About Dietitian on a Diet

Becki Parsons is a dietitian with a Master's degree in Nutrition and Exercise Physiology. She wanted to pursue accurate and up-to-date nutrition recommendations, as well as a way to understand the struggles of patients, clients, and well, everyone who eats for health. Thus, dietitianonadiet.net.

So I gotta be honest – I’m about 2 and 1/2 weeks into the Heart Healthy diet, and it’s getting to that mental point where I kinda just want to eat something REALLY salty. Because I LOVE salt, and there is that mental game we play where anything we are limiting suddenly becomes highly desirable. This is where things get tough. Yesterday, the rubber met the road.

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One weekend a month, the kids go to grandma’s and my husband and I have date weekend. This img_0706particular weekend is date weekend and yesterday, Charlie and I went a-wandering. We started out at one of our favorite breakfast places and I wanted something delicious and I also tried to get something that would be mostly heart healthy: huevos rancheros. They make these with a crunchy taco shell, black beans, poached eggs, cheese, and avocado. Mostly low in sodium and pretty darn low in saturated fat. I ate half the plate and took the rest home. So far, so good.

Mid-morning we walked around a park and got a tad chilly in the fall air, so we went to a local coffee shop and I wanted a pumpkin steamer. To be true to my heart healthy diet, I elected to have it made with soy milk (though fat free milk would have been fine) to avoid saturated fat. So far, still good.

Then it got tough. We drove up to Tacoma to check out some stores and about mid-day hunger set in. I had a craviimg_0708ng for some super-not-heart-healthy tortilla chips with nacho cheese. Cheap, not-even-food, concession-stand machine, plasticky pasteurized processed cheese product straight from 7-11. Definitely not conducive to meeting my nutritional goals for the day, particularly since I knew we had plans to go to another restaurant for dinner and I needed to save sodium and saturated fat for that. But I was started to listen to the devil on the shoulder: “You’re sick of watching your sodium. Come ooooonn…you’ve been so good for 2 and 1/2 weeks! Just don’t worry about it.” He was right – I was sick of limiting my sodium! So there! I’m going to eat it and I don’t even care!
So I ate it. And it was just as satisfying as I anticipated it would be. Alright, worth it. Maybe for dinner I’ll try to pick something more carefully.

We went to a nice restaurant for dinner and I thought I might to try getting a lean meat with some steamed veggies and maybe a roll or something. Then I got my menu and there it was – my favorite food. Seafood fettuccine. Ooooohhhhh boy.

At least I got the salad instead of the chowder...right?

At least I got the salad instead of the chowder…right?

 

I got it. I had to. It was amazing. In the whole day I overdid my calories by 300, exceeded my sodium goal by over 900 mg (I had 138% of my daily goal!) and blew my saturated fat out of the water by more than quadruple with that cheesy nacho goodness and creamy white wine butter sauce.

If I had high blood pressure or high cholesterol, this one day probably wouldn’t have been too big of a deal as long as it didn’t happen super often. If I had congestive heart failure, my sodium binge could have hospitalized me. Here enlies the mental game of a “diet,” which also tends to be one of my least favorite things about the idea of dieting. Diets are likely to promote this pendulum swing from restriction to bingeing. For me, it’s much more desirable to focus on including lots of the things that are really good for me than focus on restricting things that aren’t as good and overall promoting healthful moderation, for this very reason. But it’s super tricky if not restricting something could land you in a hospital bed or worse.

Things are back to normal now that I got my crazy day out of my system, but anyway, I wanted to make sure I kept myself honest and took note of this mental game – even dietitians are not immune to the psychology of “dieting!”


img_0696Well, folks…week 2 is done! And unfortunately, I have become an incubus of the common cold as of yesterday. Goodie. In light of my crummy cough and angry sore throat I have resorted primarily to applesauce, soup, and nonfat frozen yogurt as my primary sustenance for the time being, but I still stayed within my nutrition goals while sick.

I was surprised to notice that I had a hard time meeting my saturated fat goal while on my own this week – I never went over on my sodium, believe it or not – but I was over on my saturated fat 3 out of 7 days. I’ll have to make a more concerted effort to watch that this week.

 

  Heart Healthy Goal Week #1 Week #2 Week #3
# of days nutrition recommendations met 7 6 4  
Average calorie intake <2000 1831 1571  
Average sodium intake <2400 mg 2064 mg 2033 mg  
Average saturated fat intake <12 g 10.2 g 13.7  
Weight change   -1 lb 0 lb  
Blood pressure change   -5/-6 mmHg -2/-4 mmHg  
Waist change   -.75″ -.25″  
Grocery Budget Change   +75% -65%


So why is it that the Heart Healthy diet recommendations limit sodium? It’s highly unfortunate, as sodium is ever so tasty in many applications including (but not limited to) flavorful broths, crunchy kettle chips, and spicy sausage. Those are just a few of my personal high-sodium loves. Limiting sodium is tough for me because I can really go to town on the stuff. I’m not big on sweets – I can stay away from candies and pastries for the most part but put me near a good cracker with sharp cheese or salty chip and you have to fend me off with a stick. Limiting sodium can be a challenge. So what’s the benefit of doing it?

Research studies have shown that a lower sodium or sodium chloride (table salt) intake was associated with significantly lower BP in adults with normal, slightly elevated, or high blood pressure. In most studies, “high sodium intakes” ranged from 2400-4800 mg per day while “low sodium intakes” ranged from 440 (holy low sodium!) to 2640 mg per day (Some study examples: Bray, 2004; Coruzzi, 2001; Geleijnese, 2003; He, 2004). You may wonder why sodium makes a difference in blood pressure. You are wondering, aren’t you? Of course you are.

Well surprise, surprise, it’s complicated! Bodies are complicated. The primary explanation is due to sodium’s role in directing how much fluid the body holds on to. Generally I explain it this way: Sodium and water are friends. Wherever sodium goes, water goes too – linked arm-in-arm with charged chemical attractions (oo la la!). So when we eat a lot of sodium (hello, pizza binge), our body holds on to a lot of water to hang out with it (hello, puffy bloat body). Some people notice the extra water because their feet, ankles, face, or belly swell with it. Some people can’t even tell it’s on board.

Photo: http://doodle-rama.blogspot.com/2006/04/heart-attack.html

Illustration from http://doodle-rama.blogspot.com/2006/04/heart-attack.html

Either way, all this extra water has to move around the body to get filtered and whatnot. Guess whose job it is to move it? Your heart! Poor heart is pumping blood through the hoses of your veins and you’ve just increased the volume he has to move. His best response is to create more pressure to push all that extra fluid around to get rid of it. So, he pumps even harder and your blood pressure rises. That’s rough on him, as well as all of your hoses because in some places in your body (like your eyes and kidneys for example), your body has leeeeetle, tiny hoses that don’t respond well to pressure. Think fire hose pressure in your little green garden hose. Not a good match.

So the goal of the Heart Healthy diet in limiting sodium is to keep blood pressure within healthy ranges for your heart and blood vessels. Now, as with everything in the realm of nutrition, there is debate about this. A few studies have recently been published that throw some doubt into the mix about the role of sodium in blood pressure regulation.

One such study by NutriNet-Santé found that sodium intake alone was not related to an increase in blood pressure, but rather found that the ratio of sodium intake to potassium intake was a much stronger predictor. Potassium is known as a helpful regulator of high blood pressure and foods high in potassium (like fruits and vegetables) are commonly promoted in diets recommended to lower blood pressure. Interestingly, I’ve been having a heck of a time meeting my potassium goals on this diet. More fruit! More vegetables!

There have been other studies that have suggested a notion of “salt responders” – people whose blood pressure is affected by their sodium intakes vs. others whose is not.

More research to come I hope! But overall, that’s a quick look at why we watch sodium as a contributor in the realm of promoting strong, healthy, not overworked hearts. Come back soon for ideas on how to cut sodium without sacrificing flavor (and joy)!


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Yesterday I completed my first week of the Heart Healthy diet, which also means I’m off the meal plan today (yay!). Overall, I’m not finding this way of eating too difficult, though the meal plan certainly could have added more sodium-free and low saturated fat flavoring methods to certain dishes to reduce their blah factor (here’s lookin’ at you, plain cooked pearled barley). For the most part, this is the way I typically eat, though I am a big salt lover (more posts on that to come). There have been a couple of notable differences:

I’ve definitely upped my fish intake, which is a great healthful change. My fiber intake has also increased,  and my digestive system took note, veered off of the approved course, made adjustments, and returned to the regularly scheduled program. Fear not – we are back on track.

I’m looking forward to doing Heart Healthy on my own for the next two weeks and experimenting with sodium-free ways to flavor things. Check out the table below to see how my last week went.

  Heart Healthy Goal Week #1 Week #2 Week #3
# of days nutrition recommendations met 7 6    
Average calorie intake <2000 1831    
Average sodium intake <2400 mg 2064 mg    
Average saturated fat intake <12 g 10.2 g    
Weight change   -1 lb    
Blood pressure change   -5/-6 mmHg    
Waist change   -.75″    
Grocery Budget Change   +75%  

 

Now on to the next week! Check out this tiny pile of groceries to go with all my meal plan leftovers!

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Alright, here goes a new post (some might call it a rant) about my feelings on meal plans. I gotta tell ya, I love to hate ’em. Making them, selecting them, and most of all, following them. They are stinky, like fish. That will make more sense in a few paragraphs. Promise.

Why are they stinky, you ask? Well I would be more than happy to tell you.

The food we eat is connected to everything in our lives. Everything. Your budget, your spouse (or lack of spouse), your kids (and their preferences, allergies, and appetites), your schedule, your culture, and your mood all play in to the food you choose to eat. That being said, someone would have to thoroughly understand all of those things about you in order to select foods that are good options for a meal plan for you. Now, how many meal plan makers know you that well?

Take the meal plan I’m currently on, for example. The meal plan ingredients increased my grocery budget by 75%! Typically I use dinner leftovers for lunches, but this meal plan uses NO leftovers for ANYTHING. You know what that gets you (besides an expensive grocery trip)? A fridge full of leftovers waiting to go bad. It also leaves you cooking two meals every night – dinner and tomorrow’s lunch. Not sustainable, functional, or enjoyable.

My final gripe about following meal plans made by others? Sometimes I just don’t like the food. Like, for example, coleslaw. I’m not a huge fan, but it’s on the meal plan, because the person who made it didn’t know me and my lack of appreciation for coleslaw. So here I am, either eating coleslaw or feeling as though I somehow “failed” my meal plan because I didn’t like it.

And you know what else (yes, I lied about the final gripe part)? As a dietitian, my goal is to empower my patients to live a healthy life they love. Now even if I gave them the perfect meal plan that worked great for their lifestyle, are they empowered? What will they do when the week-long meal plan is over? Will they just eat the same food week after week forever?

Of course not.

Remember the old saying, “Give a man a fish and feed him for a day, but teach a man to fish and feed him for the rest of his life”? Well, a meal plan is a fish.

I can give someone a meal plan fish and they can meet their nutritional goals for a week (if they can manage to stick with a meal plan someone else made), or I can teach someone how to plan for themselves and meet their health and quality of life goals. Truly, they are the only ones who know themselves well enough to do it. It’s not easy and it’s awkward at first, but once they get the hang of it they are empowered. They can eat for life – on a budget and with foods they love! And that is why I love what I do!

And why I hate stinky meal plan fish. End rant.


Want a hint? It doesn’t look like this:

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Okay, here comes my first video! Editing is bad and trying to find a better video editor put me a day late (and still didn’t fix it), but I’ll get better!

Want to learn more about carbohydrates? Check out my post here.

Need some ideas of foods high in protein? Here ya go.

Photo from www.nutrientsreview.com.


Recipe feature time! By far my husband’s favorite recipe from the Heart Healthy meal plan so far, these tasty sandwiches hail from a recipe from Eating Well. My husband said even other firefighters at work were enviously ogling this veggie-laden sammich.

 

Vietnamese Steak Sandwich

Image from www.eatingwell.com – I forgot to take a pretty picture of my sandwich and I only have a picture of it wrapped in saran wrap straight from my lunch box. Sad.

 

The sandwiches are pretty high in sodium (likely one reason they are so delectable), so I was a little surprised to see them on the Heart Healthy meal plan, though the plan did keep me low enough for the rest of the day to keep me under my daily sodium recommendation of 2400 mg per day.

Heart-Healthy Tip: Use half the fish sauce and replace it with apple cider vinegar in the marinade to cut the sodium by 353 mg per serving.

The meat is flavorful and tender, the veggies are crisp and zesty. Give ’em a try – the full recipe is here!

One sandwich has 373 calories, 9 g fat, 8 g fiber, 858 mg sodium (505 mg with the heart-healthy modification), and 2 g saturated fat.


I know you are all just absolutely dying to know how I’ve been eating (note the heavy sarcasm font), so I thought I’d grace you with some sneak peeks of my heart healthy meals/snacks and the list of recommendations I’ll be following for the next 3 weeks.

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Two days in to my Heart Healthy meal plan, my meals have been mostly enjoyable. My least favorites have been breakfast – too boring, too carby, and too lacking in protein. I’m starving by lunch, even with my morning snack. I have discovered two delicious recipes pictured above (Vietnamese Steak Sandwich, top left, and warm quinoa salad with edamame, bottom right) that I’ll be sharing with you soon!

You can find the full page of recommendations from the American Heart Association here, but the quick gist is paraphrased below:

  • Use up at least as many calories as you take in (I’m aiming to hit the activity recommendations of 150 minutes of physical activity per week).
  • Eat a variety of foods from all the food groups.
  • Eat fresh, frozen, or canned vegetables and fruits without added sauces, salt, or sugars.
  • Choose fiber-rich whole grains for most grain servings.
  • Eat a variety of fish at least twice a week.
  • Eat poultry and fish without the skin. If you eat meat, choose the leanest cuts and prepare them without added saturated or trans fats.
  • Select fat-free and 1% dairy products.
  • Avoid foods containing partially hydrogenated vegetable oils.
  • Reduce saturated fat to no more than 5-6 percent of total calories (in my case, 10-12 grams per day).
  • Cut back on foods and beverages with added sugars.
  • Choose foods with less sodium and prepare foods with little or no salt. To lower blood pressure, eat less than 2400 mg sodium per day. Reducing even farther to 1500 mg per day may have an even greater effect on blood pressure.
  • Drink alcohol in moderation. For women, limit to one drink per day and for men, two. And yes, those drinks have standard serving sizes.

As with any diet recommendations these guidelines have been a subject of hot debate in nutrition, but that’s a topic for another day.

Now here’s your turn to help me out: pretend you have just had a heart attack (I know, scary – but the good news? You made it!) and you are presented with the recommendations above to lower your risk of it happening again. What are your initial thoughts? Overwhelming? Easy? What the heck does any of that mean? I want to hear it.

If you had to follow these recommendations, what would your questions be? What would you want from your dietitian to make you feel confident in taking care of your heart? Commence to comment in 3, 2, 1…

 


Welcome back – to you, reader, and to me. The absence has been long and so full of change and craziness. My life changes include a journey from being a bachelorette and part-time RD living in a travel trailer in my brother’s front yard to being a full-time RD and full-time wife with 2 stepkids. The transition made keeping up the blog just a lee-tle unrealistic, so it had to take a back-burner for a time, but I’m ready to get back into learning more about what my patients face when they make a commitment to improve health, prevent and manage chronic conditions, and change their lives.

I’ll be honest – at first I was intimidated about trying to follow a diet with a family in tow:

Will I have to make separate food for myself? What if my family doesn’t like any of the food? Will it be too expensive to feed everyone on these diets? Ehh….I don’t think doing that blog really makes sense with a family.”

Satisfied with my very justified self-care decision, I went about my life but something kept nagging at me until I let it hit me – my patients have families. My patients have picky kids (and spouses). They don’t get the luxury of saying “Ehh…that’s not important right now.” They have to choose – figure out a way to take care of yourself with a family or simply don’t take care of yourself.

My hypocrisy got the better of me. So will I be eating separate things from my family? Sometimes. Will they dislike some of the food? Probably. But we’re going on this journey because that’s being healthy in real life – challenges and all.

So this time I’m back. For real. I promise.

And to assure you of my commitment, I grocery shopped for my next diet today. The diet I have chosen to use as I re-start is….

The Heart Healthy Diet recommended by the American Heart Association! The spoils of my venture are shown below:

Note that the pile is MUCH bigger than when I was cooking just for me - and this doesn't even include some extras I bought for the fam.

Note that the pile is MUCH bigger than when I was cooking just for me – and this doesn’t even include some extras I bought for the fam.

 

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Or the meat. Doesn’t that seem like a lot of meat? And yes, I smooshed a salmon burger on the way home. Sad.

The meal plan I’m using is courtesy of EatingWell.com and can be found here.

Stay tuned for more information on what the Heart Healthy Diet is and how it’s going for me!