The Mom Chronicles: Type 1 Diabetes

Welcome to The Mom Chronicles!  This is a series of blog posts featuring families that have a child with at least one chronic medical condition helped by proper nutrition. As you read these touching stories, we are reminded that unlike societal influences, food is not just about weight control. It is a critical element to our lives that keeps us alive and functioning normally. I work with families everyday that have children dealing with health problems that require food therapy.  Here are just a selection of stories that I hope you forward to any family that may be helped. This blog is about helping families and it is my hope that we accomplish here by sharing stories of real families. This first post happens to be family friends of my family, but others may be some of my patients or others that I have been directed to for this blog series. 

Meet Joanne and Fred along with their children Elise, 3 and Mattias, almost 8 months. They are a typical family with a unique challenge. You see, Elise has Type 1 Diabetes. I recently interviewed Joanne, who is now a major networker and activist in the juvenile diabetes world. More on that after the interview.



Elise and Joanne
Check out Joanne's blog, Death of a Pancreas

Give us the background story of Elise’s diagnosis of Type 1 Diabetes.

Starting at about 6 months, Elise developed chronic UTIs. We think that may have been the culprit that caused her white blood cells to attack the insulin-producing cells in her pancreas. We had no idea that when we took her in for her 12-month well child visit that two days later we would be in the hospital with a diagnosis of type 1 diabetes. Because of Elise's UTIs, her pediatrician ordered a urine test to make sure there were no bacteria. To everyone's surprise, they found sugar. A repeat test was ordered plus a blood test called an A1C (which gives you your average blood sugar over the last three months). The A1C confirmed that Elise had diabetes, though she was in the very early stages of the disease. We were called with the news while we were in the middle of Elise's 1st birthday party, and had to shut everything down to take her to the hospital.

What were the challenges of following a constant carbohydrate prescription? How did you work through those challenges?


Elise with her baby brother, Mattias

Sometimes trying to get a baby to eat is more painful than pulling teeth! With the type of insulin Elise is on, she needs to eat the same amount of carbohydrates at pretty much the same time, every day. Thankfully, Elise has always been pretty good about eating what is put in front of her. I am not a fan of the “clean your plate” mentality, but with Elise it's a must. Since we give her insulin before her meals, she must finish everything that is put in front of her, or she could pass out or have a seizure from a low blood sugar.  One thing that really works well for Elise is to make sure she has a variety of foods on her plate at meal time. If we have pasta for dinner, we also add some fresh veggies and fruit, as well as a yogurt and a few graham crackers for dessert. She loves to eat a little bit of everything!

What do you think are the core components of living an optimal family life when one of your children is living with diabetes?

First and foremost, faith. There have been so many times I have been on my knees, crying out to God asking Him why this must be our life. And His answer always is, “I don't make mistakes”. And I believe that with all my heart. I am amazed to see how diabetes is shaping my daughter's life. She is so strong and wise; I believe she will do great things with her life, despite the hardships of her disease. I have also seen how I am ”fearfully and wonderfully made” for caring for a child with diabetes.

Joanne, Elise and Fred in 2008 on World Diabetes Day

Having a strong marriage and a partner that is as fully involved as you is also key. I would not be as healthy mentally without my amazing husband, Fred. He is there to pick me up when I’m down, take charge when I feel overwhelmed, and give me a break when I need it. He knows just as much about Elise’s care as I do, so I never feel like I am the only one who can care for her.  

And having a support system of people who “get it” is also so important. For me, that’s the Diabetes On-line Community (DOC). They cheer me on when things are good, and are there to listen when I just can’t take it anymore.

Give us a brief rundown on things to say/not say to a parent that has a diabetic child, or any chronic medical condition for that matter.

Stay away from the stereotypes you’ve heard about the disease. Stick to general questions; like, “what causes type 1 diabetes?” instead of, “did she get that from eating too much candy?”  Don’t try to give advice unless you really know what you’re talking about. And no, seeing something on Oprah, doesn’t qualify. People just need to think before they speak, and ask themselves, “is what I’m saying really helpful, or am I just talking to hear the sound of my own voice?”  I find it encouraging when people ask questions to actually learn more about diabetes. If you’re unsure, just ask! I love to educate people on type 1 diabetes because there is so much misinformation out there.

Please provide some of your favorite Internet resources for parents trying to properly manage their child’s diabetes.

All my sweet D-Moms, D-Dads, and PWD (People With Diabetes) of the DOC- Diabetes Online Community! I love to read their blogs and learn what works and doesn't work for them. I have picked up some of the best tips from other parents who are in the trenches dealing with this disease every day.  I also like Calorie King for looking up carb counts. Their food search database is awesome!

Anything else you would like to share?

That type 1 diabetes affects every facet of our lives. Everything we do, we have to give consideration to Elise's diabetes. It doesn't stop us from living our lives, but it certainly affects it. So many mistakenly think that diabetes is, “just give her a shot and don't let her eat sugar”. Besides the fact that she CAN have sugar, it is so much more than that. Diabetes is so frustrating in that you can do everything “right”, and it can still go so horribly wrong. I've often said it's like trying to play a game, and the rules keep changing on you.   But as overwhelming as this disease is, we are determined to not let it steal our joy. And our prayer is that Elise will grow up and live a wonderfully joyful life, in spite of the hardships that diabetes can bring.

Check out Joanne’s blog entitled Death of a Pancreas. Join Joanne and Fred as they continue to raise money for juvenile diabetes research. They have already raised over $30,000 with their annual Team Elise JDRF Walk for a Cure. I was very honored to be on that team this past year and we had a great time. Fred, who is from Portugal, has another team over in his home country doing the walk as well. It was very inspiring. Be sure check out The American Diabetes Association (for reliable information) and Children With Diabetes (for community support).  Alway cross check any advice given on non-professional forums for the utmost safety of your child.  To find a Registered Dietitian that specializes in juvenile diabetes, go to the American Dietetic Asscociation's RD Finder.

Dairy Power: Happy National Grilled Cheese Sandwich Day!

Cheese...Grilled Cheese!  My son, Evan, enjoying his grilled
cheese sandwich to honor this "cheesy" holiday.

Happy National Grilled Cheese Sandwich Day!  And many sources tell me that we should celebrate this the whole month of April. I am convinced they have a day for everything now. Seriously! Well, this day is very apropos for me because I just spoke at the 2011 Texas Dietetic Association Food & Nutrition Exhibition in Houston this past weekend on a dairy topic – lactose intolerance. In my talk, I spoke about how to enjoy 3 servings of low-fat dairy while also managing your lactose intolerance. But the part I believed was the most important part of the presentation was the implications of avoiding dairy.  And as a pediatric dietitian, I am mostly concerned about the impact avoidance has on growing children. [Children with a milk allergy (very different; is a reaction to the protein in milk vs the carbohydrate in lactose intolerance),  do need to avoid milk and all milk products - but also must be consulted by a Registered Dietitian so they can get the nutrients normally obtained in milk.]  My past posts in honor of National Nutrition Month’s Eat with Color theme focused much on produce that cover 2 food groups - fruits and vegetables. Well, we have other food groups that are vital for good health and dairy is one of them.

When you have a moment, re-visit my blog post entitled, “Ditching Dairy? CAUTION!” More than just calcium and vitamin D, there are at least 9 essential nutrients that are found in dairy products and with the new 2010 Dietary Guidelines out, we know that diary supplies 3 of the 4 nutrients of concern: calcium, vitamin D and potassium (the 4th one is fiber).  Did you know that dairy also contains bioactive compounds that help with blood pressure control, cholesterol reduction and anti-clotting in the blood?  There have also been a lot of studies on how low-fat dairy can help with managing your weight. 

So, go! Grill up that grilled cheese sandwich and celebrate National Grilled Cheese Sandwich Day/Month and at the same time, maximize your nutrition.  Grill it with ham, onions, spinach or serve it with chunky tomato soup.  The choice is yours.  If your like my almost 4 year old son Evan, he prefers the good 'ole traditional recipe (see photo).  Eating Well's website has a lot of choices if you want to try a new version!  My colleague, Dr. Sandra Frank, RD, has some creative grilled cheese sandwich choices on her latest blog post as well.

Disclaimer: My presentation last week and this week in Albuquerque was funded by the National Dairy Council, but that was after I contacted them initially for printed literature that I could provide the pediatricians I support that had been taking children off dairy and providing only a calcium supplement as an inadequate replacement. When they heard that these issues are coming up in the field, they wanted me to share my story. However, I am not a spokesperson for the National Dairy Council. I speak on my own clinical nutrition knowledge. As a dietitian, I believe that each food group provides essential nutrients for optimal health and dairy is one of them.

Color Your Lunch & Dinner: Ideas, Tips & Resources

Last post, I discussed how to Color Your Breakfast in celebration of March's National Nutrition Month theme, "Eat With Color."  This post will feature the other two meals of the day - lunch and dinner.

Lunch
Lunch happens in a variety of places for most people – it could be at home, but many times it is in the school cafeteria, at your desk at work, at a restaurant with co-workers or clients or even in your car from one appointment to the next. Lunch is one of those meals that need to be easily navigated so you can get it done quick and onto your next task for the day. Here are some suggestions to make your lunches colorful regardless of where you are.

School Cafeteria
I am a big fan of empowering your child to make their own choices at lunch, which is a good training ground for the real world when they are older. Depending on where you are on what I call the Three E’s of Optimal Child Nutrition, this can be more difficult or easy. Print off the school menus each week and spend some time doing meal scenarios with your child. Most school districts are trying to improve the quality of their offerings and most have to comply to USDA nutritional standards if they participate in the Free and Reduced Breakfast and Lunch Programs. There are always at least 2 produce colors served with each meal – it’s a matter of selecting them. Encourage your children to participate in this fun Color Challenge so they can be even smarter and stronger!

If you choose to have your child to bring a lunch from home, I still encourage you to bring your child into the choice selection. Please note that I am not suggesting that you simply ask your child what they want – that is what we call short order cooking (or bagging in this scenario!). It should be an effort that you and your child do together. Provide your child two acceptable choices to choose from when it comes to food and you will be more successful with acceptance. Provide one item that they choose on their very own so they don’t feel too controlled. Be sure to review my blog post entitled School Lunch vs. Brown Bag: Obvious Choice? You will find many food suggestions there and also some below at the ideas below packed up for the kids.

Whenever possible, have your children be
part of the food production process!

Lunch At Or From Home
Lunches from home can be easy, quick and healthy. Here are some ideas from the Nutrient-Rich Foods Coalition that are even broken down by *calorie amounts:

200-300 Calories
Tuna on Toast: Mix 3 ounces water-packed tuna with 1-1/2 tablespoons light mayonnaise. Spread on 2 slices toasted whole wheat bread and top with romaine lettuce and 2 slices tomato. Serve with a small orange.

Pita and Peanut Butter Surprise: Spread 1 tablespoon peanut butter inside a 4-inch whole wheat pita pocket and stuff with 1/2 cup sliced strawberries. Serve with 1 cup fat-free milk.

300-400 Calories
The Comfort Zone: Spread 2 slices whole wheat bread with 1-1/2 teaspoons butter. Make a sandwich with 2 ounces sliced reduced-fat cheese, such as smoked mozzarella, and grill. Serve with 1 cup tomato basil soup.

Dressed-Up Leftovers: Slice 3 ounces leftover grilled or roasted sirloin steak. Mix with 1 cup romaine lettuce, 1/2 cup cherry tomatoes and 2 tablespoons crumbled blue cheese. Drizzle with 2 tablespoons low-fat balsamic vinaigrette dressing.

400-500 Calories
Decision-Free Favorite: Place 3 ounces lean ham and 2 ounces low-fat Swiss cheese on a whole grain bun. Top with 2 tablespoons stone-ground mustard and romaine lettuce. Accompany with a small sliced apple.

Bistro Bite: Layer 3 ounces sliced lean roast beef on a sourdough roll and top with spicy arugula leaves and 2 tablespoons mashed avocado. Serve with 1 ounce sweet potato chips (about 10 chips).

Restaurant or Catered Meals
Restaurants and corporate sponsored catered meals have a tend to make many of my adult patients nervous. No need to fear! The first thing you want to do is look for color. On restaurant menus, you can search down vegetable side dishes made with minimal fats like oils and butters. Salads are wonderful choices as long as you are careful with the dressing amount. Choose at least 2 produce colors! My two favorite resources for healthy eating while dining out is the American Heart Association’s page that lists tips by cuisine and a fairly new site called Healthy Dining Finder where you can plug in the zip code you are at and it lists restaurants that fall within their healthy criteria. Save both those sites as your favorite!

Catered meals can be a bit more complicated. Before I went into dietetics, I was in corporate marketing and I saw the catered meals firsthand. And yes, there are certainly meals that do not have one produce item like the traditional barbecue (that may have coleslaw) with high fat meats and sides. But often times you get the sandwich and chips meal boxes. If you don’t have low-fat and colorful choices, I do not suggest that you skip the meal. Instead, keep the lunch well-portioned so you don’t break the bank on calories.

Dinner
Dinners can be a struggle for many families, especially those with children going to this activity and that after school. In my home, we all get there and my young children are like little chicks with their mouths open looking at me! They are already ready to eat. That is why dinners need to be quick, easy, but also healthy and tasty. That can be a tall order.

Here are some ideas by *calorie level, once again, by the Nutrient-Rich Foods Coalition. Check out their website for more ways to eat nutrient rich.

300-400 Calories
Good-for-You Grill: Marinate 3 ounces salmon in orange juice. Grill with 1/2 cup baby red potatoes, 1/2 cup onions and 6 asparagus spears tossed with 1 teaspoon olive oil. Serve with a crusty whole grain roll.

Palate-Pleasing Primavera: Sauté 2 teaspoons garlic in 1 tablespoon olive oil. Toss in 1/2 cup chopped tomatoes, 1/2 cup broccoli, 1/2 cup asparagus, 1/2 cup mushrooms and 2 tablespoons shredded carrots. Cook until the vegetables are tender. Mix with 1 cup cooked penne pasta and top with 2 tablespoons Parmesan cheese.

400-500 Calories
Very Veggie Pizza: Spread a 3-ounce whole grain pizza crust with 1/2 cup marinara sauce. Layer with thin slices of the following: 1/2 cup roasted potatoes, 1/2 cup red onions and 1/2 cup green and red peppers. Top with 1/2 cup shredded reduced-fat mozzarella cheese. Bake according to crust package directions.

Family Favorite: Top 1 cup cooked whole wheat pasta with 3 ounces cooked ground skinless turkey breast or very lean ground beef mixed with 1/2 cup Italian-style tomato sauce. Serve with 1 cup spinach salad tossed with 1 tablespoon low-fat Italian dressing

*To find your calorie needs based on your age, gender and activity level, go to MyPyramid.gov and choose “Get a Personalized Plan” in the top right list of selections.

Colorful Meal Resources
By now, you probably know that The Six O’Clock Scramble newsletter is one of my favorite recipe resources. If you didn’t, check Aviva Goldfarb’s service out that achieves the impossible trifecta – quick, healthy and tasty. When you subscribe, you get 5 recipes in your e-mail inbox once a week and it comes with a shopping list for all the ingredients. Don’t think one of the recipes looks good to you? No problem. Log into your account on her website and pull that recipe off and search her database for a recipe you would like to try. You can regenerate the shopping list with your 5 recipes! All her recipes have nutritional information and suggestions for side dishes. There are additional features being added to The Scramble newsletter, so keep a lookout.  Aviva has published two cookbooks that feature many of the newsletter recipes if you choose to have a book rather than the weekly newsletter.

Meal Makeover Moms: Healthy Meals with Kid Appeal website is a must save in your favorites. Janet Newel Bissex and Liz Weiss, both registered dietitians, have developed this website chocked full of free recipes, tips and commentary on producing kid-friendly meals. I will admit that I just ordered their two cookbooks myself – the most recent one entitled, No Whine with Dinner and their original book The Mom’s Guide to Meal Makeovers so I haven’t reviewed them yet. But if they are as good as everything on their website, we will have some great cookbooks for our own families and to suggest to others.

The Nutrient-Rich Foods Coalition is a great website resource on keeping color in your meals throughout the year. Also, the Fruits and Veggies More Matters continues to add awesome tips to their website including gardening tips, ways to get your children involved with food and of course, meal and shopping tips.

Mommy Dietitian Color Challenge Winners Kit

There is only 5 days left to participate in the Mommy Dietitian Color Challenge! There is still time for you. Post your colorful family plates on the Mommy Dietitian Facebook page and you can be the one that receives the winner’s kit I revealed this past week. It contains Eat Right With Color-themed apron and wooden salad spoons and a wonderful book for your family library entitled 365 Days of Healthy Eating by the American Dietetic Association. This books shows you how to combine nutrition with taste, give tips on grocery shopping and also has over 60 recipes to try on your family.  But we all know the real gift to you is better nutrition and health, right?

As always, if you have any tips or colorful recipes that you would like to share, I would love to hear from you!

Color Your Breakfast: 10 Quick Ideas

By now, hopefully you are well into taking my Color Challenge in celebration of National Nutrition Month. But there may be one meal that you may be struggling to color over the other – especially 2 colors of ½ cup equivalent in produce. Breakfast is often that meal for people. I have to admit that lately I have only had one produce color with my breakfasts, so this message is for me as well.

The key with breakfasts is that they need to be quick and easy since we are all so busy and my nutrition platform is all about practicality. Here are 10 ideas to get you and your family going each day:

- Scramble an egg with 1 or more choices of veggies (any leftover potato from dinner, peppers, onions, mushrooms), an ounce of mozzarella cheese rolled up in a whole wheat tortilla served with fresh berries.

- Crockpot steel cut oatmeal topped with small amount of cranberries, an ounce of nuts served with a ½ cup of vegetable juice.

- Spread a whole grain bagel with your favorite nut butter (peanut, almond, cashew) and serve with a side of apple and orange slices.

- Layer your favorite low-fat yogurt (regular or Greek) with crunchy cereal or reduced fat/sugar granola and mixed berries.

- Top your favorite low sugar, high fiber cereal (<10g sugar, at least 3 grams of fiber) with raspberries, chopped apples and low-fat milk.

- Stuff a whole wheat pita with a sliced, hard-boiled egg and low-fat shredded cheese and a side of kiwi and a ½ cup orange juice.

- Make a low-fat smoothie with yogurt and a variety of fruits such as banana, kiwi, berries and mango. Serve with a couple slices of rye bread with margarine.

- Top a whole grain waffle with yogurt, cinnamon and 2 different colors of fruit.

- Add lean ham or turkey with swiss cheese to a whole grain English muffin. Serve with ½ cup of cranberry juice and a 1/2 sliced melons.

- Peanut or almond butter sandwich with banana on whole grain bread and a side of grape tomatoes.

Remember, there is no breakfast police! If you don’t prefer breakfast food then just eat some healthy leftovers from dinner for breakfast or even a sandwich with spinach, tomato and sprouts with a side of fruit. This is the most important meal of the day, so don’t skimp too much on time and not get it in.  Wake up 15 minutes earlier if you must. What is your favorite breakfast? I’d love to hear from you.

We’ve got about 12 days left before the Color Challenge is over. Remember to post your colorful plates on the Mommy Dietitian Facebook page and you just might be the one that wins the mystery prize. Even if you don’t post, check out the page because others are and are giving some great ideas for us all!  Special thanks to Sandra Frank, Ed.D, RD with Wellness News at Weighing Success and Dietitians-Online who made an inspiring video of how her family with many special needs members are taking the Mommy Dietitian Color Challenge. I encourage you to watch for many reasons, but I want to point out that she mentions a great healthy cookbook that you can get for free - no strings attached - through a governmental website. For those getting this post in an e-mail, log onto my blog to watch this video which I posted below.

Take the Color Challenge -- Dietitians, Too!

March is National Nutrition Month and the theme this year is “Eat Right with Color.” I absolutely love this theme because it crosses over all ages, genders, health levels and socioeconomic levels. It really emphasizes the nutrient-rich approach to healthy eating, which has been my platform from the start. Don't think of food as just a means for weight control.  Food is such a powerful tool in your life toolbox that can help you achieve all your goals in life, not just your health goals. Our minds and bodies work better when we eat lots of colors.

Why colors? Check it out – every color represents a health benefit in your food! Produce for Better Health Foundation really does a wonderful job at listing out each color and the health benefit associated with that color. And then they list all the produce under that color for ideas! I don’t know about you, but this really drives home the reason in my mind why our bodies we need food variety. Even if we think we eat a lot of healthy foods, they may be the same foods day after day. Change it up, go to your local farmers markets, or spend more time in the produce section and browse the selections. Make a point of choosing new produce for your family to enjoy.

We are into day 11 of National Nutrition Month and this is a perfect time to issue you a challenge. Why?  Because Registered Dietitian Day was on March 9th and we celebrate our profession for all the efforts put forward to keep consumers healthy. There are dozens and dozens of blogs that are written by dietitians that are currently blogging about National Nutrition Month. That means there is a lot of evidence-based, practical ways on how to get more colors in your family’s diet.

So here’s my challenge to you: Between NOW and March 31st make it a goal to get at least 3 different colors on your meal plates. Try to make at least 2 of those colors to be of produce. You can count the other color as a lean meat or a low-fat dairy or even some type of whole grain because those are important complements to the perfect plate. Post your colorful plates on the Mommy Dietitian Facebook page and anyone that does, will be given a chance to win a mystery prize at the end of the month! I'll grab everyone's name again and put them through randomizer.org.  Hmmm…what could it be?  And dietitians, don't think you are exempt from my challenge.  My family and I will be taking the challenge on and I'd love to see your colorful plates on the Mommy Dietitian Facebook page as well!  Feel free to include recipes. :)

In honor of the recent Registered Dietitian Day, here are my favorite dietitian-associated websites that will provide great ideas on coloring your plates and learning more about nutrition:

American Dietetic Association
EatRight Kids
Professional Nutrition Therapists Blog
Robinsbite
Jennifer Neily Newsletter
Wellness News at Weighing Success
SuperKids Nutrition
Raise Healthy Eaters
Just the Right Byte
Meal Makeover Moms
Healthcastle Nutrition
Nutrition Unplugged

Two great sites that have a dietitian blog directory!

Dietitians Online
Nutrition Blog Network

I know I am missing more great of my great colleagues blogs, so if you are an RD, feel free to leave your blog in the comment section or post it on the Mommy Dietitian Facebook page.

For my family, one of our favorite multicolor easy meals is good ‘ole fajitas. We live in the heart of Texas where Tex-Mex is plentiful. This recipe is controlled on calories and explosive on nutrients and flavor.

You can get traditional fajitas very colorful by adding your
favorite sauteed veggies and topping with fresh corn salsa.

Colorful, Very Veggie Fajitas

1 lb of your favorite protein (lean beef, buffalo, fish, pork, soy or chicken)
½ each of yellow, red, green bell pepper, cut into long slices
1 small purple onion
1 cup chopped mushrooms
1 T canola or olive oil

Directions and suggestions: Heat oil in a sauté pan. Add all the vegetables and sauté until soft. Add protein choice and cook until done, about 10 minutes. Wrap fajitas in whole wheat tortillas along with ripe tomatoes, spinach leaves topped with your favorite corn salsa and low-fat shredded cheese. Serve with some black or refried beans with dallop of low-fat sour cream.  Serves 4.

Spring time is coming and it’s a perfect time to get nutrition maximized – Happy National Nutrition Month, Everyone.  I will be featuring colorful plates all month long.   Next week, we'll start with breakfast ideas.  Let me hear from you that you are taking the challenge!

Healthy Habits Giveaway – Amazing Package!

We are all about healthy family habits here on Mommy Dietitian, so we wanted to keep them going with a fabulous giveaway. The National Pork Board recently did a Healthy Habits 2011 Survey and learned that 60% of those surveyed believed that sticking with healthy habits can be more difficult than learning a new language, quitting smoking or even winning the lottery! Because of this, The National Pork Board has graciously provided a wonderful gift package which will assist you with your family’s healthy habits, that includes:

Enter to win this wonderful package.  Act quick!
This contest ends at midnight on February 28, 2011.

• $25 of complimentary pork cuts of your choice
• A large assortment of spices to complement lean pork cuts and inspire flavor-filled healthy meals
• A sauté pan for cooking your favorite lean pork recipe
• A digital meat thermometer to ensure that your healthy meals are delicious yet safe
• BPA-free glass food storage containers
• A digital pedometer to help you measure your success in the new year
• Eating Well’s 500 Calorie Cookbook that includes healthy pork recipes

Pork: The Other White Meat
Pork really is the other white meat. Just like any meat, the key is leanness. Here are some tips:
• Choose cuts of pork that come from the loin – including chops and roasts – and 96% lean ground pork, which are the leanest cuts of pork available.
• In addition to protein, look for foods high in fiber like fruits, vegetables, beans and whole grains to help keep you fuller.
• Ham It Up - What’s the key to long-term dieting success? Finding healthy foods that taste great and make you feel fuller, longer. Yet, only 30% are aware that pork can increase the feeling of fullness.
• Meat-Myth Busters - Reducing fat is essential to healthy eating. Too bad that nearly half of Americans (46%) don’t know that pork tenderloin is as lean as a skinless chicken breast, and 23% mistakenly think it is fattier than chicken.
• Swine Sans Salt - There’s no rule that diets can’t be delicious. Cut out the salt without forgoing flavor. Only a third (33%) of Americans know that fresh pork is low in sodium. Its versatile cuts pair well with a variety of flavors year round.

NEW Recipes:

One-Skillet Pork with Wild Rice and Herbs
Tex-Mex Stuffed Peppers
Game Day Pork and Chile Wraps

How The Giveaway Works

Get one entry for doing one or more of the following:

- Take the Mommy Dietitian Family Nutrition Survey (only 5 questions!): http://www.surveymonkey.com/s/7PMY7RQ Comment below to let me know you did this anonymous survey.

- “Like” the Mommy Dietitian Facebook Fan Page. If you get one of your friends to “like” it, then you will both get an entry! In other words, for every person you get to “like”, you can an entry. Document this on the Facebook page or comment section below this post.

- Follow Mommy Dietitian on Twitter! We are getting close to 1000 followers and we’d like to surpass it with this giveaway. If you are already following, get others to follow and document this via a direct message on Twitter or mentioning the giveaway with @MommyDietitian handle and a link to this giveaway post. For every person you get to follow Mommy Dietitian on Twitter, you also get an entry. For every tweet where you mention @MommyDietitian along with the giveaway link, you get an entry.

Enter to win through Monday, February 28th at midnight. One winner will be selected using Randomizer.org. Good Luck!

Disclaimer:  Mommy Dietitian and Angela Lemond, RD, CSP, LD has not received any monetary compensation from the National Pork Board, nor is employed in any way by this organization.  They only supplied the prize pool.

Food Quantity: Portion Control or Intuition?

As I continue my years in the nutrition and wellness industry, I find that there is often a division between dietitians that subscribe to one or the other philosophy when it comes to food quantity: portion control or intuitive eating. I see blogs and articles heavily promoting one or the other. But I would argue that these two approaches are not mutually exclusive of each other. They are both important approaches that can be used together for optimizing health. I was recently interviewed by a company called Healthy Steps by Jokari – a company that sells practical kitchen tools, including very useful portion control gadgets. They asked me what portion control means to me. The interview is provided here, although the video interview did not allow for me to expand on these concepts. So let’s explore this discussion in a bit more depth as we look at portion control, intuitive eating and another important eating approach – meal frequency.

Portion Control: Portion control is a tool that is used to show standard and appropriate serving sizes of foods. Examples of portion control tools would be comparing a deck of cards to represent 3 ounces of meat, or a baseball to represent a serving of starch or starchy vegetable. Or, even the useful products that companies like Healthy Steps sell to consumers that help load your plate with standard portions.  Portion control tools are meant to be a guide to what the USDA decides is an appropriate portion for most Americans based on research. Again, it’s merely a guide. In fact, I wish we renamed this to a more friendly approach – portion guidance. The word “control” seems so militaristic in nature and that is what turns many intuitive eating promoters off to this helpful tool. This approach was never meant to be something that would relinquish our right to listening to our own bodily cues. Portion guidance systems also help us to make sure we are eating enough of a given food. We are encouraged to eat a certain amount of fruit and vegetable servings each day (go to http://www.mypyramid.gov/ to get your own custom plan by plugging in age, gender, weight, height and activity level) so we need to know how much a serving is.  Portion guidance seems to be especially helpful for my patients that were raised in the "clean plate club" and are now psychologically unable to end a meal until their plate is cleaned. They need to have a jumping off point to set up their plates, and then dial in the intuitive eating concepts. We use standardized portions when prescribing constant carbohydrate diets for diabetics in order to optimize blood sugars.  For instance, one portion of carbohydrate for diabetics is 15 grams, and they must know what those portions are in order to dose insulin and/or to stay within their carbohydrate prescription.  As you can see, portion guidance is a very useful tool in a variety of situations.

But before we talk about intuitive eating, let’s insert another eating approach here that sets us up well – meal frequency.

Meal Frequency: Americans are leading busier than ever lives and often times we go way too long to eat. Most of my weight management clients either skip meals or go way too long between meals. Many times this causes a person to not be satisfied by an appropriate meal portion. In fact, this can cause them to overeat in order to make up for the lost calories earlier in the day. My recommendation, consistent with current research, is to make sure you eat three solid meals and also include 1-2 in-between those meals in order to decrease your risk of (or treat) obesity. That way, you never come too hungry to a meal. Let’s be honest, it’s difficult to make optimal food choices when you’re starved. More than weight control, the correct meal frequency optimizes energy levels and  promotes both normal blood sugars and cholesterol levels. I do find that my patients get used to not eating breakfast and they ask me if they should eat even when they don’t feel like eating. This is the one meal of the day where I would say...yes. Your body needs to be re-trained to eat with regular frequency, and this will help start the progress.

And now we have intuitive eating.

Intuitive Eating: Meal frequency and portion guidance set-up allows us to practice intuitive eating. Intuitive eating is a nutrition philosophy or approach that encourages us to tune into our bodies more and eat for simply the feeling of hunger. Living in a world of multi-tasking, it can be difficult to do what seems like such an obvious thing. But we do. We eat because the clock tells us to do so (and we try to push our kids to do the same!), or because of stress, or boredom or a variety of emotional reasons. This approach is very important and something that all people should look at in their own lives. Many times people are not overweight because of food, but because of outside influences that drive us to eat in order to soothe our feelings or emotions. Obesity caused by emotional eating can dredge up fear around food because emotional eaters don’t feel in control in its presence. Intuitive eating concepts are important for the ex-clean plate clubber or the busy parent or the emotional eater. Let’s get back to the basics and eat for real physiological reasons. If you find that you are an emotional eater, consider getting support by a counselor or psychologist that specializes in this field.

When it comes to food quantity, all these 3 approaches - in my opinion – are great tools to be used together for optimal health. The right meal frequency combined with guidance using standard portions and then letting intuition do the rest. Combine that with food quality, and you are well on your way to living your best life!