Huge portions, overeating and sedentary lifestyle have all led to the epidemic of  diabetes and pre-diabetes in America.  About 23.6 million Americans have diabetes and another 57 million have pre-diabetes (or pre-type 2 diabetes).  A whopping  3.7 million African Americans (or 14.7% of non-Hispanic black adults)  in our country have the disease and one quarter of all African-American women over the age of 55 have type 2 diabetes.  High blood sugar (or diabetes) can cause eye, heart disease, stroke and kidney problems if left untreated.  So much of African-American dietary practices are deeply rooted in rich history and culture.  These practices should be respected, but need to modified in order to prevent and treat the often deadly disease of diabetes.

Diabetes is a problem of high blood sugar. Your doctor will determine if you have diabetes or pre-diabetes by measuring the amount of sugar in your blood.  Type 1 diabetes (an auto immune disorder) can not be prevented, and must be treated with insulin upon diagnosis.  Pre-diabetes and type 2 diabetes (which are strongly related to your genetics as well as your environment), are often difficult to manage without proper guidance.  In the African-American community there are often feelings of denial and complex emotions which also go along with the diagnosis of diabetes.  According to Constance Brown-Riggs, a Registered Dietitian and Certified Diabetes Educator and author of “The African  American Guide To living Well with Diabetes”, July 2010, “African Americans suffer greater consequences from the complications of diabetes”.  She points out that African-Americans experience kidney failure four times more often than white Americans with diabetes, are twice as likely to suffer from diabetes-related blindness and more likely to experience amputation. It seems that many African Americans are not diagnosed with diabetes in the early stages of the disease, and often don’t receive proper nutrition and diabetes management information.

Brown-Riggs, who is an African American woman, has written this extraordinary informative guide which covers all aspects of diabetes care in a way that celebrates African-Americans. She points out that African American women are especially in need of advice on how to manage the disease.  They may not have taken diabetes seriously in the past, and are in desperate need of learning how to eat well, exercise properly and take medications as prescribed.  Basically, the black woman with diabetes should finally learn to put herself on top of the priority list and start managing her blood sugars in order to save her life!

The African American Guide To Living Well With Diabetes reminds women that living with diabetes is a life-long process.  Maintaining good health happens each and every day.  ”I”m only human.  I’m just a woman”, is a celebrated theme in the book.  Everyday is a new opportunity, so whether your diabetes is newly diagnosed, or you’ve had diabetes for several years, this guide can be very helpful.

Many diabetes books include self-care programs and work sheets, which Ms. Brown-Riggs has as part of this book targeting the African-American. However, this guide also includes a two-week sample menu of Caribbean and traditional southern meals. I’ve been a contributor to many books on diabetes, and I was so inspired on how this particular book focuses on “specifics” for the African-American community.

Since African-American women seem to have a challenging time modifying their dietary patterns due to meal rituals and ethnic identification with food, it’s really important to understand the intense importance of “food as hospitality” when modifying a food plan to reduce blood sugars. The “art” of cooking and serving delicious food doesn’t have to be a “thing of the past” when you have diabetes.

If you have a family history of diabetes, or are experiencing any of the symptoms associated with the disease (excessive thirst, frequent urination, blurred vision or fatigue), PLEASE make an appointment to see your doctor today. If you are an African-American with diabetes or pre-diabetes, there is help available! Let’s work together to eat well (lower our carbohydrate and calorie intake), exercise, take medications as needed and follow up with our health care providers. The goal is to REDUCE the incidence of obesity and diabetes in African-Americans. With some guidance, it is a very obtainable goal!

By Guest Blogger

Amy Santo

Master’s Candidate in Clinical Nutrition, New York University

Have you ever wondered where your nutrition and dietary advice comes from? Since 1980 “The Dietary Guidelines for Americans” have been published by the Department of Health and Human Services (HHS) and the Department of Agriculture (USDA). These guidelines are published about every 5 years and provide nutritional recommendations for Americans over the age of 2.

The 2010 Dietary Guidelines are encouraging a switch to a more portion-controlled, plant-based diet emphasizing beans, legumes, peas, nuts, seeds, fruits, vegetables, and whole grains. Fat-free and low-fat dairy products, as well as low mercury seafood and fatty fish are also recommended as part of a healthy diet. The guidelines also advise eating a moderate amount of lean meat, poultry, and eggs.

Many Americans have difficulty with the concept of moderation. We often think “if some is good, more must be better”. Or we tend to eliminate certain foods completely from our diets rather than eat them in “moderate” amounts.  The government is now recommending a “flexitarian” lifestyle in order to encourage a more plant based diet for those Americans who previously ate too much meat and who didn’t include plant based choices in their meal plans. A flexitarian is described as a semi-vegetarian who does not practice an exclusively vegetarian diet but chooses to eat meat infrequently or less often than in a traditional Western diet.

A practicing vegan or vegetarian does not eat meat. Although I am not a strict vegetarian, I have decided to follow the flexitarian lifestyle. Flexitarian diets are rich in fiber, vitamins and minerals. In addition, people who follow a flexitarian diet generally eat fewer calories and less fat, weigh less and have lower cholesterol levels than do non-vegetarians according to the Mayo Clinic. Flexitarinism is linked prevention of chronic diseases, such as cardiovascular disease, obesity, diabetes, and hypertension. It’s cost effective and delicious too!

As a flexitarian, I truly appreciate an occasional succulent steak… along side my quinoa, bean salads and lentil soups. I’m exploring more tofu salads and looking forward to trying innovative plant inspired recipes. 

The new dietary guidelines are scheduled to come out in November 2010. Stay tuned for more blog entries regarding the new Dietary Guidelines!

The full Dietary Guidelines Advisory Report is available to read (as well as more information and public comments about the Dietary Guidelines 2010): http://www.cnpp.usda.gov/dietaryguidelines.htm. Are you interested in following a flexitarian or vegetarian lifestyle? I’m enjoying the health benefits of being a practicing flexitarian.

So many fond memories focus on food. Just ask someone about a recent party or holiday gathering that they attended, and watch his or her face light up as she describes the delicious mouth watering offerings that were gobbled up in a New York minute. Growing up I used to think that it was just my family that served  huge portions of food to guests. Not only were the portions tremendous, but if there were less than 10 choices, the meal was described as “thrown together”! After practicing as a registered dietitian for over 20 years, I’ve learned that my family is a typical “food is love” tribe, and that most people eat a lot more than they think they do!

Food portions have become enormous. We simply don’t understand what constitutes a serving size. Years ago an obviously smaller bagel was 140 calories. Now a bagel is about 350 calories! The 140 calorie bagel is considered a “mini-bagel”. 20 years ago a fast food serving of french fries was 2.4 ounces and 210 calories. Now a serving of fries is 6.9 ounces and a whopping 610 calories. And when you drive up to the window, the voice behind the clown will ask you if you want the “value meal” for another couple of cents. Although it seems like a bargain, don’t do it! You are just doubling your caloric intake! I strongly recommend viewing the movie “Super-Size Me”. It will give you a great visual. Try this portion distortion quiz by the National Heart Lung and Blood Institute. hp2010.nhlbihin.net/portion/ 

Author and speaker James E. Painter PhD  RD, Chair of the School of Family and Consumer Sciences at Eastern Illinois University has done extensive research in the areas of weight gain and portion control. He  points out that we have very little understanding of portion sizes. We lose track of what we are eating due to quick restaurant service, increased recipe size at home, more visual food cues, increased size of containers and basic convenience of food. Dr. Painter has done several experiments which clearly prove that “”people who pour from larger containers eat more than those pouring from a smaller container”.  For example people will eat 45-50% more from extra large popcorn containers. And by the way, it doesn’t even matter if the popcorn is stale or fresh. Yuck!

There are now snack shops at gas stations where you can buy everything from a giant sugary soda to a hot dog or candy bar. Donut shops are opened 24 hours, 7 days a week, 365 days a year.  Inconvenience decreases food consumption. If food is made less available, we will eat less, and therefore weigh less.

Here are a few tips to help you avoid portion pitfalls:

1. Keep A Food Journal

We are responsible for what we eat. Writing down what you eat and how much you eat is very important. It’s also helpful to include the time you’re eating and feelings while eating (such as stress, boredom or anxiety). Writing down your food will increase your awareness of what you are actually putting in your mouth.

2. Be Aware Of Large Packages And Containers

The bigger the package, the more you will eat. NEVER eat out of the container. Always portion your food into a small bowl or plate.

3. Keep Healthy Food Choices Available

Simply keep healthier foods available. Cut up fruits and veggies so that they will always be available. Fill a candy dish with pretty potpourri or if you need to display food on the counter, put out fresh fruit. There is no reason to buy huge bags of candy or chips. If you do want to keep some of these foods in the house, buy smaller bags and keep them out of your direct eye sight. These are “sometimes” foods. If you start to become more aware of your portions, you can actually eat these special foods more often because they will be “portioned”.

4, Monitor Your Portions When Eating Out

Take control of your food destiny when eating out. Don’t be afraid to order an appetizer portion for your entree with grilled vegetables and a salad. Even try a child’s portion, take half of your food home or share an entree with your dinner companion.

5. Put Leftovers Into Smaller Containers

Putting leftovers into proper portion size containers will allow you to reheat  and eat them without overeating. You will be able to enjoy your next meal without extensive preparation.

6. Always Eat A Salad Or Raw Veggies Before A Meal

Unless you have a stomach issue which might prevent you from eating more vegetables, it’s a great idea to eat some fiber packed veggies before eating  a meal. This will take the edge off your hunger and allow you to control your portions.

7. Timing Of Meals And Snacks

Eat 5-6 times each day, every day. Spacing out your food will help stabilize your blood sugar and help you control hunger. If you are starving before a meal, you will most probably eat a lot more.

Portion control is a necessary key to weight control success. Along with diet and exercise we need to control our portions. Try following the tips outlined above. I’d be very interested in hearing your comments and tips about how YOU have controlled your portions. Remember if you eat a little less, and move more, you will lose weight and feel great.

                                          By Guest Blogger     Susan Kalish, R.D.

“Farm Fresh” food has a whole new meaning when you actually go to the farm to pick out the food yourself! At farmer’s markets across the country, there are fresh foods available for your choosing.  Buying locally grown products  is a  wonderful way to enjoy some inexpensive family fun while supporting the local economy. Let’s look at some of the many reasons to support farmer’s markets.

1)  An Opportunity to Try New Things.  As a loyal farm stand shopper I must admit that nothing can compare with sweet fresh locally grown corn. However, my advice is to keep an open mind when selecting some of the more unusual varieties of produce. There are interesting fruit hybrids such as pluots, (which are plum/apricot combinations).  Try delicious variations on  more traditional fare such as juicy donut peaches. These tasty fruits are not fused with donuts, they just take on the cute shape. There are so many types of fruits, vegetables and fresh herbs to choose from that it makes most “foodies” want to experience new and exciting farm fresh offerings. Experimenting with new foods adds excitement to the entire fresh market experience. The friendly farmers are more than happy to advise you on how to use their products.  There is also a strong feeling of  community support when you purchase locally grown products.

2) Fresh, Seasonal Nutrition. If you believe as I do that we need to work with nature and support our environment, than shop locally and eat seasonally.  Seasonal fruits, vegetables and hybrids will be the main source of food available at your local farmers market.  Start treating yourself to foods which were meant to be grown, harvested and eaten at a particular time of year. Enjoy vitamin rich foods the way nature intended us to eat them.  

3) Economical Shopping. In these tough economic times, many people are looking for ways to save money.  What better way to support your local economy and community than to put your money towards local farmers fare.  Another way you will save money is by cutting out middlemen services. This food comes straight from the farmer to the consumer.  Consider purchasing gorgeous  fresh flowers at the market or homemade preserves with the money you saved by cutting out the unnecessary transportation services.  

4) Pick your Own. Selecting your own fruits and vegetables is a fun, inexpensive day out. Blueberries and peaches are ripe for the picking.  Shopping with your kids can teach them about healthy food choices and provide some much needed outdoor family fun.  

5) Wineries.  Although, not exactly a farmer’s market, locally grown grapes make delicious and affordable wines, some of which may even be available at your local farmers market. Check your local listings  during the summer as many wineries even offer live music on the weekends. Try some local, heart-healthy red wines (in moderation of course). So next time you’re considering bringing a bottle of wine to a friends house for dinner, remember your local grape growers! 

The produce in grocery stores can look and smell appealing, (and is still very nutritious), but  it often takes weeks to get foods from farms to the supermarket shelves.  Between international shipping and storage, our “fresh” food may actually be quite dated. Not only is the produce we purchase at supermarkets not as fresh as it could be, but it  may also lose several nutrients and sometimes flavor with age while being transported. The best time to take advantage of your locally grown farmer’s markets is now when the options are endless.  You  may be pleasantly surprised at how many varieties of your favorite foods are grown nearby.  Don’t despair city dwellers; many cities have farmer’s come in to local parks or churches on the weekend – just look for the signs! Keep an eye out for local listings for farmer’s markets, or wineries in your region or search online for pick-your-own options in your community at: http://www.pickyourown.org/. To truly get the farm fresh flavor and full benefit of your favorite fruits and veggies, stop by and support your local farmers markets.

Recently I had the privilege of being a featured guest on “The Mother Love” radio broadcast on ”latalkradio”.  Mother Love and I continue to work together on the dLife TV show.  She is a co-host and I am a contributing medical producer (and member of the dLife medical advisory board).  It is a remarkable show and I am honored to be associated with people who are so passionate about finding a cure for diabetes, and offering helpful advise for those who have this challenging disease.  So when Mother Love asked me to talk about being a Certified Diabetes Educator (CDE), I was very excited to share my experiences.

After I became a Registered Dietitian and completed my Masters of Science degree in applied physiology and nutrition at Columbia University in New York, I became intensely interested in the treatment of diabetes. Going back 20 plus years ago, diabetes was not in the news the way it is today.  There was no discussion of pre-diabetes (or “pre-type 2 diabetes).  In those days people talked about childhood or juvenile diabetes vs adult diabetes.  We now know about the pre-diabetes epidemic, gestational diabetes, as well as Type 1 and Type 2 diabetes.  When I began my private practice, I saw the need to educate people and their families on how to live with diabetes (and manage their blood sugars).  So, I decided to become a Certified Diabetes Educator!

According to the National Certification Board for Diabetes Educators (www.ncbde.org/eligibility.cfm), in order to even “apply” to take the CDE (Certified Diabetes Educator) exam, you must be licensed and registered as a health educator for a specific period of time in one of the following areas;  clinical psychology, registered nursing, occupational therapy, optometry, pharmacy, physical therapy, physician, podiatry, registered dietitian, physician’s assistant as well as a few other health professions.  Additionally, you must have two years experience in diabetes self-management education, including 1,000 hours in diabetes education!  Before taking the test you must also be currently working in the field of diabetes education at least four hours per week. In order to maintain the CDE credential, one must participate in 75 hours of continuing education (specific to the study of diabetes) every five years. These intense credentials define why a CDE is the true diabetes expert. 

I pride myself on  really listening to all of my patients’ needs. Before meeting for an initial visit, I ask a new patient to complete a “health assessment” form.  The form includes details about the individual’s medical and nutritional history, as well current medications or supplements, physical activity level and other relevant information.  People are often anxious before seeing a new health professional, and the information “intake” can be overwhelming.  I pride myself on allowing my patients to feel comfortable and relaxed when working with me.  Having this vital medical and lifestyle  information prior to meeting with a new patient allows me spend more time counseling and less time gathering data. I encourage families to become involved when appropriate. We also include the patient’s physician and other health care professionals in our care plan (as this should be a supportive team effort).

Once we start working “together”, everything about diabetes management is discussed.  My practice focuses primarily on a nutritional care and exercise plan.  We also discuss medication compliance and overall improved emotional health and well being.  Developing a nutritional care plan is a collaborative effort.  Your diet plan should not be overly restrictive and difficult to follow.  If I  told you to only eat dry fish and dark green vegetables all day, every day, you’d run out of my office!  So it’s important to work together to make “lifestyle changes” that will improve blood sugar control, while allowing  long term compliance (in the real world).  Only after I learn a little more about a person (and their lifestyle), can we start to amend and tweak what they eat.  We pay special attention to carbohydrate consumption, and eventually manage blood sugar levels.  Our goals can be somewhat varied. But basically, everyone wants to improve their blood sugars to prevent all of the long term problems that are associated with poor blood glucose management.  Sometimes goals include weight control, increased physical activity and portion control.  But everyone wants to live a long healthy life, without developing problems related to high blood sugar (such as diseases of the eyes, kidney and heart).

If you know someone who would benefit from working with a Registered Dietitian who is also a Certified Diabetes Educator, please check out the NCBDE website (www.ncbde.org). We truly are the diabetes experts!

 Next time you open your refrigerator, please glance at the back of this essential kitchen appliance and pull out any “questionable” items that you might not have seen in the recent past. Perhaps you’ll find a yogurt you bought on sale (last month), or funky American cheese or unfamiliar salad dressing. Your first reaction is to possibly check the item for an “unpleasant odor” or “plant growth” and  you might glance at the expiration date of the item. Do not rely on your sense of smell when deciding whether or not to eat a particular “aged” food!

What most people don’t realize is that the expiration dates on most foods are  based on a “voluntary” food labeling system. Federal labeling laws regarding expiration dates are only required on infant formulas and some baby foods. Several states also require food markets to remove dairy items from store shelves based on expiration dates.

The expiration date refers to the last date a food should  be eaten. Basically, foods can be sold past the printed expiration date. My recommendation is to NEVER eat a product past the expiration date. What about other commonly used terms?

-”Sell By“ date. The sell by date is a term which indicates how long to keep the product on the store shelf. The product should be purchased before the sell by date. My family always comments that I “reach back”, when buying items in the supermarket, and I never take the food item in front. That’s because I know that the sell by date is a way for the stores to continue to rotate items, and therefore the newer items are usually toward the back. Although foods might still be “edible” if they are sold after the sell by date, they are not necessarily fresh.

 -”Use By”  The manufacturer of the product, not the Federal Government determines the use by date. The use by date refers to the last date the product should be eaten or used for top quality. The use by date has nothing to do with the safety of the food being sold.

-”Guaranteed Fresh” date. Most baked goods have a guaranteed fresh date. Nothing is actually guaranteed here! Rather the guaranteed fresh date refers to when a product is most fresh. Baked goods obviously are on store shelves for a shorter period of time, so this date may not be “guaranteed” for long! That’s why “day old bread” or muffins are often on a reduced sale rack.

Food stays fresher longer if it is placed in the coldest part of the refrigerator (which should always be below 40 degrees Fahrenheit- 36-38 degrees is optimal). Try not to place uncooked meat or dairy next to the light bulb or on the door (which is opened often and therefore the temperature of the foods on the door is often higher). Always refrigerate perishable food items as soon as you get home!

Because expiration dates are voluntary, they are often not uniform and therefore very confusing. It’s important to remember that the dates on food products refer to “quality” and not food “safety”. Select foods carefully and store them properly. Please make sure your freezer and refrigerator are clean and functioning optimally. Don’t over pack your refrigerator, because air flow and temperature regulation are very important.

If you would like more information on food storage check out:

Cold Storage Chart:

http://www.pueblo.gsa.gov/cic_text/food/cooking4groups/8.htm

Refrigerated foods:

http://www.pueblo.gsa.gov/cic_text/food/cooking4groups/9.htm

Remember the motto ”when in doubt, throw it out”! If you have any concerns about a food item, don’t eat it! It’s best to keep an updated inventory of foods in your home. Make sure you buy foods that you plan on eating “soon”! And clean out your refrigerator, freezer and pantry. Toss foods that you think might be questionable. To avoid wasting money and throwing out food, try to purchase perishable and canned food products in smaller quantites. It will improve the freshness and quality of your food while reducing waste. Remember, enjoy what you’re eating, but stay safe!

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Summer has officially started and the grills and fireworks are being lit! July 4^th celebrations are starting and this season, just because your social calendar is expanding, doesn’t mean your waistline has to as well. Here are a few tips and tricks to help you  enjoy those summer time BBQ’s without packing on  unwanted pounds.

Eat like a vegetarian, even if you aren’t one.  If you are vegetarian, or are considering a plant based diet (whether it is for your health, love of animals or the environment), it’s a great opportunity to explore the world outside of a typical high fat burger. Opt for a veggie burger, refreshing summer green or bean salad, grilled vegetables and or enjoy the crudités with fresh salsa (and skip the creamy dip).

Skimp on the sides. The side dishes are usually loaded with mayo and mystery sauces that are packed full of calories – such as potato salad, coleslaw and pasta salad. Try your own spin on the side dishes by bringing an accompaniment that tastes good and is good for you. Give my summer bean salad a try (recipe is below). Be creative and experiment with your own favorite vegetables and seasoning substitutes. It’s not to say you can’t have your old family favorites, but if you really want to have Aunt Ethel’s famous potato salad, remember to watch your portions!  

Go Back to Basics. When in doubt, stick to the tried and true. If you can’t bring your own options or they aren’t available at the party, just go back to basics. Chop up a large veggie based salad, grilled chicken or fish and include fruit for dessert. Remember not to embellish the salad with excess dressings or the burger with extra cheese! Take advantage of the beautiful weather and get moving outdoors! Beginners and experts alike can enjoy a nice walk or bike ride, especially on days where you know you might want to indulge. Just make sure you wear SPF and drink plenty of water to stay cool and fit!

Limit Alcohol. Empty calories in alcohol will add up fast. On top of the calories, you are at greater risk for dehydrating or making poor dietary choices. Fill up on higher fiber foods (especially seasonal fruits and veggies), which are lower in calories and will help you stay satisfied and healthy.

Making a party at your home is always the best way to ensure the foods you are eating work for your specific needs, whether the goal is calorie control, health promotion, or just to suit your preferences. When hosting a party at home, you can sneak in healthy choices for you that are also crowd pleasers for your guests. I prepare  traditional dishes  using low-fat dressings or mustard in place of mayonnaise, or use leaner meat (or vegetarian) selections for family parties. Even those who usually pride themselves on avoiding healthy choices might appreciate some more adventurous selections!  Friends and family members who are  calorie and health conscious,  will certainly note and appreciate your efforts.

If  you’re attending a party where there may not be healthy choices available, then bring your own creative entree  or dessert. You can be a gracious guest and be guilt free by bringing  the quintessential dessert, and my personal favorite, sliced watermelon. Juicy seasonal fruits are a  natural healthy treat! Remember, you can enjoy your entrée and everything before and after without the weight (literally or figuratively) of guilt on your shoulders this grilling season. Your hostess, guests, and certainly your figure will appreciate it!        

Summer Bean Salad

Ingredients:

• 1 15 1/2 ounce can chick peas (garbanzo beans), drained
• 1 1/2 cups grape or cherry tomatoes, halved
• 1 ½ cups cucumbers, sliced or diced
• 1/4 cup red onions, sliced or diced
• 1 tbsp olive oil
• 2 tbsp balsamic vinegar
• Garnish with finely chopped fresh mint, parsley or cilantro
• Seasonings (optional)

Preparation:

Combine all ingredients and mix well. Refrigerate.

Serves 6

Nutrition Analysis/Serving:

 150 calories, 4 g fat, 22 g carbohydrates, 6 g fiber, 7 g protein

nutritiondata.com

A confrontation with co-workers, disagreements with your children, partner or parents or a seemingly unexplainable traffic jam can all cause your stress level to sky rocket. Most of us know what to eat. And even though we are often bombarded with “weight loss programs” we continue to gain weight as a society at least in part due to stress eating.  

Of course there are are some people who eat significantly less when they are stressed out. Certain people can’t eat or drink anything when their stress levels rise. But most people I counsel often eat to “stuff down emotions”. They know that it’s not healthy. It’s not a desired behavior. But it is very difficult to control.

So if we are not hungry why do we “stress” eat?

 We are social eaters

Even with the recent significant dip in the US economy, we still go out to eat often (or bring in “take out food”) and bond over food. Just turn on a TV soap opera or sappy movie and you’ll see a few friends sitting around digging into a gallon of ice cream or eating pre-cooked cake mix out of a bowl. Between dining out often (without regard for healthy choices) and crying together while sharing a can of frosting, a  social get-together can lead to consuming more calories than controlled eating at your kitchen table.

 Hormones

If you are very stressed out, you probably have an increased level of “cortisol” which is a stress hormone. The more stress you have (and lack of adequate sleep), the higher your cortisol level. Cortisol can cause an increase in “belly fat”, which in turn can increase insulin resistance and could result in an increased risk of developing problems like type 2 diabetes. Some reports even indicate that once cortisol levels are increased, so are cravings for salty and sweet foods.

 Boredom

Downtime is something we all need. But sometimes we don’t know what to do when we have five minutes of time to ourselves. Rather than doing something “positive” (like exercising, which would also increase “endorphins”, a feel good hormone), we simply eat. Think about the things you eat when you’re bored. Usually we go for a less healthy choice like a cookie or chip rather than a carrot or apple.

 Eating In Our Younger Years

When you did well on a report card, participated in a band concert or received a track ribbon your parents probably rewarded you with ice cream! Visiting your grandparents or a favorite aunt often revolved around the powerful aromas of sauces simmering or crumb cake baking. These positive food memories can translate into a way to control stress when we get older. So if you associate Aunt Betty’s home baked Lasagna with fond memories, you might crave it when you need some comfort. If you associate chocolate ice cream with sprinkles with being comforted for a scraped knee, you might desire that calorie rich creamy treat after a challenging day at work or school.

 Avoiding Emotions

Sometimes we eat rather than dealing with our emotions. Rather than confronting a problem, we eat. For a moment, we feel a little better. Food can be an inexpensive easily accessible drug. When a cup cake is stuffed down your throat, you are pushing down your emotions. The result is often weight gain, which will compound the original problem, but certainly won’t solve it.

My advice is to become aware of what causes you to “stress” eat. There is no easy way to stop eating due to stress, however it is very important to realize that it might be an issue in your life. Future articles will focus on the importance of exercise, maintaining a food journal, and good nutrition in the battle against stress eating. Please send along your comments on how you deal with eating and the stress in your busy life!

Long gone are the days that we feared the taste of high fiber foods! Foods rich in fiber are delicious and provide important health benefits.  Fiber can help us feel fuller longer and therefore help us with weight control! Fiber can reduce the risk of developing type 2 diabetes and heart disease. Since fiber can increase the size of your stool  (fiber helps produce a bulkier stool) it can also prevent or relieve constipation. Fiber is also linked to colon and breast cancer prevention.

We do not have the ability to completely digest fiber. Simply put, our bodies don’t produce the digestive enzymes that break down fiber. Insoluble fiber  is the type that can help ward off constipation by increasing the bulk of stool. It may also help control blood sugar.  This type of fiber is found in wheat, corn, nuts, green beans and dark green leafy vegetables.

Soluble Fiber  can help lower blood cholesterol and blood sugar. It regulates blood sugar by signaling the liver to stop making  glucose. Additionally, soluble fiber can improve insulin sensitivity. Soluble fiber lowers “bad cholesterol” or LDL (low density lipoprotein) levels which is great news for heart health.  Soluble fiber is found in barley, oats, psyllium, beans, apples, citrus fruits, carrots, flaxseed and oat bran.

Trying to lose weight? A high fiber diet makes you feel fuler longer so you tend to eat less. Also many high fiber foods take a long time to chew, which will help with portion control.

According to the American Dietetic Association, the average American eats about 14-15 grams of fiber per day, while the American Heart Association recommends we eat 25-30 grams per day! It’s important to increase your fiber consumption slowly to help prevent excessive gas build up and stomach upset. Without water, fiber will cause severe stomach discomfort. So as you increase your fiber intake, make sure you drink an adequate amount of water (at least 6- 8 glasses per day).

Here’s a look at some high fiber foods. As you can see, fiber is only found in plant based foods.  (The data below is from the USDA National Nutrient Database):

Apple, with skin                              1 medium                                     3.3 grams fiber

Asian pear                                          1/2 medium                               5.0 grams fiber

Raspberries                                        1 cup                                             8.0 grams fiber

Dates                                                     1/2 cup                                        7.1 grams fiber

Cooked whole wheat spaghetti   1/2 cup                                        3.4 grams fiber

Air popped popcorn                        3 cups                                          3.5 grams fiber

Cooked lentils                                     1/2 cup                                       7.8  grams fiber

Cooked black beans                          1/2  cup                                       7.5 grams fiber

Almonds                                               24 nuts                                          3.3 grams fiber

Peanuts                                                  28 nuts                                         2.3 grams fiber

Cooked mixed vegetables              1/2 cup                                        4.0 gram fiber

Sweet red pepper                               1 medium                                   2.4 grams fiber

If you are suffering from inflammatory bowel disease or another digestive disorder which might limit your ability to eat high fiber foods, please consult your doctor before altering your nutritional care plan. I usually recommend getting most of your fiber through food sources. Foods rich in fiber are generally high in vitamins as well (and fairly low in calories). Consult your physician if you feel you  might benefit from a fiber supplement. Learn to read food labels to make sure you are working towards your fiber goals.  Make fiber part of your healthy diet today!

Let’s consider some useful nutritional suggestions to help manage IBD. Although it can feel as if everyday is a challenge, I’d like to help you improve your overall nutritional health. Some of my suggestions vary based on your current state of IBD control! For instance, if you are in the midst of an IBD flare up (or crisis), it’s important to follow a “low residue” diet (also limited in fiber). Low residue and low fiber are not exactly the same thing. However, during an acute bout of pain and inflammation, we don’t want to do anything that would further irritate or inflame the intestines. That means eating softer and easily tolerated foods.

If your physician recommends following a low residue/low fiber diet during periods of extreme discomfort, try to avoid high fiber foods (no more than 10 grams of fiber per day). Avoid foods such as  whole grains and fresh fruits and vegetables as well as nuts and seeds.I  know, it sounds like the opposite of what we usually preach for good health! I also recommend cutting back on dairy products and caffeine, as those foods can stimulate bowel movements.  But remember, this is a temporary diet that should be followed during a  painful flare-up.  Cook high protein foods such as fish, poultry and eggs well (so that they are soft), puree most vegetables (avoiding broccoli, cauliflower and cabbage). Try applesauce and unsweetened canned fruits. Soft pasta might also be well tolerated. Sometimes nutritional supplement drinks (in a very elemental form) can be suggested by your physician (if you feel you can’t tolerate whole foods).  Sugar free foods that contain sugar alcohols (such as sorbitol) can be very hard to digest and should be avoided (as they can cause diarrhea). It is also important to limit large amounts of foods such as fat which could make your symptoms more severe. It’s also important to limit alcohol.

Even during those times when you are experiencing a flare-up, you must try to stay well hydrated and well nourished. I recommend eating 5-6 small meals per day, at all times with IBD. Eating smaller meals (higher in lean well cooked protein) can help you recover faster and feel stronger. Drink lots of water. This will also help prevent severe constipation. When you have IBD, bowel habits can range from diarrhea to constipation (over a short period of time). Water should be an important part of your daily regime.

When your IBD is under control, ask your physician and registered dietitian about increasing the fiber content of your diet. Many studies have proven that higher fiber diets can help reduce the risk of digestive and bowel diseases. The American Dietetic Association recommends a daily fiber intake of 25-30 grams per day for the average adult. However if you have IBD and have been following a lower fiber diet, you must increase your fiber intake very slowly (and only with the permission of your doctor)! Foods which contain high amounts of fiber include: whole grains, fresh fruits and vegetables, nuts and beans.

Treating and managing IBD requires individual assessment and treatment.  In addition to nutritional management and medications, exercise and stress management can be very helpful.  Please check out my previous post “Inflammatory Bowel Disease: More Than Just An Upset Stomach” for more information on IBD. Also check out CROHN’S & COLITIS FOUNDATION OF AMERICA for more support and information. Stay tuned for more information about eating well with IBD!