March - National Nutrition Month!

Happy National Nutrition Month!!!
Wow-a whole month dedicated to nutrition. I am one happy "RD" in training.

Check out this site for a list of Good Nutrition Reads
http://www.eatright.org/gnrl/

Also, check out eatright.org/nnm/ for lots of great tools and tips to help you live a healthier lifestyle.

As a future RD, I feel compelled to post the following. I can't believe in less than 8 weeks I will be eligible for the National RD exam and will one day (hopefully mid-summer) be part of this elite group of professionals:
Who is a Registered Dietitian?
Registered dietitians are food and nutrition experts, translating the science of nutrition into practical solutions for healthy living. The expertise, training and credentials that back a registered dietitian are vital for promoting positive lifestyle choices
Trust a Registered Dietitian
When you need food and nutrition information based on fact or need to know how a healthy diet improves health and fights disease— rely on qualified professionals in the field.
Registered dietitians draw on their experience to develop a personalized
nutrition plan for individuals of all ages. They are able to separate facts from fads and translate nutritional science into information you can use. A
registered dietitian can put you on the path to lowering weight, eating healthfully and reducing your risk of chronic disease.
RD=Expert
Registered dietitians know the science of nutrition. They have degrees in nutrition, dietetics, public health or a related field from well-respected,
accredited colleges and universities.
Looking for a Registered Dietitian?
When you need trusted, accurate, timely and practical nutrition advice, seek the services of a registered dietitian.
To find a registered dietitian in your area, visit www.eatright.org and click on “Find a Registered Dietitian.”

I just have to share my super delicious and refreshing carrot, ginger and pineapple slaw...YUM!! BTW-it's packed with anti-inflammatory foods!!


Carrot, Ginger, Pineapple Slaw
Equal parts shredded carrots, chopped pineapple and shredded green delicious apple (about 1 cup each)
2-3 tsp shaved raw ginger
2 tsp brown sugar
1 tbsp lemon juice

1. mix together and refrigerate

Anti-Inflammatory foods

Whereas fatty meats and sugars may promote inflammation in the body, there are so many wonderful foods that can help reduce inflammation in the body.
I don't see anything wrong with anti-inflammatory medications (NSAIDs) such as advil, alieve or ibuprofen, but there are lots of wonderful properties in food, not to mention the ability to act as anti-inflammatories.

Here are some must-have's for your diet to support your daily training/fitness routine:
(Disclaimer: some foods may not have extensive research to confirm anti inflammatory effects, however, you can't go wrong with the nutrients that the following foods will provide to your body)

-Celery - did you know celery is a good source of potassium!?
-Devil's claw - found in tissue rejuvinator by Hammer Nutrition
-Ginger - buy it raw at the grocery store and shred in carrot slaw or in smoothies
-Oregano - a great antioxidant
-Red pepper, cayenne pepper - may help relieve pain
-Pineapple - containing bromelain, helps prevent inflammation
-Rosemary - contains anti-inflammatory substances - earnosol, oleanolic acid, rosmarini acid and ursolic acid
-Sesame Seeds - contains essential fatty acids, calcium, magnesium and copper.
-Tumeric - may be as effective as cortisone in some models of inflammation
-Omega-3 fatty acids - fatty fish, leafy greens, walnuts, pumpkin seeds and flax oil (or ground flax seeds)
-Fiber - whole grains, veggies and fruits
-Vitamin C - may help inhibit an enzyme in the body that is responsible for inflammation, choose strawberries ($1.98 at Wal-mart right now or 3 for $5 at Publix!), kiwi, tomatoes, citrus fruits, peppers and mango

Rather than waiting til you feel sore, tight or inflammed, focus on the daily diet so that you are taking preventative measures to maintain a consistent exercise routine, rather than not taking pride in your choice of foods that fuel your workouts and your lifestyle.

Racing nutrition

I can't believe it is almost March!!
I signed up for the Gate river run 15K for March 12th but I am not sure if I am feeling 'it' at this moment. I have my eyes set on New Orleans 70.3 (and Kona) and my internship is keeping me entertained with little room for "free-time". I guess I have a week or so to think about it but I believe that you have to mentally prepare for a race, just as much as you need to train for a race. Right now, there is not much room for visualizing and getting excited to push my body to the max. I'm 100% exhausted and my training is a great way to start my day and relieve stress. Over the years, I have learned to center my energy around a race and be 'ok' with not doing every race that is on the "to do" list...in the case that I am not feeling energized to do the race. More often than not, if the mind isn't excited for the race, the body won't be either.

I don't believe in compromising my training (or exercise) routine when I feel busy or overwhelmed. Sure, some workouts get moved around and workouts may change in volume and intensity. But wouldn't it just be silly of me to tell myself that I am too busy to exercise or train???? Could you imagine if I was counseling a patient and the patient told me that he/she is "too busy to exercise". I find that my role as a future RD (with a background/Masters in exercise physiology) is to lead by example. With a little creativity and a flexible and consistent schedule, exercise is simply part of the plan when wanting to live a healthy and balanced life.

About 2 weeks ago I spoke to a running group in downtown Jacksonville regarding racing nutrition. The group consisted of around 40+ newbie runners, training for the Gate river run.
One of the key points in my talk was talking about things in a race that are in your control. My April Iron Girl article will discuss these things in more detail.
My biggest suggestion to newbie (or veteran) athletes, when creating a practical race day nutrition plan, is to consider two factors. The duration of YOUR race and the intensity of YOUR race. The nutrition for the athlete running a 15K in 1 hour and 10 min @ 70% max HR is going to be a bit different than the athlete running a 90 minute 15K at 90% max HR. The faster you run, the higher the HR (ridding the body of CO2, while providing the body with oxygen-rich blood). The longer you run, the greater the risk of experiencing fatigue (mental and tissue breakdown). The higher the HR the quicker use of stored carbohydrates. Because muscle glycogen is the proffered fuel source during intense activity, it’s very important that you focus on a constant stream of fuel throughout the duration of your race. Therefore, in addition to focusing on your individual nutrition needs in the daily diet, it’s important that you create a pacing strategy that is based on your current fitness and previous training routine. Important to your fuel intake, it is important to maintain a consistent pace throughout your race. This will allow you to take in and use fuels as efficiently as possible, thus reducing the chance for fatigue in the early periods of the race. Keep in mind, that with a higher HR rate, comes the risk for GI distress because it’s often difficult to digest and absorb calories while the heart is pumping a great amount of blood to the working muscles. Even if you have a few weeks/months left until your upcoming race, I can’t stress how important it is to be realistic with your race day goals. Sadly, no amount of nutrition is going to make you run 6 min/miles if you haven’t trained your body to do so.

Carbo-loading

It's hard to sum up all the fantastic info in my latest issue of Nutrition Action (March 2011) that came in the mail today. I loved the front page that featured the words CARO LOADING in large print. Sadly, the article isn't geared towards athletes but rather to the average American.

Pg. 3 - 6:
In 1970, the average American consumed about 430 calories a day from grains (wheat, rice, corn, oats, etc.), according to the USDA. By 2008, we were up to 625 calories a day, a huge bump. And roughly 90% of the grain we eat is refined, not whole. Only one other category - fats and oils, which includes butter, oils, margarine and shortening - supplies that many calories. (So much for the popular notion that we've been on a low-fat diet). Added sugars also climbed, though less so. They're up by about 60 calories a day sine 1970.
How does so much refined grain creep into our diets? Restaurants pile on the pasta, rice, pancakes, breads and other cheap carbs.

Many restaurants combine multiple carbs into one meal. That burrito stuffs rice into a tortilla. And that's after you dive into the free basket of tortilla chips or polish off a cheese quesadilla appetizer.
Like many Italian restaurants, Olive Garden offers unlimited bread with your pasta. That often follows an appetizer like bruschetta (on white bread) or artichoke spinach dip (with while bread) or fondue (with white bread). And no one's offering whole grain chocolate cake or tiramisu for dessert.

It's not just restaurant food. We're eating bigger bagels, muffins, doughnuts, scones, ice cream, cones, pretzels, cookies, wraps and slices of bread (most of which are made with white flour). "People see bread labels that say '15 different grains,'" says Kris-Etherton. "They think, 'Wow, this is super.'" They don't notice that each slice has 100-120 calories and a bagel can easily have 300 calories.
"But if you look at a thin slice of bread, which has 70 calories, that's what we used to eat before," notes Kris-Etherton. Now 70-calorie slices are called "small".

"Roughly 30 percent of our calories are coming from SoFAS - solid fats and added sugars," says Kris-Etherton. "We're eating way too many added sugars. But we also have to be mindful of the amount of refind grains we're eating."

"The bran in whole grains is an excellent source of fiber that can help keep you regular," say Lichtenstein. "Most people don't get enough of it."

Refined grains are lower in vitamins (like B6 and E) and minerals (like copper, magnesium, potassium, selenium, and zinc) than whole grains. The potassium may lower blood pressure, and the magnesium may protect against diabetes. Why miss out on those and other nutrients that are stripped away in refined grains?

I quit

No..I would never do that. But I could sure use an interning break!

I wanted to write something great today or feature a yummy creation, but I got nothing except for a tired brain. I wish I could say that my body was tired from training but it is recovery week and I am taking full advantage of just exercising this week. This morning was 30 min on the elliptical and weights. That's it! Tomorrow I plan to swim and hoping to find my inner-nemo that loves to come out twice a week from 6am - 7:30am.

With 9 1/2 hours of interning at the hospital, you'd think that I would be able to see a dozen patients but I spent the entire day seeing 3 patients. Yesterday I saw 4, which is an improvement from my 2/d average but these three patients had me scratching my head and looking up a lot of info. Because I am still in the "interning" phase of my internship, it's important that I take my time and learn as much as I can so I don't overlook medications, physician orders or status updates. I still love talking to patients but trying to compose a note and sum up everything that is going on with a patient is still a work in progress. I am finally getting the "lingo" but every patient is a new case.

Today I saw a bilateral below the knee amputee which required new calculations for calorie, protein and fluids needs. However, the patient had some changes in blood work which forced me to adjust nutrient needs. I never did calculations on an amputee so this was new for me. I also saw a pt who recently had a few toes amputated and had weight changes. The patient needed a diet change, was on fluid restriction and had several changes in status which had me wondering what I should prioritize in this case. Lastly, I saw a patient who was taken off TPN feeding after speech evaluated the patient with a modified barium swallow. I had to recalculate the patients needs but there was no new weight to figure out needs per kg of adjusted weight and ideal body weight. Needless to say, I learned a lot today and had a headache by 6pm!
The highlight of my day was giving a cancer patient an educational book on diet suggestions during chemo. Talking to the pt made my day and the pt was very happy to have suggestions to help with vomiting and constipation (two of the many side effects of chemo and chemo meds).

Well, my eyes are sleepy and I am off to dream about what tomorrow will bring....

Training to be a RD

What an amazing weekend...weather wise. As for me, 15 hours of last minute studying on Sat and Sun and a B on my mid-term (I had another quiz on medical nutrition therapy on burns, wound, stress and surgery on Fri). The difficulty of the questions exceeded my expectations and I was nearly in tears mid-way through my exam. Giving myself a grade for my test-taking skills, I'm probably a high A for not being the best test taker. I tend to overthink and right now in my pursuit to be a RD, there is still a lot of thinking and second guessing. The body is amazingly complex and I am still struggling putting all the pieces together. But nevertheless, 150 questions and 1 hour and 54 minutes later, I was finished with my exam and I did much better than I expected. Whewww.

My training has really taken a back-seat lately...as has much of the other things I like doing for fun (ex. blogging). But, I had no trouble getting out the door on Sat at 7am for a 3hr and 30 min, 67 mile bike ride. Karel was out of town all weekend, to race 4 races in 2 days. Karel and his teammate James have ended up on the podium for almost every race they have done this weekend and the new Gearlink Pro 1,2 Team is fun to watch in action. Too bad I have only seen 1 race thus far but I know I'll have plenty to watch after April 25th.
Great job Karel!!

While Karel was off racing in Lake Mary, FL, I joined a large group of guys (and 1 other female) for a fast and fun group ride. I LOVE my saturday group ride and the people on the ride. It was Trimarni's (my tri bike for new readers) first group ride and second ride outdoors since IMWI and we had no trouble keeping up with the guys. I wanted to ride longer but my studies were on my mind. Can't wait til next weekend. Karel is off from racing and I am craving a group bike ride with my hubby.

I never realized how difficult it was going to be to be a Registered Dietitian. Throughout this week, I saw people from all stages in the life cycle. I saw people as young as 6 months and some as old as 80+ yrs of age. While interning as an acute care clinical dietitian, I can't help but think about the normal population and how much we take for granted, the normal and healthy body.
When a baby is born, the focus is getting him/her to be as healthy as possible and to obtain the necessary nutrients to grow and age properly. I can't express in words the sadness in a mother and father's eyes when their child is not growing or has developmental problems. Our role as a RD is to prescribe the right nutrients, supplements as well as tips in order to help the child grow. While in the hospital, I walk by the rooms with cancer patients and I imagine myself in the room. It's not hard for me to thank my blessings that I am healthy at this point in my life and that I am taking the necessary steps to reduce my risk for disease and illness.
Because of all that I see in the hospital, you'd think that it would be easy to talk to people in the community, because much of the population (especially those reading my blog) is fairly healthy. Maybe an altered lab or two or a few chronic conditions but overall, most of us are able to live our life how we want and not be confined to a hospital room with around the clock care.
However, for much of our life, perhaps even 20-30 years, we abuse our body. Whether it is starvation from recommended calories, nutrient timing, fueling while exercising (or after exercise) or rigorous exercise (even while injured), many people spend much of their adult life worrying about weight and trying to reach unrealistic goals and expectations with impractical measures. If the entire world was the same weight, I have a feeling no one would really focus on their body image but would rather eat for health. But with such a hype for the "perfect" body in the media (as well as in sport), it's almost as if adults don't really care so much about health but rather about image. Do you know what it feels like to be healthy? Despite having a little jiggle when you run or seeing a little bulge around your hips, do you believe that your weight classifies your success as an athlete? Do you feel as if others are criticizing your body as you are training and racing for a personal best?
With 8 months of interning behind me and only 2 more months to go, I would strongly advise the public to worry less about body image and to focus more on keeping your body healthy throughout all stages in the life cycle.
Thanks for reading!

Quicky wrap

I'm sure we all share the same story of life "not enough time".
I'm quickly realizing that my idea of balance is gradually shifting to a 'just get it done' philosophy. I'm still getting quality sleep but my bed time moved from 9 until 10. I still wake up at 4:30 but there have been several shortened workouts due to being tired and needing more sleep. Exercise/training is still a priority but I am just aiming for quality workouts with no big expectations. New Orleans 70.3 should be a fun and great race for me but the Ironman World Championships is my main focus.
As for my life at the moment, I'm mentally stimulated during my 9 hours of interning and come home with a completely exhausted brain, only to squeeze in a few more hours of work. The motivation is certainly lacking in the evening but there just isn't enough time on the weekend for me to do work. My weekends are 100% devoted to reading, studying taking quizzes. Speaking of which, I have my mid term due by Mon at 9am and it is 150 questions and a time limit of 2 hours. Just thinking about it is making me exhausted.
Throwing in food prep, campy walks, catching up with Karel over dinner and trying to stay somewhat connected to the outside world, I find myself clicking off the last few weeks of my internship as if I'm running 15 mph on the treadmill. 8 months down...9 weeks to go! Last official day is April 22nd but my "interning" will end in 5 weeks (which means no more projects, papers and assignments for my binder!!). I will then have the final exam for my internship and nothing else to worry about until I take the National Registered Dietitian Exam (sometime this summer).

Last night I found myself studying for almost 1 1/2 hours as soon as I got home from Nemours. It was almost 7pm and Karel would be home from work and ready to eat. I knew it was close to dinner because I was getting hungry and with only 10 minutes until Karel came home, I needed to make some quick, healthy and easy. I am happy to say that throughout my internship, we have not gone out to eat nor ordered out/gotten take out. I am fueled by my own creations :)

This meal came to me rather quickly because both Karel and myself LOVE wraps. Rather than preparing some type of meat for Karel, I opened the pantry to find chicken and rice, vegetable soup. PERFECT!!
With a leftover stir fry for me, I had two easy meals prepared in less than 10 minutes.
Enjoy!


Quicky Wrap

1 can soup (drained) - save the liquid for a broth or for marinating
Mushrooms
Chickpeas
Corn
Hummus
Whole wheat tortilla (I found these at Winn Dixie on sale. 100 calories, whole wheat)
Dark Greens
Cheese
Spices (no salt)

1. Drain liquid from soup can. Pour into a bowl.
2. Cook soup with veggies for 90 sec (cover to prevent splatter)
3. Heat tortilla for 15 sec (or you can give a light toast in the oven)
4. Spread with hummus. Top with cheese and spices.
5. Add greens and a few large spoonfuls of "soup" mixture.
6. Fold and Enjoy!






Inside my wrap:
Broccoli
Mushrooms
Tofu
Garlic
Chickpeas
Corn
(not pictured dark green medley)

What's New?

What a week this has been. I'm too exhausted to write about it in detail at the moment but I can say that I had 2 exciting and busy days at St. Vincent's Hospital on the Cancer unit and 2 amazing days at Nemours Pediatric Outpatient Hospital. I've been interning for about 8 months and in the home stretch, I am feeling very confident that I will pursue a clinical dietetic job as soon as I become a Registered and Licensed Dietitian. There is so much to learn about the human body and I'm quickly learning that there is no shortage of brain stimulating info when you are an acute care clinical dietitian.

During my lunch break today at the pediatric hospital I skimmed through the latest American Dietetic Association newsletter (ADA TIMES Winter 2011). I always look forward to the research briefs and industry news section because I think it's fun to be a bit ahead of tv media when it comes to scientific research or consumer nutrition.

I didn't want to keep this info to myself....enjoy!

-New Measure Trumps HDL levels in Protecting Against Heart Disease
A measure of DHL function called cholesterol efflux capacity is more closely associated with protection against heart disease than HDL cholesterol levels themselves, according to the Jan 13 issue of the New England Journal of Medicine

Eating fruit and vegetables every day may reduce heart disease risk
A diet rich in fruits and veggies is associated with a reduced risk of ischeemic heart disease, according to a large observational study published in the Jan 18 European Heart Journal, but whether this association is causal remains unclear.

The number of U.S. Adults Treated for Diabetes more than doubled between 1996 and 2007
Approximately 19 million U.S. adults reported receiving treatment for diabetes in 2007, more than double the 9 million who said they received care in 1996, according
to the US Department of Health and Human Services Agency for Healthcare Research and Quality.

Breast Cancer patients with Diabetes more likely to die
Breast cancer patients are nearly 50 percent more likely to die of any cause if they also have diabetes, according to a review published in the Jan issue of the Journal of Clinical Oncology suggesting future research could focus on whether high levels of insulin in patients with type 2 diabetes might promote tumor growth.

Ban on Chocolate Milk in Schools Delayed
Florida's new agriculture commissioner has stopped efforts to ban chocolate milk and most other high-sugar drinks in schools, reported the Dec. 25 Orlando Sentinel, saying a broader approach to student nutrition is needed.

Is nutrition labeling for alcoholic beverages on the way
Wine, spirits and beer industry insiders are sparring over a proposal presently before the federal Tax and Trade Bureau to list nutrition information such as calories, carbohydrates, serving size and alcohol per serving. According to a Jan 19 article by the associated Press, points of contention include confusion over cocktail serving sizes, generalized data instead of analyzing each vintage of wine variety and how and where a nutrition label would appear on packaging, bottles or cans.

Nutrition facts panel will appear on meat
By next year, whole, ground or chopped meat and poultry will feature nutrition facts panels either on their package labels or available for consumers at the point-of-purchase.

Fazoli's introduces four 400-calorie entrees
Three cheese baked ravioli, hearty tortellini and bacon, mushroom chicken alfredo and penne tuscano headlinee Fazoli's line-up of New Year's specials, all designed to help Americans watch their waistlines and wallets.

Walmart Pledge Cheaper produce, reformulations
Superstore corporation Walmart announced an initiative to reduce sodium and trans fat in packaged food items by 2015, make healthier choices more affordable, develop a front-of-package seal and build stores in food desserts.

Tropicana Announces Squeezable fruit snack
PepsiCo is launching a portable snack for children called Tropicana Tropolis, a smooth blend of fruit that is a good source of fiber and offers 100% of the recommended daily value of vitamin C with no added sugars, high fructose corn syrup or artificial flavors, sweeteners, colors or preservatives.

Supplements to skip

I had just enough time the other night to browse through my latest Consumer Reports on Health, March 2011 issue. There is a great article on top selling vitamins and I hope to read the entire issue...when I get a minute of free time.
The researchers worked with the Natural Medicines Comprehensive Database which evaluate the safety and effectiveness of nutritional supplements, to identify the dangerous ingredients. All supplements listed have been linked by clinical research or case reports to serious side effects such as heart problems, kidney damage and even death. And there's insufficient evidence to determine whether they're effective for most of their purported uses.
Here's the list:
Aconite - used for inflammation, joint pain, wounds and gout. Dangers include toxicity, nausea, vomiting, low blood pressure, respiratory-system paralysis, heart-rhythm disorders, death.
Bitter orange - used for weight loss, nasal congestion, allergies. Dangers include fainting, heart-rhythm disorders, heart attack, stroke, death.
Chaparral - cold, weight loss, infections, inflammation, cancer, detox. Dangers include liver damage, kidney problems.
Country mallow- used nasal congestion, allergies, asthma, weight loss, bronchitis. Dangers include heart attacks, heart arrhythmia, stroke, death.
Kava - used for anxiety. Dangers include liver damage.
Lobelia - used for coughing, bronchitis, asthma, smoking cessation. Dangers include toxicity, overdose can cause fast heartbeat, very blow blood pressure, coma and possibly death.
Yohimbe - use for erectile dysfunction, aphrodisiac, chest pain, diabetic complications, depression. Dangers include at usual doses; high blood pressure, rapid heart rate. At high doses; severe low blood pressure, heart problems, death.

Happy Valentine's Day!!

I just love this pic. We got married on Oct 26th 2008 and Campy had just come into our life. It was truely love at first sight.

“The way you get meaning into your life is to devote yourself to loving others, devote yourself to your community around you, and devote yourself to creating something that gives you purpose and meaning.”


Right now I feel a little blah. My life is a routine and I find myself with little flexibility. Karel has been amazing through this entire dietetic internship journey and he never lets me give up.

"I know God will not give me anything I can't handle. I just wish that He didn't trust me so much."

When I met Karel I was training for my first Ironman (IMFL). I am pretty sure by now (4 1/2 years later) that Karel understands that I am very structured and disciplined and I always have my eyes set on a goal. Perhaps there was a reason why he came into my life when I wasn't looking for anyone to interfere with my schedule. While he let me be me, he also forced me to take chances. Both in sport and in life. Understanding that life requires balance and not strict regime, Karel has shown me a whole new way of living life.

"This is the beginning of a new day. You have been given this day to use as you will. You can waste it or use it for good. What you do today is important because you are exchanging a day of your life for it. When tomorrow comes, this day will be gone forever; in its place is something that you have left behind...let it be something good."

My family is the world to me. Without them, I don't know how I could be where I am right now. It's been 10 1/2 years since I have graduated high school and I have spent 8 of those year in school. My mom, dad and brother have always supported me in all of my crazy adventures and ideas and they are my #1 fans. I really have the best family ever and I believe I am who I am because of the love I receive from my family.


“Be who you are and say what you feel because those who mind don't matter and those who matter don't mind.”

My friends, blog readers and athletes = motivation. Sometimes I wonder how to make it all work but when I stop thinking about the task at hand and live in the moment, it all seems to work itself out. I hear stories from others and feel inspired as if I have nothing to complain about. Everyone has a story and a reason. I am fortunate that I have the opportunity to work with so many amazing athletes and I can't tell you how much I love receiving random emails from blog readers, sharing with me their stories and letting me know how I have been a part of their active and healthy journey.

“Don't lower your expectations to meet your performance. Raise your level of performance to meet your expectations. Expect the best of yourself, and then do what is necessary to make it a reality.”

Thanks for reading. Happy Valentines day!

Egg-tastic Friday!

I had a lot on my mind last night. You'd think that I could relax a little after 4 days of interning but I find myself always thinking about the next 3 days. You see, my interning never ends. I really don't have a life right now...just a dietetic intern life.
As soon as I leave the hospital M-Th, I make my way home for a little Campy quality time, followed by making dinner (and lunch), eating dinner w/ Karel and getting my things ready for the next day. Once I finish everything, I find some motivation and discipline and study/read my dietetic material for an hour or 90 minutes, before it is time for bed, sometime around 9-9:30pm.....then it is time to do it all over again. Of course, Tues-Thurs wouldn't be complete without my 4:25am alarm and a 5-7:15 am workout.
So, now that it is Friday, I had my typical 4:30am wake-up but not the normal rush like the other days this week.
I never have trouble falling asleep and I absolutely love sleeping at night. I'm not a nap person at all (can't remember a time in the last 2 years that I have taken a nap) so I really look forward to getting a restful night of sleep.
With so much on my mind last night, I grabbed my notebook and pen (on my nightstand) and wrote down my 'to-do's' for Fri-Sun. There are a lot of them but they must get done before another week of interning.
Last night I told Karel that I wish time would just slow down 'cause it seems to be rushing right by me. I'm definitely along for the ride (which is an exciting one) and trying to make the most of my days, but my days just seem so rushed. I don't take anything for granted and I really look forward to my "me" time when I train and when I cook. Two things that make me so incredibly happy. Good thing I have Karel and Campy to enjoy my food and to keep me excited to train.

Did I mention that 3 weeks are down and I only have 10 more to go!?!?! April 22nd is my last week of interning..forever!!

So in other news, how about some egg breaking news!!

Eggs-better than they are cracked up to be

I am a vegetarian for animal reasons but since the age of 11 (17 years ago), I have been a lacto-ovo vegetarian, consuming eggs and milk. And I absolutely love my eggs and milk.

There was a time during my "diet book" days when I was an egg-white-aholic. But a few years ago I learned about the many benefits of egg yokes and I quickly introduced them back into my diet. Over the years I find myself not eliminating foods from my diet but rather, finding creative ways to include a variety of foods in my diet. Therefore, having no "off-limit" foods...especially the healthy ones.

According to new research from the U.S. Department of Agriculture a large egg has about 185 milligrams of cholesterol, down from 215 milligrams. Recommended dietary cholesterol is 300 mg/d. The body needs cholesterol to make hormones and vitamin D so it is not recommended to be cholesterol-free. Vegetarian's will likely consume less cholesterol than meat eaters but there are many plant-sources of cholesterol in the diet. Cholesterol is an essential structural component of cell membranes, where it is required to establish proper membrane permeability and fluidity. In addition, cholesterol is an important for making bile acids and steroid hormones.

Apparently, the drop in cholesterol may be because of changes in hens' diets, the way the animals are bred or other factors. "Evidence suggests that one egg (i.e. egg yolk) per day does not result in increased blood cholesterol levels, nor does it increase the risk of cardiovascular disease in healthy people," according to the government's Dietary Guidelines for Americans.

The USDA research also showed that an egg has 41 international units (IUs) of vitamin D, up from 25 IUs measured several years ago.

Although protein is in the white, most of an egg's vitamins and minerals are found in the yoke.

Here's a yummy egg-fiesta salad for you to enjoy!

Avocado
Black beans
Tomatoes
Green Peppers
Tomatoes
Dark Greens
Corn
Purple Onion

Another week down

What a week. I am not sure how many times I can say it but I just can't seem to squeeze any more minutes into my day. I saw so many patients this week and every case presents something new. I have learned so much this week regarding the human body and I am really picking up on medications, labs and disease conditions. This week I saw (not limited to) the following diagnosis:
prostate cancer
Lung cancer
severe malnutrition
Stage IV sacral wound
Vaginal cancer
Liver cancer
Aspiration pneumonia with PEG placement
suicide attempt w/ alcohol overdose
CABG/open heart surgery
ICU patient on propanol and a paralytic drug, with NG tube

Today I gave my first inservice. I thought I was giving an inservice on coumadin and purine in the diet, to the kitchen staff but to my surprise, around 40 members of the dietary department attended the monthly meeting where I was speaking. I was nervous this morning when I found out I was presenting to all of the RD's, but I think everything went well. I absolutely love public speaking and look forward to another speaking opportunity.

As for the rest of the week/weekend, I have two case studies to do, 2 quizzes to take, a chapter on burns, wounds and metabolic stress to read and if I can find the time, reviewing my notes and charting from this past week.

The other night I made one of my favorite foods for topping my salads...toasted chickpeas!
YUM!!


Super easy....
A little olive oil in a pan on medium heat. Add your washed chickpeas and after 4-5 minutes of cooking, sprinkle with paprika and pepper.

I'm super excited because this morning I used my brand new trainer! I'm also super hungry and sore because this trainer gave me a heck of a workout!






I have always enjoyed riding my fluid trainer but I absolutely LOVE my cycleops PowerBeam Pro Bicycle Trainer.

Here's the specs of the trainer:
-PowerTap power measurement technology accurate to +/- 5% for precise power measurement.
- Allows locking in exact power output or slope for precise interval training with instantaneous resistance changes.
-The only wireless electronic trainer available.
- Easy set up and portability. 100% data integrity, no drop outs or interference.
- ANT heart rate and cadence sensor included.
- PowerTuned fl ywheel optimizes inertial effect with limited dead weight for smooth, realworld feel.
- Console features easy-to-use interface, backlit display that is easy to see in all conditions.
- Create and manage custom workouts with PowerAgent Workout Creator software based on slope, power, and training zones.
- Prescribe training and testing protocol to athletes and training partners.
- A stiffer yoke limits vibrations at all speeds for smooth, quiet operation.
- Large, precision machined alloy roller reduces tire wear and slippage.
- Quick-cam locking mechanism allows fast installation and removal of bike.
- CycleOps Pro series frame is the easiest to use and most stable frame available.
- Includes Realrides Race Day DVD.


My main set this morning was 3 x 10 min @ sub LT w/ 5 min ez. 4 x 5 min @ sub LT w/ 5 min ez. 5 x 1 min LT w/ 1 min EZ.
2 hours later, as the rain was falling hard outside, I was toasted. A quick recovery drink and shower and I was out the door by 7:40am for exciting day of interning.
I absolutely love this trainer because I don't have to change my gears. You plug in the trainer and on the screen you can choose your "power zone" and the trainer forces you to get and stay in that zone. If you go beyond that zone, the trainer eases up on you. For me, this great because I am always wanting to work on my cadence (faster cadence) as well as not going too easy between intervals. I can also adjust the slope to simulate climbing. This is really going to be a great addition to my quality training routine. I 100% believe in finding ways to measure your effort so that every training session has a purpose and can be reviewed for future training sessions.

Speaking of training, I had to switch my tues and wed workouts so I did the elliptical, lifted and swam on Tues and did my brick on Wed. After a tough 1:05 interval bike (1 min on, 1 min off, 2 min on, 1 min off, 3 min on, 1 min off, 4 min on, 1 min off, 5 min on, 1 min off, 3 min on, 1 min off, 2 min on, 1 min off, 1 min on, 1 min off - all at VO2max power, or close to it) Campy asked me if he could join me for my brick run. Knowing that Campy is all fast-twitch fibers, I happily welcomed my best furry friend for a fun 2 mile run. To my surprise, Campy put on his speedy legs at 6:45am because we ran 8 min/mile for the first mile and 7:30 min/mile for the 2nd mile! WOW-I was amazed! After I dropped Campy back at home, I took myself for a run (boring compared to my campy miles) and ran the same route (but a little longer) for 2.5 more miles, 7:25-7:30 min/mile average.

Despite my crazy schedule...I'm hanging in there. A few close mental breakdown's but I have a great support system of friends and blog reader, (including my family and Karel) keeping me going. Thanks for reading.

Israeli couscous salad

Two days down, two to go. This has been a really busy week for me! I am finally getting the hang of things at the hospital which means a lot more info to retain (who knew the body to be so complicated and fascinating..not to mention all the drugs that the body can handle!!) and a lot more responsibilities as a clinical dietetic intern. On thurs I will be giving an inservice to the kitchen staff on coumadin and purine diet and sometime this week I will be finishing up 2 case studies (which I need to type before the end of the week). I also have two quizzes this weekend (liver disease and RD prep quiz).
On Monday I received the best text from my amazing husband.

"I know you are in tough times right now with your internship but it's like when you are dying in a race and somebody rings the bell and says '5 laps to go'. Ok, I know that is in bike racing but I have no experience with triathlons. Will the 1 mile mark work better?"

I don't know how but Karel always knows the right thing to say, at the right time. This totally brightened my spirits for my 9 hour day of interning and he is absolutely right. Sometimes you just have to dig deep when the going gets tough and remind yourself of all of the sacrifices you are making to get to the finish line.

And speaking of finishing lines...my speedy hubby landed on the podium this past weekend in the Gainesville Pro 1,2 criterium. Congrats to Karel on his 3rd place finish...I'm hoping one of these days I will be able to get away from my studies and watch Karel and his team.



The other day at Publix I found two bags of Israeli couscous for .80! Talk about a deal I couldn't pass up! I have never had Israeli couscous but based on my meal last night, it is very similar to the consistency and texture of orzo. YUM! It takes about 8 min to cook so it is super quick. It is high in protein compared to other rices but low in fiber (compared to whole wheat pasta/brown rice). However, added to a salad you are sure to get a nice mix of protein and fiber for your mid-day mental break.
I hope you enjoy my lunch as well as my dinner!

Israeli couscous salad
Couscous
Broccoli
Tomatoes
Tofu
Onions
Spinach

Side: Celery sticks w/ a mix of hummus and salsa



Dinner omelet with couscous

Salad crazy

I just finished my first week of build for the build phase of my training and I am feeling great. A bit sore and tired at times but no injuries and an amazing amount of energy...taking into account my 8.5 hours/d of interning + 2-3 hrs/d of weekly studying + 6+ hrs/d of weekend studying. I am coaching a handful of amazing athletes and they keep me motivated and inspired. I have received several emails for future athletes and I am just counting down the weeks until I can devote more time to coaching. But for now, thanks for understanding. And to my blog readers...you all give me so much energy just knowing that you visit my blog and appreciate my writings!! Thanks :)

So where is all this energy coming from? Must be all the wonderful vitamins and minerals that I am receiving from my meals...not to mention enough sleep to keep me energized during my long educational days. Recovery nutrition is also key so with all things taken into consideration, something is working and I have to admit that it is likely that it is the rewarding food that I provide to my body. Sure, it takes a little experimentation to find what works (and likely, once you find what works, something in life/training changes) but it's all about getting in tune with your body and making the most out of your days.

Right now I am all about finding what works best for my body in terms of leaving me satisfied and well-fueled during the day. Most days of the week I just crave a nutrient-dense lunch that is balanced and super yummy.

I recently bought some new Tupperware which is super important when planning lunch, away from the home. I strongly recommend getting a variety of Tupperware so that you have no excuses when it comes to preparing lunch. I bought my new Tupperware at Big Lots (I LOVE Big Lots!!).

I hope you enjoy my latest salads! Most of the salads have items from my dinner meal. I always make my lunch while I make dinner.
There is lots of room for creativity when it comes to filling your Tupperware with nutrient dense foods.
(I always have nuts and a baggie of cut fruit/veg for quick snacking. Also, I leave a multigrain wasa cracker w/ PB in my car, wrapped in tinfoil, for my 30 minute commute home. I Love my wasa crackers)

Monday: Cucumber and tomato salad
Cottage cheese
Oranges


Cucumbers
Tomatoes
Green peppers
Spinach
Egg
Crumbled rosemary wasa cracker
Mozzarella cheese




Tuesday: Veggie crumble salad
Apples
Cottage cheese

Veggie crumbles
Egg
Spinach
Onion



Wednesday: Asparagus and mushroom salad
Cottage cheese
Cucumber
Plum

Asparagus
Mushrooms
1/2 veggie burger
Tofu
Spinach

2 weeks down!

I can't believe I am already entering week 3 of my acute care rotation. Technically, after this week I will only have 6 more weeks of "interning". This kinda scares me because I still have so much to learn. After my 9 weeks of acute care interning (which followed 5 weeks of long term care), I will have 4-weeks of staff relief to finish up my internship. I have plenty to keep me busy between now and the end of April and I find myself wondering if I can squeeze any more minutes into my long and busy days.

This week I was amazed by what I saw in the hospital. The week started with a Code Blue around 4pm on Monday. All of a sudden I notice around 20+ people, including physicians, family practice, MD's, surgeons, nurses, pharmacists, nurses, etc, rushing to a patients room. I asked the RD what was going on and she told me that a patient was in cardiac arrest. I wasn't able to multitask and work on my case because I was watching the excitement down the hall. I am not sure how the patient is doing but they took him to the ER after they used the defibrillator on him. Talk about an exciting end to my day.

I did my first electronic charting this week and managed to do 3 nutrition assessments during my first real week of clinical interning. I've been spending much of my time on the infectious disease, Cancer and heart/open heart floors but every case is new and I am still getting familiar with reading physician notes, understanding labs and getting the right lingo for my nutrition note. I feel good about my nutrition calculations and finding a good intervention and I just love talking with the patients (that's my favorite part).

So far this week I have seen the following conditions (not limited to):
-kidney stones
-MRSA, Ecoli and UTI
-C-diff
-Cerebral Palsy w/ schizophrenia
-Septic joint
-Left total knee replacement
-Chron's disease (2 cases) with one of the pt's having 80% pancreas, no spleen, no gallbladder and 12 inches of intestine left and the other case in a young patient with abdominal pain. Both pt's were on PPN feedings for nutrition support.
-Open heart surgery pt
-Pancreatic cancer pt
-Renal failure with excessive alcohol abuse (pt was recently discharged with home hospice)

I am amazed by the human body and now, more than ever, I don't take for granted what my body allows me to do on a day-to-day basis. My heart, brain, lungs, kidney's and liver are healthy and my muscles are strong. I am independent, I can move as I please and I'm able to make my own choices when it comes to my diet.

Have you thanked your body today? It's never too late to give a little thanks to the one and only body that allows you to swim-bike-run, sleep, love, cuddle with your furry little one(s), eat and live a quality-filled life.

And, after you thank your body, take a little time to assess whether or not you are making the best choices for your individual needs and lifestyle, when it comes to fueling your body and reducing your risk for disease. I certainly don't want to see any of my blog readers in the hospital for a high risk nutrition assessment!

USDA Dietary guidelines - latest edition, key points

If you are a regular reader of my blog and try to apply some of my suggestions to your every-day life, I think you'd agree that we are doing well in terms of meeting the new USDA dietary guidelines! Not to mention, meeting the guidelines while pursuing an active, multi-sport lifestyle...and balancing the rest of life! YAY for eating more plant-based meals! Keep up the great work!

Key points from the new USDA dietary guidelines:
-WHAT you eat and HOW you eat, both matter in overall diet and health.
-Have a snack before you head out to a party
-Enjoy your food, but eat less
-Avoid oversized portions
-Make half your plate fruits and vegetables
-Switch to fat-free or low-fat milk (1%)
-Compare sodium in foods like soup, bread and frozen meals - and choose the foods with lower numbers (the average intake of salt from Americans is 3,400 mg/d. Recommendations are 1,500 mg/d for high risk groups and 2,300 mg/d for all others).
-Drink water instead of sugary drinks
-Eat more fruits and vegetables and consume at least half of all grains as whole grains.
-Choose a variety of proteins, including beans, peas and soy products.



QUICK SUMMARY:
*Eat more whole grains, vegetables, fruits, low-fat or fat-free milk, yogurt and cheese or fortified soy beverages, vegetables oils such as canola, corn, olive, peanut and soybean and seafood. Eat less added sugars, solid fats (including trans fats), refined grains and sodium.
*Reduce sodium consumption to 1,500 mg/d (about 2/3 tsp of salt) and no more than 2,300 mg/d. High risk individuals (51 yrs or older, African Americans and individuals with a history of high blood pressure, kidney problems or diabetes).
-Consume less than 10% of calories from saturated fatty acids and replace with monunsaturated and polyunsaturated fatty acids. Focus on the type of fat, not the overall amount. Reduce consumption of solid fats and increase liquid fats such as oils as well as plant-based foods, like nuts, seeds, olives and avocados. Also, consume omega-3 polyunsaturated fatty acids like cold-water fish (aim for at least 8 ounces of seafood each week).
*A healthy eating pattern limits intake of sodium, solid fats, added sugars, and refined grains and emphasizes nutrient-dense foods and beverages—vegetables, fruits, whole grains, fat-free or low-fat milk and milk products,3 seafood, lean meats and poultry, eggs, beans and peas, and nuts and seeds.
*To curb the obesity epidemic and improve their health, many Americans must decrease the calories they consume and increase the calories they expend through physical activity.


Here is the link to the 2010 Dietary Guidelines.

2010 Dietary Guidelines

I don't think it is necessary to read the entire 112 pg document. However, in order to stay up-to-date with scientific and practical guidelines/information, I recommend reading a few of the chapters so that you have a little educational background when it comes to hearing "myths" or ads/commercials for "quick fixes" when it comes to your health and/or weight loss. For my blog readers, who like to live a healthy and active lifestyle, I think you will find some of the pages very helpful and informative. Take a little time to read the following pages so that you can start finding what may work best for you and your lifestyle and athletic needs/goals.

Chapter 1, pg 5 - Importance of the Dietary Guidelines for Health Promotion and Disease Prevention
Chapter 2, pg 13-17 - Calorie Balance: Food and beverage intake and Physical Activity
Chapter 3, pg 32 - Chapter summary of foods and food components to reduce
Chapter 4, pg 33-40 - Foods and Nutrients to increase
Chapter 5, pg 46-53 - Building healthy eating patterns. Principles for achieving a healthy eating pattern and putting the principles for a health eating pattern into action (pg 52 has a section on vegetarian adaptations of the USDA food patterns)
Chapter 6, pg 59 - Resource list for helping Americans make healthy choices


The appendix list is on pg 8 of the guide. There are several great resources located on this page, such as food safety principles (p 62), using the food label (p. 73) and lacto-ovo vegetarian adaptations of the USDA food patterns (p. 81). You can also find selected food sources of potassium, fiber, calcium and vitamin D.

New Dietary Guidelines

Breaking news (albeit, a few days late).
I hope you can find a little time in your day today to read the new 2010 dietary guidelines.
Here is the email I received from the American Dietetic Association early this week:

Today is a significant day for our Association and profession as the 2010 Dietary Guidelines for Americans were released. You can download the Guidelines and supporting materials at USDA Center for Nutrition Policy and Promotion website. They represent the government’s cornerstone for nutrition policy and education for the next five years and affect the work of every registered dietitian and dietetic technician, registered.
ADA has issued two press releases on the new Dietary Guidelines – one that gives our overall reaction to the new DGAs and another that focuses on how consumers can apply the Dietary Guidelines to their own individual eating plans. In addition, media coverage of the release of the Dietary Guidelines includes a substantial number of interviews with ADA members, including our Spokespeople. Links to some of this media coverage will be included in this week’s issue of Eat Right Weekly.

Enjoy!
helping consumers

urgent prescriptions

less sodium and sugar, more exercise

More exercise, less food

Training for Weight Loss

Did you hear that Iron Girl has a new main sponsor!!!
Athleta, the Sonoma County based women's sports and active apparel brand, has signed on as the new title sponsor for Iron Girl. With 13 events nationwide, ranging from 10K/5K to half-marathon, duathlon and triathlon, the Athleta Iron Girl Event Series empowers females of all ages to lead a healthy and active lifestyle.

Also-Trek is the official bike sponsor of the Iron Girl Series.
http://www.trekbikes.com/women/

HOW EXCITING!!

I hope you enjoy my latest article in the Free Iron Girl Newsletter.

Training for Weight Loss
Marni Sumbal, M.S.

The 2011 Athleta Iron Girl Event Series is rapidly approaching; do you have your mind set on a race? Participating in an athletic event can be an excellent way to increase fitness, overcome physical and mental obstacles, reduce risk for illness and improve cardio-respiratory endurance. Training with a set goal in mind, rather than resorting to compulsive exercise or extreme calorie restriction, can also be a great way to lose or maintain weight.



However, with time, the dramatic weight loss you saw when you started training will reach a plateau. As you get deeper into a training plan, your lactate threshold, strength, speed and endurance capacity will increase as your body becomes a well-fueled, efficient machine. Overall, this will be beneficial to your fitness, but your body will not respond to the physiological demands of training like it did in the past.



To avoid this dreaded "weight plateau," change your current routine (both cardio and strength training) to include more short, high-intensity intervals or workouts. Additionally, be sure to give your body adequate rest, not only during workouts, but during the week. A well-rested body will be able to respond more favorably when it comes to adapting to the physiological demands of training.



When it comes to your daily diet, take time to prioritize your individual pre-, during (if needed) and post-training nutrition to help prevent fatigue and assist in both performance and strength gains. Keep in mind that as your training changes, so must your daily diet. Pay attention to the intensity and duration of each training session, which will help in planning your sports-nutrition strategy and meeting your individual weight (and training) goals in line.



Marni holds a Master of Science in Exercise Physiology, is a Certified Sports Nutritionist (CISSN) and holds a certification by the American Dietetic Association in Adult Weight Management. Marni is a Level-1 USAT Coach and is currently pursuing a registered dietitian degree. She is a 4x Ironman finisher and has qualified for the 2011 Ironman World Championship. Marni enjoys public speaking and writing, and she has several published articles in Lava Magazine, Hammer Endurance News, CosmoGirl magazine and Triathlete Magazine, and contributes monthly to IronGirl.com and Beginnertriathlete.com.
Any questions, Email trimarnicoaching@gmail.com

Oprah staff goes vegan

Just about to get on my trainer to start an early bike+run interval workout.
Saw this on TV and quickly set my DVR. Thought you all might be interested.


Vegan one week challenge

I am always interested in how others are portraying different diets, so this should be interesting.