Great Grains: Farro

Farro is one of my *favorite* ancient grains, and it lives up to the hype of Super Food for sure!

One serving is 1/4c dry (about 1/2-2/3 cup cooked) and packs 6 grams of protein plus 5 grams of fiber to keep you satisfied and energized!

Whole grains intake is linked to lower rates of heart disease, type 2 diabetes, stroke, and certain types of cancer. The USDA recommends that at least half of your grains be whole grains, so it’s important to incorporate things like farro, quinoa, brown rice, or whole wheat into your day.

If you’re looking for a new whole grain to swap into your diet, try throwing farro into soup, making it into a healthier risotto, adding it to salads, or cooking as a side dish on its own.

Dietitian-Approved Lower-Carb Breakfasts (Yes, they exist, and No, it’s not just eggs!)

Breakfast is the golden meal for many Americans, but one of the biggest complaints I hear is that our iconic breakfast foods are packed with carbohydrates. It’s a valid point: pancakes, waffles, cinnamon buns, croissants, coffee extra light and extra sweet, sugary cereals, grab-and-go granola bars… Your morning meal can easily turn into a landslide of sugar.

But let’s take a step back – don’t get frustrated and skip breakfast!  The word breakfast comes from breaking fast — it is a chance for your body to get some actual external energy to help fuel your day. Without it, your body will rely on your energy stores from the night before and, if those run too low, you may be sluggish and sleepy.

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Kodiak pancakes (they’re made with extra protein and whole grains) plus fresh berries and a drizzle of syrup (about 1 tsp) – my go-to weekend breakfast

Research stands behind breakfast as an important part of your routine (check out the links throughout this article for the original studies). Consistent breakfast intake has been linked to maintaining weight loss and higher levels of a hormone called Peptide YY which helps decrease appetite and intake.

Skipping breakfast, however, may lead to higher blood sugar spikes at your next meal, insulin resistance, and larger intake later in the day- which major implications for anyone with diabetes!

The actual foods that you eat for breakfast also play a big role in how hungry you are later as well as how high your blood sugar will go:

Higher protein / lower carbohydrate breakfasts have also linked to lower blood sugar after breakfast). Choosing lower Glycemic Index (GI) foods — foods that impact your blood sugar less drastically — can help you predict your blood sugar response even more than the just carbohydrates counting alone (study here), which supports the choice of whole grains and high-fiber foods rather than refined sugars.  A clinical trial also supported Low Glycemic Index / High Fiber breakfast combinations as they led to lower blood sugar spikes and less required insulin than High Glycemic Index / Low Fiber breakfasts (think high in refined grains and sugar). For more info on glycemic index, check out my break down.

Okay- so what can I eat?!

I generally recommend around 30 grams of carbohydrates with breakfast, which should provide you with some wonderful energy without spiking your blood sugar too much.

Try any of these combinations to get a moderate amount of carbohydrates, adequate protein, and healthy fats:

  • 1 slice whole grain toast + 1 tablespoon almond / peanut / sunflower seed butter + 1/2 cup fresh berries
  • 1 cup cooked plain oatmeal + 1 tsp maple syrup + 1 tsp cinnamon + 2 Tablespoons of walnuts or almonds
  • 1 whole wheat pancake + 1 tsp light butter + 1 tsp maple syrup + 2 links turkey bacon or sausage (~1 oz)
  • 1 piece whole wheat toast + scrambled egg mix (Mix 1 egg + 3 egg whites together, or 1/4 cup liquid whites alone) scrambled with 1/2 cup chopped veggies.
  • 1 whole wheat mini bagel + 2 tablespoons whipped cream cheese + 1 piece of fruit
  • 1 6-oz flavored Greek yogurt + 1 tsp of flax seeds + 1 Tablespoon sliced almonds
  • 3/4 cup bran flakes + 1 cup skim milk + 2 tablespoons of diced prunes or raisins
  • 3/4 cup cooked grits + 1/2 oz low fat cheese mixed in + 1 egg
  • 6 ounces plain yogurt + 1 tsp honey + 1/2 cup berries + 4 oz almond milk – blend for smoothie
  • 1 slice whole wheat toast + 1/2 sliced avocado (trendy but also healthy!)
  • 1/2 cup part skim ricotta + 1 tsp honey drizzled + 1/4 cup berries + 1 Tablespoon sliced almonds
  • 1 small apple + 1.5 Tablespoon almond butter 

If you have diabetes, you may want to substitute sugar-free syrup to minimize blood sugar spikes. For others, though, small portions of these items can still fit into a well rounded diet.

Bonus Round: Frozen Breakfasts

Are you used to grabbing something from your freezer before you hit the road each morning? Sometimes convenience is king, so I’d rather see you stock your freezer with healthy breakfast options than grab something high fat and high calorie from a fast food joint on the go. These are some of my top healthy options from the freezer aisle:

My main caution with frozen items is that they tend to have a ton of added sodium, so you may want to avoid these options if you are prone to hypertension. It’s also wise to eat lower sodium foods during the rest of the day if you rely on these quick and convenient breakfasts.  When looking at other options, I recommend avoiding anything with a croissant, biscuit, or texas toast (they tend to be both high fat and high carb). Anything made with whole grains, egg whites, and veggies is usually a decent option. If you’re choosing something with a breakfast meat, turkey bacon and sausage are leaner but higher in salt; bacon and regular sausage are higher in saturated fat.

Whichever breakfast option works best for you, remember to try to combine high quality carbohydrates from fruits, grains, and veggies along with lean protein and you’ll be setting yourself up for success! Choose one option here and make it your mission to try it out this week.

If you’re looking for more personalized nutrition advice, contact me for an appointment!

Is the Glycemic Index the secret to better blood sugar control?

“Glycemic Index” and “Glycemic Load” have become buzzwords for the carbohydrate-conscious public, but the burning question remains: What exactly is Glycemic Index?  Is it worth learning in an effort to control your blood sugar? How is it even different than counting carbs?

Counting carbohydrates will tell you just how many grams of carbs you are getting with each meal, but not all carbs break down in our body the same; some are made of longer-chain molecules or are higher in fiber and take longer for your body to break down. Simpler sugars tend to be digested and absorbed much more quickly, which leads to a more rapid blood sugar spike. Carbohydrate counting along does not provide that kind of information, but Glycemic Index does.

Glycemic Index (GI) measures how a 50 gram serving of a specific food will impact your blood sugar overall. It takes into account both how high your blood sugar will spike as well as how how long it takes for it to return to normal, and it summarizes this overall glycemic effect as a number on a scale from 0 to 100. Pure glucose has a GI score of 100, as a reference point, so lower scores mean a lower blood sugar response:

Low GI: 55 or less
Medium GI: 56-69
High GI: 70 or higher

The mortal flaw of GI, however, is that is is so incredibly variable that it is difficult to actually trust any specific number. Just take a look at the extensive table (over 55 pages long) found in the journal Diabetes Cares, which lists GI data for items based on a huge range of sources. Brown rice is listed multiple times with the GI ranging from 50 to 87— which obviously complicates the idea that we can quantify exactly how your blood sugar will react to 50 grams of brown rice.  Tufts University recently studied glycemic response within individuals by measuring people’s unique blood sugar response to doses of glucose and white bread, and they found that a person’s blood sugar response varied by 20-25% at different times. This study is important in showing that Glycemic Index isn’t as precise as we’d like, though it provides a good ballpark for you.

Reference this abbreviated table from Harvard University which is based on an American Diabetes Association article that looked at GI as an average of multiple valid studies – this average is likely the most accurate you’ll find.

One major issue is that eating a large volume of a low-GI item can be worse than eating a little bit of a high-GI food. This is because GI measures the impact of 50 grams of an item, so you can only compare the GI of (for example) table sugar (GI 60) and watermelon (GI 72) if you assume you are eating 50 grams of each. Hopefully, you don’t actually eat the same amount of straight sugar and watermelon, so the GI comparison is deceitful. This is where Glycemic Load (GL) comes into play. The GL applies GI concepts to actual realistic portion sizes to help you gauge how your intake will really impact your blood sugar, so you can see that the glycemic load of ~2 teaspoons of sugar (approximately 6) is higher than that of a 4 ounce portion of watermelon (GL of approximately 4).

Again, all Glycemic Load data is based on Glycemic Index, so you need to keep some flexibility in mind when using this information for food choice.

Glycemic Index also varies based on a number of different food qualities; the GI will be higher in foods that are riper, cooked longer, or processed into a finer / easier to digest product (like quick oats as opposed to rolled oats). Even once you have a good estimate of an accurate GI score, the combination of foods in a meal will change how your body responds because fat, protein, and fiber all slow digestion and therefore blood sugar spikes.

So what’s the verdict?

There is mixed research about Glycemic Index (GI) and Glycemic Load (GL) in terms of how helpful it can be for actual blood sugar control. Some studies have found no link to improved blood sugar at all, but a Cochrane Review of glycemic index examined the literature and found that lower-GI diets are linked to better blood sugar control when you consider all of the data together.

My takeaway is that understanding the glycemic impact of food can be a helpful reference tool but is too variable to rely on entirely. It may help you understand how different types of foods might impact your blood sugar, and it’s great for comparing similar items and to see which types of foods lead to a better glycemic response. The result will likely be that you’ll see the benefit of foods that are higher in fiber, less processed, lower in simple sugars, and higher in protein – which is the same generally healthy carbohydrate-consistent diet I would recommend in the first place.

Here is a summary of some major Glycemic Index numbers to consider.
Remember, this is Glycemic Index, so it does not take portion size into account, and these numbers have a big error range so assume they can be about 10 points higher or lower.  This information tells you how these items MIGHT impact your blood sugar ON AVERAGE if you consumed IDENTICAL PORTIONS of each.  Use this more for reference between similar items with a fixed portion. Should you necessarily avoid high GI foods like watermelon and potatoes all together? No! Just monitor your portion sizes and eat them with higher protein / fiber / fat foods to help slow digestion.

  • High GI: 70 or higher
    • Corn flakes (~81)
    • Puffed rice cereal (~82)
    • Instant potatoes (~80)
    • Instant oats (~79)
    • Potato, boiled (~78)
    • Watermelon (~76)
    • White bread (~75)
    • Cheerios (~74)
    • White Rice (~73)
    • Bagel (~72)
  • Medium GI: 56-69
    • Brown Rice (~68)
    • Popcorn (~65)
    • Table sugar (~65)
    • Sweet potato (~63)
    • Honey (~61)
    • Pineapple (~59)
    • Muesli (~57)
    • Plantain (~55)
  • Low GI: 55 or less
    • Sourdough bread (~54)
    • Rice noodles (~53)
    • Stone ground or pumpernickel bread (<55 per the American Diabetes Association)
    • Rolled oats (~55)
    • Corn (~52)
    • Banana (~51)
    • Spaghetti (~49)
    • Corn tortilla (~46)
    • Canned peaches (~43)
    • Oranges (~43)
    • Grapes (~43)
    • Fruited Yogurt (~51)
    • Milk (~39)
    • Apple (~36)
    • Lentils (~32)
    • Chickpeas (~29)
    • Under 20: Eggplant, broccoli, raw carrots, cauliflower, mushrooms, lettuce, red peppers, onions,  tomatoes

There are several Glycemic Index apps to help you keep this information in your pocket if you’re interested in learning more, though keep in mind that the numbers will always be estimates and you may find very different guidelines based on what the app references.

I also recommend the following resources and articles:

 

If you’d like to pursue more personalized counseling, contact us for information about in-person or virtual sessions!

Share your thoughts on Glycemic Index below – I’d love to hear your experience with this, whether you found it helpful, confusing, interesting, too restrictive, or otherwise!

Why It’s Totally Acceptable (and Nutritious) to be Obsessed with Pumpkin

The air is getting cooler, the days are getting shorter– this can only mean one thing: Pumpkin Season is here!

Whether you love to pick ’em, paint ’em, carve ’em, or just admire ’em, pumpkins are the quintessential fall crop. Pumpkin spice has become the wildest autumn food trend, originally dominating our latte orders and muffin choices but now popping up in everything from cereal to twinkies to cheese (yes, pumpkin spice cheese).

The spice blend itself is a combination of cinnamon, ginger, cloves, nutmeg, and allspice, which can be mixed into anything for a healthier autumn celebration. Try these tricks:

  • Mix 1 tsp pumpkin spice mix into your oatmeal with 1/2 tsp of maple syrup
  • Add 1 Tablespoon pumpkin spice mix directly into your coffee grounds when brewing your next cup – the flavor will infuse into the coffee– for the pumpkin flavor without the calories and sugar of a traditional latte flavor syrup.
  • Mix 1 teaspoon of pumpkin spice, 1/2 tsp honey, and 2 Tablespoons part-skim ricotta cheese or low-fat cream cheese for a dessert-like topping for toast or graham crackers

Pumpkin itself is a wonderful ingredient and is packed with beta-carotene, the antioxidant that gets converted to vitamin A in our bodies– so much, in fact, that a cup of cooked pumpkin provides twice your daily need for vitamin A. This helps protect your vision (a lack of A in the diet is linked to night blindness) and directs cell growth throughout your body. They’re also a great source of potassium, which essentially every cell in your body needs to function as it goes hand-in-hand with sodium. You’ll get a nice dose of vitamin C for immune function and antioxidation, too. Pumpkin is definitely deserving of the superfood title.

Pumpkin is not just for pie! You can add it into a huge range of foods with the goal of either rich pumpkin flavor or subtle vegetable addition. Since it’s incredibly low fat yet moist, it often replaces part or all of the fat in a recipe as well as eggs. You’ll often get a different consistency than you’re used to so I would play around your recipes to see the result, but you’ll get a much more nutritious baked good.

  • Have pancake mix on hand and canned pumpkin in the cabinet? Then you can make pumpkin pancakes easily! Try 1 cup mix + 1 cup water + 1/3 cup pumpkin, plus pumpkin spice if desired. For a Food Network semi-homemade version, check out Sandra Lee’s recipe.
  • For a sneakier pumpkin addition, take boxed brownie mix (to make fudgy brownies) or any cake mix (for a fluffier muffin consistency) and add 1 cup of pumpkin. For a family-sized mix (18 ounces or larger), use a full can of pumpkin. You’ll get a fun twist on dessert with less fat and more nutrients!
  • I will tell you that my personal favorite pumpkin recipe is these pumpkin breakfast cookies (check it out here) by Leealicious – I highly recommend them!

 

What is your favorite pumpkin recipe? Share in the comments!

What exactly is an RDN, and why should I trust one?

Everybody eats. All day long, no matter what you do from sun up to sun down, at some point your body needs food and you will eat. You’ll repeat that every day for the rest of your life, and so you will naturally form opinions about your food and perhaps which ones are ‘good’ or ‘bad.’ Your mother and your grandmother will tell you what to do to stay healthy; the fittest guy at the gym will swear he knows how to shred fat; catchy headlines and Google searches and talk show hosts will all offer ‘the key to weight loss!’ The enemy is fat! No, gluten! No, sugar!

I’ll give you a hint: if there was one key to overall health or weight loss, one simple meal plan to solve it all, whomever discovered it would be a trillionaire and you wouldn’t be reading this article. However, nutrition is much more complex than that. 

If you feel like there is an overwhelming amount of conflicting information out there, you’re right! That’s because there isn’t really one clearcut ‘healthy diet’ for everyone. Certain people DO need to cut out gluten, or watch how much potassium they eat, or strictly cut their sodium, or follow a medically-prescribed ketogenic diet to prevent seizures. However, deep Google dives will yield a lot of discordant information if you don’t know exactly what kind of nutrition information is a) pertinent to you, b) scientifically sound, and c) safe.

That’s why we need Registered Dietitian Nutritionists (RDN). Most people don’t know that an RDN is different than a ‘nutritionist’ or a ‘health coach.’ I myself didn’t know the difference until I pursued this path professionally, but those three little letters — RDN — hold a lot of meaning about the quality of nutrition education and counseling my colleagues and I provide. To become an RDN, you must:

  1. Complete an undergraduate degree including about 90 semester hours (more than a standard major) of in-depth science and nutrition-focused curriculum
  2. Complete over 1200 hours of supervised professional practice internship working under dietitians in clinical settings (hospitals, nursing homes, rehabilitation centers, dialysis centers), community locations (like WIC, Head Start, or Meals and Wheels programming for food security), and food service roles (implementing food safety standards and learning the managerial functions of food service directors)
  3. Pass a credentialing exam that covers principles of nutrition and food science, human anatomy and physiology, educational theory and application, counseling techniques, research techniques and interpretation, medical nutrition therapy for individuals in all stages of life and with varying diseases, employee and financial management skills, and menu creation and implementation just to name a few topics.
  4. Soon all RDNs will be required to hold Master’s degrees, though many dietitians (including myself) already hold a Master’s in areas like clinical nutrition, nutrition and food science, business, health care administration, or public health.

Other nutrition professions like ‘health coach’ or ‘nutritionist’ do not require the same degree of formal training (some have quick online courses that cover overall healthy eating without any explanation as to the scientific foundation of these principles or the medical implications). You may find some non-dietitian individuals who do have formal health education and experience, but you can’t be certain of the wealth of training your practitioner has completed unless he or she is a dietitian.

The New Jersey Academy of Nutrition and Dietetics has launched a campaign to support Registered Dietitian Nutritionists as the nutrition expert– and I highly suggest you check out the launch video here!

Vita-Myth Busters

It’s time to address the realities behind Vita-Myths– those legends and lore surrounding *magic* vitamin supplements with tall claims, as well as misconceptions about the vitamins and minerals in our food. There’s a new trend of hyper-focused micronutrients blends capitalizing on our health goals. Some of them are chewy. Some of them are sugar-coated. Most of them are being touted by celebrities as the reason their hair is so darn shiny. Do we need vitamins and minerals? Absolutely. Are some of our beliefs about these vitamins and minerals missing the target? Probably.

 

Vita-Myth #1: There’s no such thing as too many vitamins!

The answer here is a resounding FALSE. Vitamins can either be water or fat soluble, which determined how your body stores them. While you can eliminate excess water soluble vitamins from your body easily (use your imagination), fat soluble ones get stored for the long haul and can actually be toxic in mega-doses. The ones to watch are vitamins A, D, E, and K. If you’re taking one or more supplements that contain these, make sure you’re not accidentally doubling up on doses or you risk storing far more than you need.

Vita-Myth #2: You don’t get any vitamins or minerals from meat.

Again- this one is false! Meat has such a mixed reputation in the nutrition medica world; people praise it as the ultimate protein source but also shun it due to the fat content of some cuts. Meat is actually one of the best sources of B vitamins as well as minerals like zinc and iron; our bodies actually absorb the iron from meat much more efficiently than iron from plants. It is also the only major source of vitamin B12 in the diet, so it is generally recommended that vegetarians and vegans take a supplement to avoid deficiency (Lack of B12 can cause nerve tingling, numbness, weakness, and fatigue). Overall, meat really is a nutritional powerhouse – so enjoy it! (In reasonable moderation, of course).

Vita-Myth #3: Vitamin-rich foods may decrease your chance of getting cancer.

This one has some truth behind it, and it all comes down to the science of free radicals and oxidation. ‘Free radicals’ was the hot buzz term a few years ago, and though we still know that it has a negative implication, most people don’t quite know the science supporting that.  The world around us is made of molecules or groups of atoms (as are we!), and unfortunately, certain molecules can damage others through their interactions. When an atom steals a little piece (an electron) from another molecules, it creates a ‘free radical.’ These are basically rogue atoms that will do whatever it takes to get a new replacement electron. In our bodies, free radicals go around aggressively stealing electrons from our cells, doing damage along the way and putting your cells at risk of abnormalities like cancer. Antioxidants, however, have the ability to stop these free radicals in their tracks so they can do no further damage. Vitamin C, vitamin E, and beta-carotene (a precursor of vitamin A) are the three most potent antioxidants, and they’re found very high concentrations in (you guessed it!) fruits and vegetables. It’s true what they say, kids – eat your fruits and veggies!

Vita-Myth #4: Only dairy has calcium.

My apologizes, cow friends… your milk is not the only place we can get our highly important calcium. The ‘Got Milk’ ads sure did their job, didn’t they? In reality, you can get calcium from a wide range of foods including leafy greens (kale, collard greens, bok choy, broccoli), boned fish like sardines, sesame seeds, almonds,  and a lot of fortified non-dairy alternatives like almond milk or even orange juice. Milk is one of the best sources, but eating a diet rich in these other foods can help you make up the difference if you aren’t a huge dairy-eater.

 

Now that we’ve cleared the air of some of the most common vitamin rumors, I’ll leave you with this: I do believe in vitamin supplements. If you eat a perfectly balanced diet, you may be eating the recommended amount of vitamins and minerals (aka the micronutrients), but unfortunately the standard American diet is not always rich in variety. There is not a large body of research supporting the benefits of supplementation (except for folic acid during pregnancy – that is directly correlated to lower rates of neural tube defects), but I do think that a general multivitamin is a good safety net for most people. Overall, the best way to get the bulk of your vitamins and minerals is through a well-rounded diet made up of foods from all food groups (surprise!)

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