I Love Chick-fil-A

Admittedly, you won't see me ogling over fast food restaurants very often on this blog, but Chick-fil-A is an exception in almost every way! First of all, let me share with you some of the non-nutrition reason why I love Chick-fil-A.....

• They have a play-land area in nearly every restaurant that is clean and fun
• They have Purell wipes available at the exit of the play-land
• They have "sticker" place-mats available that stick to the table for your kids
• The employees are ALWAYS friendly, courteous and helpful
• There is always an employee circling the dining area asking if your drink needs to be refilled, how is your meal, etc. Name one other fast food restaurant that does that!
• They are closed on Sundays -- I'm a fan of that! Let the employees spend that day with their families, going to church, etc.

Now for the purpose of this blog.... Here are the Nutrition Reasons why I love Chick-fil-A:

• They have a Nutrition Guide available in the dining area
• Their website is fabulous, full of nutrition information that is easy to find. They even have a "meal calculator" where you can punch in the food you are planning on eating/did eat and it calculates the nutrition information for you!
• Here are some great meal options that are 300 calories or less: Chargrilled Chicken Sandwich (300), Nuggets 8-count (270), Chargrilled Chicken Garden Salad (180), Southwest Chargrilled Chicken Salad (240), Chargrilled Chicken and Fruit Salad (230).
• For Breakfast, try the 3-count chick-n-minis (260) or the Sunflower Multigrain Bagel (220).
• If you want something other than water, try the Diet Lemonade. It's only 15 calories. It's made from scratch daily using only water, freshly squeezed lemon juice and Splenda. Other low-calorie/calorie-free options are Unsweetened Iced Tea or Diet Coke.
• Chances are, you'll be full after all this yummy food, but if you want dessert, try the Icedream small cone (170 calories).
• If you do decide to get the nuggets, I suggest trying the Buffalo Sauce. It's delicious and only 10 calories!

Milk: Should you buy Organic?

I've had several friends ask me recently whether or not they should buy organic milk; is it worth the money? Well, here's the thing...... there is no right or wrong answer, in my opinion. It's simply a personal choice. If you have a little wiggle room in your food budget and you feel more comfortable buying organic milk because of what you've heard/read about hormones, then go ahead and do it. I know some people who buy organic milk for the girls in their family and regular milk for the boys. That's what works for them.

But, the follow-up question to whether or not I think THEY should buy organic milk always seems to be: Well, what do you buy? Here's the thing. I do buy some organic foods. I guy organic carrots and apples, for example. The cost difference is minimal and you eat the skin of those foods (well, you peel carrots, but still). But I don't buy organic milk. Why? Because I went to a conference a couple years ago and the speaker was talking about how the reason why most people buy organic milk is to avoid the hormones. He went on to say that milk comes from cows. Cows are animals and therefore, have hormones. If you drink milk, organic or not, you will get some hormones. And multiple studies have shown that the rBGH that is given to cows results in "no significant difference between milk from cows treated with rBGH and untreated cows" (source FDA). HOWEVER, I FOUND THE BEST OF BOTH WORLDS!!!!!! When I was at Whole Foods recently, I was thrilled to find that their milk was only $2.99 a gallon (nearly $1.00 cheaper than the milk at my local grocery store) AND their NON-ORGANIC milk states on the label that this is "Milk from cows not treated with rBGH." So, hey, if you want to pay non-organic prices, but still want milk from cown not treated with rBGH...... head on over to Whole Foods and buy the 365 Everyday Value brand of Milk!

PCOS Diet

Question: I was diagnosed with PCOS, so I have been trying to follow a low carb, high protein diet as my understanding is that the diet is similar to a diabetic diet. However, lately meat has been making me nauseous and I find myself gravitating back to carbs and noticing a difference in my PCOS symptoms. Any suggestions?

Answer: You are correct in that PCOS, Polycystic Ovarian Syndrome, is treated, in terms of nutrition, similar to diabetes because, like diabetes, it is an endocrine disorder associated with hyperinsulinemia and insulin resistance. Further, PCOS markedly increases the risk of developing type 2 diabetes. However, it is important to note that a diabetic diet is not a low-carb diet. A diabetic diet is a consistent-carb diet. There is a big difference. Our bodies, regardless of whether or not we have diabetes, are designed to use carbohydrate as our main fuel source, so even most diabetics, are still prescribed a diet with ~50% of calories from carbohydrate. The difference is that those carbohydrates should be evenly spaced with approximately the same carbohydrate eaten at approximately the same time each day. For most women, this will mean approximately 3 "carb choices" (or 45 grams of carbohydrate as 1 carb choice = 15 grams of Total Carbohydrate) at each meal with snacks being equivalent to 1-2 carb choices (15-30 grams of carbohydrate) per day.

Having said that, carbohydrate does promote insulin secretion, so high-carb diets should be avoided. The diets I see most commonly prescribed for PCOS are ~45-50% complex carbs with ~20% protein and ~30% fat (from mostly unsaturated fat sources). So, it is okay to have carbs in your diet as long as they are mostly complex carbs and are moderately and consistently spaced throughout the day. Further, if meat is making you feel sick, focus on non-meat protein sources such as reduced-fat cheese, eggs or egg-substitute (Egg Beaters, etc), nuts, beans, etc.

As a side note, several diabetic medications have been found to be helpful in individuals with PCOS. Metformin, for instance, has been found to help with insulin regulation of glucose, improve ovulation activity and lower the incidence of miscarriage.

As a resource, you may want to check out pcosupport.org which is full of useful information.

Good Luck!

If you have a question, please email me at mypersonaldietitian@gmail.com

A Cure for Diabetes?

Well, this is about as close as you're going to come. And I wouldn't call it a cure. But, I have been working with gastric bypass patients for the past 2 years and have seen many Type 2 diabetics have "resolution" of their diabetes following gastric surgery. In other words, they still have diabetes, but may come completely off their diabetic medications and manage their diabetes with nothing more than healthy lifestyle choices.

What is gastric bypass? Well, when most people say "gastric bypass," they are referring to Roux-en-Y, the picture shown here. However, there are currently several gastric surgeries available. At our facility, we offer four different procedures: the Roux-en-Y Gastric Bypass (RYGB), the Adjustable Gastric Band (AGB), the Vertical Sleeve and the Duodenal Switch. The Duodenal Switch, according to a 2004 study, had nearly a 99% remission rate of diabetes. However, this is the most drastic/invasive of all the procedures and is not done nearly as often as the other three. The most common of the four in the United States is the RYGB and, although the "remission rates" vary from study to study, overall, the numbers are approximately 90% of Type 2 diabetics (Type 1 diabetic are not similarly affected) will come off their medications entirely after surgery. And although, it may take up to 2 years for this to happen, many come off their medications within a few days or weeks of surgery. Although we do not know exactly why, the surgery in and of itself can lead to a resolution of hypo/hyperglycemia.

While nearly 50% of AGB patients may also have a "remission" of their diabetes, the remission seems to be directly related to the weight loss itself, and therefore the remission is not immediate like it often is with RYGB.

If you have diabetes and are interested in gastric surgery, the American Diabetes Association currently recommends considering bariatric surgery if 1) you have Type 2 diabetes and 2) have a Body Mass Index (BMI) of at least 35.

Making a List and Checking it Twice....

Question: I know fast food isn't good for me, but I just don't have time to cook! I work full time and I'm tired when I get home, so I feel like I have to choose between fast food or cold cereal. And cold cereal gets really old really quick? Any ideas?

Answer: Two words for you: PLAN AHEAD!!! This is truly the key to eating healthy. We all lead busy, crazy lives. I have a 1 year old, a 3 year old and a job. I know the meaning of the word "busy!" But, we have dinner at home at the dinner table most nights of the week. Believe me - it's not that I have any more energy or time than you do, it's simply because I do one thing: Plan ahead. Where I live, the ads come on Thursdays. I save the ads because what is on sale will play a role in what we will have for dinner the following week. I sit down on Saturday morning and come up with meals for the week. Looking at items on sale will give me ideas of things to make and I will also look on-line, in recipe books or in my recipe file. I then write down every day of the week and put a meal next to it. I know making dinner 7 nights a week may seem daunting or unrealistic. And I agree. We usually have at least 2 nights a week that we deem as "fend" nights where we eat leftovers from the previous meals. And if you eat out one night a week, that's okay.... as long as the other 6 are at home. So, that really only leaves ~4 meals a week you actually need to prepare. Now, that's doable! Especially if you use your crock pot (check out http://www.crockpot365.blogspot.com/ for ideas), 30-minute recipe ideas and other short-cuts. I make my grocery list as I write down our dinner meals and then I add some staple items of thing we eat for breakfast and lunch (cereal, milk, fruit, bread, etc.) And whala! The grocery list is complete! I go to the grocery store with one rule: Buy ONLY what is on my list! This will save you both time and money. Now, every night, you know ahead of time what's for dinner. Start it in the crock pot before you leave for work. If you live with someone, have an agreement that whoever gets home from work first starts dinner. If you know in advance that you're going to get home late, have that be a fend night.

So, plan ahead! And then enjoy a home-cooked meal nearly every night. Your wallet and your waist-line will thank you!