Nutrition, Uncategorized

Eating Healthy on a Budget

By Josann Nichols
MGH Dietetic Intern

You don’t have to break the bank to have a healthy diet. Below you’ll find tips and tricks to eat well on a tight budget.

  1. Get produce in season. Buying produce in season and from local farmers is often less expensive. More corn on the market means competition, which drives prices down. For example: 4 ears of corn in season costs about $1 from local sources compared to $18 on Amazon during the winter. Produce you buy in season is also picked at peak ripeness, which packs in more flavor and nutrients.
  1. Try frozen fruits and vegetables. Frozen produce is a cheaper alternative to many fresh fruits and vegetables. They’re also picked at peak ripeness, meaning they have the same nutritional quality as fresh produce. You can also store it longer, leading to less food waste which saves money over time.
  1. Stock up on canned fruits and vegetables. Canned fruits and vegetables are a very cheap option and can be stored longer than either fresh or frozen produce. Make sure to buy fruit canned in its own juices to avoid added sugar. To reduce sugar and salt, rinse before eating.
  1. Don’t give up on meats. There are many cheaper cuts of meat available such as brisket, skirt, flank and top rump. Typically, these cuts are cheaper because they are a bit tougher but don’t be discouraged! Cooking meat like pot roast in fluid for a long period of time can make it so tender it falls off the bone! Another money saving tip: check with your local grocery store for sales on older meats. These should be used within a few days or immediately frozen.
  1. Substitute other protein sources for meat more often. Plant-based protein sources are inexpensive, contain fiber and higher-quality fat than meat and will last longer in the kitchen. Beans and lentils for example are usually purchased canned and/or dried. Use them as a substitute for meat in stews, salads, casseroles and side dishes to help your dollar go a little farther. Peanut butter, seeds and eggs are also excellent sources of protein. Add an egg to your breakfast for only $0.25!
  1. Try canned fish. A healthy diet includes seafood, which can often be pricey. Tuna is one cheap alternative, but if mercury is a concern try sardines. Not only are sardines rich in protein, they’re another source of anti-inflammatory fats. Again, watch out for added salt!
  1. Go whole grain. Fiber is your friend! It helps manage blood sugar levels and keep your digestive system healthy. Whole grains have more fiber than white flour products and can be affordable. Instead of expensive specialty grains, try switching to old-fashioned oats, whole wheat bread and brown rice.
  1. Buy in bulk. This can include frozen, canned or dried whole foods. The larger the quantity the cheaper the price per unit, so even though you pay more up front you end up saving money over time.
  1. Choose generic brands. These typically have significant price cuts. Check the ingredient list, though, to make sure you aren’t losing any quality of the product.
  1. Take advantage of sales and coupons. Stores frequently have deals on fresh, canned and dried foods.
  2. Don’t feel pressured to buy organic. Organic farmers do not use chemicals on their crops, but that doesn’t mean non-organic produce is full of chemicals. Many non-organic farmers use little to no chemicals on their produce and simply can’t afford to get the organic certification. Research has also shown that conventionally grown organic and non-organic produce does not differ in nutritional content. So you can be just as healthy eating non-organic foods while saving big bucks at the checkout line.
  1. Follow the Balanced Plate Model. Protein-rich foods tend to make the largest dent on your wallet, compared to starchy foods and vegetables. By maximizing plant-based foods and limiting your meat portions, you’ll improve the quality of your meals and make your dollar stretch farther.

Just follow the tips above to mix and match your protein, starch and vegetables to maximize your dollar and eat healthy!

Content reviewed by Melanie Pearsall, RD, CDE
Health, Nutrition

Blood Sugar: What Does It Mean for Your Health?

By Felicia Steward, Dietetic Intern

Blood Sugar Defined

Blood sugar is the measurement of the amount of glucose, or sugar, in your bloodstream. This is important because it tells us how much energy our cells and tissues are receiving from the food we eat. Some foods affect blood sugar more than others. Any food that is mostly carbohydrates will affect blood sugar levels. These include dairy (milk and yogurt), all fruits and fruit juices, starches (pasta, bread, rice, and tortillas), and starchy vegetables (corn, peas, beans, potato, and butternut squash). Eating more carbohydrates at a meal can raise blood sugar, so it’s important to think about portion size along with when we eat and what food items we choose to eat together.

Why Care About the Amount of Sugar in My Bloodstream?

 Glucose provides our body with energy, and is needed for the brain to properly function and process information. Therefore, it is important that we choose foods containing small amounts of carbohydrates whenever we have a meal or a snack throughout the day so there’s enough glucose to support our tissues and cells.

When someone with diabetes eats large portions of carbohydrate-rich foods, too much sugar is released into the blood stream and, because there’s either not enough insulin or they have insulin resistance, their body is unable to use this sugar for energy effectively.  It builds up in the blood stream, causing damage to the body.  Over an unhealthy extended period of time, the body will eventually store much of the excess sugar as fat, which can lead to weight gain. Therefore, it is important to be aware of how the food we eat influences the amount of sugar in our bloodstream and how it affects our weight.

How is Blood Sugar Managed?

helthy-plate

 A healthy eating pattern that includes balance and portion control is an important part of managing the amount of sugar in the bloodstream.  Pairing whole grain, carbohydrate-rich foods with protein and fiber helps maintain healthy blood sugar levels. Eating a meal or snack that contains foods that increase blood sugar with those that do not affect blood sugar means the glucose is absorbed slowly into the blood and prevents blood sugar from spiking too high. Paying attention to portion size will also ensure that we are providing our body with exactly what it needs each time we eat. What the body doesn’t use for energy right away can be stored as fat and cause weight gain.

Balanced Lunch Examples:

  • PB&J on whole wheat bread + 1 cup carrot and celery sticks dipped in plain yogurt
  •  2 cups tossed salad + 3 oz. grilled chicken + oil/vinegar dressing + 1 banana
  •  3 oz. salmon + 1 cup brown rice + 1.5-2 cups cooked green beans
  •  2 oz. tuna salad (with light/mayo), lettuce, and tomato on whole wheat bread + 1 small apple + 8 oz. of skim milk
 Content reviewed by Melanie Pearsall, RD, CDE

 

 

Nutrition, recipes

“Everything in moderation!”

By Melanie Schermerhorn, Dietetic Intern

Most of us have heard the phrase, “everything in moderation.” Many say moderation is the key to success; for someone who has diabetes this phrase is especially true when it comes to what you eat. Moderation in relation to healthy eating habits, especially portion control, can have a huge effect on your overall health! To break the phrase “everything in moderation” down further, let’s talk about what it means. What your healthcare providers are saying is:  eat a balanced diet most of the time, but do not deprive yourself of the not-so-healthy things you enjoy. In other words, it’s alright to eat them but be sure to have them less frequently and in a smaller portion.

With diabetes this is important for your blood sugar management. The goal is to not completely deny yourself things like chocolate chip cookies, but instead maintain a healthy lifestyle while still treating yourself.  A tip to do this is buy smaller portion sizes, so having one small cookie won’t have as much of an effect on your blood sugar as a larger one would.  Another great way to keep track of your portions is reading the labels on packages for serving sizes. Sometimes a package could be more than one serving!  Sharing a baked good with a friend instead of eating the whole thing can help you consume less as well. You could make homemade treats with healthier ingredients like in the recipe below so you aren’t consuming a heavily processed carbohydrate.  So aim to keep your portions in check and when it comes to sweets “Everything in moderation!”

Recipe: Healthy Banana PancakesCombine 1 ripe banana, 2 large eggs, and a few shakes of cinnamon in a bowl until smooth. Heat up a pan on medium heat and spray with cooking spray. Put a few spoon fulls of the “batter” into the pan. Cook until lightly brown on each side and serve.

Post content reviewed by Department of Nutrition and Food Services
Announcements

Are you newly diagnosed with diabetes, or struggling to control your blood sugar? If so, DMSE/S programs can help!

Diabetes is a chronic, complex disease. Self management is key, but what does that even mean?  Where do you start? Self Management is the ‘taking of responsibility for one’s own behavior and well being.’   Living well with diabetes means you need to learn new skills and behaviors. This can seem overwhelming during an already stressful time.  DSME/S programs teach you the self management skills you need to truly thrive.

You will first see a nurse or nurse practitioner (who is often usually a Certified Diabetes Educator or CDE).  You will either continue to see that clinician by yourself or attend group classes with other people just like you. Group classes are a great way to learn and be supported by people who know what you’re going through. You are not alone! During appointments or classes, you will learn about important topics like nutrition, exercise, medications and more.  You will also set specific behavioral goals to work towards between each visit.

Research has shown that DSME/S works. It can lower your A1C and stop complications from happening or getting worse. Attending can also improve your quality of life and keep you out of the hospital. Major organizations like the American Diabetes Association, American Association of Diabetes Educators and the Academy of Nutrition and Dietetics all believe that everyone with diabetes should have DSME/S at some time in their life.

Mass General DSME/S programs are offered at Chelsea, Revere, Charlestown, Internal Medicine Associates, Diabetes Associates and Bulfinch Medical Group. For more information, contact Jen Searl at jsearl@partners.org.

My Story

My Story: What I Learned Caring for My Grandmother with Diabetes

By Vanessa

My grandmother is a tenacious and vibrant woman who was diagnosed with type 2 diabetes earlier this year. She had uncontrolled blood sugar levels along with other health issues and limited mobility. With no formal educational background, she doesn’t know much about diabetes or possible complications. Her low health literacy makes it difficult for her to utilize diabetes related health care resources.  “There are too many rules in my diet!” she would exclaim in Twi, her native dialect.  She also has low nutritional knowledge and at times would reduce her consumption of certain staple foods. She assumed that eating less of these foods would cure her body from the disease. Her daily diet in Ghana is mostly starchy and sugary foods with low nutritional benefits.  One staple meal that she eats quite often is called fufu:  a soft dough-like mix of cassava, plantain, and other flours served with different types of warm soups full of meat and/or fish.  Fufu is relatively high in carbohydrates and has a significant and rapid effect on my grandmother’s blood sugar levels.

As my grandmother’s caregiver, I provided diabetes care management and education.  My goal was to help her avoid blood sugar spikes keep her blood sugar in a healthy range before she went back to Ghana. Every day I checked her fasting blood sugar in the morning and again two hours after eating.  These results were reviewed by her PCP and nurse case manager.  I modified my grandmother’s meals and incorporated more green leafy vegetables, fiber-rich foods, whole-grain breads and old-fashioned oatmeal with almond milk and honey for added sweetness. I also introduced her to cooked quinoa and cauliflower rice as substitutes for fufu, white rice, and other fufu-like foods to give her meals a nutritional boost. After a meal, I would encourage her to take a walk to the local shopping plaza or to circle around the neighborhood for an hour.  Despite her stubbornness and fiery temper towards changes to her diet, we were able to improve her eating habits by stressing the importance of portion control.

My grandmother does not know how to pronounce diabetes or manage her care on her own, but making sure she understood that her medications, changes to her diet, and daily walks to her favorite consignment stores are effective tools for managing her blood sugar levels were key components to her care plan.  My experience as a caregiver was a wonderful opportunity to spend time with my grandmother, and it also highlighted the importance of diabetes education in following a care plan and reducing risk of complications.  I also learned how that approaching care in a culturally tailored manner that respects individual preferences, opinions and ideas is necessary for reaching optimal health.

 

Nutrition, recipes

Be Fit Basics: Quinoa Parsley Salad

Celebrate Whole Grains Month with this easy grain salad.  One serving is a good source of iron.

Ingredients:
1 cup of water
½ cup uncooked quinoa, rinsed
3 tbsp fresh lemon juice
1 tbsp olive oil
1 tbsp honey
¼ tsp salt
¼ tsp black pepper
¾ cup fresh parsley, roughly chopped
½ cup thinly sliced celery
½ cup thinly sliced green onion
½ cup finely chopped dried apricots
¼ cup pumpkin seeds

Directions:
Bring water and quinoa to a boil in a medium saucepan; cover, reduce heat and simmer for 20 minutes or until the liquid is absorbed.  While the quinoa is cooking, whisk the lemon juice, olive oil, honey, salt and pepper together in a small bowl.

Fluff the quinoa with a fork and place in a bowl.  Add the parsley, celery, onion, and apricots.  Toss with the dressing to coat and top with pumpkin seeds.

Yield: Serves 4

Serving Size:  about 2/3 cup.

Nutrition Information Per Serving:
Calories: 195 calories • Protein: 5 g • Sodium: 160 mg • Carbohydrate: 33 g
Fiber: 4 g • Fat: 6 g • Sat Fat: 1 g

Recipe adapted from Cooking Light.  Originally posted on mghbefit.com.
Nutrition

Smart Grocery Shopping Strategies

By Nichole Reed, Dietetic Intern

When you have diabetes, it’s critical to stay on top of what you eat on a day-to-day basis. Cooking meals at home gives you more control over what goes into your food. Of course, this is all easier said than done – so here are some quick tips for meal planning and grocery shopping to help get you started.

Sit down and plan your weekly menu: Taking a moment to plan out your week ultimately saves you time and money. Knowing the answer to What’s for dinner? keeps you from going through the drive-thru or ordering take-out. Pick a few main dishes and rotate them throughout the week. (Use this menu planning tool to make it even easier.) Choose recipes that you will both enjoy and are willing to make! Sites like Pinterest, Eating Well or our own MGH Be Fit page are great resources for recipe ideas.

Make a shopping list: We all make the mental notes of what we need to pick up, but actually writing it down commits you to the list. You can do this on paper or even your phone. Having a list keeps you on a mission. Otherwise, your eye will wander and your cart will end up looking like you bought the whole store.

Shop locally: Farmers market season has arrived! The grocery store can seem chaotic and more like a chore. Buy your produce from local vendors. Enter your zip code on Mass Farmers Markets and see the one closest to you! You’ll get to enjoy some fresh air, beautiful weather, and support your local farmers. Make a day of it and take some family or friends.

Remember, keep it simple. You don’t have to be five-star chef to make delicious meals. Getting organized makes grocery shopping a breeze and gets you one step closer to taking control of your diet.

Post content reviewed by MGH Department of Nutrition and Food Services
Nutrition, Uncategorized

Trans Fat: What is it and Why Should I Avoid it?

Alison Bliven, Dietetic Intern

What is it?

Trans fat has been used since the 1950’s in order to add certain tastes and textures to packaged and prepared foods while also increasing their shelf life. These fats naturally occur in small amounts in some animal products and oils, but the product used in processed foods is man-made and differs slightly from the naturally found substance. Hydrogen ions are forced into oil in a process called ‘hydrogenation’ which turns the oil into a solid. This product is called partially hydrogenated oil (PHO for short) and is filled with trans fats. This PHO is what is used in place of butter or oil in a variety of processed foods in order to keep them fresher longer.

Why is it bad for me?

For half a decade trans fats were included on the Food and Drug Administration’s (FDA) Generally Regarded as Safe list. However, more recent studies have linked the consumption of trans fats to increased risk of coronary heart disease: by raising ‘bad’ cholesterol (LDL) and lowering ‘good’ cholesterol (HDL), trans fat contributes to the buildup of plaque in arteries which can lead to heart attack. Insulin resistance, a sign of Type 2 Diabetes, has also been shown to have strong connections with trans fat intake.

What foods contain trans fat?

Trans fats naturally occur in meat, dairy, and some oils. The amount of trans fats found in these sources make up an insignificant part of the American diet and are not considered a health concern. The majority of trans fats come from processed foods.  For example:  crackers, cookies, cakes, frozen pies, microwave popcorn, stick margarine, coffee creamer, biscuits, cinnamon rolls and ready to use frosting. Luckily, the number of foods containing trans fats is decreasing, and should soon be nonexistent.

What is being done to protect us?

As mentioned above, studies have overwhelmingly shown a direct connection between trans fats and certain negative health outcomes. This evidence has led to the FDA passing laws that will phase trans fats out of food manufacturing completely. The first step in this process is including the content of trans fats on the nutrition label. This allows the consumer (you) to know what the product contains, to an extent. Food companies are allowed to put ‘0 grams trans fat’ on their labels if the product contains less than 0.5 grams per serving. There are two problems with this: 1) foods with small amounts can add up to a significant intake when more than one serving is eaten and 2) the Institute of Medicine has concluded that there are no safe levels of artificial trans fats in the diet. Even though the FDA is attempting to preserve Americans’ health, there is only so much it can do during the lag time before trans fats are outlawed completely.

What can I do?

Read the label! Look for products that include the phrase ‘trans fat free’ – by law these products can contain no trans fats. Also, scan the list of ingredients for words such as ‘hydrogenated oils’, ‘partially hydrogenated oil’, ‘PHO’, and ‘vegetable shortening’. If the food contains any of these ingredients, there is sure to be some amount of trans fat in it. Other tips include choosing liquid oils or soft tub margarine over stick margarine, and avoiding or limiting commercially baked foods and packaged snacks. Filling up on foods naturally high in fiber (whole grains, beans, peas, fruits, vegetables) means there will be less room for foods containing trans fats and will help promote general health as well.

Remember, Trans Fat Free ≠ Healthy!

One very important takeaway from this article is that just because a food is trans fat free or has very low trans fat, it doesn’t automatically make the food well-balanced or healthy! Limiting trans fats is just one component of a healthful diet that includes lots of fruits and veggies, a focus on whole grains, and limited intake of higher fat meats and dairy products.

(Post content reviewed by MGH Department of Nutrition and Food Services)

 

 

Nutrition, Secret Ingredient

Profile: Mushrooms

By Reneé Ortolani
Dietetic Intern

When talking about fruit and veggie consumption, it’s usually recommended to look for the brightest colors of the bunch (i.e. bright red tomatoes, rich purple eggplant or green leafy spinach). The vibrant colors means the fruit or veggie is packed with vitamins and nutrients. While you’re painting your plate with color, leave room for the less vibrant hues too! While they don’t make for as striking a presentation as a carton of blueberries, paler veggies like cauliflower; onions and mushrooms are good sources of nutrients and antioxidants.

Okay, so technically mushrooms aren’t really vegetables, but rather a type of edible fungi. They have more in common with yeast than most of what you’ll find in the supermarket’s produce section. Some of the most common varieties of mushrooms include: portabello, shiitake, cremini, and chanterelle but there are thousands of different types of mushrooms. Mushrooms range in color from white to tan to golden and generally have a mild to strong (depending on variety) earthy flavor. Not all mushrooms are edible, though. Because some poisonous mushrooms look very similar to edible varieties, it’s best to leave mushroom picking to the expert mushroom hunters.

So why are mushrooms so great? Let’s break down their nutrients. Mushrooms are naturally low in sodium, fat, cholesterol, and calories making them a healthy option to add to any meal. Mushrooms are also packed with the B vitamins riboflavin, folate, thiamine, pantothenic acid, and niacin. They’re also the only non-fortified dietary source of vitamin D, a huge benefit to vegans. The list goes on with several minerals that mushrooms can add to the diet such as selenium, potassium, copper, iron, and phosphorus.

If you thought that was all that mushrooms offered, keep reading. Not only does this food from the fungi kingdom rate high on the nutrient scale, they provide a slew of possible health benefits as well. Beta-glucans (a type of fiber found in mushrooms) has recently been studied to evaluate its effect on improving insulin resistance and blood cholesterol levels, while lowering the risk of obesity. Choline, another nutrient, aids in sleep, muscle movement, learning, and memory, while also helping support fat absorption and reduce chronic inflammation. The mineral selenium delivers cancer-fighting qualities by assisting in detoxifying cancer-causing compounds in the body. It also prevents inflammation, lowers tumor growth rates, and is important for liver enzyme function. The list goes on with supporting cardiovascular health, improving immunity, aiding in weight management, and increasing satiety too.

With all of these nutrient benefits, where can you go wrong with incorporating mushrooms into your lifestyle? There are so many ways that mushrooms can be added to a dish. Whether replacing your burger with a grilled and marinated portabello, adding creminis to an egg frittata, or mixing shiitake mushrooms into your favorite pasta dish, this powerhouse of a “veggie” is sure to be a crowd pleaser.

So, what are you waiting for? Add mushrooms to your grocery list and try them in this delicious portobello mushroom burger recipe from the MGH Be Fit Program, the perfect addition to your palette this summer season!

Be Fit Basics: Stacked Summer Veggie Portobello Burger

Ingredients:

6 portobello mushrooms (any dirt brushed off with a paper towel), stems removed
¼ cup balsamic vinegar
4 tbsp olive oil, divided
4 rosemary sprigs (or 1 tsp dried rosemary)
3 peaches cut in half with peach pits removed
3 bell peppers cut in half with seeds and stems removed
3 small onions, skins removed and sliced in half (preserving onion rings)
1 lemon
Salt and pepper (salt estimated at ½ tsp)

Instructions:

Place mushroom caps in a large bowl; add balsamic vinegar and 2 tbsp of olive oil. Tear leaves off rosemary sprigs and add them to the bowl. Add salt and pepper and toss all ingredients until mushrooms are fully coated (Adding additional balsamic as needed). In another large bowl place peaches, peppers and onions. Cut lemon in half and squeeze juice into bowl. Add remaining 2 tbsp olive oil with along with salt and pepper; toss to combine.

Light grill; allow it to come to medium-high heat or when you can hold your hand about 5 inches above the grill (being careful not to burn your hand) for 3-5 seconds. The process for lighting your grill will vary depending on whether you have a charcoal or gas grill. [Note: If you don’t have a grill you can roast the mushrooms, peaches, peppers and onions on a large baking sheet in a 425 degree oven for about 30-40 minutes. (The cooking time may vary slightly depending on your oven.)]

Place mushrooms, peaches, peppers and onions on grill. Grill until slightly charred and cooked through, about 5-15 minutes. Turn vegetables once half way through cooking.

Assembly: On bottom of a wheat bun place peppers, onions, peaches and mushroom cap. Place other bun half on top

Yield: 6 serving

Nutrition Information per Serving (not including bun):

Calories: 180 • Protein: 4g • Sodium: 210mg • Carbohydrate 22g • Fiber: 5g •
Fat: 10g • Sat Fat: 1.5g

(Content reviewed by MGH Department of Nutrition and Food Services)

Health, Nutrition

What to Expect with the New FDA Food Label

By Aubrey Brophy, Dietetic Intern

The United States Food and Drug Administration (FDA) is proposing new updates for the current Nutrition Facts label that appears on most food and beverage items. The new food label is meant to reflect the current nutrition issues Americans face, primarily overweight and obesity, lack of certain vitamins and minerals and increase readability and comprehension

What are the main changes?

  • Serving Sizes – The serving sizes seen at the top of the food label will reflect the actual portions most Americans consume. For example, food packages and beverages that can typically be consumed in one sitting, like a 20 oz bottle of soda, will reflect only one serving. Also, “Amount per Serving” will now be listed by the actual serving size, such as “amount per 1 cup.”
  • Format Changes – The calorie and serving size section will now be larger and bolder to emphasize the amount of calories that are actually in the item. Additionally, the percent daily value will be shifted to the left to help consumers understand the nutrient content of the item compared to the estimated daily needs.
  • Added Sugars – A new “added sugars” section will be included to help consumers identify which sugars are not naturally found in food items.
  • Fat – “Total Fat,” “Saturated Fat,” and “Trans Fat” will continue to be required, but “Calories from Fat” will be removed from the food label because it does not distinguish between healthy and unhealthy fats.
  • Potassium and Vitamin D – The new food label will now be required to list the amounts of potassium and vitamin D in the food or beverage item because these have become nutrients of concern in the U.S.
  • Vitamin C and Vitamin A – These vitamins will no longer be mandatory due to lack of concern for deficiencies (they may still be listed voluntarily).
  • Calcium and Iron ­– These nutrients will continue to be required on the food label because they are still of concern for the general population.

Below is a comparison of the current Nutrition Facts label and the proposed food label.

oldnew food labelWhen to Expect These Changes?

The new Nutrition Facts label is still under review by the FDA, so an official launch date is unknown at this time. Once the changes are effective, manufacturers will have two years to comply with any of the final requirements.

(Post content reviewed by MGH Department of Nutrition and Food Services)