protein plays key roles in building and maintaining muscle, keeping the immune system working, regulating hormones, and healing wounds.  Protein is made up of compounds called amino acids. Some amino acids are made by your body, while others come from the food we eat. Amino acids that come from food are called essential amino acids. This is why it’s important to eat protein from a variety of sources, including plants!  The Recommended Dietary Allowance (RDA) for protein for the average adult is 0.36 grams per pound of body weight.  To find out how many grams of protein you need to eat each day, multiply your body weight in pounds by 0.36.

Sources of Plant-Based Protein
Protein is found in a number of plant foods.  While plants provide quality protein, they typically do not contain all of the essential amino acids. But, if you eat several sources proteins throughout the week, you will have no problem getting all the amino acids and nutrients your body needs. Some plant-based protein, such as beans and legumes, contain carbohydrates, so always check the nutrition facts label for grams of carbohydrate per serving and factor them into your meal or snack.

 Some Examples of Plant-Based Protein

  • Beans and Legumes: Black beans, chickpeas, cannellini beans, kidney beans, pinto beans, lentils
  • Nuts and Nut Butters: Peanuts, almonds, walnuts, cashews, hazelnuts, pecans, pistachios, pine nuts
  • Seeds:Chia, flax, sesame, sunflower, pumpkin, hemp, quinoa
  • Soy and Soy Products: Soy milk, edamame, tofu, tempeh
  • Meat Substitutes: Veggie burgers and sausages, seitan, faux “chicken” and “burgers”

 Benefits of Plant-Based Protein
Most plant-based proteins are naturally low in calories, saturated fat, and sodium; have no cholesterol; and are high in fiber, vitamins and minerals. The combination of protein and fiber helps to slow digestion so you feel fuller longer, and raises blood sugar gradually after a meal or snack (avoiding blood sugar spikes).  Many plant-based proteins are more environmentally sustainable and affordable than animal sources of protein, too!

Plant proteins can be incorporated into any dietary pattern. Vegetarian and vegan diets are especially high in plant proteins and are also rich in fruits, vegetables, and whole grains. The American Diabetes Association recommends plant-based eating patterns because they can help prevent and manage diabetes. Research shows plant-based diets are good at lowering A1C, blood pressure, cholesterol, and body mass index.  Studies have also shown that plant-based diets are helpful for losing weight and maintaining a healthy weight.  Including more plant-based meals in your routine, such as by following “Meatless Monday,” is a wonderful way to fuel up on more plant-based protein!

Ideas for adding Plant-Based Protein to Your Meals
Breakfast:

  • Sprinkle nuts and seeds on oatmeal or yogurt
  • Sautee tofu and veggies for a breakfast scramble
  • Spread hummus or nut butter on toast

Lunch & Dinner:

  • Use beans or lentils to make “meat” sauce
  • Add tofu or tempeh to a stir-fry meal or sandwich
  • Top salads or grain bowls with beans or edamame
  • Vegetable or black bean burger

Snacks:

  • Hummus with raw veggie sticks
  • Roasted chickpeas or edamame
  • Handful of nuts
  • Plant-based protein bar
 Content reviewed by Melanie Pearsall, RD, CDE