Quality of Life

Yesterday, I had my 'last' round of chemo. The doctors will re-evaluate in a month and decide based off my labs, tests, and symptoms, if I need more treatments.  The last 3 weeks for me have been a bit tiresome. Chemo therapy, plus lupus nephritis (kidney disease) can inhibit the production of red blood cells, leading to low hemoglobin and iron levels. Last treatment my hemoglobin was down to 7 (normal is >11). You can imagine how my body felt-run down, sleepy, and every bit of energy went to chasing around Liam, who by the way is getting into every drawer in my bedroom and knows how to 'help' me with laundry by dismantling it, but he makes me smile and laugh every time he does it!  During my the last treatment they gave me an injection, Aranesp, which helps by stimulating the bone marrow to produce more red blood cells in order to raise my hemoglobin and iron levels.  It worked! My hemoglobing is now up to 8.6!


Once again, my husband was amazing too! With all the work he does in the home office and manages to make my child safe, happy, and also able to feed myself and my child healthy food during meal times-he amazes me every time. One night last week, I had NO appetite, and this really brought me down.  I know we are suppose to "eat to live", but "I live to eat"! I love food-everything about it!  I said to my husband, "I just want to crave something, want to eat something, have an appetite" and in order to stimulate my appetite, we decided to walk around the grocery store to get ideas. It worked! I started craving a 'thanksgiving' dinner. It may have not been the most lengthy and a little more processed thanksgiving meal, but the most important thing at the time was that I make sure I get some calories and nutrients into my body.


As a dietitian, I always stress to my cancer patients and those who are facing appetite loss: if you are having trouble with the 'health foods' and they are making you nauseous or sick, then look at the foods that comfort you and foods you can tolerate! Having additional nausea and throwing up your food is only going to cause you to lose the nutrients and hydration you need!  It is best you are able to digest the food and obtain some calories! You need to weigh the pros and cons when you have an acute illness, and it is most important to receive the calories! I often have patients, who can only tolerate living off ice cream and milk shakes. They have calories and protein too!


I worked in a nursing home for a few years, and often my patients would refuse to eat anything that wasn't sweet!  I am a very liberal dietitian and I strongly feel that at the end of life or when disease process inhibits appetite, it is important to focus on the quality of life, quantity may follow! As I said before it is better that they receive optimal calories, rather than skip and refuse meals. There are 2 goals for older-adults in long term care: maintenance of health through medical care and maintenance of quality of life. When medical nutrition therapy prescribes a 'therapeutic diet' such as a diabetic diet or a low fat/low salt diet, these diets often restrict certain foods and portions of food in order to help control the patients 'disease process', However, when an older-adults or patient has been affected by cancer or the side effects of cancer, they may fail to comply with the 'therapeutic diet' and additionally refuse to eat, causing a decline in medical status and additionally hinder their quality of life.


I'll leave you with an amazing picture of the 'thanksgiving meal' my husband made for me: portabella mushroom stuffed with low sodium stuffing mix, topped with lightly sauteed red peppers and parmesan cheese. On the side: canned whole cranberries, peas, and whole wheat toast with apricot jam! Sounds amazing, right? I was able to taste the food, and not left with a 'metallic' flavor in my mouth- a side affect from chemo. The best part about this meal was not only that it tasted and looked amazing, but the man that prepared it, and the love that went into it! In my next blog, I plan to discuss: coping with cancer during the holidays and the 'care taker' role.


Quick References:
http://www.adajournal.org/article/S0002-8223(02)90289-0/abstract
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000266/

Experience is Everything

I remember being a dietetic intern and so afraid to step out on my own. Thinking that one of the doctors would not like my recommendation or that another more experience dietitian would find the constant need correct me. My husband and family would tell you that I have always been a very confident individual and there was nothing that would get in the way of Laura.  When I wanted something done, I did it or I found a way to get it done.

 As an intern at the Bay Pines VA Medical Center, my preceptors did an amazing job of giving us the knowledge and experience we needed to be exceptional dietitians! However, when my husband and I moved to Virginia, I found out I had a comfort zone. I had never lived this far from home, and nobody around me knew "I got my way" back home.  I wanted to hide my head, like a turtle in it's shell.  If you know me, you probably find this very hard to believe me, but it is true.  I started a knew job at a small hospital in Loudon,Virginia.  It was the perfect job for a new dietitian, the other dietitians took me under their wing, and I was able to build up my confidence once again. I started to gain more experience!

 I share this with you because without our experience and understanding of the individuals we work with, we cannot truly empathize with our patients or clients.  Each of us has a story to tell, and without these stories, we are nothing!  Our stories make us up as an individual person and also help us become one with each other. We cannot deny our past experiences, and we must embrace each new experience as a learning curve.

Yesterday, I had the honor to share my experience and knowledge of nutrition with some amazing women who are dealing with cancer or have dealt with cancer.  We started off the evening listening to Dr. Carlos Castillo with 21st Century Oncology of Jacksonville. It is not everyday that you have a physician who is passionate about the spiritual, nutritional, and physical components needed for healing before, during, and after cancer!  He is truly an amazing doctor.

 After a great night of talking nutrition, I woke up inspired to recreate an Arabic inspired lentil soup. Lentils are packed with protein, and fiber. Proteins are the building blocks that help your body heal and grow strong, especially when dealing with cancer!  I also added in some carrots and beet greens. which are packed with antioxidants benefits, anti-cancer benefits, and are the one of best-researched areas of health research with respect to dietary intake of carrots and beets. 

Lentil Soup with Beet Greens and Carrots

 2 Cups Lentils (any kind)
1 lbs Beet greens or other favorite greens such as mustard greens, spinach, or swiss chard
1 large Onion, chopped
1 cup diced carrots
1/4 cup olive oil
1/2 cup lemon juice
Pepper and salt to taste
7 cups water
1/2 tsp cumin
2 bay leaves

1. Heat stock pot with 1 tbsp olive oil. Saute onion until opague. Add in Cumin. Saute for 1-2 minutes. 
2. Clean and wash lentils thoroughly. Add lentils and 7 cups water to pot, cover, and simmer for 30 mintues. 
3. Add in beet greens (or other green preferred), diced carrots, and 2 bay leaves to pot. Cover and simmer for 50 minutes, or until tender. 
4. Mix olive oil, lemon juice, pepper, and salt to taste in small bowl. Add mixture to soup and simmer for a few more minutes. 

To compliment my soup, I found a recipe on whole foods for Apple and Cheddar Whole Wheat Quesadillas and a green salad. Enjoy! 

Free Nutrition Class

Do you are someone you may know want to learn more about the benefits nutrition on cancer?  21st Century Oncology of Jacksonville and Back to Balance have paired up to provide you with a monthly series of free nutrition classes on topics regarding cancer and nutrition.  Space is limited!

First Class

Nutrition Therapy for Cancer Patients

Tuesday, October 4th, 4:30-5:30pm

Registration information

Contact Caroline Lee @ clee@rtsx.com or call 904-710-2852

Location

21st Century Oncology of Jacksonville 

7751 Baymeadows Rd East

Jacksonville, FL 32256

For more information on future classes

Email: Laura Rellihan, RD, LD/N @ Laura.Backtobalance@gmail.com. 

Fight Like a Girl

My third round of chemo went great, sounds like an oxymoron, at least compared to the others! The treatment center was full of women this time! It sounded like a beauty shop, only we weren't there to primp ourselves, but rather hope to improve our health and prognosis. After talking with some of the women for a little, I decided to take a much needed nap. This was a treat!  I have a 9 month at home and for those of you with little ones running around, three hour naps are few and far between!

That night after my treatment, I felt strong enough and hungry enough to make dinner and I insisted! Not only is preparing and cooking your food a healthier option to eating out, but budget friendly, and for me, a stress reliever.  If you are also on a strict diet, such as low sodium, it can also be very difficult to eat out and know exactly how the chef prepared your food!

This winter I plan to host a Mindful Eating class. Mindful eating includes paying full attention to the experience of eating and drinking, both inside and outside the body! It is an amazing concept, and once put into practice, will give you more appreciation for more nutritious foods and drink and a healthier lifestyle. Keep your eyes open for the class; more details to come!

Along with healthy eating habits, and moderate exercise, the last round of chemo appears to be BEATING the lupus nephritis! As I always say Beat Lupus! For the last 3 days, I can see my ankles! Thats right, my ankles-not cankles! I think I admired my ankles for about 3 hours and was excited to sport my GATOR sun dress for the past Gator game! My energy level is up, and I am starting to feel like "Laura" again. 

The day after my chemo, I had the honor of presenting my company, Back to Balance, at the Women in Business Network fair at Flagler college. I met some amazing women, talked nutrition, and shared my passion for a healthy lifestyle! It was great to get out, market my business again, and meet some other very inspiring women in business!

In honor of all the wonderful, hard working women in the world... FIGHT LIKE A GIRL!


She has achieved success who has lived well; laughed often and loved much;… who has filled her niche and accomplished her task; … who has always looked for the best in others and given the best she had; whose life was an inspiration. ~ Mrs A. J. Stanley

Veggie Burgers

Today is chemo treatment # 3 and lately, I do not have a great deal of energy to cook dinner every night, so I thought I would share my secret to eating healthy with little energy.

PLAN AND PREPARE.....

PLAN out your meals at the beginning of the week. This way you are less stressed about what to make on Thursday night after work or soccer practice. PREPARE food ahead of time. Use the freezer! Instead of store bought toaster waffles or veggies burgers, which are full of sodium, preservatives, and can be also can be expensive, try making your own and storing them in freezer bags!  Now that the fall is coming, break out the crock pot.  Check out some of these healthy recipes: Healthy Slow Cooker Recipes.

These yummy veggie burgers I have created are low in sodium, contain no preservatives, and are full of protein and fiber! The recipes makes about 12 veggie burgers and cost about the same price as 4 store-bought veggie burgers. 

3-4 cups canned or cooked beans (I used mixture of red kidney beans, navy beans, black beans).
1 Tbsp Olive Oil or Canola Oil

1 Medium vidalia onion chopped
1/4 cup green pepper chopped
1 Tsp Cumin
1 Tsp Oregano
1 Tsp Tumeric
1/4 Tsp Red pepper

Salt and Pepper to taste

1/2 cup thawed frozen corn or fresh corn kernels

1 cup bread crumbs
1 egg white (3 tbsp) OR 1 egg

1. Saute onion, pepper, and olive oil for 5 minutes or until opague. Add all seasonings (cumin, oregano, tumeric) to pan. Cook for 1-2 minutes on medium heat. Set aside to cool. 

2. Put onion, pepper mixture and the rest of the ingredients in food processor and mix until combined. 

3. Form 3-4" wide/1" thick patties on a baking sheet with wax paper. Place in freezer for 1 hour or fridge for about 2 hours. This will dry the burgers and make them hold up when grilling and cooking. You can use either a grill pan or place them on a gas or charcoal grill.

4. Set burgers on a plate to cool. Wrap each burger in wax paper and store in freezer bag. They can be stored for up to 6 months!

Round Two

Last Tuesday, September 6th, was my second round of chemo.  This time it took 3 nurses (not there fault but my veins) to attempt finding a vein and after a brutal 6 tries we finally got some blood! I was beginning to think I didn't exist.  After years of steroids, my veins are shot!

After they were able to draw some blood, we could get the treatment started. I put up the legs on the recliner, curled up with my blanket, got a good book out, and then.... they gave me IV benydryl! It was a little  hard to focus on reading so I indulged myself in a little cable TV! (We opted for Netlix instead of cable). So even though I was stuck to an IV pole, life isn't that bad when you are forced to relax for a few hour.

After my treatment, I was still a little groggy. Patrick came and picked me up, and cook me an AMAZING dinner. He is the best! I am very thankful for a wonderful, hard working husband! AND since they have great anti-nausea medicines now, I did not have any trouble with nausea this time and the IV steroids kicked up my appetite.  Patrick was only back in town for a few days, and I wanted to spend as much quality time with him as I could so I did everything I could to fight sleep. It was hard! Thursday, after he left, I slept and slept and slept!  I am not a big fan of sleep, so I felt like a wasted the day, but I guess my body needed it.  Being home when you are sick can be your worst enemy. Instead of resting, I see toys that need to be picked up, clothes that needed to be washed, dishes that need to be cleaned, counters that need to be wiped, and the list goes on and on.  Through all of this, I have now learned that there will always be "projects" to do and I have learned to listen to body and REST. Some of you can relate. We run ourselves down, trying to be super mom, super wife, and super hard worker.  Kind of strange that I am one of these people and I was diagnosed with a disease that is aggravated by stress.

The last few days I have had swollen feet from some of the medications and disease process, causing me to have beautiful cankles (when the ankle and calf disappear). Quite sexy! It comes and goes. Along with that, I have severe cramping in my legs occasionally. Today, the nurse called to tell me about my labs and it is a good thing I am a clinical dietitian and know a great deal about lab work-especially in relation to diet. I found out it was my low blood calcium level and low albumin level (protein in the blood cells) that is causing the camping and swelling. I am going to start taking 2 tums (calcium carbonate) a day and increase my intake of food/drink fortified in calcium (milk, cheese, yogurt, broccoli, canned salmon, tofu-YUM)!.  My labs are already starting to improve!! I needed to hear this good news, because unlike my usual self, I was starting to think negative thoughts and the worst possible situation. You need to always think positive, whatever problems you are facing! AND focus faith, hope, and love!

Quick side note: I don't know what I would do without my friends! I used to be very prideful and did not ask for help when I needed it. Forget that!!! I love the help and especially the calls and "stop by's" from my friends! A few of my friends brought me homemade enchiladas and watched a movie with me! Another friend came by for dinner and to play with Liam and I. My girlfriends are constantly calling/texting to check up on me! You know who you are and you all are amazing! Thank you for all the kind words, thoughts, prayers, and especially love you have shown!

"Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around."  ~Leo Buscaglia

Obstacles

I think everyday I get asked the same questions, "how are you able to deal with everything you are going through and still find time to eat healthy and exercise?"

My answer: I just do and you can too! We have to make the choice. We can choose to eat healthy or we can choose to grab a double whopper and fries; we can choose to put our running shoes on and exercise or we can choose to stay in bed.  We make the choice. We may have influences that help us make our choice, but ultimately make the choice.

We all have different obstacles and are dealing with life's situations, and in order to make changes in our behavior, we need to know how to deal with the obstacles that are in our way of living a healthy lifestyle. 

Follow these tips to help you stay healthy and balances your lifestyle:

1. Become aware of your actions-when you realize what you are doing, you can change it.
2. Keep a record of what you want to change-If you write it down, you are more likely to change it.
3. Avoid situations that trigger bad habits-such as eating in front of the tv or sitting at the computer.
4. Write down your new routine-Change it until it works for you
5. Post reminders about healthy habits-post in places where you will notice them: refrigerator, on the table, in your car, mirror
6. Practice your routine, because practice makes PERMANENT!

"A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles." Christopher Reeves 

Exercising with Chronic Illness

Day 3:
Most of my friends and family know I am a morning person. I wake up energized and love the feeling that I can start over that day!  I usually wake up around 6am and if any later, my husband knows something is not right!

This morning I woke up ready to swim some laps! Exercise has always been a part of my life and I often treat it as a medication; without it, I feel ill!  In my own experience, I feel exercise is most essential for chronic pain, but it can also be very difficult when fighting the pain!  I have found that once I get moving and face the pain, my pain level decreases throughout the day.  I just bite my tongue and keep moving.  Luckily, I learned to swim at a young age and LOVE the water!  It is easier on my joints and helps me keep the weight off!

I always enjoy my time spent working out with friends. It also helps the time fly by, especially when you find yourself in deep conversation while riding bikes or kicking laps in the pool!
My friend Susan picked me up this morning to swim some laps. She is an AMAZING chef by the way, and can offer some great advice on cooking healthy meals and great cooking tips to help you organize yourself around the kitchen! You can check out her business @ http://www.mycuisinecoach.com/.

Some of you reading my blog may already face chronic pain or have a friend that is facing chronic pain. You might be overweight and attempting to exercise for the first time.  It is not an easy road to start, but it will be well worth the journey once completed! I encourage you or your friends to seek advice from a health care professional such as a physical therapist or exercise specialist (http://trimarni.blogspot.com/) for more information and tips regardimg exercise, and how it can help you and the pain you are facing!

"He who hesitates is lost" American Proverb/Author unknown

Sunshine, Water, Rest, Air, Exercise, and Diet

First day of Chemo went well. All of the nurses were extremely nice and every one of them left saying, "Is there anything else I can get you." The rest of the day my appetite and energy levels were amazing. I would probably contribute that to the dexamethasone (IV steroid) they gave me in addition to the chemo. They also gave me IV benadryl, which knocked me out for a few hours on the couch.

Last night Patrick cooked up a cashew curry coconut crusted chicken with green beans and red potatoes. I was very impressed! I forgot to take a picture, but it looked and tasted amazing! I guess as long as I buy the ingredients and provide a recipe, that boy could make anything!

Day 2: I had some trouble sleeping, mostly because my mind was else where and did not want to rest. My appetite is fair today, forcing myself to eat good foods is not a problem, since I love fruits and veggies and so far I have not had any change in taste buds and no nausea:). My energy level is fair. I plan to walk a mile or two with my son Liam and my dog B-man later today. 

"The best six doctors anywhere
And no one can deny it
Are sunshine, water, rest, and air
Exercise and diet.
These six will gladly you attend
If only you are willing
Your mind they'll ease
Your will they'll mend
And charge you not a shilling."
~Nursery rhyme quoted by Wayne Fields, What the River Knows, 1990

A Personal Note...

I want to apologize to all of my (4 and then some) blog followers. I am not much of a writer, in fact, my husband often has to proof read my blogs, because my grammatical errors are atrocious. So please forgive me now, because I am not letting him proof read this before I post:). He is sleeping!

I woke up this morning (4:45am), feeling the need to share a more personal journey; my friend Marni has been telling me to share as a dietitian and friend, in order to relate to my patients and clients more. You can check out Marni's blog at http://trimarni.blogspot.com/. She is amazing and even though I am a registered dietitian has tought me so much about nutrition and exercise!

Today I start chemo, yep that is right, Chemotherapy, the stuff that makes you feel like $%^& and possibly makes your hair fall out.  First I need to inform everyone that I do not have cancer, but a rare form of lupus, lupus nephritis. Lupus is a chronic autoimmune disorder that may affect the skin, joints, kidneys, and other orders. In my case, lupus nephritis, the lupus attacks my kidneys. There are many forms of treatment for lupus, such as nonsteroidal anti-imflammatory drugs (ex: advil/motrin), antimalarial drugs, corticosteroids, and in rare, more serious cases, cytoxan treatments (chemotherapy). I like to think that God thought I was STRONG enough to handle the rare, more serious case of lupus! 

As a dietitian and health care professional, I thought it would be interesting to share my journey with lupus and what it is like to go through cytoxan chemotherapy treatments. AND seeing as I am a dietitian, I figure it would be wise to share with you all the foods I can and cannot eat and how the side affects play a role on my nutrition. I will also share about my exercise routine, the people I meet, the care I received, and how I am striving to be a great mom and wife, even when I am not feeling well!

Day 1-August 23, 2011:
I have my first treatment this morning at 8:30am. I did cytoxan chemo before, when I was 17. Because I was a pediatric (child), I was admitted inpatient and at the time (1997) the treatment recommendation was a much longer/drawn out process (once a month for 6 months and then once every 3 months for 3 years). Today I am an adult, and apparently somewhere along the way somebody said adults do not like to look at colorful painted walls with rainbows and fun farm animals, and white walls would be more appropriate. BORING!

My treatment this time will be done at an infusion site, which is often at a hematology/oncology clinic. The treatment takes a little over an hour.  I get my own recliner and , my own t.v., my own nurse, my own IV pole, and my own white wall to stare at! Also, in the attempt that I would be too tired to cook this week, (and because of my OCD behavior), I planned out meals (easy enough) for my husband to cook. He is a great cook and really knows how to make the kitchen look like a bomb went off:), but he always seems to make the kitchen look spotless when he is done. My husband is amazing! Our 5 year anniversary is this Friday!!  I will leave you with a cute story: One of our songs is Forever and Ever, Amen, by Randy Travis. There is a line in the song he sings to me: "They say time takes it's toll on a body, makes a young girl's brown hair turn gray. Well, honey I don't care, I ain't in love with your hair, and if it all fell out, well I'd love you anyway." AND he still loves me:).

Vegan Whole Wheat Cinnamon Rolls

I have a hard trouble following a recipe (as my husband knows). I love to be creative with food! AND what a better challenge for a dietitian, but to try to make it more nutritious and TASTE great! I have tried and tried to make vegan cinnamon rolls healthier and actually rise, but have never been able to master them, until now! I am sure my vegan friends will enjoy these! 

Vegan Whole wheat Cinnamon Rolls

Ingredients:

·         ¾ cup non-dairy milk-I used original flavored almond milk

·         1 packet active yeast

·         Mix together 1 1/2 cups whole wheat pastry flour and 1 cup white flour

·         1 tbsp baking powder

·         ¼ cup raw sugar

·         2 tsp cinnamon

·         ¼ tsp salt

·         1 mashed banana (or about 6-7 tbsp)/may also use 6-7 tbsp apple sauce

·         2 tbsp molasses

·         2 tbsp agave nectar

·         2 tbsp raisins (Or other dried fruit, such as cranberries or  dried apples)

·         ¼ cup walnuts (Or other nuts, such as almonds, pecans, etc)

·         1/2 cup confectioners sugar

·         3 tsp lemon juice (optional)

·         1 tsp non-dairy milk-again used almond milk

Instructions:

Preheat oven to 350F. Grease a circular cake pan or baking sheet and set aside. Gently warm 3/4 cup non-dairy milk to about 110 degrees. Sprinkle yeast over warmed non-dairy milk and let it dissolve, about 5 minutes. Combine 2 cups of flour, 1/4 cup sugar, baking powder, 1 tsp cinnamon and 1/4 salt in a large bowl. Add 5 tbsp banana or applesauce and yeast mixture, stirring spatula to combine. Add in another 1/2 cup flour, stirring to combine. Sprinkle remaining flour on a flat surface and knead dough, kneading in most of the flour. Knead about 15-20 times. Using a floured rolling pin, roll dough out into large, thin rectangle and set aside. Prepare filling by combining 2 tbsp molasses, 2 Tbsp Agave nectar with 1 tbsp banana or unsweetened applesauce, 1 tsp cinnamon, chopped walnuts (almonds or pecans), and raisins. Spoon filling in the center of the dough and spread it around, leaving 1" edge clear. Gently but tightly roll the dough up. Use a pizza cutter, sharp knife or string to cut off 6 rolls. Place rolls in a warm dry place/cover with clean towel and let sit for one hour to rise. After one hour, place into prepared cake pan and bake 20 to 25 minutes, until golden and cooked through. Meanwhile, prepare icing by mixing 1/2 cup confectioners sugar, 3 tsp lemon (optional), and 1 tsp non-dairy milk, whipping until it becomes a thick glaze with no sugar chunks. Spread glaze over hot buns! YUM!

Healthier Menu Options for Children!

As a young child, my parents never let me order from the "kids" menu and I very seldom could choose chicken nuggets and french fries as my main course. I usually had to split items with my parents or siblings, and it always had to have a vegetable! I can remember one instance, where my younger sister wanted to order the adult size hamburger and french fries. My dad stated, "if you can eat it all, you can have it". It was hard to watch my 50 lb sister try to eat a whole hamburger from the adult menu! She could not finish and I am glad! Today we often find that the kids portion sizes are the same sizes as the adult portions, and they exceed well over 1000 calories a meal! An active 6 year old child needs 1200 calories at sedentary activity level, 1400 calories for moderate activity, and 1600 calories for an active child!

Healthier Children's Menu Requirements: 
The healthier menu options will have a heart next to the item, contain less than 600 calories, contain a side that is less than 200 calories, offer increased amounts of fruits and vegetables, lean proteins, whole grains, and low-fat dairy, and contain less fats, sodium, and sugar! Great day for kids health! 

Chain restaurants committed: 
Au Bon Pain
Bonefish Grill
Burger King
Burgerville
Carraba's Itatlian Grill
Chevy's
Chili's
Corner Bakery Cafe
Crackr Barrel
Denny's
El Pollo Loco
Friendly's
IHOP
Joe's Crab Shack
Outback Steakhouse
Silver Diner
Sizzler
T-Bones Great American Eatery
ZPizza

Read the full story at www.Thefranchisehound.com

Healthyeater Kale and White Bean soup

Ingredients: 

2 cups chopped fresh kale
2 Tsp olive oil
½ cup diced celery

1 small diced yellow or white onion
1 clove garlic diced fine
1 cup diced carrots
2 cups fresh chopped tomatoes OR 1 -14 oz can low sodium diced tomatoes
4 cups vegetable broth OR homemade vegetable broth (see recipe below)
½ Tsp salt
½ Tsp pepper
2 Bay Leaves
1 can Navy beans or any white bean drained OR 1/2 cup dried beans (If you use dried beans, soak them in water over night prior to cooking)
1 Tsp chopped fresh or dried basil (I used fresh-very easy to grow)

Add 2 Tsp olive oil to medium-high heat stock pot.  Add celery and onions and sauté until opague.
Add in diced garlic and carrots. Saute for 1-2 mintues. Add 2 cups tomatoes and sauté for another 2-3 mintues. Pour in vegetable stock, navy beans, 2 bay leaves, chopped basil, salt, pepper, and Kale. Mix together. Simmer on low heat for 1-2 hours. Remove bay leaves and enjoy a healthy, low sodium, bowl of soup that is jammed packed with nutrients!

Homemade vegetable broth: 

Save ALL vegetable scraps from the week in an airtight container in the fridge. At the end of the week fill a 4 qrt stock pot with 3-4 cups water and the vegetable scraps, 1 tsp salt and 1 tsp pepper. You can also use a low sodium vegetable bouilion cube for added flavor. I use Rapunzel Vegetable Bouillon cubes. Remove vegetable scraps using a strainer over a heat resistant bowl to catch the broth. 

I am not sure you can get more nutrients from a soup and you will feel great that you did not waste any of the nutrients from those leftover vegetable scraps! Enjoy! 

Tips for Pickey Eaters

Is your child a picky eater? Does your child only want to eat chicken nuggets and Spagghetios? I often get this concern from parents. I can now admit that it isn't a piece of cake to spoon feed a 6 month old, while getting dinner prepared for the rest of the family. Why on earth would I want to make 3 different meals for everyone! Growing up in my family there was one meal for dinner, and we either ate it or sat there and watched everyone eat it. We learned to enjoy the hard work and appreciate a good healthy home cooked meal! Whatever the meal was, we always had a fresh green salad on the table and surprisingly I still love salad and continued the tradition. On birthdays and special occasions my parents let us pick out our favorite meal. My favorite meal was london broil with asparagus and red potatoes. YUM! Here are some great tips for your picky eaters!

1. Be patient when introducing a new food. Children can have food adversions and taste changes, so don't give up the first time! I remember the first time I tried sushi I was not a big fan and now I love it!

2. Mealtime routines: set regular times and do not offer snacks one hour before meals. You want hungry tummies coming to the table!

3. Get sneaky! Make casseroles with veggies mixed in!

4. Let your child help you shop, prepare, and help cook! Children want to help, and what a better way to get them excited about food, and get them in the kitchen.

5. DON'T use dessert as a reward! Desert should also be a special occasion! Your kids too will learn to be satisfied with the meal itself.

6. Mealtimes and snack times should be fun! Kids love to nibble and especially love to dip, so make some snacks trays with healthy bite-sized treats.

7. Set good examples with your own eating habits. Your children are making sure you eat your veggies!

8. Teach your children about the benefits of fruits and vegetables! For example: carrots contain vitamin A and beta-carotene that help you maintain good eye health; broccoli contains calcium, which help you build strong bones.

Images obtained from microsoft clip art.

One Step Closer to Teaching Our Children about the Important Role of Nutrition

I found this article (Home Away From Home: http://www.eatright.org/Media/content.aspx?id=6442463092) to be most helpful to new moms that might be researching child care programs or already have their child in a program. The article discusses child care programs as a "home away from home" and "where our children adopt early nutrition-related behaviors". With today's economy and both parents working, child care is utilized by more families in the US, therefore they have a huge influence in our child's food choices and future health.

It is already a known fact that child obesity is becoming an epidemic and that 1/3 of our nations children are carrying too much weight. Our children our watching us eat!! I appreciated the statement..."Young children appear more likely than older children to be influenced by adults in an eating environment".

You can read the full article at http://www.eatright.org/Media/content.aspx?id=6442463092

As a registered dietitian and health care professional, it is my role to educate the community on the importance of nutrition and especially the role we plays as adults in our children's future health. If you or anyone would like for me to come speak (for free) at your child care program, school, or after school care please contact me at Laura.backtobalance@gmail.com.

Fun Breakfast Ideas for the Whole Family

Believe it or not, there is more to breakfast than cereal! Here are just a few fun and balanced breakfast ideas your kids will love!

1. Whole grain waffles: Make some home made whole grain waffles, wrap them individually in freezer bags, and store them in the freezer for the week! When you are ready to eat them, Stick 1 in the toaster, jazz it up with some berries, and top it off with some low fat vanilla yogurt (Greek is my favorite and loaded with protein!). Check out this yummy whole grain waffle recipe at http://www.myrecipes.com/recipe/honeyed-yogurt-mixed-berries-with-whole-grain-waffles-10000000671034/.

2. Power up with oatmeal: Does your oatmeal taste like cardboard? Well it doesn't have to! There are endless possibilities- change it up with a tsp of honey or peanut butter, or a dollop of greek yogurt, handful of walnuts or almonds, dried fruit, bananas, chopped apples. I never get bored with oatmeal!

3. Egg white breakfast sandwich/burrito: This is one of my favorites!

Take 1 egg white OR 3 tbsp all natural eggs whites (found at local grocery store). Grease a ramekin or custard cup with non-stick cooking spray. Poor in egg whites. Cook on high in microwave for 1 minute-times may very depending on microwave. Cut a whole grain english muffin in half and toast. Place cooked egg whites and 1 slice of low fat cheddar cheese. Pair it up with a 1/2 cup or small piece of fruit and some low fat yogurt-YUM! And if you hit snooze one too many times, wrap in foil and brown bag it up with some low fat yogurt and 1/2 a banana. Change it up with a whole grain tortilla wrap and some salsa to make a breakfast burrito!

4. Smoothies: My nephews and I love making smoothies together! Smoothies are packed with vitamins, minerals, and a great start to the day!! Give your blender some love!

Try this recipe:

Makes 2 servings.

Ingredients:

1/2 cup blueberries

1/2 cup strawberries

1/2 cup blackberries

1 cup low-fat milk OR 1 cup low fat plain greek yogurt

2 tsp honey OR agave nectar

2 cups ice

Mix in blender and ENJOY!

You can also use frozen fruit or seasonal fruit to save money!

Supplement Review: Juice Plus®

Recently I was asked about the supplement Juice Plus®. Juice Plus® number one claim is that it is "the next best thing to fruits and vegetables", leading the consumer to believe that these pills are "closer to real fruits and vegetables than is likely to be the case"-says Center for Science in the Public Interest (CSPI). CSPI also explained that the labels indicate that the capsules contain high levels of vitamins A and C and folate naturally, and do not disclose that these vitamins and minerals are added to the capsules during processing.”(1) Very deceiving! Recently Airborne made false claims that the supplement cures and prevents colds. Airborne is now under a 23 million class action law suit and the CSPI would like to do the same with Juice Plus®.

The fact is that supplements in the US are not regulated by the Food and Drug Administration (FDA) and there is little to no viable research. It is a great money making industry and often can be very deceptive. Then how do we know? A few great websites to find more information on supplements are http://www.nsf.org/certified/dietary/ andhttp://ods.od.nih.gov/. While it is true that people who eat more fruits and vegetables have a lower risk of heart disease, stroke, and certain cancers (2), the research completed never considered or used juice sweetened cookies, crackers , or gummy chews made from dehydrated fruit and vegetables (2). JuicePlus® claims that one pill contains your daily intake of fruits and vegetables in compact form. Is this sound? We would like to believe that we can shrink 3-5 servings of all the amazing antioxidants, vitamins, minerals that are found in whole fruits and vegetables into 2 little capsules! There is nothing natural about this process! No pun intended!

Another benefit from eating whole fruits and vegetables is fiber! Juice and pill form supplements contain little to no fiber. Research conducted at the Institute of Medicine shows our bodies need 20-30 gms of fiber daily. Our main source of fiber comes from whole fruits and vegetables consumed in our diet. A high fiber diet has been proven to prevent cardiovascular disease, and possibly other forms of cancer (2).

Conclusion and lesson for the day: A vitamin/mineral supplement should never replace eating whole fruits and vegetables!

A side note on fruits and vegetables with children:
As parents we want our children to eat fruits and vegetables and some of us are looking for ways to “sneak” fruits and vegetables into meals in order for them to get their servings of fruits and vegetables. And not to mention some of us are supplementing our child’s diet with dehydrated fruit/vegetable crackers, cookies, or supplement chews that looks like candy teddy bears replacing or counting these as fruits and vegetable servings. We have underestimated the benefits of whole fruits and vegetables! We have put such a negative spin on fruits and vegetables! Why not teach our children the truth about all the benefits that whole fruits and vegetables can provide! Let them pick out a new fruit or vegetable at the grocery store or farmers market next time, find a recipe, get in the kitchen, and COOK with your kids!

References:
1. http://www.cspinet.org/nah/12_07/special.pdf
2. http://www.nap.edu/openbook.php?record_id=10490&page=339
3. http://www.nsf.gov/
4. http://ods.od.nih.gov/