Welcome back – to you, reader, and to me. The absence has been long and so full of change and craziness. My life changes include a journey from being a bachelorette and part-time RD living in a travel trailer in my brother’s front yard to being a full-time RD and full-time wife with 2 stepkids. The transition made keeping up the blog just a lee-tle unrealistic, so it had to take a back-burner for a time, but I’m ready to get back into learning more about what my patients face when they make a commitment to improve health, prevent and manage chronic conditions, and change their lives.
I’ll be honest – at first I was intimidated about trying to follow a diet with a family in tow:
“Will I have to make separate food for myself? What if my family doesn’t like any of the food? Will it be too expensive to feed everyone on these diets? Ehh….I don’t think doing that blog really makes sense with a family.”
Satisfied with my very justified self-care decision, I went about my life but something kept nagging at me until I let it hit me – my patients have families. My patients have picky kids (and spouses). They don’t get the luxury of saying “Ehh…that’s not important right now.” They have to choose – figure out a way to take care of yourself with a family or simply don’t take care of yourself.
My hypocrisy got the better of me. So will I be eating separate things from my family? Sometimes. Will they dislike some of the food? Probably. But we’re going on this journey because that’s being healthy in real life – challenges and all.
So this time I’m back. For real. I promise.
And to assure you of my commitment, I grocery shopped for my next diet today. The diet I have chosen to use as I re-start is….
The Heart Healthy Diet recommended by the American Heart Association! The spoils of my venture are shown below:
Note that the pile is MUCH bigger than when I was cooking just for me – and this doesn’t even include some extras I bought for the fam.
Or the meat. Doesn’t that seem like a lot of meat? And yes, I smooshed a salmon burger on the way home. Sad.
The meal plan I’m using is courtesy of EatingWell.com and can be found here.
UPDATE: Eating Well has since changed this meal plan. If you click the link, you will see their new Heart Healthy meal plan.
This post has nothing to do with nutrition but I hope it will make you laugh. Today was my last day at my current job(s) and I’m feeling a little nostalgic. I thought I’d do something a little different today and share some of the craziest, sweetest, most hilarious and oh-my-goodness-worthy quotes from my beloved patients. Enjoy!
1. Patient: Where do you get your cream of rice? I’ve checked all the stores. I looked at Sears, Home Depot, and Staples and none of them have cream of rice.
2. Patient: You have a fiance, don’t you?
Me (wearing gloves – my engagement ring is not visible): Well yeah, actually, but why do you say fiance instead of boyfriend or husband?
Patient: You have that ‘engaged’ look. I can tell.
3. Me: Would you like me to take your blood pressure?
Elderly male patient (with strong German accent): Vhy yes…do you vant to sqveeze me?
Me: Umm….nope.
4. Patient (to another dietitian): Thank goodness it’s you. That other dietitian (me) was so scrawny.
5. Elderly female patient: Your eyes are so pretty. I don’t know why you wear your hair over your eyes like that…it covers up the pretty part of your face.
6. Me: Well, that’s all of my questions. We’ll check on you tomorrow and see how you’re doing. Have a nice day!
Elderly male patient: Don’t leave! You’re pretty!
7. Me: We have several types of nutritional supplements if you’d like to try any of those to help increase your calorie intake.
Older male patient: Do you have Boost?
Me: We sure do!
Older male patient: I love Boost! What flavors do you have?
Me: We have chocolate, vanilla, and strawberry.
Older male patient: Strawberry! I love strawberry!
Me: Great! Would you like me to have one sent with each of your meals?
Older male patient (takes my hand, looks at me very seriously): I love you.
8. Patient: Are you skipping school to be here?
Me: I’m sorry?
Patient: You look like you’re fourteen!
Me (to myself): Make mental note not to wear braids to work. Ever. Again.
9. Me (working on teaching some diabetes education): The next thing on the nutrition label you need to look at is Total Carbohydrates.
Patient: Yes. Carbohydrates. Got it. How much money do you make?
Me: Why do you ask that?
Patient: Because I want to know. How much do you make?
Me: Well, I’d rather not say, actually. Is that alright?
Patient: Okay. How many hours do you work?
Me (teasing): Well, that depends on how long it takes to get through your handout.
Patient: How many hours do you work each week?
Me: Well, it is different every week, but these aren’t really relevant topics. Is it alright if we go back to looking at the nutrition label?
Patient: Okay. So how much money do you make?
aaaaand my personal favorite…
10. Older male patient: You look so pretty with your hair up. You should wear your hair up every day. If you were my girlfriend and you wore your hair up I’d say, “Da**, you’re a gorgeous wench!
Normally I love to use legumes (beans, peas, lentils, peanuts) as fiber and protein sources in my diet, so I got to wondering why it is that legumes are not allowed on the paleo diet. Honestly, I have no clue how they were introduced into our diets in the first place and thus no clue whether the hunter-gatherers would have had any or not. So I set off to do some research and found an article entitled “Why No Grains and Legumes?” on a paleo blog (eureka!).
So the author was claiming that legumes are out on paleo for a variety of reasons, one of them being their lectin content. I had never heard tell of such thing so of course, further research ensued. Come to find out lectins are proteins that hang out on the outside of plant and animal cells and bind carbohydrates. They just so happen to be found on legumes, particularly beans, as well as wheat, potatoes, and some other foods. It seems that one of their purposes is to prevent insects and critters from eating the plants. The lectins are actually toxic and they cause hemagglutination – which is a fancy word for “they make blood cells stick together.” When animals are fed raw bean diets, they develop lesions, fatty livers, and digestive/absorptive problems among other appetizing maladies. Other researchers have suggested possible (though not proven, as far as I can tell) links between lectins and diseases such as diabetes and rheumatoid arthritis. Now I’m thinking, “What the heck? Why have I never heard about this before?”
Well most likely that is because according to the Cornell University agricultural website, wet cooking methods including soaking coupled with adequate boiling are sufficient to eliminate the toxicity of most of the lectins and render them safe for human consumption. Several paleo blogs I found, however, disagree that cooking eliminates all of the harmful potential of these little proteins.
What I find interesting (aside from all the disagreement) is that it seems these foods are not being eliminated from the paleo diet because the hunter-gatherers didn’t eat them, but rather because of these lectins. Since that is what I understand to be the premise of the paleo diet in the first place, the elimination of foods such as beans and potatoes seems beyond the scope of the diet itself. In fact, according to the Wikipedia page “Bean” (I know, we’re using big-time science here), beans have been around since 7th millenium BC. On top of that, the “Paleolithic” Wikipedia page says that we suspect humans in the Paleolithic era ate a substantial amount of tubers. Potatoes are tubers. So, I’m not exactly sure how the “paleo diet” crew latched on to the elimination of potatoes and legumes, but nonetheless, lectins have proven to be an interesting topic of research. I tend to agree with the following statement, courtesy of my fiance: “I’m pretty sure the cavemen ate whatever they could get their hands on. If they found some good eats they probably didn’t pass them up because of their lectin content.”
I gotta tell ya, this is the kind of stuff that makes being in the health field so difficult. Everybody is always saying something different from the next and unfortunately even well-done research is not perfect. We have to do the best we can with what we have and press on to the next topic. If you know anything more about lectins that you’d like to share, be sure to let me know in the comments!
This was by far the best paleo meal I ate in all of my three weeks on Paleo. Get the recipe here. I added cubed yams to the crock pot too, which was an excellent decision. I would (and will!) eat these any day of the week!
Fudgy Paleo Ice Cream
I adapted this one from a Vanilla Bean Paleo Ice Cream recipe I found here. And then I ate it. Lots of it. For days. This ice cream was so good!
Ingredients:
2 cans full fat coconut milk
1/2 cup raw honey
2 egg yolks
1/4 cup baking cocoa
1/2 teaspoon vanilla
Freeze bowl of ice cream maker for up to 12 hours.
Whisk together all ingredients in a medium saucepan. Turn on burner to medium-low heat.
Whisk occasionally until mixture lightly simmers. Do not allow to boil.
Remove from heat and pour into a bowl. Refrigerate for about 2 hours until cool.
Once cool, process according to ice cream maker instructions.
The Good: Once I started using recipes and eating more fruit life got a lot better. My blood pressure even dropped back down to 107 (lower than normal)/86 (better, but still higher than normal). During the first week I had tried to avoid using my three allotted non-paleo meals in order to stay true to the diet and “get the full experience.” But later on careful usage of my non-paleo meals helped me to participate in enough social situations to keep this extrovert functional during the last two weeks.
Also, I lost weight over the first two weeks, so if that would have been a goal, this diet did the trick…until week three when I started gaining weight. Interesting turn of events, actually, because though my average calorie and carbohydrate intakes increased minimally in the last week, it was not by a considerable amount.
Finally, my favorite thing about paleo is that it forces you to eat real food. Nothing processed, nothing artificial. Definitely more nutritious than pretty much anything you can buy pre-made.
The Bad: Eating paleo took up a LOT of time, which is what you would expect on a “real food” diet. Every meal had to be made from scratch, which is great but definitely packs on hours in the kitchen. My bro and sis-in-law can vouch for the fact that I was in their kitchen for 3-4 hours three times per week cooking. That’s a lot of prep time for a single gal working full time and driving all over western Washington every week; hence, my sparse blogging during my paleo diet. I made a paleo pizza for which I had to make the crust (out of cauliflower), the sauce (from home-canned tomatoes), and the cheese (out of macadamia nuts, believe it or not) completely from scratch to meet the diet restrictions. The one recipe took 2 1/2 hours! And it certainly didn’t taste that great.
On top of the time it took, it was also very expensive. After the first week, a reader suggested that organic, locally-grown, and in-season produce and grass-fed meat was the true “paleo” way to eat…so I adopted that for the last two weeks or so. It certainly is more “paleo,” though I don’t suppose the hunter-gatherers had to pay twice their normal grocery bill for it like I did.
The Ugly: My main beefs with the paleo diet are twofold (not counting the social impact I described here and here).
My first and main issue with the diet is that it entirely eliminates certain foods, creating a “bad food, good food” mentality. I can’t tell you how many people I explained my diet to over the last few weeks who said, “Boy, if you were to tell me there’s something I couldn’t have that’s all I would be able to think about eating.” Interestingly, I didn’t have that experience. In fact, I didn’t really have any cravings at all, I just kind of stopped enjoying food. But what I’m really getting at is the danger of the psychological game you start to play when you label and restrict specific foods as “bad.” It creates a fear of food that is a slippery slope to disordered eating.
I’ve even experienced this a little bit myself since I stopped eating paleo. When I eat foods that weren’t “allowed” on paleo my brain, if even for a second, tells me I’m not supposed to have it. I eat it anyway because I don’t truly believe that X food is inherently bad. But I can easily see how someone (and I know many who have done this) looking to lose weight or improve his or her health would try out different diets, being told that X food is bad, then Y food is bad, and yet another diet says that Z food is bad. Pretty soon in the back of your head your vegan experience tells you not to eat meat, your paleo and Atkins experience tells you not to eat carbs, and your low-fat diet’s got you afraid of every butter and oil under the sun. Now you’re left either afraid of everything but vegetables or throwing your hands up saying, “Screw it! I’m going to eat it all!” and fostering feelings of guilt and failure. For this, I have an issue with any diet that says certain foods (particularly lots of different foods) are “not allowed.” The benefits of a real food diet could certainly be achieved without eliminating entire food groups.
My second issue with paleo stems from this elimination of entire food groups. Each food group has its own strengths as far as the vitamins and minerals it provides. Let’s take calcium, for example. The first types of foods you think of when you think of calcium are probably dairy products. That’s because dairy products are the front-runners when it comes to calcium content. “Now listen crazy dietitian lady,” you may say, “there are certainly non-dairy sources of calcium!” And you would be right (at least about the calcium part, I’ll let you make your own judgements on crazy). Just check out this chart on calcium content put out by Harvard University Health Services. The problem is that several of these sources (molasses, soy nuts, tofu, fortified foods like soy milk or orange juice) aren’t allowed on paleo either. The good sources of calcium on this list that are included in paleo are artichokes, collard and turnip greens, sardines with bones, clams, and oysters. Boy, I don’t know about you, but those are not foods that make my meal plan every day. The kicker is that other paleo staples such as sweet potatoes, spinach, and almonds have high amounts of oxalic acid, which binds calcium and prevents its absorption. It certainly doesn’t mean one couldn’t meet their calcium (and other vitamin and mineral) needs on a paleo diet, but you’d have to make a concerted effort to do so.
In fact, many paleo websites encourage supplementation along with a paleo diet (though others say a paleo diet actually eliminates the need for such). This particular website discusses the top TEN different vitamin, mineral, and nutrient supplements to help you meet your needs on paleo. Granted, the author qualified these recommendations by saying that the need for them is due to the degradation of the nutrition provided in food by genetic modification and nutrient-depleted soil. That may be so, but regardless, that is what Americans have to work with today. Certainly the standard American diet is not nutrient-rich and is by no means a way I would recommend to eat, but I’m not yet convinced that cutting out lists of food types is the answer.
So, what’s next? Good question. I have decided that there is so much more unpacking to do in regards to paleo that I’m going to hang with it for a while. I won’t be following it anymore (I know, so surprising) but I have a lot of research I still want to do. If you have specific questions about paleo, let me know in the comments section so I can address them in the next few weeks. In the meantime, I’ll hang up my apron, pull out my reading glasses, and get to work.
If you visited a few days ago you may have read my lamentations about the social struggles I have been facing on my journey with paleo. I have realized how much of a social eater I am, and the way that eating paleo affects that part of my life.
I then asked myself a question I never thought to ask before: is it worth it? Say hypothetically that paleo or any other “diet” for that matter is the absolute perfect, most healthful way to eat (I don’t endorse this to be true for reasons I’ll talk about in future posts, but just go with me for a minute). If I knew for a fact that eating this way was ideal for my body but that it would bring forth this separation from social activities that I love and experiences I want to have, would it be worth it? Would I still do it?
The answer to that question had to come after some introspection about even broader and more philosophical issues: why did I become a dietitian in the first place? Am I on the search for identifying the perfect way to eat? Do I want to help people live as long as humanly possible? Do I want to help the healthy continue without disease? My answer was tough to identify, but eventually it came to be that I want to help people live their best possible lives.
I want to help people live lives of quality that are meaningful and enjoyable to them. For most people that involves being healthy. For some people, that means living to 100 years old or avoiding every possible chronic disease. For others, it means going to bed every night without a growling stomach. Others want to lose extra weight so they can play outside with their children. For me, it means participating in the full experience of preparing, sharing, and discovering all of the foods I enjoy.
So the answer to my first question is no, for me it isn’t worth it to eat this way forever. I personally would rather live 70 years of my “full meal deal” than 100 years on paleo or any other diet that leaves me feeling so restricted. And that’s my best possible life.
I brought the issue to my former classmate and friend Nick, who also happens to be a dietitian (check out his website here). Now, there is something unique about Nick that you all should know. He eats basically only meat and vegetables and will encourage his clients to do the same. I came to him during the peak of my misery in my first week of paleo and basically scolded him for ever recommending this miserable existence to anyone (if you know me at all, you know I have a tendency to be just a tad dramatic). He found my frustration with the restrictions of the diet interesting because he said he finds eating that way liberating. I couldn’t believe it. Nothing but meat and veggies is liberating?!?
As we talked more, the pieces fell into place. In his past, Nick had spent some time in the bodybuilding community and was introduced to a world of disordered eating behaviors. From what I understand (correct me if I’m wrong, here Nick), he felt controlled by his body’s desire to eat certain foods – namely, carbohydrates. Over time he began to research the part that carbohydrates play in the body and decided to start eliminating carbohydrates from his diet bit by bit (probably a better strategy than the cold-turkey one I used) until his body no longer craved them. Carbohydrate addiction is a real thing – and there is definitely science to prove it. To beat any addiction, most people have to eliminate the offending substance entirely. For Nick, he is now essentially carb-free, healthy, and doesn’t have to fight his own body to eat the way he knows is best for him. He works with clients who are obese and carbohydrate-addicted and has been majorly successful because he understands their battle, what they need, and the science behind it. Carb-free is his best possible life.
Though the cliche is not new, I am realizing how it applies to my profession: different strokes for different folks. There may be one “perfect” way to eat. Maybe someday scientists will identify it, but even if they do it won’t really be perfect for everyone. People have different needs, desires, and priorities in regard to their food. As a dietitian, it is my responsibility to encourage clients toward their own best possible life and understand that it doesn’t look the same for everyone. What do you all think? What’s your best nutritional life?
Aside from evaluating the health ramifications of paleo eating, I am also considering its real-life applications for my patients and clients. During my trek through the paleo diet, my main question has been, “is this realistic?” Is a diet like paleo truly something that I feel is so undeniably important that I could, in good conscience, recommend it to the people that I see every day and expect it to improve their lives? Thus far, based on my experience, the answer has been “no.”
There are definitely stories out there about people who start eating paleo who feel so much better. And I have no doubt that that is the case for them. Paleo eating is a drastically healthful change from the way that an “average” American eats. It entirely eliminates “empty calories” in the sense that nearly every single thing that goes in your mouth on a paleo diet contributes something beneficial to your body. Anyone who consumed copious amounts of foods that contribute nothing nutritionally besides calories (I’m talking about you, donuts, soda, and candy) is bound to feel exceptionally better after cutting out these harmful foods and replacing them with foods that actually nourish his or her body. What’s more, the paleo diet eliminates some key underlying allergens that can wreak inflammatory and digestive havoc on their undiagnosed victims. For those people, the paleo diet is sure to improve the way they feel.
Personally, my body feels exactly the way it always has, which is pretty great. Honestly, it would be hard for me to say that I felt better unless I suddenly had Roadrunner energy or Superwoman strength pop out of nowhere. And trust me, that’s not because I am the model of perfect eating (that is a common misconception about dietitians) or exercise, but because I am healthy and still rather young. I have no aches and pains, no digestive issues, no allergies (that I know of), no chronic diseases, and plenty of energy if I get enough sleep. So I really struggle to see how this restrictive eating plan makes my life any better.
In fact, following paleo is kind of a drag for me. I haven’t had any crazy sugar cravings or desperate desires to raid my fiance’s bagel supply, but my dietary quality of life is pretty lame. You see, normally Charlie and I love to go out to eat and cook together, and I would venture that it is safe to say we are novice foodies. We love to try new dishes from all kinds of restaurants and cultures and savor all the delectable flavors we can get our hands on. Since I started on paleo we have only eaten out twice, one of which I chose to be one of my non-paleo meals so that I could actually enjoy it. The other time I was able to order a meal that fit the paleo restrictions, and honestly it was pretty gross. Really all I can order out most places is some version of a hunk of meat or eggs with vegetables, and I’ll be frank – that eating pattern started turning my stomach at day 3. Other than that, my fiance and I rarely end up eating the same food when I visit because mine is so expensive (and doesn’t taste that great) that he usually makes something different for himself. I don’t blame him – though I have found a couple winners, the best thing I can say about most of the recipes I try is “well, it’s better than a hunk of meat and a pile of veggies.” I’m also getting pretty tired of all my food tasting like coconut (which if you know me you know I do not like) because nearly everything involves either coconut milk or coconut oil, but I digress.
I couldn’t really eat much at the places that my friends and I like to go to hang out, so I sat awkwardly and drink my water or tea (or occasionally eat my fruit plate) while everyone else chows down. It is also particularly difficult to anticipate following these diet restrictions when eating at others’ houses (which I do semi-often), and I feel that briefing my poor hostess with “well, I can eat anything except dairy, grains, peas, beans, peanuts, vegetable oil, salt, and sugar” is a pretty rotten thing to do. Together, these issues have placed me on an island of dietary isolation that has definitely impacted my life in an unfavorable way. Imagining a lifetime of eating this way is completely out of the question for me – making, eating, sharing, and discovering good food and drink is far too much a part of my life to amputate it like this.
Wow…I have a lot more to say about where this experience led me and how I discovered that paleo most certainly has a place and an importance for people I meet every day, but this post has grown beyond my expectations rather quickly. I’ll have to make this a “To Be Continued”…Come back next time for part 2!
Diet culture is determined to tell you that you have to be miserable to be healthy.
That couldn’t be more wrong.
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