Should I make an appointment with a dietitian?

As a Registered Dietitian Nutritionist, I appreciate the opportunity to serve our patients as they work to improve their health. If proper nutrition intake is not a major cornerstone for good health, it is certainly in the team picture. A solid nutrition game plan takes commitment, mindfulness, and a good coach. It requires the expert advice of your primary care physician and a Registered Dietitian to assist you.

Consider some reasons that you may want to make an appointment with a dietitian:

• You have diabetes, cardiovascular problems or high blood pressure.
• You have digestive problems.
• You are pregnant.
• You need to lose or gain weight.
• You are thinking of having, or have had gastric bypass surgery.
• You are caring for an aging parent.
• You want to eat smarter.
• You want to improve your performance in sports.

If you are just starting the journey to better health, or, if you just need a kick start, an appointment with a dietitian is a wise place to begin.

Nutrition Counseling is available for individuals and families through Nutrition Services at these Franciscan Alliance - Northern Indiana locations.

To schedule an appointment*, call Nutrition Services at:

• Franciscan St. Anthony Health – Crown Point: (219) 757-6283
• Franciscan St. Anthony Health - Michigan City: (219) 877-1545
• Franciscan St. Margaret Health - Hammond: (219) 932-2300, ext. 34704
• Franciscan St. Margaret Health - Dyer: (219) 932-2300, ext. 45180
• Franciscan Healthcare - Munster: (219) 922-4253
• Franciscan Midwest Bariatric Institute: (219) 852-2518

* A physician referral may be required.

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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.

Coconut Oil - What’s the health benefit?

The recent hoopla surrounding the use of coconut oil has grabbed my curiosity. Since coconut oil is considered a saturated fat that we recommend limiting in the diet, I wanted to investigate more.

According to the Academy of Nutrition and Dietetics, coconut oil is available in two different forms at most markets. "Virgin" coconut oil is made from the fruit of mature fresh coconuts without using high temperatures or chemicals. This form is considered unrefined. "Refined" coconut oil is made from the dried coconut fruit that is often chemically bleached and deodorized.

Both forms of the oil are considered solid fats, and high in saturated fat. One tbsp. of coconut oil provides 117 Calories, 13.6 grams of total fat (11.8 g saturated fat) - more than butter according to the Academy of Nutrition and Dietetics. Coconut oil provides no protein or carbohydrate and has trace amounts of iron and vitamins E and K. Like all plant based oils, it contains no cholesterol. Other common household oils - canola, corn, soybean, safflower, flaxseed, grape seed and extra virgin olive oil - contain significantly less saturated fat than coconut oil.

So is coconut oil healthy or not? The Academy suggests that enough strong scientific evidence falls short to support all of the positive health talk. When it comes to total fat intake, most of the fats we eat should be monounsaturated and polyunsaturated fats. These fats are found in foods of vegetable origin - nuts, seeds and olives. The American Heart Association suggests that calories from saturated fat should be no more that 7%, and limiting trans-fat to 1% of total daily calories consumed. These guidelines are recommended because higher intakes of saturated and trans-fats have been associated with and increased risk of heart disease and elevated levels of total cholesterol and LDL or "bad cholesterol."

Virgin coconut oil, according to the Academy, is high in lauric acid, a saturated fat with a medium chain fatty acid structure, can elevate both good and bad cholesterol levels. Some preliminary evidence – both animal and human studies suggest that coconut oil intake may have a neutral, if not beneficial effect on cholesterol levels.

The saying "all things in moderation" applies to coconut oil. It seems prudent to avoid food products that contain partially-hydrogenated coconut oil. Choose virgin coconut oil, and use it only in moderate amounts. This strategy will keep your saturated fat intake within recommended heart healthy levels.

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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.

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.