Nutrition Management for the Holiday Season

The holidays are approaching fast. This time of year presents additional food challenges for the bartiatric patient. To help you achieve control; be mindful, and focus on your daily nutrition during the holiday season. Being mindful is not only important at meal times, but in between meals as well. Ensuring that you are in a calm and relaxed place may help you achieve success. Eating slowly, chewing your food well, and recognizing when your stomach is full can create a relaxed and pleasant meal experience.

Here are some other tips that may help:

• Portion control, know your serving sizes:
  • 3 oz. cooked meat, poultry, fish = deck of cards.
  • 1 oz. of hard cheese = 4 dice.
  • 1/4 cup dried fruit or nuts = golf ball.
  • 1/2 cup cooked pasta or rice = 1/2 baseball.
• Choose complex carbohydrates (nuts, whole grains, fruit or vegetables) to help balance blood sugar spikes caused by holiday stress.
• Avoid alcohol.
• Eat a meal before you do your holiday baking, and drink water while you cook.
• Use small plates, bowls, glasses and serving spoons.
• Leave a little food on your plate. (You control the food, it doesn't control you).
• Before you arrive at the holiday party, have a healthy snack at home, like a low-fat string cheese with a piece of fresh fruit,or a protein shake with 1 or 2 Tbsp of almonds.
• Avoid sampling everything. Stay in your safe food comfort zone.
• If you're hosting a meal, have all sizes of carryout containers available to send leftovers home with family and friends.

The holidays require some mindful work on your part. If you're prepared for the seasonal meal challenges, you reduce the possibility of overeating, GI discomfort or weight gain creep.

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By Dale Batz, Registered Dietitian Nutritionist with the Midwest Bariatric Institure in Dyer. Dale has 32 years of healthcare and nutrition management experience. He is a member of the Academy of Nutrition and Dietetics, and an associate member of the American Society for Metabolic and Bariatric Surgery.

How much protein do you need?

Submitted by Dale Batz, RDN, a Bariatric Dietitian Nutritionist with the Midwest Bariatric Institute in Dyer

Next to water protein is the most plentiful substance in our bodies . Every single cell in the body contains some protein.

Protein is made up of simpler substances called amino acids. There are two types of amino acids. Nonessential amino acids can be made by a healthy body from the foods we eat each day. The essential amino acids, however, must be obtained through the diet. These nine amino acids cannot be made inside the body.

Source: ADAM

Foods that provide all the essential amino acids are sometimes called high quality proteins. Animal proteins like meat, fish, eggs and milk are all high quality proteins. These foods offer a perfect protein balance. Foods that do not provide a perfect amino acid balance are called lower quality. Most plant foods contain lower quality proteins. Fruits and vegetables are excellent for your health, but are a poor source of protein. Other foods like beans, lentils and tree nuts are better protein sources. They can contribute significantly to our overall protein intake.

Adequate protein intake is essential to reduce the risk of nutritional complication related to your bariatric surgery. When protein is not adequate, you will continue to lose weight, but this can lead to loss of lean body tissue including muscle mass, hair loss, and a decrease in energy and endurance.

How much protein do you need? As a general rule, most women need 60 – 80 grams daily. Most men may require 70 – 90 grams daily.

So plan your protein intake carefully, and enjoy the tasty variety of foods rich in high quality protein.

Protein first ... indeed!

Nutrition Nuggest of the Month: Artificial Sweeteners

Submitted by Dale Batz, RDN, a Bariatric Dietitian Nutritionist with the Midwest Bariatric Institute in Dyer

We receive many questions at the Midwest Bariatric Institute about sugar substitutes. Without a doubt there seems to be some speculation, and maybe mistrust, regarding their safety and role within the prudent healthy diet.

The most popular non-caloric artificial sweeteners include:

• Acesulfame –K : Found in Sweet One
• Aspartame : Found in Equal and Nutrasweet
• Saccharin: Found in Sweet – N Low
• Sucralose : Found in Splenda

Stevia is a combination of sweetener types and is difficult to fit into one category because of what they're made from and how they're made.

Artificial sweeteners are attractive for weight control and diabetes because they add virtually no calories to the diet. These sweeteners provide intense sweetening power and may be made from naturally occurring substances. Some artificial sweeteners can have an after taste, so it helps to experiment with the various types to find a desirable taste combination. Another benefit to artificial sweeteners is that they do not contribute to tooth decay and cavities.

These sweeteners are regulated by the FDA as a food additive. They must be approved by the FDA before being available for sale.

Each consumer should decide on how or if they choose to use these products. In general, the medical community regards them as safe and effective for use with weight loss and diabetic patients.

For more information on artificial sweeteners and sugar substitutes include recommendations and potential side effects, visit our Online Health Library.

Healthy Grocery Store Tips

Submitted by Kelly Devine Rickert, MS, RDN, CSSD, LDN, Registered Dietitian/Health Coach, Franciscan WELLCARE

Cheers to healthier shopping!

1. SHOP THE PERIMETER of the grocery store for nutrient dense foods (Produce, Meats/Seafood/Poultry, Dairy)
2. PLAN AHEAD. Create weekly menus based on seasonal foods/sales and make a grocery list BEFORE shopping
3. NEVER SHOP HUNGRY. Avoid purchasing High Calorie/High Fat foods by eating a small snack before going shopping
4. CHOOSE WHOLE GRAINS instead of refined grains for more fiber, B-vitamins, and minerals
5. READ NUTRITION LABELS CAREFULLY. Choose nutritious products with less fat, saturated fat, trans fat, sugar, and sodium
6. CHOOSE WHOLE GRAINS instead of refined grains for more fiber, B-vitamins, and minerals

Produce
Here’s where we make ½ of our plate fruits and vegetables

• Choose a RAINBOW of colorful produce rich in vitamins, minerals, and phytochemicals
• Purchase produce that is in season for maximum flavor & value

Wash produce under running tap water just before consuming it as it will spoil faster when washed

Meats/Seafood/Poultry
Go LEAN with PROTEIN

• Choose boneless skinless chicken breasts and turkey cutlets, lean beef and pork, and seafood rich in omega-3 fatty acids, such as salmon and trout
• Eggs are a great, inexpensive protein source
• Broil, grill, roast, poach, or boil meat, poultry, or fish instead of frying
• Avoid processed meats high in sodium such as ham, sausage, frankfurters, and luncheon or deli meats
• Store raw meat, poultry and seafood on the bottom shelf of the refrigerator so juices don’t drip onto other foods

Dairy
Dairy foods are an excellent source of bone-building calcium and vitamin D

• Select non-fat or low fat dairy options
• Aim for 3 servings per day
• Good sources include 1% or fat-free milk, yogurt, and cheese
• Make this section of the store the last on your shopping list and refrigerate promptly

Watermelon… Magic Fruit?

Submitted by Kelly Devine Rickert, MS, RDN, CSSD, LDN, Registered Dietitian/Health Coach, Franciscan WELLCARE

Having difficulty with eyesight? Body fat reduction? Or cardiovascular health? Who knew watermelon can assist with all of these issues! Watermelon is not only an amazing and fun summer treat, it also beneficial in the following ways:

• Body Fat Reduction: Watermelons contain the amino acid citrulline which goes through a series of steps that results in our fat cells creating less fat than usual.
• Bone and Cardiovascular Health: Large amounts of watermelon have been linked to improved blood flow through relaxing blood pressure. Additionally, watermelon contains lycopene which promotes bone health, due to the lessening of oxidative stress, therefore improving bone strength. Watermelon also contains potassium which assists in calcium retention in ones bones.
• Antioxidant: Watermelon is rich in flavonoids, carotenoids, and triterpenoids. Lycopene is a cartenoid that reduces chances of inflammations by eliminating free radicals that can infect the body.
• Diuretic & Hydration: Watermelon contains about 92% water. Therefore it is a natural diuretic that increases urination without putting stress on the kidneys like alcohol or caffeine.
• Improves Eye Health: Watermelon is a wonderful source of beta-carotene or vitamin A. Vitamin A assists in skin, teeth and eye health.

So make sure to indulge in this sweet treat as often as possible this summer! Watermelon Strawberry Smoothie Recipe (courtesy of food.com)

• 3 cups watermelon
• 1 1/2 cups strawberries
• 3 tablespoons lime juice
• 1 cup ice
• sugar, to taste ( I use Stevia sweetner)

1. Make a smoothie by blending watermelon with the strawberries, lime juice, ice, and sugar (Stevia).
2. Or juice small amount and add a splash to lemonade.

Protein-Palooza helps patients ‘shake off’ weight

First-place Protein-Palooza winner Melissa Gronendyke, left,
with Lori Granich, registered dietitian for the
Midwest Bariatric Institute.
The winning recipe is posted in the story copy.

The Midwest Bariatric Institute at Franciscan St. Margaret Health - Dyer offered its first "Protein-Palooza" recently at a monthly patient Support Group meeting.

Said Millie Sasaki, RN, who is the institute’s certified support group coordinator, “We survey patients twice yearly to find out what they would like to be addressed at support group. The protein shake cook-off was born from patient input.”

The contest consisted of patients bringing in their favorite protein shake recipes for others to sample. Shakes were graded on taste, nutrition and creativity. The institute contacted various protein vendors to obtain samples for patients to try.

Winning Protein Shake Recipe

Weight-loss surgery patients are required to consume protein shakes before and after bariatric surgery.

“We had support from more than a dozen companies. They sent us everything from protein powders to bariatric vitamins,” said Lori Granich, registered bariatric dietitian.

Granich added that proteins play numerous, vital roles in the body, such as helping to repair cells and build new ones. Consuming enough high-quality protein is important for building lean muscle. Diets higher in protein have been shown to promote weight loss, since it aids in healing and helps maintain muscle mass.

Support Group meetings take place at 6 p.m. the first Tuesday of the month and 11 a.m. the first Thursday of the month, at Franciscan St. Margaret Health, 24 Joliet St., Dyer. For more information, call (800) 931-3322.

National Nutrition Month – “Enjoy the Taste of Eating Right”

Lori Granich, RD, Registered Dietitian, Midwest Bariatric Institute at Franciscan St. Margaret Health

National Nutrition Month is a campaign sponsored every March by the Academy of Nutrition and Dietetics. It has various themes focused on nutrition and physical activity. The goal is to help consumers make better food choices and live healthier lives. This year’s theme is “Enjoy the Taste of Eating Right”. Research has confirmed that taste is the number one reason for choosing certain foods.  Many people think that “healthy” means boring and bland, but once they start using fresh ingredients to flavor their foods, they realize they prefer the taste of more natural food.

National Nutrition Month encourages consumers to eat healthy foods that taste great. The healthy eating guidelines continue to promote plenty of fruits and vegetables, low fat dairy products and whole grains, while limiting sodium, saturated and Trans fats, refined grains and added sugars.

Add flavor to your meals (not calories!) with these tips:

• Mix one tablespoon of olive oil with fresh lemon for a zesty salad dressing. Lemon can also add flavor to your chicken or fish, especially when paired with sautéed garlic.
• Cucumbers can transform your water into a revitalizing spa-like beverage.
• Spices like cinnamon and nutmeg can add a sweet flavor to your fruit or baked goods without the added sugar.
• Fresh herbs can transform your meats, vegetables and soups. Add rosemary to chicken before baking or fresh oregano to salads.
• Flavored vinegars such as balsamic, cider and red wine can be used as marinades or salad dressings.
• Cut half the calories and fat by pairing one tablespoon of olive oil with vegetable broth to sauté vegetables or fish.
• Add pureed apples or berries to chicken or pork for a sweet sauce.

Source: Academy of Nutrition and Dietetics

Weight Loss Surgery Success: Laura's Story

Submitted by Laura M., Miller Beach Resident and past client of the Midwest Bariatric Institute

I was looking back at pictures recently and realized that even when I had lost weight on my own, I was still not as thin and healthy looking as I am 9 months after my Gastric Sleeve procedure at the Midwest Bariatric Institute at Franciscan St. Margaret Health in Dyer, Indiana.

I realized after looking through 20 years worth of pictures that I had struggled with my weight for most of my adult life. I had done every diet out there. I lost the weight on my own three different times. In my twenties, it was always about wanting to lose the dreaded extra 25-30 lbs. In my 30’s, it was losing the dreaded extra 50-60 lbs. In my 40’s, it became losing the extra 100 lbs. This was something I could not tackle on my own. I needed help.

In January 2013, when I once again found myself as a size 20 and at the age of 42, I decided I could no longer live with the adversarial relationship I had with food. I thought I was making good decisions when it came to food. I was eating "diet" foods and was still gaining weight. Food was supposed to nourish me and instead, I felt guilty all the time. No matter what I ate, I felt bad about it.

I had passed a billboard for months advertising weight loss surgery. One day, last January I called the number on the billboard for Dr. Cahill, head of the Midwest Bariatric Institute and a surgeon at Franciscan St. Margaret Health. Immediately, I had a positive experience. I was informed of an upcoming educational session, which I attended just days later. At the session, I learned why morbidly obese people have difficulty losing weight as their body chemistries are working against them. I learned about the different surgical procedures that were available. I also learned about the support which is available from the Midwest Bariatric Institute including a nutritionist, counselor, internist, exercise program, a support group and so much more.

Of the procedures described, I chose the Gastric Sleeve. I had my surgery on April 16, 2013. Every patient situation is different so I can only speak from my experience. It took about an hour and a half. I did not experience any pain and was up walking around within several hours. The procedure is laparoscopic and leaves just tiny incision points.

Even at home, I did not experience pain. I had mild discomfort which I could use ice packs to relieve on the incision points. But did not need any of the pain killers that were prescribed in case I should need them.

After three days, I did not even need the ice. I had my one week follow up at the doctor's office and all was well. I was on my way to success! I strictly followed all of the directions provided and attended all of my follow up visits as prescribed. I followed the strict all liquid diet for several weeks and then slowly re-introduced soft foods as prescribed in the program.

I was losing 5 pounds a week for the first three months. As it turns out this is pretty common with many patients reporting losing 50 pounds in the first three months. At about four months, I was losing 2.5 to 3 pounds per week and at five months out, I was losing 5 pounds a month. At around 6 months, I started stabilizing and at nine months out, I have lost another 6 pounds.

I started at 216 pounds and am now 116 pounds. I went from a size 20 to a size 4. I feel fantastic!!

My relationship with food has completely changed. I enjoy it very much but in a different way. I see it now as life sustaining and filled with nutrients for my body. My metabolism has greatly sped up, and I enjoy the foods I enjoyed before and still lose weight.

I went on a cruise at the beginning of December 2013. I did not skip any meals on the cruise and still lost 4 pounds by the end of the trip.

Again, every person's experience is different, and I can only speak to my own. I am incredibly grateful for the new life I have. I enjoy shopping for clothes; being in pictures; and never get tired of running into people who have known me for decades and don't recognize me!

The program and staff at the Midwest Bariatric Institute are fantastic. The program is structured and geared for success. If you are ready to have your life back, give them a call.

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It's hard to begin a weight loss program on your own, but you don't have to. The Midwest Bariatric Institute is committed in helping you achieve your weight loss goals in a way that can be sustained for the rest of your life. To learn more about the program, including information about free seminars and support groups, visit FranciscanStMargaret.org/weightloss or call (219) 852-2510.