Bad diabetic -- the importance of an evening snack

As I mentioned yesterday, it was date night last night. We ended up going to a swanky Italian restaurant in Tulsa called Garlic Rose. It was pretty much as delicious as could be, even for our snobby Italian food standards. Mark and I ordered 2 pasta dishes to share -- one was bow tie with chicken in pesto with pine nuts, goat cheese, and spinach (these 3 ingredients combined create nothing short of taste bud ecstasy!), and the second dish was a lemon seafood bucatini that included HUGE chunks of fresh squid, lobster, scallops, and ginormous shrimp. As a seafood lover, I was in heaven...especially when such divine food is polished off with a sip of 2005 Banfi Chianti Classico..mmmm!

Now would be a good time to admit that I likely went over my carbs for the meal. However, I did skip the cookie at the RD meeting yesterday, unexpectedly, and went with a 2% mozzarella cheese stick instead.

Pasta, is a "rip off" as far as carbohydrates -- 1/3 c. cooked = 1 carb choice. I'd say I had 1 1/3 cup, or 4 carb choices worth. Not bad, right? I sure didn't think so! Because our meal started with a cheese platter with toast pointes and fresh fruit (I had 2 toast pointes and approximately a half a handful of fruit -- 1 carb), I would say my meal totaled 5 carb choices. Oops!

In counseling a diabetic who goes over their carb choices, I would recommend taking their blood sugar 2 hours after they've completed their meal. When tested two hours post-prandial, blood glucose readings should fall at 140 mg/dl or less in a controlled diabetic.

From dinner, we went to a local bar that hosts hundreds of beers from across the world. I love beer, and so I partook. I limited myself to 2 beers (Black Velvets, pictured to the left -- 1/2 cider and 1/2 Guinness) -- 1 carb choice. This was obviously not the best way to spend calories OR carbohydrates, but more importantly for a diabetic is the fact that consuming alcohol LOWERS blood glucose. When we arrived home, 3 hours after finishing our dinner, I did not have an evening snack. Firstly, of course I was not hungry. Secondly, I'm not into the mind-set yet of remembering to eat a snack before bed. And thirdly, I was pooped...it was a work day ending at midnight! Regardless, I would've told any patient that it would be of utmost importance to have had a snack after last evening's alcohol consumption. If I were a diabetic and checked my blood sugar this morning, chances are it would have been high due to a blood glucose drop mid-rest and a rebound high, compliments of the liver, as we discussed previously. So, I was a BAD diabetic yesterday! Turning the page to today and moving on!

Breakfast:

1 1/2 c. Cheerios (2 carbs)

1 packet Truvia (0 carbs)

1 c. skim milk (1 carb)

cappuccino with 2 Tbsp sugar-free International Delight (0 carbs)

     Total: 3 carbs

Lunch:

1/6th Chicken Tamale Casserole (3 carbs)

2 c. toss salad with mixed veggies (0 carbs)

1 Tbsp Light Toasted Asian Sesame dressing (0 carbs)

     Total: 3 carbs

Dinner & snack:

TBD - football party over here

Predictions: Illinois over Penn State, OSU over Indiana, Michigan over Michigan State, and Oklahoma over Miami.

Does anyone have any butternut or acorn squash recipes to share? I'm heading to the grocery store for some squash and other produce...and need a squash fix soon!

Wednesday's Hodge Podge

I just LOVE the American Dietetic Association’s quote of the week:

"Those who think they have no time for healthy eating will sooner or later have to find time for illness." - Edward Stanley

Could this be any less true? Along the same lines is financially supporting health and disease – putting in a bit more each trip to the grocery store can same hundreds of thousands in medical expenses down the road. That’s all I’ll say, I don’t have time to step on my soap box today!

My morning started off with a delicious smoothie to go, containing whey protein powder and flaxseed oil. As for fruit, I threw in raspberries, blueberries, blackberries, strawberries, banana, kiwi, grapes, peach, and pineapple. Did I miss a color in there? Definitely started the morning off with a rainbow of antioxidants, vitamins, and minerals - yum! A friend at work was asking for my smoothie recipe, so I hooked her up with a mini smoothie, too! P.S. The cup wasn't as big as it looks...I got a serious close up!

Today was taste test day at work. Some of the employees requested comfort food, so I chose a mac'n cheese recipe...made in the crock pot (but of course!). It was my first time trying this recipe and I will SURELY be making it again...it was amazing! Almost TOO cheesy, I may use 3 cups of cheese next time. It served a bunch of people, though...and all good reviews! 

 

Crockpot Mac ‘n Cheese


1 c. skim milk

1 can evaporated milk

1 can cheddar cheese soup

4 c. 2% cheddar cheese, shredded

16 oz. box elbow macaroni

¾ c. egg substitute (i.e. Egg Beaters)

½ c. Smart Balance butter

½ Tbsp paprika (optional)



Directions:

Start crock pot. Melt butter in crock pot and pour into separate dish after melted. In a pot, boil macaroni until almost done. In a separate bowl, beat eggs, milk, evaporated milk, soup, and 3 cups of cheese. Pour macaroni into bowl, pour over butter and then wet mixture. Mix slightly.



Allow to cook on low for 3 hours. Pour remaining cup of cheese on top and sprinkle with paprika.



Makes 30 servings (1/2 c. per serving)

Nutrition Facts (per serving): 143 calories, 6 g. fat, 15 g. carbohydrate, 8 g. protein

My email was PACKED with some really interesting articles out today and of course, I would like to share them with you.

Mega doses of antioxidants such as vitamin C and E may do more harm than good in type-2 diabetics

While exercise increases insulin sensitivity, exercise also produces oxidative stress. What we know of antioxidants such as vitamins C and E is that they help reduce free radicals in the body produced by oxidative stress. According to recent research, antioxidant supplements may block the oxidative stress…but also interfere with the beneficial effects of exercise on insulin sensitivity. While exercise is a proven means for increasing insulin sensitivity in the body and reduces the risk of developing diabetes, antioxidant intake may be best advisable through whole foods and not supplements [1].

Case in point: move more and never neglect the diet; supplements are not a cure-all and not always advisable.

The changing dinner party -- cooking together in the Chicago Tribune.

This article hit close to home as the subject lives in Forest Park, Illinois, one suburb west from my home town of Oak Park. Sheridan, an interior designer and avid home cook, has switched gears for entertaining -- she asks her guests to bring ingredients with them and she and her dinner guests cook together as a team. This way, the preparation, cooking, and cost are distributed among both host and guests. A Chicago-based research firm, Technomic, states that 33% of polled consumers reported entertaining in the home more often than a year ago. With economic hardships, American’s are finding new ways to get together without stretching the budget. Sheridan states, “There’s something so earthy about cooking with other people in your home. I think people are going to do more of this [2].”

What do you think of this means of entertaining and hosting a dinner party?

I have to admit, I think it’s a WONDERFUL idea! I think there’s lots of positives that come from participating in such an event, such as:

- Trying new foods

- Learning the preparations of new foods

- Locating new foods in the grocery store – wouldn’t want to bring the wrong item!

- Increasing the frequency of get-togethers with friends

- Saving money

- Eating less (restaurant portions are huge!)

- Togetherness (the home seems much more intimate than a restaurant to me, anyways)

On a completely unrelated note…

Study links kids’ unhealthy exercise and eating habits to moms who work.

British researchers found that children of mothers who worked part-time of full-time were more likely to have bad diet and exercise habits than those whose mothers stayed home. The results were recently published in the Journal of Epidemiology and Community Health. The children of working moms were more likely to drink sugary beverages between meals, watch TV or use the computer at least two hours a day, and be driven to school rather than walking or biking. Dr. Jennifer Shu, a pediatrician in private practice in Atlanta and co-author of a book on parenting says she worries that “parents will feel guilty about working, when most do so out of necessity…Parents shouldn’t feel guilty about leaving kids in other people’s care [3].”

Of the 12,576 5-year old children assessed in the study, 37% snacked on potato chips or sweets, 41% drank sugary beverages between meals, and 61% watched television or used the computer at least 2 hours a day. It should be noted, “In initial analyses, children whose mothers worked actually had healthier habits. But after adjusting for possible confounding factors, such as income and education, those relationships reversed.” Why was this? Likely due to the fact that most of the working women were “relatively advantaged” and had higher levels of education and incomes, according to the researchers who concluded in saying, “Health behaviors in childhood are going to be influenced by a range of factors, and this might be one [3].”

Interesting. Do you feel the children of stay-at-home-moms are at deceased risk of developing poor diet and exercise habits?

Hopefully I can catch up with DVR and watch the Biggest Loser, but it may get pushed back another night, we'll see! Catch ya tomorrow...Day #1 as a diabetic!

[1]. Neff, Barbara C. Vitamins, Exercise & Diabetes. Naperville.

[2]. Levin, Amelia. The Dinner Party Has Changed: Sharing the Cooking – and Costs – of Dinner Parties at Home. Chicago Tribune. September 30, 2009.

[3]. Fiore, Kristina. Kids May Be Less Healthy if Mom Works. MedPage Today; ABC News. September 30, 2009.

Poll says: Mexican and Italian

My blog followers voted on their favorite ethnic food. With a whopping 12 votes (sigh!), 1/3 of the voters chose Mexican and 1/3 chose Italian. While Mexican takes the place of #1 in my heart, GOOD Italian is a close 2nd. I figured with all this talk it may be helpful to go over some menu strategy when consuming Mexican and Italian food. So here we go!

Mexican
- Chips and salsa. While delicious, you're adding a lot of added calories to your meal. Consume in moderation.
- Margs. STEER CLEAR. These babies should be a TREAT! A 16 ounce frozen margarita will run you 300 calories. Ouch! A great alternative: Corona Light. Yum! And a savings of 200 calories.
- Queso and white sauces. Green or red sauces are preferred for a lower-calories/lower-fat option.
- Chicken v. beef. While I'm not a beef basher, I am a basher of low-quality beef. Ground beef served in a restaurant is not going to be lean, so going with a chicken or fish entree will shave off some calories and fat.
- Go corn. Flour tortillas aren't the best choice and there's WAY more calories than you care to know packed into those babies. Corn tortillas are a healthier, and more flavorful option (in my opinion).
- Easy on the sour cream and guacamole. Great additions, lots of calories. Moderation.
- PORTIONS! Of all ethnic restaurants, portion sizes at Mexican restaurants are astronomical. I recommend ordering your meal al a carte (i.e. 2 chicken facos and a side of rice) if over-eating is an issue for you.

Italian
- Sauces. Butter, alfredo, and cream sauces should be replaced with marinaras and olive-oil based sauces.
- Choose a protein. Ordering a large pasta dish will not only leave you carb-crazed, but will also require more volume to leave you satisfied. Adding a protein (i.e. chicken or seafood) can help balance your meal and provide more satiety.
- Easy on the bread...and oil. While olive oil is rich in healthy MUFA's and PUFA's, a teaspoon or two is adequate intake. Dipping away will only lead to an excess of calories and fat.
- Caesar on the side. Caesar salad, while delicious, is high in fat. Order your dressing on the side and ration it sparingly yourself across your salad.
- Choose red wine. If you consume alcohol while dining, choose red wines rich in antioxidants. We've gone over this before...red wine = good. One glass for ladies, two for the gents.

This post made me hungry! Can't go wrong with Mexican or Italian!

The DL on Panera

Did you know “Panera” translates to “time of bread” in Latin? But, of course!

Even in the current economic state, with most restaurants suffering the worst quarterly decline in 28 years, Panera is experiencing otherwise. Since 1981, the franchise has opened 1,264 stores in 40 states. There’s another 80 stores opening this year, which is about the same number as last years’ openings. Panera has even raised two menu item prices: bagels and soup. There is also a new addition to the Panera menu: a $7.59 chopped cobb salad [1].

While Panera sports hefty prices, I continue coming back for more. Those baguettes are worth fasting for breakfast in order to fund the addiction (I’m only half kidding…we should all eat breakfast). Though Panera is known for the use of wholesome ingredients and lack of fried foods, the menu still very much so requires navigation in order to be healthy.

Q: What does the RD order at Panera?

A: You-Pick-2: ½ smoked turkey on sourdough (light on the mayo) with Garden Vegetable or Black Bean soup.

Top 5 “best” picks:

1. Panini: Turkey Artichoke Panini (750 calories, 27 g. fat, 7 g. saturated fat)

2. Signature Sandwich: Asiago Roast Beef (710 calories, 32 g. fat, 13 g. saturated fat*)

3. Café Sandwich: Mediterranean Veggie (610 calories, 13 g. fat, 3 g. saturated fat)

4. Salad: Classic (170 calories, 11 g. fat, 1.5 g. saturated fat)

5. Soup: Vegetarian Garden Vegetable (120 calories, 1 g. fat, 0 g. saturated fat)

Top 5 “worst” picks:

1. Panini: Chicken Bacon Dijon (940 calories, 36 g. fat, 13 g. saturated fat*)

2. Signature Sandwich: Chipotle Chicken on Artisan French (1070 calories, 55 g. fat, 15 g. saturated fat*)

3. Café Sandwich: Sierra Turkey (970 calories, 54 g. fat, 12 g. saturated fat)

4. Salad: Chopped Chicken Cobb (490 calories, 35 g. fat, 8 g. saturated fat)

5. Soup: New England Clam Chowder (450 calories, 34 g. fat, 20 g. saturated fat*)

Crazy, huh? Just this week I made a “Which is the better burger?” handout for my patients on the local burger hot spots like Sonic, McDonald’s, Carl’s Jr., and Burger King. While not a single burger exceeded 1,000 calories, the Chipotle Chicken on Artisan and the Sierra Turkey reach that 4-digit mark…one we probably want to avoid at all costs. Similarly, not a single burger exceeded 2,000 mg of sodium, while every sandwich on Panera’s menu met or surpassed that amount**. And while Carl’s Jr.’s Famous Bacon Cheese Six Dollar Burger comes in at a sickening 950 calories and 1980 mg sodium, Panera keeps up with the best of’em in keeping us with excess poundage [1].

Want to check-out the damage in your usual order? Check it out: http://www.panerabread.com/menu/cafe/.

*Exceeds the recommended daily allowance.

**2,300 mg of sodium is the recommended limit while 1,500 mg of sodium is recommended daily for those with hypertension

[1]. Horovitz, Bruce. Panera Bakes A Recipe For Success. USA Today. July 23, 2009.

Food competition

I am a self-proclaimed foodie. I love eating, I love cooking, and I love restaurants. I love it all. When my friends and I are planning a get-together, it typically involves a restaurant. And same goes for many people. Forbes published a recent article on women and the competitiveness surrounding dieting, body-image, and food choices, particularly in restaurants. My first thought: I don’t do this.

Wrong!

After a little self-reflection, I admit…I sometimes do fall into this trap, as well.Very much so unbeknown to me until now, by the way.

The first thing that popped into my head: cart surfing. Admittedly, I cart surf. When I'm standing in line at the grocery store, I do look to see what consumers are buying. Sometimes, their carts reflect their weight status...other times not. However, I like to call this "market research"...not cart judgment.

I have a friend or two whose metabolisms I envy. Health aside, I do wish cheeseburgers, french fries, Hamburger Helper, and homemade chocolate chip cookies were staples in my diet…without the addition of unwanted pounds, hyperlipidemia, and hypertension, however. There are definitely those out there who are just blessed. And while we like to dwell on the unfair luck of those individuals, we must recognize that they are far and few between. And we must recognize, that we cannot "keep up with them," as my mother used to explain as the ice cream truck slowly passed by my off-the-charts physique since the age of...birth.

On the flip side, there are those individuals who make you feel at ease and judgment-free when consuming something that may be.... “recommended in moderation.” As a kid growing up, my best friend and I would egg-on one another's poor food selections and converse about our diet short-comings at length. A lot. Surprise: we were both "chubby" kids, to put it nicely. We'd seek each other out to induldge in our local favorites: wings at Shanahans, falafel at Grape Leaves, et cetera. When we surround ourselves with or are surrounded by individuals consuming a diet we know to be not ideal, we do feel comfort when indulging in the same fashion, and we become desensitized to the implications and results of our actions. This is one huge reason obesity tends to appear in entire family and friend units, and not just scattered throughout.

That friend I just mentioned...she's visiting Mark and I this weekend. I'd better not let her drag me down, right? :)

While I follow a fairly steady diet of “80-20” (80% spot-on healthy eating, 20% more lenient intake), I readily admit that my dining out falls into my 20% allotment. I am a dietitian and a regular exerciser...but when I enter a restaurant don't expect me to be ordering grilled chicken and/or a salad! Sorry to disappoint, but I can make that at home a heck of a lot better for way less money. Limit the damage, have a plan, and eat moderately - that's my restaurant "Plan of Attack".

For so long, my now husband and I were in a long-distance relationship -- Italy-to-Chicago and Chicago-to-Michigan. When we were together, it was typically a whole to-do and we celebrated. Dinner, drinks, and maybe even the occasional dessert. He could surely reason as to why I didn’t boast the 115 lb figure suggested for my height…according to BMI standards, right? Yet, after living together for several months now, and with a steady diet of my cooking, I think he’s come to find out that my 80-20 really is 80-20…and I wasn’t just kidding myself. (Duh).

Read the Forbes article. Laugh a little. Eat, drink, and be merry…consciously. Darn us mean, conniving women!

Suckerrrrrrr

If your healthy habits aren't habitual, train and trick yourself into making healthier food choices. Here's my top 10 recommendations:

10. If you're going to a restaurant which lists the nutrition facts online (consult websites such as thedailyplate.com or fitday.com) or in print, pick what you'll order before you walk in the doors. Don't even look at the menu. Stick with the plan! P.S. I love the thedailyplate.com -- check it out!

9. Pack your lunch! And when you pack it, make sure there's at least one truly satisfying item so that you look forward to your lunch and aren't (as) tempted to head out with your co-workers to the nearest burger joint.

8. ...when you pack your lunch, cut up and/or peel your fruit and vegetables ahead of time. That apple will be brown tomorrow, so you'd better not waste it.

7. If you go to a buffet, picnic, or place of infinite choices, survey your options before making your selection. Further, try not to let foods touch one another so you'll pack less on a plate. If you must go back for second helpings, limit yourself to 1 item. Two items, tops.

6. In scenarios such as the above, use the "plate method" of serving yourself. Aim for 1/2 fruits/vegetables, 1/4 protein, and 1/4 carbohydrates. This will keep your calories down and ensure you're eating a balanced meal.

5. At parties or restaurants (think chips and salsa on the table or the bread basket), sit AWAY from the appetizers and snack foods. They're nothing but trouble!

4. If you have a craving (gyros come to mind for me), take a friend you can share with (as in half-and-half, not the infamous "80-20" plan) . Scratch the itch, but don't draw blood...if you know what I'm sayin'.

3. Add fruit and vegetables to some of your favorite foods -- zucchini, squash, mushrooms, and onions go great on a quesadilla (made with low-fat cheese and high-fiber wheat tortillas) while berries and bananas go great in your morning cereal or oatmeal.

2. Keep a piece of fruit in your car or office at all times. When the healthy stuff is easily accessible, you're more likely to eat it. Further, if you're finding it difficult to eat all your F&V's, commit to having 2 snacks a day and making at least one a fruit or veggie. Another great idea is having a cut-up veggie tray with hummus or low-fat dip in your fridge at all times. If hunger is striking the second you walk in from work, the veggies can stave off hunger long enough to get dinner on the table without racking up the calories.

1. Bite it, write it. Keeping a food journal is the tried and true best method of keeping your intake in check. Keep a small journal or notebook with you and commit to writing down everything you eat. When you're accountable for writing it, you typically always think twice before eating it.