Nutrition Tip of the Week

January 28th, 2015 by admin

Author: Heather K. Mackie, MS, RD, LD

Week of January 26, 2015

Vitamin D2 vs. Vitamin D3

As high as 60-80% of patients pursuing weight loss surgery (WLS) experience a vitamin D deficiency prior to their surgery.  After surgery, the rate of deficiency is not much better with some studies reporting rates as high as 50% of post-op bariatric patients experiencing a vitamin D deficiency, even though they are taking a multivitamin!

Why Does this Matter? Vitamin D deficiency makes it harder for the body to absorb and utilize calcium appropriately.  It may also lead to leg muscle pain and soreness.  Some patients report an improved mood after getting their vitamin D levels normalized as well.

Testing Vitamin D Status. There are many different protocols when it comes to treating vitamin D deficiency.  The most important thing is to get your blood work done, including what is called 25-hydroxyvitamin D to test your vitamin D levels.  If low, your physician should be working with you to increase your levels and optimize your nutritional status.  Part of this process is getting your lab levels checked again.  Some physicians will do this as quickly as six to eight weeks after starting treatment, while others may re-test 25-hydroxyvitamin D in 2-3 months after starting treatment.  Either way, make sure you go back and get your levels re-tested to see how your treatment plan is working or if it needs to be altered.

This test examines the total amount of vitamin D in the body coming from all sources (food, supplements, and the sun).  Low levels of 25-hydroxyvitamin D cause secondary hyperparathyroidism (high levels of parathyroid hormone or PTH).  The reason this is important is because when PTH levels are elevated, it means an individual is losing calcium from their bones and puts them at greater risk for bone loss and/or osteoporosis.

When to Test? It is important to get your blood work done any time your physician says to, but there is also a general recommendation when it comes to the sunlight vitamin (vitamin D).  Ideally, this test should be offered from the beginning of the fall through winter (September through March) when vitamin D blood levels are at their lowest.  Testing in spring and summer months (unless warranted because of your WLS), can give a false sense of security.  Typically, this test is performed fasted at the same time as your cholesterol panel for the general population and only done once per year, however many bariatric patients need more frequent testing.  Fasting is not necessary for vitamin D testing, but it is easier to combine multiple tests and you do have to be fasted for your cholesterol panel.

What is Considered a Normal Level? The normal blood level of 25-hydroxyvitamin D has altered over the years to prevent PTH from being abnormally elevated.  All labs may vary slightly on what they consider normal, but in general it is recommended that 25-hydroxyvitamin D be above 32 ng/ml.  Some healthcare professionals recommend trying to achieve levels between 40-60 ng/ml for optimal health status.  Talk to your healthcare provider about what your normal should be and where you are currently at with your 25-hydroxyvitamin D level.

The Difference Between Vitamin D2 and Vitamin D3. There are two types of supplements when it comes to treating vitamin D deficiency or preventing a deficiency.  Vitamin D2 is also known as ergocalciferol and vitamin D3, is also known as cholecalciferol.  There are several reasons vitamin D3 is superior to vitamin D2 and a few of these are included below:

  • The light from the sun strikes the skin, causing humans to synthesize vitamin D3.  Therefore, it is thought that vitamin D3 is more natural than vitamin D2 since humans do not make D2.
  • Most healthy fish contain vitamin D3.
  • Vitamin D3 could be less toxic than vitamin D2 because higher concentrations of D2 circulate in the blood when consumed when compared directly to vitamin D3, meaning it has a shorter half-life.  Vitamin D2 does not bind as well to the receptors in human tissues when compared to vitamin D3.
  • Vitamin D3 is the more potent form of vitamin D, which has its own potential benefit.  For example, obesity lowers blood levels of vitamin D, so a more potent form is necessary to increase blood levels.
  • Vitamin D3 is more shelf stable when compared to vitamin D2 and is more likely to remain active for a longer period of time when exposed to different conditions, such as temperature, humidity, and storage.  This might explain why the amount of vitamin D2 in some fortified food products have significantly lower amounts of vitamin D than that listed or advertised on the label.
  • Your body must convert both vitamin D2 and vitamin D3 to a more active form and vitamin D3 is converted 500 percent faster than vitamin D2.
  • Vitamin D3 is more effective at elevating and maintaining the 25-hydroxyvitamin D blood test.

What is Vitamin D2? Vitamin D2 is actually a fungus/yeast-derived product and was first produced in the early 1920s by exposing foods to ultraviolet light.  This process was patented and licensed to pharmaceutical companies.  Currently, there are many major prescription forms of vitamin D and they are actually utilizing vitamin D2, not vitamin D3.

Vitamin D2 is synthetically made from radiating ergosterol (a compound) from the mold ergot.

What is Vitamin D3? Vitamin D3 is commercially and synthetically made in a similar way that it is produced in the human body when skin is exposed to the sunlight.  Wool sources of 7-dehyrdocholesterol are used (from cholesterol) and irradiated to form active vitamin D3.

Interesting Fact Further Separating the Two Types of Vitamin D. One recent study reviewed the mortality rates (i.e., death rates) for those who supplemented their food intake with vitamin D2 versus those who used vitamin D3 instead and reported that those who used vitamin D3 had a six percent relative risk reduction when compared to only a two percent relative risk reduction for those who used vitamin D2.

The overwhelming message should be that it is important to achieve normal blood levels of vitamin D and to work with your healthcare provider to ensure your success in doing so, whether they prefer to use vitamin D2 or vitamin D3.  Unfortunately, in the United States, we cannot get prescription vitamin D3 like you can in some other countries and that is why many physicians are still prescribing vitamin D2.  However, there are plenty of over-the-counter options when it comes to vitamin D3 including one from your friends at Celebrate Vitamins!  The even bigger message is to get your blood work done, know where you stand, and work with your healthcare provider to get all levels within normal limits so you can truly CELEBRATE your success!

Nutrition Tip of the Week

December 29th, 2014 by hmackie

Author: Heather K. Mackie, MS, RD, LD

Week of December 29, 2014

Setting a SMART New Year’s Resolution

It is that time of year again where everyone starts thinking about a New Year’s Resolution.  Regardless of your opinion about New Year’s Resolutions or if you plan to set a New Year’s Resolution, we can all agree that setting one is somewhat similar to goal setting.  When it comes to your health and wellness, goal setting is quite instrumental to long-term success.  Let’s take a look at how you can set goals in a healthy manner, as well as help yourself achieve success.

Goal setting is extremely important when done correctly for long-term weight loss and maintenance.  Often when we set goals, they are too broad and that is a big reason we do not reach the goal.  Many professionals recommend using the following mnemonic when discussing setting goals: SMART.

  • S = Specific.
  • M = Measurable.
  • A = Attainable.
  • R = Relevant.
  • T = Time-Bound.

For example, if we specifically look at the goal: “I want to lose weight this year” and then apply the SMART principle, we would:

  • S = Specify the amount of weight loss desired.
  • M = Determine what and how you are going to track and measure (i.e., weigh weekly and record starting and end weight).
  • A = Make sure it is an attainable goal when setting the specific amount and timeframe.
  • R = Is losing weight relevant to your overall goals?
  • T = What is the time frame specifically (i.e., how much weight in what time frame)?

So a better goal would be to say: “I want to lose fifteen pounds in four months by increasing my physical activity and taking my lunch to work instead of eating out so I can be healthier and reduce my risk of chronic disease.”

Prepare yourself mentally for the goal ahead by keeping everything in perspective and break down your goal into mini goals to ensure you reach your overall goal.  For example, instead of just saying, “Be more physically active” it would be better to set a goal of exercise three days per week to start with at least twenty minutes per session.  Then as you reach that goal, you may want to increase the time and/or frequency.  Specify the activity you are going to do, how you will track it, and how to overcome any potential barriers.  For example, if the plan is to walk outside, come up with a plan for a rainy day, such as walking in the mall, find a friend that might let you borrow a treadmill, or purchasing one.

Be prepared to adjust the goal if necessary.  For example, if you slip on ice outside and sprain your ankle, you will not be able to walk outside.  Adjusting your goal might include exercises in the pool that do not aggravate your ankle.  You may need to also adjust the time frame and extend it in order to meet your goal of losing fifteen pounds in four months.

Setbacks. Setbacks are going to happen and these can be lessons to learn from so we do better the next time.  When setbacks occur, identify the barrier and brainstorm ideas to overcome that barrier next time.  Do not let yourself get down about the setback.

Consider sharing your goals with others.  It is important to tell those who support you about your goal(s) as they might be able to help motivate you when you are feeling like you are falling off course from your plan.  For example if it is a rough week or you want to spend time with a good friend, maybe they will consider walking with you one evening in order to meet your goal of walking three times per week rather than meeting for dinner.

Positiveness is Powerful. Positiveness is quite important when trying to change your lifestyle.  Avoid negative thinking and making negative statements and try to focus on the changes you are currently making even if you feel you are not doing everything perfect all the time.  Remember, moderation and positive thinking are the keys to your path to success.

Relapse and Restarting. Once you meet your goal, congratulations are in order!  However, it is important to go ahead and talk about relapse and maintenance as that is one of the hardest parts of staying on the path to success.  Whatever your goal weight is, it is important to set a plus and minus of five pounds to this goal.  This way you know if you are five pounds above your goal, then you know it is time to restart the program.  We all know it is a lot easier to lose five pounds rather than waiting until you have to lose thirty pounds.  Some people just need to start tracking a little better to keep themselves accountable, while others need to return to their healthcare professional.  Both are perfectly fine methods of reaching and maintaining your goals, but it is important to know what works for you and to go ahead and start thinking about that in the beginning.

So as we venture into the adventures that lie ahead in 2015, think about what your goal(s) are going to be and how you can be SMART and ensure you success so we continue CELEBRATING that success!

Nutrition Tip of the Week

November 19th, 2014 by admin

Author: Nadea S. Minet, MS, RDN, LD

Week of November 17, 2014

Food Journaling: Is it For Me?

When it comes to remembering what I have personally eaten, I tend have a pretty discerning memory.  I could tell you exactly what I ate at each meal; but what I probably would not remember is snacking on a few handfuls of mixed nuts while watching The Mysteries of Laura.  So, needless to say, accountability is a huge part of successful weight loss.

This is where a food journal can come in handy and be extremely helpful!  A study from the American Journal of Preventative Medicine found that the more food records people kept, the more weight they lost.  Most people are not really aware of what they are eating until they actually write it down and most people are shocked at how much they are consuming, once they have looked at it.  Journaling drastically increases awareness, which can help you immensely on your weight loss journey.  It can also keep you focused, provide that much needed motivation, and help you maintain and keep your personal goals.

Keeping a food journal is not always about weight loss or maintenance, but it is about knowing where you have the opportunity to improve your health.  Here are some tips to get you started on your way to deciding if journaling is right for you:

Choose a Journal.  There are many, many ways to keep a food journal and there are many options to choose from.  A typical journal with blank pages may not work for everyone.  A thinner notebook can easily slip in a back pocket or a small handbag, making it a great choice.  There are also applications (apps) for your smart phone that keep track of your food intake.  Or if you would rather keep your journal on your computer, both Microsoft word and excel are excellent options as well, since they allow you to format the journal as you please.

Apps.  Tech savvy food journalists may prefer to keep their food records close at hand, such as on a smart phone or a tablet.  This is a great option because most people have their phone/tablet with them wherever they go, even when mindlessly munching in front of the TV. There are many apps available to choose from, so there is bound to be one that suits your needs.

Write as You Go.  Please, please, please do not wait until the end of the day to record what you think you have eaten or what you remember eating.  It is most helpful to keep records in “real time”, right after you have eaten.  You will be better able to recall, “I had this amount of ____ item, versus “I think I had this to eat and I do not remember it having a sauce or condiment.  Taking the few extra minutes to write it down in “real time”, rather than guesstimating, is best.

Take Notes.  Once you have a few days worth of food records, you can start noting what you have eaten.  The number one rule with food journaling is that if it passes your lips, you must write it down.  Listing a time and how you felt while you ate can also be helpful, additional information to consider.  How detailed you want to be is up to you, however more details are not necessarily better.  You want to make sure you are not just listing the foods you have consumed, for example:  chicken, green beans, salad, protein shake, etc.  Instead, do your best to estimate the amount you have actually consumed. You do not have to measure everything, but you should have a good idea of what a 3 oz. serving of chicken breast looks like (which is about the size of a deck of cards).

It Is Not Just About Food.  To see an even bigger change, try looking beyond the food you consume and tap into how you feel before and after you eat in terms of hunger, satisfaction, and emotions.  An easy way to assess hunger is to use the hunger-fullness scale.  This is a scale where you rate your hunger on a scale from 0-10, 0 being after a fast and 10 being so full you feel sick.  If most of the time you eat you have notated the number 1 (the rating for extreme hunger) next to your dinner entry, than this denotes you probably need a snack in-between lunch and dinner.  If you have recorded the number 9 (meaning you are stuffed) next to each lunch then this signifies that you probably need to stop eating earlier in the meal.  It is perfectly acceptable to leave food on your plate.  Once you see the numbers next to each of your meals, you can start working to change your habits.

Being aware of your emotions during a meal is extremely important. Most people are emotional eaters in some sense of the word, but it can be difficult to identify precisely what causes them to eat.  For instance, maybe you polish off a giant slice of cake when you are by yourself —but you barely touch that same cake when you are around your judgmental mother-in-law.  Being able to identify your emotions in your food journal and then recognizing them before a meal can truly help you avoid overeating.

Review the Trends.  A food journal is impractical if you are not going to review it.  By looking over the past day, week, month, etc.…you will start to spot trends in hunger and satiety.  There is no specific time that is best to review your food journal, but it may be ideal to review your entries at the end of the day.  To notice longer-term trends, try reviewing your food journal on a weekly basis.

React.  Keeping a food journal gives you the opportunity to note where you can improve and change the way you eat. If you notice you are not eating enough vegetables, make it a point of incorporating more at each meal.  Take time to prepare snacks that you can easily eat throughout the day, assuming you need them.

Tell the Truth.  If you want to lose weight or maintain your loss, DO NOT LIE.  The main goal is to be honest with yourself so that you can identify where you might need to increase your efforts.  For instance, you can journal that you ate one fun size Snickers from your child’s Halloween candy, but if you really ate four, then you are only hurting yourself.  If you are keeping a food journal for your dietitian who makes recommendations based on it, you are not going to receive the correct feedback.  Even if you are the only one who reviews your entries, you can still hold yourself accountable for what you almost ate, what you did eat, and how it affected your body.  In the end, that is what truly matters!

Sometimes overeating is not so much a lack of control, but a lack of awareness.  It can be easy to lose sight of how much or how little you are eating and gradually gain weight, almost if by accident.  For those of us who have had the occasional setbacks with eating, for all the wrong reasons (to celebrate, console, or compensate), understanding when, what and how it happened can be an important change and start down a healthier path.  So, put it in writing and it can become a great tool for self-discovery.  Ultimately, it is about accountability and knowing what you are eating, how much you are eating, and how that all adds up compared with your calorie goal.  Now that you  have read this, you can be on your way to obtaining the benefits of and having a successful experience with food journaling and you can CELEBRATE your success!!

Nutrition Tip of the Week

September 29th, 2014 by admin

Author: Nadea S. Minet, MS, RDN, LD

Week of September 29, 2014

Going Organic on a Budget

Devotion to organic foods has hit the roof in recent years. Organic food sales have increased from ~$11 billion in 2004 to an estimated $27 billion in 2012. In 2012, organic food products accounted for more than 3.5% of total food sales in the United States.

So why are people buying organic foods?  Many consumers believe organic foods can serve as preventative medicine against health risks and help cure illness.  There are numerous health benefits linked with eating organic foods. In turn, many are willing to pay a premium price for organic foods.

Organic foods are made in a method that excludes the use of non-organic insecticides and pesticides, which provides you with the best nutrients you need. Studies indicate that organic foods are less likely to have pesticide residues than their conventional counterparts.  And most people who try organic foods do find they enjoy the taste better.  But how can you introduce organic foods into your everyday lifestyle without breaking the bank?

Believe it or not, eating organic foods does not have to be expensive. Over the past 5 years, the growing interest in organic food and its many benefits has led to more competition and increased availability. Organic options are more accessible, which as we know from basic economics, decreases the price. If you are concerned with where your food comes from, affordable organic items are a very welcoming choice.  Here are 9 tips that can help you pick up lots of organic products on a budget:

Shop at your Local Farmers’ Markets.  Growing your own food can be an exciting and economical choice, but there are also going to be times when you have immediate needs for specific produce not found in your garden.  When this happens, try seeking out a farmers’ market in your area.  Ask if they have organic choices before you start filling up your basket.  In most cases, buying directly from the person growing the produce will render a better price, since you are not paying for the supermarket mark-ups.

Toss the Refined Sugar and Go ALL Natural.  Raw sugar is about the same price as refined sugar.  However, the health benefits far outweigh the slight price difference.

Buy “In Season”. An easy way to save on fresh fruits and vegetables is to buy what is in season.  For example, in the summer months, fruit is easy to obtain and therefore more inexpensive. To find what is in season, visit your local farmers’ market and see what type of produce is plentiful.  There is no shame in asking when the answer is not apparent either.

Eat Less Meat by Going Meatless on Mondays.  Ethically raised meat is a wonderful option, but it can be expensive; there is no getting around it.  Eating meatless just one day a week can help diffuse the cost.  You can also get plenty of high-quality organic proteins from non-meat sources, such as eggs, beans, tofu, and nuts.  With the money saved on beef, pork, and chicken, you will have more money to purchase even more fresh, organic fruits and vegetables.

Buy Unpackaged Foods. More and more grocery stores have package-free, bulk dispensers for items like nuts, beans, lentils, coffee grounds, and even cereal. You can buy the exact amount you need at a lower price point than the packaged counterpart of these items. Since you are not paying for a big brand name, you will not be wasting money subsidizing fancy packaging or big advertising campaigns. Plus, if you bring your own grocery bags, some stores will pay you a $0.05-$0.10 per reusable bag, and you are helping out the environment.

Skip Processed Items. This is an obvious way to improve your food budget, yet it is also one of the most overlooked ideas, even when it comes to organic food. Organic does not always mean healthy; you will find organic chips, candy, and frozen pizzas for nearly four times the price of organic produce. Swap out the organic snack crackers for a pound of organic carrots and hummus. You will be saving money and calories, as well as eating healthier at the same time.

Look for Store Brands.  Chains and boutique stores correspondingly now carry their own generic line of organic products, in addition to their standard generic food lines. My neighborhood Kroger, for instance, carries organic diced tomatoes, pasta, beans, peanut butter, strawberry fruit spread, ketchup, mustard, and many other products for a much lower price than brand name organic items.

Become a Member of a CSA (Community Supported Agriculture) or Food Co-op (Cooperative).  A CSA is a farm-share program that enables you to “buy in” to an organic farm.  For an upfront payment, you will “share” in the farm.  Food Co-ops are often a member-owned business that provide produce and other farm products to their members. You usually pay a certain price.  By being a member of either group, you will receive a box of fresh, all organic produce for a fraction of what you would pay at the store.  This is also a great way to try different produce that you may or may not normally consume.  And they usually supply you with different recipes and cooking tips for whatever produce is fresh in the box that week.  A quick google search will help you to find a CSA or Food Co-op near you.

Be Wise.  Another option to going organic on a budget is to be sensible. If you cannot afford to buy entirely organic foods, choose wisely to which items it is best to pay more for. A good rule of thumb is to buy organic fruits and vegetables that have thin skins (such as apples and berries).  These foods tend to absorb the most pesticide residue and herbicides. These foods are often referred to as the “dirty dozen” and they include:

  • Peaches
  • Apples
  • Potatoes
  • Sweet Bell Peppers
  • Celery
  • Strawberries
  • Cherries
  • Pears
  • Nectarines
  • Grapes
  • Spinach and Lettuce

In turn, buying organic food does not have to break the bank. By practicing a little self-discipline and choosing your grocery purchases with precision, you will be able to afford more organic food items on a regular basis. You will be sitting down to a family dinner that you know offers the best nutrition and food safety, which you are well able to provide - for a fraction of the cost.  Here is to CELEBRATING your success by eating more fresh organic produce AND not breaking the bank!

Nutrition Tip of the Week

August 21st, 2014 by admin

Author: Nadea S. Minet, MS, RDN, LD

Week of August 18, 2014

Vitamin Basics = ABCDs

Is it really that easy?  I am sure we have all heard for years that vitamins are good for us and we need them to stay “healthy”.  We know that vitamins and minerals are essential to our health.  We also know that vitamins in food are fundamental to the development of ALL the body’s tissues and fluids and vital to the numerous functions that keep our internal systems operating each day.  But, do we know and understand the particular benefits of each vitamin?  Here you will discover a quick reference to the vitamin basics: A, B complex, C and D, and the precise roles they play in the body.

Vitamin A.  This vitamin comes in 2 forms: retinoids from animal products and beta-carotene from plants.  It is significant because it contributes to normal vision, gene transcription, bone metabolism, a healthy immune system, healthy skin and cell growth, as well as reproduction and maintaining the cell lining of the eyes, intestines and respiratory system.  The food sources that contain high amounts include eggs, beef, chicken liver, cheese, fortified cereals, orange vegetables/fruits such as carrots, sweet potatoes, winter squash, cantaloupe, mangos, and apricots, broccoli, collards, spinach, and kale.  Vitamin A is fat-soluble and disposing of any excess taken in through the diet takes much longer than with water-soluble B vitamins and vitamin C.  Toxic levels of Vitamin A can occur, although rare.

B Vitamins.  These vitamins function as a complex group and are vital to many processes in the body, including energy production, as well as the metabolism of amino acids (the building blocks of protein), fats, and carbohydrates.  They are essential for a healthy liver, skin, eyes, hair, mouth and nervous system.  The food sources rich in B vitamins include whole grains, whole unprocessed foods, legumes, milk, eggs, nuts, fish, fruits, and leafy green vegetables.  B vitamins are soluble in water so excess are generally readily excreted, although individual absorption, use and metabolism may vary.

Vitamin C.  This is the vitamin also known as ascorbic acid and is a cofactor in at least eight enzymatic reactions.  It boosts the immune system and protects against cell damage, while also helping to form collagen in the body.  It aids in the absorption of iron, but can become an issue in patients with rare iron overload disorders, such as hemochromatosis. Some great sources of vitamin C include oranges, grapefruits, strawberries, broccoli, spinach, brussels sprouts, tomatoes, and cabbage.  Vitamin C is water-soluble, which means that dietary overloads are not absorbed and excesses in the blood are promptly excreted in the urine.  This makes the probability of toxicity exceptionally low.

Vitamin D.  This is also called calciferol and helps the body absorb calcium from foods.  Although Vitamin D is generally called a vitamin, it is NOT an essential dietary vitamin as it can be synthesized in “adequate” amounts in most individuals when exposed to sunlight.  However this process is not as effective when excess weight is a factor.  Essential vitamins cannot be made in sufficient amounts in the body and must be obtained from the diet.  Vitamin D is needed for strong muscles, movement, and proper nerve functions.  Food sources high in vitamin D include fatty fish (salmon, tuna, mackerel), fortified milk products, fortified cereals, and mushrooms.

Vitamins are essential to support life and we must get them from our foods and/or dietary supplements.  The nutrition they provide helps us feel enhanced, vigorous, and they assist the body with normal functions.  CELEBRATE products have been developed with careful attention to how different vitamins and minerals will interact with each other.  Not all companies pay attention to this important factor.  Having the proper amount of vitamins in the proper form is what makes the CELEBRATE difference.  Don’t forget to take you multivitamin today!!