Showing posts with label Bariatric Surgery. Show all posts
Showing posts with label Bariatric Surgery. Show all posts

Monday, August 29, 2016

@InspiraHN SNJ Today Hotline - Are egg whites healthier than yolks? @SNJToday @eatright @EatRight_NJ

Recap of my interview 
with Jim on SNJ Today!
Our nutrition conversation covered everything from adult obesity and Bariatric surgery and obesity-related diseases such as high cholesterol and diabetes. We talked about pediatric obesity, excess sugar and portion distortion. I didn't know in advance what we would be discussing. To view our interview click here or on the link posted above. See below for a recap of my interview with Jim at SNJ Today's studio in South Jersey.

Jim opened our discussion with his personal interest in Inspira's Bariatric Weight Loss Program with the cliche: “You are What You Eat". I added, “You are Where You Eat” since so many of us do eat out. And, food choices are greatly influenced by our environment.

Portion control and selections are key: Some selections are high in calories and sugar and can lead to obesity.

Calories posted in restaurants: Jim asked “Do we have a mandate for that in NJ?” My response was "No". Chain restaurants with over 20 locations have to post their nutrition facts. Many restaurants do have the info available. Just Google the restaurant and look up nutrition facts of their menu items.

Distorted portions today: Larger portions = excess calories and energy.

US Obesity Rates: Jim asked if 2/3’s of people are overweight? Yes, as of 6 years ago more than 2/3's (67%) of people in the US were overweight according to the NIH. That statistic is still nudging higher. As of 2012, 68.5% of Americans are either obese (34.9%) or overweight (33.6%). And, even more concerning is the number of severely obese people, which has quadrupled in the past 30 years according to the Robert Wood Johnson State of Obesity 2014 Report.

Despite a slight improvement, I pointed out that NJ still has one of the highest obesity rates in the nation for low income children ages 2-5. And, I should have mentioned that health outcomes are the worst in the state of NJ in Salem and Cumberland counties.

We touched on the fact that increased diabetes in our nation is a serious concern. And that obesity may lead to diabetes and other diseases, including cancer, according to science. I mentioned my belief in “health at every size”, but acknowledge that statistics show increased diseases linked to obesity. 



Jim asked, "What would be a good 3 meals?" My response was that it depends on the individual. Dietitian recommendations are often centered on MyPlate food groups. Visit ChooseMyPlate.gov for more information about meal planning in both English and Spanish.

Most popular vegetables in the US: #1 Potatoes, #2 Tomatoes, #3 Onions, #4 Head Lettuce, #5 Sweet Corn, #6 Romaine and Leaf Lettuce, #7 Chili Peppers.
 

South Jersey locations for Inspira's outpatient Nutrition Counseling: Bridgeton, Vineland, Elmer and Woodbury.

Foods to lose weight: Eat more vegetables! Salads help. Downfall is that creamy types (Ranch, Thousand Island, etc.) salad dressings can be high in fat and calories. Creamy salad dressings can be used sparingly or thinned with water. Oil and vinaigrette salad dressings are generally healthy.

Jim enjoys Wendy’s berry salad…"~360 calories". He feels it is a good selection. After our interview I looked it up. And, it looks like it's a Wendy's summer special. I didn't see it on their regular menu selections. If I selected the right nutrition facts - it looks like their Summer Berry Chicken Salad has 380 calories (not including any salad dressing) so Jim was pretty accurate. Saturated fat: 3.5g (they don't include percent daily values %DV so it is not so easy for the average person to tell if 3.5g is high or low. It happens to be 18%DV; 20% is considered high). Sodium: 980 mg (without any dressing). The average persons daily sodium recommendations is no more than 2,300 mg/day. 980 mg is very high sodium.

I encouraged Jim and listeners to Read nutrition facts labels for food choices eaten out. Then, you can determine if it is a good selection depending on your needs. Some healthy sounding items can be deceiving.

People in southern NJ get bombarded with fast foods and advertising. Fast food restaurants are more prevalent from Burlington County down into South Jersey. 


We also talked about High Cholesterol: avoiding saturated fatty foods – and that dietary cholesterol is no longer a nutrient of concern according to the Dietary Guidelines for Americans, but we should still be mindful of not eating excess from saturated fats.
 

Many people still believe egg whites are healthier than yolks… I explained that you “...don’t have to leave out the yolks out anymore”. Yolks provide vitamin D, choline and other important nutrients. There is not enough scientific evidence suggesting that dietary cholesterol increases serum cholesterol according to the panel of experts involved with the 2015 Dietary Guidelines for Americans.

Jim brought up bariatric surgery again and shared that he has tried every diet in the world. Surgery should indeed be a last resort or be medically necessary.

I pointed out that surgery can be a tool for weight loss; dietitians encourage the importance of diet and lifestyle changes in order to keep the weight off. There can be weight regain after any type of bariatric surgery, especially if food preferences are not improved. Post-op support groups can be helpful.

We concluded with a brief discussion of other Inspira Health Network Connections that included The Family Success Center Vineland, which is where my main office is located. 


I encouraged listeners to look on Inspira’s website to learn more about Inspira's programs and any upcoming community events like our Superfood Nutrition Bingo and Healthy Cooking Classes.

1-800-INSPIRA

Related Articles
Diana Wind's SNJ Today Interview 
You Asked: Are Egg Yolks Unhealthy?
Harvard School of Public Health - Types of Fat 
FDA Calorie Labeling on Restaurant Menus
Blog post Copyright (C)Wind. All rights reserved.

Friday, March 22, 2013

Make your own ricotta and mozzarella cheese! @cherrygrovefarm #GardenCuizine @NOFANJ

Ricotta and Mozzarella
Cheese-making Class 
at Cherry Grove Farm!

As Harry and I set out for Cherry Grove Farm in Central New Jersey, we knew we were headed for a fun experience. We handmade ricotta, stretched mozzarella and stuffed ricotta burrata balls from grass fed whole cows milk. Even when we were in Sicily last spring we didn't get the opportunity to make or even observe how ricotta cheese was made. My last real cheese-making adventure was when I attended the Academy of Culinary Arts and learned how to make farmers cheese.
  • Cheese is an excellent source of protein and calcium, but can be high in sodium and saturated fat - so enjoy in moderation
  • What's nice about organic farm cheese is that the milk is more nutrient-dense from pastured cows that feed on organic grasses and weeds like clover. For example, some milk may have a yellow hue, a visible sign of having more beta-carotene. 
  • Milk from free roaming pastured cows also contains much more beneficial conjugated linoleic acid (CLA) than milk from grain-fed cows.
  • Making ricotta and mozzarella is easier than you may think. But, before you make your own cheese at home it helps to understand curds and whey.
Bariatric clients may like this information too because whey protein is recommended initially after weight loss surgery as an excellent form of supplemental protein.

What is Whey Protein?
Remember the nursery rhyme Little Miss Muffet, who sat on a tuffet, eating of curds and whey? Well, curds come from coagulated milk. And, whey comes from the leftover liquid when milk coagulates and the curds are removed. Whey is a byproduct in cheese-making and is used to make ricotta.

Ricotta
Whey cheese is ricotta. Ricotta means "recooked". it is made from the leftover fluid after straining out the curds, which are coagulated proteins in cheese-making. Proteins are coagulated by low pH and high temperatures. Milk can be coagulated through the action of adding acid such as lemon juice or citric acid powder to the solution. Time and temperature become important elements in the cheese-making process. 
In Sicily we had plenty of tastings though of warm, fresh made ricotta from sheep's milk. Molded Sicilian ricotta was served on the table with fresh bread. In Sicily, we used fresh ricotta in Italian Cassata - a classic Sicilian dessert. Ricotta is also popular in cannoli and in savory eggplant and pasta dishes.

Here in the US, most ricotta is made from cow's milk versus sheep's. There is a distinct difference in taste - with sheep's milk having more flavor, and cow's milk ricotta being more bland.

Cheers to Cherry Grove's cheese-making class!
In the cheese class, we didn't make Ricottone (whey only) ricotta, we made a ricotta variation from whole milk that some call farm cheese. The results are similar. Ricottone is finer in texture. Farm cheese has delicate ricotta curds that can be used as you would Ricottone or made into mozzarella like we did in the class. In the class, we took our stretched mozzarella and stuffed it with a creamy ricotta filling to make burratas.

Cherry Grove has over 50 milking cows that graze on 230 acres of certified organic grass pastures located in Lawrenceville, NJ. Cheese-maker Sam Kennedy, CIA graduate, uses their fresh milk production for making artisan cheeses that are sold at their farm and to chefs, restaurants and stores in the tri-state area.

I first visited Mercer County as a food vendor with my former health food store and restaurant, Garden of Eden Natural Foods and Country Kitchen, Inc. We proudly served organic foods at the NOFA Organic Country Fair on the grounds of the Stony Brook-Millstone Watershed. NOFA-NJ is dedicated to supporting sustainable food and agriculture throughout New Jersey. 

If you live in the area and get a chance, visit Cherry Grove Farm for some sustainable agriculture fun. In addition to providing cheese-making classes, they have a small market that offers organic eggs, hormone and antibiotic-free meats and of course, their award-winning artisan cheeses.

Here are a few photos we took at Cherry Grove Farm
Thanks for a fun cheese-making class! 

GardenCuizine Ricotta Nutrition: Based on USDA Nutrient Database for Standard Reference calculated by Diana Wind, RD
Excellent Source: Protein, Calcium, Phosphorus, Selenium
Good Source: Riboflavin, Vitamin A
Whole milk Ricotta: 1/2 cup (124g): Calories 216; Protein 14g (28% DV); Calcium 257mg (26% DV); Magnesium 14mg (3.5% DV); Phosphorus 196mg (20% DV); Selenium 18mcg (26% DV); Riboflavin 0.24mg (14% DV); Vitamin A 552IU (11% DV); Vitamin D 12 IU (3% DV)

Related Links
Making Mozzarella, a Hands-on Affair
Ricotta recipe and using leftover whey
New England Cheesemaking Supply Co 
Blog post and photos Copyright (C)2013 Wind. All rights reserved. 

Saturday, February 23, 2013

High Protein, Good Fiber Convenience Snack @kaysnaturals #glutenfree #wls

Product Review
Kay's Naturals Gluten-free 
Cinnamon Almond 
Protein Cookie Bites
We can't nibble on fruits and veggies all the time. Every now and then it is okay to indulge in convenience foods - only after reading the product label, of course! Nutrients in Kay's Naturals product line caught my attention for being gluten-free, low fat, and high in fiber and protein. And, the whole 1 ounce bag was under 150 calories.

Everyone in my family gave these protein bites a thumbs up, but we would not describe them as "cookies". They reminded us more like a cereal puff. Their stevia sweetened, cinnamon flavor is pleasant and their texture is light and crunchy. They can also be mixed with added nuts and dried fruit. 
  • This protein snack is suitable for those on gluten-free diets and for post-op weight loss surgery patients who have low sugar and higher protein needs. They are available online direct from Kay's Naturals or from many different online retailers. Other flavors include Cinnamon and Honey Almond.
Excellent source: Protein
Good Source: dietary Fiber and Iron

Blog post and photo Copyright (C)2013 Wind. All rights reserved.

Thursday, November 22, 2012

Thanksgiving be sensitive to family/friends who have had or planning #weightlosssurgery #wls

Weight Loss Surgery
and Thanksgiving
Thanksgiving is a time for family and friends to gather, visit and eat a feast. What happens when you can't eat that feast anymore? Bariatric patients who have had weight loss surgery can NOT consume a single, big meal with excessive portion sizes. I repeat, they can NOT and should NOT attempt to overeat during any social celebration or gathering.

Overeating can be dangerous and work against important nutrition and health weight management goals for those who have had, or plan to get, weight loss surgery.
 
There are 3 main types of weight loss surgeries that are happening across the country today:


1) Laparoscopic Gastric Banding (LapBand) surgery
2) Vertical Sleeve Gastrectomy (Gastric Sleeve) surgery
3) Roux en Y Gastric Bypass
 

In all of the above surgeries the stomach is greatly reduced in size to minimize the amount of food that can be consumed during one meal. Individuals who have had surgery should never feel compelled or encouraged to eat more than they can mindfully eat. 

You should also be aware that people who have had, or are planning, weight loss surgery have been instructed by their dietitians and surgeons not to drink during meals. What does this mean for you? Do you comment at the dining table when you see them reach for a beverage during dinner? Of course not. I know I sure wouldn't want to hear it. It probably would be wise to keep your comments to yourself, but be considerate and avoid offering a beverage during mealtime.

Don't push sweets. People who have had gastric bypass can get physically ill with nausea, the shakes/sweats, vomiting or diarrhea (dumping syndrome) by eating concentrated sweets like cranberry jelly, pumpkin pie, ice cream or cakes.

If you have family or friends who have had surgery or are planning surgery, do them a favor and ignore the topic of what they are, or are not, eating and simply enjoy their company during the holiday.  

And, if you're reading this and you have had surgery or are planning it, please do the best you can to stay focused on your goals during Thanksgiving and the upcoming holiday season. Plan on having an enjoyable and blessed holiday.

Happy Thanksgiving!

Related Links
Giving Thanks for Nature's Harvest by Diana Wind, RD
Surviving Thanksgiving after Weight Loss Surgery

Saturday, September 22, 2012

Food Marketing/Ads continue to tempt us. Weight Management can save your life! @CDCObesity @EatRight

Fast Food Restaurants
Continue to Tempt the Nation

Even in today's obese times with public health improvements of putting calories on menus, offering lower fat choices and fresh garden salads and reducing soda sizes - most advertising dollars are still, to this very day, spent on the highest fat, highest calorie, tastiest foods. After all, fat and salt equal flavor to our taste buds and happiness to our brains. 

The problem is control. In light of the recent soda size limitation in NYC, the controversial calorie question seems to be: who should control available high calorie foods - you, or should government step in? This a heated current debate, which we all have an opinion about.

We can debate all we want, but the obesity epidemic is here and now. According to the Centers for Disease Control and Prevention, over 78 million U.S. adults and about 12.5 million U.S. children and adolescents were obese in 2009-2010. And, obesity statistics continue to rise.

As a clinical out-patient Dietitian, I am counseling kids who tell me about their experience with chest pain and having to get their first EKG (a test that records electrical activity in the heart). Children tell me they never learned how to run because of their weight. 

Obesity is in the news every day of every week. This week, the news reported again on the increasing incidence of children getting high blood pressure... this is not normal. Pediatric hypertension-related hospitalizations in the U.S. practically doubled, from 12,661 in 1997 to 24,602 in 2006.

We should not lose time in the chit-chat and finger-pointing of who should or should not control the foods we eat. We all must be health warriors before the next unplanned doctors visit is yours.

Weight Management is important now more than any other time in U.S. history. We have to continue working together to improve the diets of all Americans both at home and in schools. Pay close attention and monitor everything you buy, cook, eat and drink. 

Don't be tempted to eat unhealthy foods promoted by advertising and marketing. This includes product positioning to lure you in places that sell food. Often times case stacked end caps (soda, chips, cookies, candy) with low price points are not promoting healthy food choices.

Most studies show individuals who are obese have significantly higher risk of death from all causes, compared with healthy weight individuals (Body Mass Index (BMI) 18.5 to 24.9). Obese individuals with high risks may get weight loss bariatric surgery. Over 100,000 bariatric surgeries are now done each year from only 8,597 procedures in 1993.

Create a winning strategy in your mind on how to limit high fat, high calorie, high sodium foods. Work with a Registered Dietitian if you need help.

Blog post and photo copyright (C) 2012 Wind. All rights reserved. The photo is not to pick on Wendy's, they offer more healthful food choices too. I'm picking on advertising a food that is a weakness for most people - French Fries. A small package of Fries contains 320 calories, 350 mg sodium and 16 grams of total fat, which is NOT a healthy choice.


References: 
Flegal KM, Graubard BI, Williamson DF, et al. Cause-Specific Excess Deaths Associated With Underweight, Overweight, and Obesity. Journal of the American Medical Association. 2007; 298(17):2028–2037.

Livingston EH. The Incidence of Bariatric Surgery Has Plateaued In the U.S; Am J Surg. 2010 September ; 200(3): 378–385. doi:10.1016/j.amjsurg.2009.11.007.

Ogden CL, Carroll MD, Kit BK, Flegal KM. Data Brief Number 82, January 2012. Prevalence of Obesity in the United States, 2009-2010. CDC http://www.cdc.gov/nchs/data/databriefs/db82.htm. Accessed 9/22/12.  

American Heart Association 6/2012. More hospitalizations, higher charges, for kids with high blood pressure. http://newsroom.heart.org/pr/aha/more-hospitalizations-higher-charges-235126.aspx Accessed 9/22/12.

Related Links
Obesity and Obesity Statistics
Let's Move 

Saturday, June 30, 2012

Cool off ~ Stay hydrated ~ Make your own Vitamin Water! @SweetLeafStevia #GardenCuizine

 Fruit Infused Vitamin Water
Went out today and bought a few Fruit Infusion Water Pitchers to take to my out-patient nutrition counseling offices. Many people I meet for weight management are looking to replace sugary sodas and juices with zero calorie beverages. Fruit infused vitamin water is fun to make and when lightly sweetened with natural stevia is ZERO calories! It's a cool and refreshing way to stay hydrated in the summer heat.
 

This is our first recipe. We used orange and strawberry; you can be creative and combine fruits that you have available. 

Try pineapple, mango, kiwifruit, strawberries, raspberries, blackberries, blueberries, watermelon, oranges, limes or lemons. Fresh cut herbs make a great flavor addition too. Try lemon balm, basil, rosemary, mint or monarda blooms. 

Fresh fruits add a subtle flavor and Vitamin C, which is water soluble and naturally infuses into your water along with other water soluble nutrients.
 
Strawberry Orange
 
Ingredients
  • half an Orange
  • one Strawberry
  • 1-2 SweetLeaf Stevia packets
Putting it all together
First, wash your new fruit infusion pitcher and wash the fruit you plan on using. 
  1. Cut the fruit small enough to fit in the center infusion cylinder. 
  2. Fill the pitcher with cold tap water and add 1-2 packets of SweetLeaf stevia
  3. Give it a quick swirl to stir and refrigerate to infuse hints of natural fruit flavors 
Rethink your drink
Sure beats 130 calories in a 12-ounce soda! Two sodas = 260 added calories. It only takes an extra 500 calories a day to slip on an extra pound of weight gain per week. And, if you're diabetic, just one 12-ounce soda or one cup of sugary lemonade counts as 2 to 2 1/2 carbohydrate servings respectively. Vitamin water has zero carbs with zero glycemic index.

SweetLeaf® Stevia products available also include Liquid Stevia Sweet Drops™ that come in 17 natural fruit, nut, cola, cinnamon or chocolate flavored drops that make a great addition to non carbonated beverage drinks, dessert sauces or foods such as yogurt or oatmeal. Ask for them at your local health food store.

Strive for a healthy body weight. Avoid sugary foods and beverages!
Related Links
Vitamin Water The Yummy Life blog
SweetLeaf.com
Using Herbs and Fresh Fruit to make Flavored Water Dave's Garden article by Melody Rose
Rethink Your Drink
Hydrate Right
How Much Water do Kids Need? 
Make Better Beverage Choices ChooseMyPlate.gov
Photographs and blog post Copyright (C)2012 Wind. All Rights Reserved.

Saturday, May 5, 2012

Contemplating Weight Loss Surgery? Have You REALLY TRIED to Lose Weight? An RD can help


Weight Loss

Really Try to Lose Weight before Opting for Weight Loss Surgery

My South Jersey Healthcare out-patient offices are bustling with patients contemplating weight loss (bariatric) surgery or who have already decided on the specific type of surgery they will soon be having - either a restrictive (laparoscopic gastric banding) or malabsorptive/restrictive (gastric bypass or laparoscopic vertical sleeve gastrectomy) surgery, depending upon what their surgeon recommends. 

Weight loss surgery is intended for morbidly obese individuals averaging 80-100 pounds overweight, especially those with serious health conditions. Weight loss is imperative to reduce excess body weight for disease prevention and/or relief of obesity-related metabolic conditions such as diabetes, joint and knee pain, acid reflux (GERD), high blood pressure, high cholesterol, sleep apnea, non-alcoholic fatty liver disease, heart disease and lung disease. 

Surgery should be an absolute last resort for weight loss and be considered only after many attempts at conventional methods for losing weight have been exhausted or are not possible. With bariatric surgeries on the rise throughout the country, my concern is for those who may not have seriously tried hard to lose weight before landing in the operating room. 

Be honest with yourself and give your weight loss efforts the attention it deserves. A Registered Dietitian (RD) can help you achieve your desired body weight.

You Can Do It!
This inspirational message for weight loss was recently posted by Virtua Hospital from Tumblr, which said, "Even if you can't physically see the results in front of you, every single effort is changing your body from the inside. Never get discouraged!"

Related Links: Reader's Digest 50+ Ideas to Lose Weight
Weight Control Information Network
Weight Loss for Life

Monday, July 25, 2011

#GardenCuizine #Recipe: Savory Crepes for homemade Italian Manicotti


Savory Crepes
~ Low Fat, Low Sodium ~
Savory Crepe Batter Recipe
yields 10-13, 7-inch crepes

3/4 cup all purpose unbleached flour
1/8 teaspoon salt
3 eggs
1/3 cup 2% milk
1/3 cup water
nonstick spray
  • In a mixing bowl whisk together the flour and salt
  • Add the eggs
  • Pour 1/3 cup of milk directly into a measuring cup. Add water to the 2/3 cup mark. Add to the eggs and flour mixture
  • Whisk together until combined
  • Cover with clear wrap and set aside for 30 minutes to rest at room temperature (Food safety note: If your kitchen is hot with no air conditioning, let batter rest in your refrigerator and bring back to room temperature before using)
  • Stir before using
Heat a small 7-8-inch non-stick skillet over medium high heat. Spray with non-stick pan spray. Using about 3 tablespoons of batter quickly and all at once (I use a 2oz ladle and fill it to just below the top) - pour the batter into the pan while simultaneously swirling the pan to spread the batter evenly to completely cover the bottom. You have to work fast because the batter is thin and will begin to cook as soon as it hits the pan.

After a few crepes you will develop your own technique. Cook until the bottom begins to get lightly browned then flip over and cook the other side (I use a small spatula and grab the edge with my fingers to flip). 

Remove from skillet and cool on a piece of wax or parchment paper. Repeat until all of the batter is used up. If some edges get a little crispy, don't worry because generally they will soften up again when they get used in your recipe.

Make Crepes Ahead
Crepes can be stacked up in single layers and frozen for later use. To prevent them from sticking together you can separate each crepe with a piece of parchment or wax paper. Cover them tightly with clear wrap and refrigerate or freeze for later use. Savory crepes work well in recipes like Italian crepe-style manicotti. 

Cooking for Company
If you are cooking for company, some of your guests may have never made a crepe, let alone seen them used in Italian crepe-style manicotti or other recipes. If you have room in your kitchen or your kitchen is an open kitchen and you feel up to it, your guests may enjoy watching the process! 
  
Buon Appetito!  

GardenCuizine Nutrition Analysis per crepe, 1/13 of recipe (26g): calculated from USDA nutrition data
Calories: 46 (2%DV); Total Fat: 1.3g (2%DV); Saturated Fat: 0.4g (2%DV); Cholesterol: 49mg (16%DV); Sodium: 42mg (2%DV); Potassium: 33mg (1%DV); Total Carbohydrate: 6g (2%DV); Dietary Fiber: 0.2g (1%DV); Protein: 2.4g (5%DV); Iron: 0.5mg (3%DV); Vitamin D: ~7IU (~2%DV); Thiamin: 0.1mg (4%DV); Riboflavin: 0.1mg (6%DV); Folate: 19mcg (5%DV); Vitamin B12: 0.2mcg (3%DV); Phosphorous: 36mg (4%DV); Selenium: 6.3mcg (9%DV) 

Related Links: GardenCuizine Recipe: Homemade Italian Crepe Manicotti
GardenCuizine Recipe: Pomodoro (Tomato) Sauce
Percent Daily Values (%DV) are reference values based on eating 2,000 calories for adults and children age 4 or older. Your daily values may be higher or lower based on your individual needs.
Blog Article and photo collage Copyright © 2011 D.Wind. All rights reserved.