Valerie Rakes, RD
Nutrition Outpatient Center
Bon Secours St. Mary’s Hospital
804-287-7037
Wanting those New Year’s resolutions to “stick” this year in relation to healthy eating and maintaining an ideal weight? Below are some tips that can help you meet your goals and have a healthier 2016.
Develop a plan for lifelong health, not just short-term weight loss. A “diet” has a beginning and an end… and then what? Making healthy lifestyle changes that are sustainable over the long term is vital in reaching and maintaining a healthy weight.
Set healthy, realistic, measureable goals. Start with one or two specific, small changes at a time. Track your progress by keeping a food and activity log. When you have turned a healthy change into a habit, reward yourself with a non-food fun activity.
Eat at least three meals a day and plan your meals ahead of time; use a slow cooker; cook more than you need and freeze the rest. Learn which restaurants and supermarket delis have salad, soup, or grilled chicken so if you have to eat “to go,” you can make healthy choices. Use one day of the week to plan your meals and shop with a list.
Balance your plate with the right portions of a variety of foods. Half your plate should be filled with vegetables, one fourth with lean meat, poultry or fish and one fourth with grains/starches.
Try changing from a large dinner plate to a smaller one. It may help you feel satisfied with reduced portions.
Start your meal with low-calorie foods like fruits, vegetables and salads, then move on to the main course and side dishes.
Get plenty of fiber from fruits, vegetables, beans and whole grains. Fiber can help you feel full longer and lower your risk for heart disease and type 2 diabetes
Focus on your food. Pick one place to sit down and eat at home, preferably the kitchen table, with no distractions. Eating unconsciously while doing other things, like watching TV, may lead to overeating.
Know when you have had enough to eat. Quit before you feel full or stuffed. It takes about 20 minutes for your brain to get the message that you are full. Slow down!
Plan for nutritious snacks to prevent between-meal hunger; this will prevent overeating at the next meal. Enjoy a small handful of nuts or trail mix, or low-fat yogurt, fruit or veggies with hummus. Keep portable, healthy snacks in your desk, backpack or car.
Before you eat, ask yourself “Am I Hungry?” Sometimes we reach for food because we are bored, stressed, happy or sad. It may be helpful to post a list of non-food alternatives (on the refrigerator or pantry door) to help to cope with emotional eating and break the habit. Try the “Am I Hungry” app and website for some great advice and tools.
Find a support system; ask a friend or family member to hold you accountable to your goals and to be your “cheerleader.”
Now is not the time to try and “diet” or lose weight – its just not realistic. But you can work on maintaining your weight and come out of the holidays not feeling as stuffed as your Thanksgiving turkey!
Eating Healthy in General (including during the holidays)
Eat 3 meals a day and small snacks
Eat balanced meals (always include a variety of food groups including fruits, vegetables, fish, lean meat, poultry, whole grains, cereals and low-fat dairy products)
Make better food choices (trade off: pretzels vs. chips, vegetable sides vs. fries, mustard or light mayo vs. regular mayo/salad dressings, grilled or broiled meat vs. breaded or fried)
Load up on veggies (tired of salads? Pile up on sandwiches or stuff into potatoes, rice or pasta casseroles)
Drink non-calorie beverages (substitute water and diet soda for regular soda; or choose Crystal light, sugar-free Kool-aid, unsweetened tea or use artificial sweetener if necessary – it could save you close to 300 calories for every 20 ounces)
Enjoy small amounts of foods you love (completely omitting foods/depriving yourself of foods you really like might cause you to overeat those same foods or give up on healthy eating all together – so treat yourself once in a while – moderation is key! Trading off is key!)
Increase physical activity (it’s critical – make the time!)
Holiday Parties
Center entertainment around non-food events, such as ice skating, renting a holiday movie, or singing carols
Offer to bring a favorite low-calorie dish to holiday parties, so you know there will be at least one “safe” item available.
Arrive fashionably late and stand far away from buffets so you’re not tempted to nibble constantly. Instead, indulge in conversation.
Eat something before going to an event with alcohol. The effects of alcohol are felt much more quickly on an empty stomach and can lead to overeating and overdrinking (calories in alcohol and mixers).
Try to drink one glass of water before each glass of an alcoholic beverage.
Don’t skip meals in anticipation of a feast later in the day – you’ll only be more vulnerable to overindulging on typically higher calorie foods.
Coping with the Hustle and Bustle
To avoid indulging in high-fat fast food when your days become hectic, pre-plan several quick, healthy meals and have them readily available for reheating (can buy Tupperware in grocery store that goes freezer to microwave)
Keep freezer stocked with precut frozen vegetables to quickly add to a meal. Filling half your plate with veggies can cut the calories and fat in that meal nearly in half! Just watch the toppings for the veggies – season with vinegar, herbs, spices instead of butter, bacon or cheese sauces
If you must stop for fast food, choose grilled chicken sandwiches – hold the mayo, or a small hamburger (not loaded or double meat), and order a garden salad or baked potato instead of fries. Top potato with salsa or 1 Tbsp sour cream, ask for the low calorie dressing for the salad). Deli sandwiches are not always low fat, but Subway does offer several that are. Choose lean deli meats such as turkey, chicken, and roast beef. Leave off cheese, olives, mayo, oil. Instead, add veggies, mustard or other low fat dressing.
Lots of gas stations are now stocked with fruit choices – bananas and apples are easy to find. Choose those for quick snack instead of candy bar, chips, or cheese-filled crackers.
Keep a small cooler in your car, load it with bottled water, light yogurt, fruit, bite-size veggie sticks, low fat salad dressing, string cheese with no more than 5 grams of fat, even a healthy sandwich made at home. This is really great if you have small children too who might get hungry and irritable during a long day of shopping.
Holiday Treats
Its hard to eat healthy when faced with Aunt Terry’s famous apple pies and Grandma’s amazing double chocolate chunk cookies – just remember that eating too much over the holidays can result in low energy levels, not to mention weight gain.
The key is moderation – by balancing high-fat treats with some healthy ones, you can keep energy levels high and weight low.
A big mistake many people make around the holidays is completely abandoning their usual eating habits (“I’ll get back on track New Years…”). It’s normal to indulge a little, but be sure to get some variety in your diet during this time.
If you eat a sugary dessert tonight, try a healthy fruit salad after your next meal.
Don’t try to completely cut out high-fat holiday favorites like eggnog and holiday cookies. Instead, choose small portions and fill your plate with lower fat choices, such as fruit, baked squash, pumpkin, and whole wheat rolls.
Seek out lower fat, lower calorie treats to prepare.
Dried fruit is colorful and sweet – add it to cookies and breads instead of chocolate and nuts.
Old-fashioned Chex Mix? Why bake it with butter? Mix cereal, dried fruit, pretzels and sprinkle with herbs and spices if desired– it’s ready to eat!
Modify the current recipe you are using – use half the amount of sugar called for (use brown sugar for more intense flavor), use 1% milk instead of whole, 2 egg whites instead of 1 whole egg, applesauce or pumpkin instead of oil, and evaporated skim milk instead of whole cream.
All those treats you made were for the kids or grandkids or holiday visitors right? – So why did you end up eating most of them? Many times we eat food just because it is there. Bake a few family favorites if you need to, but not so many that you have full tins of them all around the house. Portion them out into decorative gift bags or in small stockings to give away.
Nibbling on treats off of coworkers’ desks can add up to lots of calories. Don’t bring in any to sit on your desk. Ask a co-worker to place out of sight. Or provide a big bowl in a common area for treats to be stored so that they are not always in your eyesight tempting you. Have to have one? Then just have one – pick your favorite and chew it slowly. Savor it and make those calories count!
Despite what the apron says – Christmas calories do count! So do the calories in raw ingredients – keep that in mind next time you are tempted to “sample” what you are fixing.
Holiday Meals – At home and at somebody else’s home
Use a 1-10 rating system during holiday feasts. Rate each food that is passed on a scale of 1 to 10, 1 – not appealing and 10 – WOW my favorite! Eat only 9s and 10s. Pass up the rest – it’s not worth the extra calories.
If at your own house, make a wide variety of tasty but nutritious selections, have several vegetable choices. Sprinkle hot vegetables with dill or other herbs for flavor instead of adding a butter or cheese sauce.
Use low fat canned cream soup in recipes, such as the traditional green bean casserole.
Don’t stuff the turkey with dressing, as it absorbs much of the fat. Bake it in a covered casserole instead. Add fruits (apples, raisins, dried cranberries) instead of sausage to your stuffing.
Sauté onions in only a small bit of oil, use fat-free cooking spray or defatted chicken or turkey broth for additional moisture.
Roast your meats on a rack or grill them so the fat drips away.
Use a fat separator for the roasting pan juices or put juice in fridge overnight and then skim off the fat that’s risen to the top before making gravy.
Use pineapple and/or orange juice thickened with cornstarch to make glazes for carrots and sweet potatoes instead of butter.
Mash potatoes with evaporated skim milk and chicken broth – nobody will even notice you didn’t add butter!
When reducing fat in a recipe, add more spices than the recipes suggest – it can have all the flavor of a high fat dish this way.
Make just one dessert so that you aren’t tempted to sample all of them.
If at somebody else’s house, offer to bring a favorite low-calorie dish or two so that you know there will be at least one “safe” food to fill up your plate with.
Begin the meal with a salad (beware of high-fat ingredients and dressings). You’ll eat less during dinner.
Drink water or other non-calorie beverage with your meals. And drink a full glass after your first plate before considering going back for seconds.
Use all fruit spreads on rolls vs. butter or skip the rolls due to so many other “bread” items (stuffing, sweet potatoes, whipped potatoes, etc). Don’t let Aunt Mary force feed you 2nd and 3rd helpings of her famous warm sourdough bread – take your time enjoying the first slice – make it last the whole meal.
More than one dessert to tempt you? Choose your favorite (use the scale) and take a small slice instead of trying to sample them all. If it’s a pie you can reduce the calories by just eating the filling and leaving the high fat crust behind.
When you are done eating – leave the table! Suggest the conversation be continued in another room so you aren’t tempted to keep nibbling.
Remember that the holiday meal is a special occasion. The meal after it is not! Resume normal eating habits the very next meal – instead of setting yourself up for a pattern of overindulgence.
Leftovers
Cookies, candies, etc? Freeze for later use or bag up and give away (take to nursing homes, shut-ins, homeless shelters, etc. Not sure where to take it? Ask your church or community center for a list of potentials. (Bring them into work? Not a good idea – you all work together! Plus they’ll still be within your reach, and now not just at home but at work too!)
They can be a good thing by saving you on meal prep time. Baked chicken and turkey go great on sandwiches. Remove the skin and top sandwich with mustard or light mayo instead of regular mayo. Leave off the cheese, but pile high with assorted fresh vegetables (onions and green peppers, carrots, lettuce, tomato, cucumber).
High-calorie leftovers? When it’s a meal just for your family, limit the amount of high-calorie foods prepared so that you won’t have any leftovers. Having dinner or party guests? Make a to-go plate of leftovers and insist they each take a plate home with them (make it a deal breaker before inviting them over). Wrap with colorful plastic wrap for a more festive gift-giving feel.
Exercise
Do your best to maintain your exercise routine during the holidays. If you can’t get to the gym or you don’t have enough time to do your usual activities, take a brisk walk around the block, shovel snow, or rake leaves.
Keeping yourself active will also help reduce holiday stress and keep your energy levels high.
After your holiday dinner go for a walk! Get the whole family in on the action – this way you can maintain conversations while burning off some of the calories you just ate. Added benefit that you are away from tempting leftovers to nibble on. Walk around the neighborhood to look at holiday lights or go to a nearby park if you need extra help getting motivated (or others motivated) for that walk!
September is healthy aging awareness month. In an effort to show our commitment to providing quality care to seniors, Bon Secours Virginia Health System has joined NICHE. NICHE is an international program designed to help hospitals improve the care of older adults. The vision of NICHE is for all patients 65 and older to be given sensitive and exemplary care. The mission of NICHE is to provide principles and tools to stimulate and change the culture of health care facilities to achieve patient centered care for older adults. NICHE is based at the NYU College of Nursing and is comprised of a network of hospitals and health care facilities in 46 states, Canada, and Bermuda. It engages hospitals and their affiliates in achieving and sustaining the NICHE designation. More information is available at www.nicheprogram.org.
Each of the Bon Secours Virginia hospitals has joined NICHE in order to provide excellent evidence-based care to older adults. St. Mary’s Hospital has successfully had more than 270 nurses, patient care techs, and ancillary staff complete additional education to help improve our care for older adults. Twenty-six RNs have become gerontological certified nurses. Education covers provision of evidence-based care on topics such as falls prevention, medication safety, nutrition, function, sleep, skin protection, incontinence, depression, dementia, delirium and pain. Our Hospital Elder Life Program (HELP) provides volunteer visits to help prevent adverse effects of hospitalization including loss of function and delirium. In the emergency department, a family nurse practitioner, case manager, and physical therapist focus on the needs of seniors. Nurses in the operative area and in behavioral health are also exploring how to improve care for older adults. Nurses report that the information in the NICHE modules is helpful for patient care, and also in their personal lives if they are providing care for an older adult at home.
One of our HELP volunteers shared her experience in assisting our efforts to improve care for older adults:
“While helping to deliver papers at another hospital, I, at times, was torn between listening to patients who just needed company and delivering papers. When I read about the HELP program at St. Mary’s, I jumped at a chance to participate. The experience has been more rewarding than I expected. The coordinator of the program prepared volunteers for the experience and made sure we were comfortable with visiting patients and knew the routine when entering and leaving a room before we were on our own. The nurses are great at identifying patients who would like company or need a little help with meals.
The bonus for me is meeting wonderful people and listening to the amazing stories they tell about their lives. I often wish I could tape them so their relatives could share them with future generations. An added blessing is hearing patients say, “Thank you, I didn’t think about my pain while I was talking to you.” Or “I’m glad you came. Will you come back?” They all praise the HELP Program, and so do I.” - Anne Fanelli
Each Bon Secours Virginia facility has individualized their NICHE program using the available resources to respond to the needs they have identified. We want to contribute to improved care for older adults and bring honor and dignity to those who come for care.
NICHE has offered a new app for patients and families. It can be downloaded at www.nicheprogram.org. Click here to learn more about NICHE, HELP, and other programs for our senior population.
It’s that time of year again – summer is winding down, and the kids are headed back to school! You may dread the thought of finding healthy, nutritious ways to feed the kids this year, but helping kids eat healthy is easier than ever.
Gone are the days of listening to children complain about that boring PB&J sandwich. You can sleep soundly knowing you have nutritious options that will keep the kids happy and healthy! Transform those boring brown bags into bright, fun lunches that your kids will love.
Follow these tips to build the perfect school lunch:
Talk to your kids. Ask which fruit and vegetable options they prefer. Start by letting them pick something new and exciting to try from the grocery store. Let them participate by choosing fun shapes and sizes to cut them into.
Plan ahead. Wash and cut fruit and vegetables ahead of time so things are not so hectic the day of.
Think presentation. To encourage your child to try new things, assemble food in eye catching ways. Make veggie or fruit kabobs, cut sandwiches, fruits and vegetables into fun shapes, and bring in as many colors as possible. For example, cut a tuna fish sandwich into a fish shape and pack a portion size of Goldfish crackers, an apple and some carrots.
To learn more about nutrition and other health needs for your children, speak to your pediatrician or family medicine provider. If you need help finding a provider in a convenient location who meets your family’s needs, visit http://goodhelpdocs.com/ or call 804-359-WELL [9355].
Low back pain is the leading cause of activity limitation and work absence throughout much of the world. It is estimated that more than one-third of people will experience an episode of low back pain during a year, and many of those will experience a recurrent episode that same year. One comprehensive study in North Carolina found the incidence of chronic low back pain to have risen from 3.9% to 10.2% between 1992 and 2006. This serious problem can be prevented and treated to avoid injury and expedite healing to keep your workforce active and healthy.
Prevention:
There are no definitive risk factors for low back pain as it is multi-factorial with dozens of variables contributing to potential injury
Some important variables that you can control within the workplace are:
Ergonomic desk setup
Top of computer screen should be at eye level
Legs should be bent at a 90- to 110-degree angle with thighs supported
Feet should be flat on the floor
Forearms should be parallel to the floor
Chair should have a backrest with lower back support
Lifting mechanics
Keep objects as close to your body as possible
Avoid excessive flexion (“bending over”) or rotation
Physical activity level
Maintain an active lifestyle to reduce your risk of recurring low back pain
Treatment:
Ideas around treating low back pain have shifted considerably
The most important advice is to stay active
While aggravating or high-stress activities should be reduced, one should continue to perform lower demand physical activity:
Stretching
Active range of motion
Walking
If your pain does not improve after several days, consider seeing your local Bon Secours physical therapist for further evaluation and consultation.