The Nutrition Blog

Kirsten Gram, a registered dietician, has worked for Cascade Health Solutions’ Center for Healthy Living for over 20 years. She loves sharing her professional wisdom and healthy living tips as part of her blog.

Step 1: Understand how you eat
To eat healthier, you first need to know what constitutes a balanced diet. The food pyramid is a great guide to understanding nutritional requirements. You can even customize your plan at www.pyramid.gov/mypyramid/index.aspx by entering your gender, age, height and weight. Once you understand which food groups and portions make up a balanced diet, you can decide what changes to make.
I usually recommend keeping a food diary for a week or two. Recording everything you eat and drink helps you gain a better understanding of how well you’re meeting your needs and determine areas for improvement. After the first week, review your food diary.

Ask yourself: “Do I…”
• Get the minimum number of servings for each food group?
• Eat enough fruits and vegetables each day?
• Consume mostly foods low in fat, sugar, and salt?
• Prepare my meals at home, or instead eat fast foods or convenience foods?
• Drink beverages that are high in sugar?
• Drink plenty of water?

Step 2: Start thinking about changes
Consider this: If you…
• Eat out a lot, you may be consuming more fat, salt, and calories than you need or want. Try to prepare more meals at home.
• Eat a lot of meat but not many vegetables, your diet may be too high in saturated fats and too low in fiber. Eat smaller meat portions and add more vegetables to your plate.
• Rely on packaged convenience foods, you may be getting too much salt and sugar. You have more control when you make your meals from scratch and avoid pre-packaged foods.
• Find your portions are larger than recommended, you may be getting too many calories. Using a smaller plate can help reduce portion sizes.
• Miss meals, you could end up overeating later. Try to keep healthy snacks around – fruit, yogurt, nuts – in case you have to skip a meal.

Step 3: Start small
Don't try to make big changes in your eating habits all at once. You will likely feel overwhelmed and deprived of your favorite foods and, therefore, will be more likely to fail. Start slowly, and gradually change your habits. Try any of the following:
•   Use whole-wheat bread instead of white bread.
•   Eat brown rice instead of white rice.
•   Try whole wheat pasta instead of pasta made with white flour. Or try a mixture of the two.
•   Use skim (nonfat) or 1% (low-fat) milk instead of whole milk or 2% milk.
•   Try low-fat cheeses and low-fat yogurt.
•   Add more fruits and vegetables to meals, and/or have fruits and vegetables available for snacks.
•   Add lettuce, tomatoes, cucumbers, and onions to sandwiches.
•   Add fruit to cereal.

Step 4: Make healthier choices more often
We don’t have to be perfect in how we eat, just work on eating healthier more often!

Our Basic Needs

Grains: Aim for 6-11 servings each day. Choose whole grains whenever possible.

Example	One Serving	Size of
Bread	1 oz (1 slice, ¼ bagel, ½ small bun	Index card
Cooked grains	½ cup cooked oats, rice, pasta	Billiard ball
Dry Cereal	½ cup flakes, puffed or shredded wheat	Billiard ball

Fruits and Vegetables: Aim 5-9 total servings each day. Choose fresh fruits and veggies whenever possible.

Examples	One serving equals	That's about the size of
Raw fruit	1/2 cup raw, canned, frozen fruit	Billiard ball
Dried fruit	1/4 cup raisins, prunes, apricots	An egg
Juice	6 oz 100% fruit or vegetable juice	Hockey puck
Raw vegetables	1 cup leafy greens, baby carrots	Baseball
Cooked vegetables	1/2 cup cooked broccoli, potatoes	Billiard ball

Meat and Beans: Aim for 2-3 servings each day. Choose lean meats and plant proteins whenever possible.

Examples	One serving equals	That's about the size of
Meat & Tofu	2-3 oz cooked beef, poultry, fish, tofu	Deck of cards
Beans	1/2 cup cooked beans, split peas, legumes	Billiard ball
Nuts & Seeds	2 Tbsp nuts, seeds, or nut butters	Ping pong ball

Dairy: Aim for 2-3 servings of calcium-rich foods each day. Choose low- or non-fat products whenever possible.

Examples	One serving equals	That's about the size of
Cheese	1 ounce or 1 thin slice of cheese	A pair of dice
Milk	1 cup milk, yogurt, soy milk	Baseball

Fats & Oils: Eat fats and oils sparingly and in small portions. Choose heart-healthy fats whenever possible.

Examples	One serving equals	That's about the size of
Fat & Oil	1 tsp butter, margarine, oil	One die

You may not realize it, but your bagel and glass of soda have doubled in size over the past 20 years – most foods have. This increase in serving size has gone largely unnoticed, so has the extra 200 to 300 calories that accompany it.

Eventually, you may feel those extra calories sneaking up on you if you don’t increase your activity. Consuming those extra calories can mean 20 to 30 pounds in weight gain over a single year. This increase in portion sizes has likely contributed to the increase in our waistlines and obesity in our society, as a whole.

Research shows that the larger the portion, the more people tend to eat. Given a one-ounce, single-serving bag of potato chips, a person generally stops eating when the bag is empty. Give that same person a seven-ounce bag of chips, and he or she will likely eat more than one serving – it’s all about packaging.

Don't get me wrong, it’s OK to eat a large amount of one food or have a big meal – just be sure to balance it out by eating fewer calories at subsequent meals. The problem is, many of us have a difficult time striking that balance because our image of portion size is skewed. We call this “portion distortion.” To avoid it, we must come to realize the true meaning of a single portion.

Servings vs. Portions

A serving is a recommended amount of food. A portion is what you serve yourself - it is often larger than a serving. For example, a serving of cooked pasta is ½ cup. But the portion that you put on your plate may measure 3 cups. That equals six servings. (Remember: it is fine to eat more than one serving at a meal, as long as you stay within your daily limits for each food group.) For more information on the number of suggested servings for each food group, go to the MyPyramid Web site at: www.mypyramid.gov.

Portions by Measure & Weight

When in doubt, measure it. You may be surprised by the results. If you don’t know what ½ cup of cooked rice looks like, measure it. Then put it on a plate or in a bowl to see how much space it takes. For drinks, measure 8 ounces of liquid, then pour it into a drinking glass to see what a suggested serving looks like.

More Tips:

• Read food labels. Many foods come in packages that contain more than one serving. Read the Nutrition Facts Label to find out how many servings are in the package and what counts as a single serving.

• Use smaller plates, bowls, glasses and mugs. Studies have shown that if you use a smaller plate, you will feel content and satisfied on 40 percent less food.

• Leave serving dishes off the table. This makes it harder to reach for second helpings.

• Focus on the meal. If you eat while you do other things, such as reading or watching TV, you may forget to keep an eye on portions.

• Eat slowly. You can eat a lot in a short time if you gulp down food.

To learn more about “portion distortion” and how portion sizes have changed over the last 20 years, visit http://hp2010.nhlbihin.net/portion.

Many nutritional trends come and go. While some are based on science, others seem to be the outcome of marketing hype or a result of something discussed on a talk show watched by millions. Remember the “Cholesterol-Free,” “Fat-Free,” then “Carb-Free,” followed by “Trans-Fat Free” years?

We have all experienced them, been a part of them and even bought into them. These hypes have led to change and some, such as eliminating trans fats in foods, have been helpful. Sometimes, however, we tend to focus too much on the hype and forget the bigger picture of balance and moderation.

I always encourage folks to get back to the basics, back to the way our grandparents or great grandparents ate. These are the trends they followed and are still part of the nutritional arena today.

1. Eat less-processed foods
You can’t go wrong with fresh, local foods. Our grandparents didn’t have the processed, ready to go, timesaving foods we have today. But over the last 50 years many stores have been lined with processed, prepared, ready-to-go foods to support our busier lifestyles. I challenge you to try less processed foods and work to prepare more meals from scratch. Your entire family will benefit.

2. Eat More Fish
Fish is good for us; there is no question about that. It provides the best source of Omega-3 fatty acids that have been shown to protect your heart. The American Heart Association encourages us to eat 7 ounces of fish every week. This year, challenge yourself to eat fish twice a week. Albacore tuna (canned) is an easy one, then find some fresh fish at the market for an evening meal.

3. Eat Whole Grains
Whole grains were popular in 2008 and I believe this marketing will continue in 2009 with development of new products that make eating whole grain easy. Whole grains are good all the way around, from adding more bulk to your diet to a sense of fullness. Fell good knowing that whole grains provide a variety of nutrients.
Your challenge, this year, is to switch to a whole-grain product, such as noodles, bread, brown rice or cereal.

4. Eat Nuts
Some people may hesitate to eat nuts, because they think that they’re high in fat. It is true that a handful of mixed nuts is around 150 calories, 80 percent from fat. However, most of the fat in nuts is good-for-you fat, monounsaturated and polyunsaturated. The monounsaturated fats in nuts tend to lower LDL (bad) cholesterol, as well as total cholesterol without lowering HDL(good) cholesterol. Though nuts are healthful, don’t go overboard – limit yourself to an ounce or two a day. One small handful is about an ounce. Best nuts to choose: almonds, filberts, walnuts and pecans. They make an easy snack that may last you throughout the afternoon.

5. Eat Smaller Portions / Smaller Plates
My grandmother’s plates, bowl and glasses are much smaller than the ones I have in my cupboards. I wonder if that made a difference in their health and a reason there was less obesity 50 years ago. Studies show that we will eat 40% less if we use a smaller plate, bowl and cup and still report feeling satisfied! Try smaller plates this year and see how it goes, you may be surprised to find you are perfectly satisfied with a smaller amount of food.

6. Take your Vitamin D
The vitamin of the year! I have noticed more doctors in our area testing their patients for vitamin D and they are finding many are deficient. It is important to ask your doctor about your vitamin D status and work on getting more vitamin D through diet. Rich sources include vitamin-D fortified milk, yogurt, soy milk, as well as eating more salmon and albacore tuna. You may want to consider taking a vitamin D supplement, but first ask your physician to test your Vitamin D status, as they may have recommendations based on that finding. A good site to get more information on Vitamin D is www.nationaldairycouncil.org/NationalDairyCouncil/Health/Digest/dcd78-2Page1.htm

Each year, we set goals or resolutions to become healthier with our food choices and/or exercise routines, only to find that shortly after setting them they become distant memories.

What happens to these worthwhile goals that were so important to us? Did we set a goal, but not process an action plan to meet the desired goal? Or did we set out to do too much? Was the goal unrealistic? Or was it really a New Year’s wish: “I wish I would…”

An effective goal encourages you to develop strategies for the path to meet your desired goal. The loss of weight, in itself, is not an action. The action is the changes you make in your eating habits – choices of food to consume or not to consume and routine physical activity. To achieve a goal, there one normally needs to make some lifestyle changes.
One strategy is to make your goal tangible. Spend some time writing out what it is you want to change, what is it that you want to achieve and set “SMART” goals that will keep you motivated on your journey toward a healthier you.

SMART goal setting is an acronym that stands for:
S-pecific
M-easurable
A-ttainable
R-ealistic and relevant
T-imely

Here is how you set SMART goals:

• Be specific, so you can measure them. What do you plan to do? Can you break it down into smaller steps? The smaller and more specific the steps you set to reach your goal, the more likely you will be successful.Instead of saying, "I'm going to eat more fruit,” say "I will eat a piece of fruit for one of my snacks every day.” You may want to start with even smaller steps, such as, “The days I work I will eat a piece of fruit for my snack.” Then plan the steps required to make it happen. “I will buy five pieces of fruit at the start of the week and take them to work.” Make plans for the times you may forget or come up short. “I will buy some dried fruit or lite canned fruit and keep at my office for the days I forget my fresh fruit." An exercise goal may look like this: Instead of saying "I'm going to exercise,” be more specific. Say, "I will walk for 20 minutes at lunchtime Monday through Thursday.” Know exactly what you will be doing and when you will be doing it.

• Measure your actions to see if you're attaining the goal. Perhaps your goal is to write down everything you eat and drink for one week. Review your food records at the end of the week and see whether you met that goal. You can then set a new goal. Your new goal might be the same as your prior goal, or you might change your goal based on the results of your prior goal. If it was your fruit goal, you will easily know at the end of the week how well you did based on how many pieces of fruit you have left on your desk.

• Attainable. Don't make your goal unattainable. While you want to push yourself, try dividing your ultimate goal into many smaller ones. Instead of saying, "I'll never eat lunch out again,” resolve to pack lunch three days a week. Or instead of thinking, "How could I ever eat a whole cup of vegetables?" add a salad to your dinner two nights a week.

• Be Realistic. This includes the goal and the number of smaller steps you plan to work on and achieve. Instead of thinking, "I'll never have dessert again,” only eat dessert on Saturday night. Or instead of saying, "I will walk 60 minutes seven days a week,” say, "I will walk 30 minutes five days a week.” Anything extra is a bonus.

• Timely. Pick a time period, like a week or a month, when setting a goal. That will keep you focused on a starting and end point. You can then build on the goal you're measuring by adding a new one for the next time period.

Food preparation techniques that reduce calories, fat, and sodium go a long way to keeping you healthy during the holidays. Lighten up your favorite holiday foods and create new recipes with these tips: