Category Archives: volumetrics

motivated by money

I talked a little bit about what I’ll be doing as a renal dietitian, but I didn’t mention that I am responsible for improving very poor lab values in my patients. In dialysis, dietitians most closely monitor albumin, potassium, phosphorus, calcium, and parathyroid hormone (PTH). And most importantly, low albumin levels correlate with increased risk of mortality and morbidity. Not good. I walked into a rather bleak situation and it’s 100% on me to turn this around. Pressssure!!

Because everyone loves “free” money and winning, I created a little competition for our patients. Every month, after labs are drawn, patients can earn chances to win Kroger gift cards that they can use on medications, food, or gas. Patients get 1 entry for every criteria they meet: albumin within range, potassium within range, phosphorus within range, and NO missed treatments. If they are able to meet all 4 criteria, they get 2 extra entries.

And in order to increase long-term compliance with medications and diet, this competition will be on going each month, with 4 winners each month. I hope it works! Or at least helps 🙂

I’ve also requested the clinic to purchase protein supplements for our patients who need the added nutrition. Most of the malnourished patients find protein supplements to either be too expensive or not palatable. And because of strict potassium, phosphorus, and fluid restrictions, not just any protein supplement is appropriate. After doing some research and speaking with drug reps, I chose LiquaCel for my patients. This is a product previously unfamiliar to me, but it is gaining popularity quickly among the protein malnourished populations. After tasting samples I can confirm that this stuff is DELICIOUS! And just 1 ounce provides 16 grams of protein — perfect!

Quesiton: What’s the last challenging situation you were in at school, work, or otherwise? Do you like to be challenged or does it push you out of your comfort zone?

I have to admit, I’m a bit out of my comfort zone on this one. Especially since I have to stand before a committee next Wednesday and give evidence as to what steps I’m taking in order to remedy our patient’s poor nutrition statuses. 😦

Or on a lighter note…anything fun planned for the weekend?? 😀

I am meeting Gina tonight for dinner and drinks! We got together back in June, and I’ve been anxious to hangout again! And now that we’re in Columbus for good, that will be much more doable 😉 We both have new jobs and I’m sure we’ll gab on and on about dietetics…especially since we’re leaving the guys at home! 😉

TGIF,

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Filed under dialysis & kidney disease, dietitians, dining out, friends, protein, supplements, volumetrics, water, work

Happy National Registered Dietitian Day!

Happy National Registered Dietitian Day to all my fellow RD’s and bloggers…!!!

Gina of Candid RD
Estela of Weekly Bite
Melinda of Nutrition, Food, Travel, and More
Rebecca of Chow and Chatter
Kristen of Eating RD
Kristen of Swanky Dietitian
Nour of Practical Nutrition
Georgie of Ask Georgie
Nicole of Nicole Geurin, RD
Anthony of From a Dietitian’s Perspective

I hope I’m not missing anyone! RD’s, chime in! Happy RD Day to you, too!

This is my 2nd National RD Day as I became a dietitian last March! March 8th to be exact! I passed the RD exam just in time to celebrate last year! Dietitians are the registered (and licensed in most states) professionals in diet and nutrition. I urge you to check out the above bloggers and learn lots from them just like I do! Nutrition is a forever evolving field and we are constantly learning together. If you saw my post from Monday on “real food” you know there are some extremists out there who have no credentialing to back up their claims. As wonderful as the Blogosphere is, always be weary and cautious of any off-the-wall posts or ideas. Anyone can be a blogger, but not everyone is a Registered Dietitian! 😀

If you ever think of a nutrition-related question, send it on over to PreventionRD@gmail.com. My weekly Q&A’s help give accurate and helpful nutrition information to topics YOU want to know more about! Never hesitate to ask! 😉

So, Happy RD Day to all the dietitians out there! Cheers to a wonderful and rewarding career committed to making people healthier and happier one bite at a time!

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I must also update you on my garden! This past weekend I planted all my seedlings in starter kits (which are toasty under our bed).

…And painted my garden….WHITE. I was going for red, but the fencing to keep Miss Lily out only came in white. And I can’t have an un-stylish, mismatched garden!!! I’m really happy with the final product!

Total Cost: $343 (ahhh!)

I purchased a large planter and soil for basil after a recommendation from a reader to keep the basil out of direct sunglight some of the day. I feared the Oklahoma heat would just smolder the basil and I need basil to support my love of pesto which is currently costing a small fortune to buy in stores! I also picked up paint, fencing, and steaks to make where my vegetables are growing.

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Today’s NNM Topic: Hypertension

Stoke is the 3rd leading cause of death and is often exacerbated by the “silent killer”: hypertension (high blood pressure). Blood pressure refers to the force of blood agansty artery walls. Over time, too much force on the arteries can cause hardening of the arteries.

There are a lot of ways to control high blood pressure through diet and lifestyle changes, including:

Limiting sodium in the diet to 1,500 milligrams a day (2,300 milligrams in non-hypertensive individuals)
Smoking cessation
Exercise
Stress management
Potassium, magnesium, and calcium
Eating a high-fiber diet containing lots of fruits and vegetables
Reduce cholesterol, trans fat, and saturated fat intake
Reduce red meat intake
Limit simple sugars and sweets

Hi from Lily!!!

Happy RD Day to those celebrating! And Happy Hump Day to everyone!

Q&A on Friday — send in those questions! 😀

Be well,

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Filed under American Dietetic Association, blog, cholesterol, diet, dietitians, exercise, fiber, fruits and vegetables, garden, heart health, hypertension, minerals, National Nutrition Month, pets, physical activity, saturated fat, sodium, stress, trans fat, volumetrics

Diabetes + Vegan

It was news to me that positive results from vegan diets are being seen among the diabetic populations. For those that aren’t familiar with veganism, it is a diet and lifestyle that seeks to exclude the use of animals for food, clothing, or any other purpose. Therefore, vegans consume no animals or animal products including eggs and milk.
Traditionally, the cornerstone of type 2 diabetes treatment is diet, as many type 2’s do not require oral hypoglycemic agents or the use of insulin. Diet modifications include the use of portion control through measuring foods and counting carbohydrates which fuel blood glucose so readily, and thus, are of particular interest. A new approach to diabetic diets includes the adopted lifestyle of veganism which evolved from a comparison of world populations. People whose diets consist of plant-derived foods such as rice, noodles, beans, and vegetables were less likely to develop diabetes when compared with a traditional Western diet which is high in meatier, fattier dishes [1]. Likewise, when Easterners (i.e. Japanese) move to and adopt the Western diet, their relative risk of diabetes goes up.
Studies show that the adoption of a low-fat, plant-derived diet improves insulin sensitivity, helps with weight loss, and reduces both blood sugar and blood cholesterol. Specifically, such diets are extremely low (many times void) of saturated fat which is traditionally found in meat, dairy, and tropical oils (coconut, palm, and kernel). In order to effectively remove fat from the diet, one much reduce consumption of animal fats and also reduce the use of vegetable oils [1].
In order to eat in accordance with this recommended regimen one must [1]:
– avoid red meat
– avoid poultry and fish
– avoid dairy
– avoid eggs
– avoid added vegetable oils and other high-fat foods
– avoid fried foods
– avoid avocados, olives, and peanut butter
Next, glycemic index is addressed. The glycemic index is a number identifying foods which increase blood glucose rapidly. High glycemic foods include: sugar, white potatoes, most wheat flour products, and most cold cereals. Good news: pasta is actually a low glycemic index food because of the way it’s processed!
High fiber foods are encouraged and the recommended daily intake for fiber is 40 grams. Recommended sources of fiber include beans, vegetables, fruits, and whole grains (barley, oats, quinoa, millet, whole wheat pasta, etc.). On labels, aim for foods containing at least 3 grams of fiber and for meals containing at least 10 grams of fiber [1].
And this is new to me….VOLUMETRICS. If the grams in a portion are greater than the number of calories in the portion, it is said to be a “heavier” food which is low in calories. Such foods can increase satiety and decrease overall caloric intake. This concept was developed by Barbara Rolls, a researcher at Penn State University. Foods that are volumetric-friendly include: soups, salads, and foods cooked in water (i.e. oatmeal) [1].
Worried about protein?
Plant foods contain protein. According to this research, post-menopausal women require 10% of their calories from protein. Most vegetables contain this amount or more. Beans, lentils, spinach, broccoli, asparagus, and mushrooms are high in protein.
Worried about calcium?
Plant-based diets actually reduce one’s calcium requirements. A vegan diet requires less calcium intake to maintain calcium balance. Good sources of calcium include: broccoli, kale, collards, mustard greens, beans, figs, fortified orange juice, fortified cereal, and fortified, nonfat soy or rice milks.
Worried about B12?
B12, traditionally found in meat, can become depleted in those following vegetarian and vegan diets for longer than 3 years. A B12 supplement of 5 mcg per day is recommended. Most commonly found multi-vitamin supplements will provide this amount.
Show me the RESEARCH!
So, can a vegan diet REVERSE type 2 diabetes? Prior to the below mentioned study, no vegan diet study using a comparison group had been performed. A grant provided to Physicians Committee for Responsible Medicine by the Diabetes Action and Research Education Foundation allowed the control-case research to be completed. A high-fiber, low-fat, vegan diet was compared to the standard American Diabetes Association (ADA) diet (think “carb counting”). Non-insulin dependent diabetic (type 2’s) were invited to follow one of the two diets for three months. Caterers prepared take-home lunches and dinners so the food could easily be heated and consumed in the home [2].
The vegan meals contained 10% fat, 60-70 grams of fiber, 80% complex carbohydrates, and no cholesterol. The ADA diet contained 30% fat, 50% carbohydrate, 30 grams of fiber, and 200 milligrams of cholesterol per day [2].
The results showed that the vegan group decreased their fasting sugars by 59% when compared with the ADA group. The vegan group also required less diabetic medication than prior to the start of the study while the ADA group required the same dosing. Likewise, the ADA group lost 8 lbs and the vegan group lost 16 lbs [2].
[1]. The Vegan Diet How-To Guide. Physicians Committee for Responsible Medicine.
[2]. Nicholson, Andrew. Diabetes: Can a Vegan Diet Reverse Diabetes? Physicians Committee for Responsible Medicine. February 15, 2005.

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Filed under blood glucose, diabetes, diet, fiber, fruits and vegetables, glycemic index, heart health, reduced-calorie, research study, vegan, volumetrics