Author Archive

5 Tips for Navigating Recovery during the Summer

Posted June 4, 2024

Person holding ice cream cone outsideSummer is right around the corner!! It’s almost time for pool parties, celebrations, picnics, BBQs and fun in the sun! While many of us may read that line and feel excitement for what’s to come, many of you may also sense some nerves and feelings of being overwhelmed. Warm weather months often bring up many worries around food and body image for those in eating disorder recovery. I’m here to give you some tips for how to not only survive, but most importantly, have fun during these months!

Structure with Flexibility

Depending on where you’re personally at in recovery, structure is often helpful during these months, especially if your school or work schedule is changing. If your days become wide open when the summer months hit, it may be helpful to develop a routine to ensure you’re staying on track with your recovery goals. Sometimes it’s helpful to think about what your day will look like, and then you can envision when you’ll eat around your schedule. For example, if you are going to the beach with your friends at 11am do you need to pack lunch? Snacks? Hydration?

Comfortable Clothing

Clothing has such a huge impact on how we feel about ourselves and our bodies. If you have time before the summer months hit, it might be helpful to work with your team to build a plan to go through even some of your summer clothes before the season fully hits. It can be hard to get dressed in the summer when you haven’t gone through your clothes in a year. There can be a lot of uncertainty about how stuff feels on your skin or what fits. Once you have a better feel for your closet, you’re only grabbing for what is your current style, what fits, and what is comfortable! Though it won’t take all of the stress away around summer clothes, it sure does help some! Remember – clothes are meant to fit you, not vice versa!

Prepare for Events

When I think of the summer, my mind is filled with endless gatherings and celebrations, many of which have a cookout or food involved in some way. Use your therapy and dietitian sessions to plan for these events! It can be helpful to even role play certain comments or scenarios that could take place. You can work with your team to best determine if a lot of planning is needed, or if the challenge will be to engage in less planning in your stage of recovery. Remember to include topics about body image when planning with your team, too.

Support

Often during the summer months our schedules open a bit more, especially if we’re on break from school. Lean into this increased flexibility if you could use more support. Chat with your team to determine if meals with your team, food exposures, body image groups, or other means of support would be beneficial for you during this break from your usual schedule.

Create a Summer Bucket List

I always think this can be a fun way to navigate a new season. Develop the list without the idea of changing your body or engaging in eating disorder behaviors. What do you want to remember about your summer next year? Is there anything you want to push yourself to do this summer? Here are some ideas that come to mind for me. What’s on your list?

  • Try a new restaurant
  • Attend a music festival or concert
  • Learn a new hobby
  • Travel somewhere new
  • Attend a farmer’s market
  • Go to the beach or pool
  • Find a new ice cream shop
  • Read a new book
  • Have a picnic in the park
  • Star gaze at night
  • Enjoy a cozy campfire with smores
  • Hike a new trail
  • Have a board game night

While summer can be a hard time for individuals working on eating disorder recovery, it’s important to remember that it is possible! Continue to lean into your “why” for recovery during these months and use your treatment team to celebrate your wins and discuss your challenges. I hope these tips help you to have a fun summer you’ll never forget!

Adrienne DinkArticle by Claire Bowar, RD, CDN, LDN, CEDS
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5 Dietitian-Backed Strategies to Combat Winter Blues in Chicago: From Vitamin D to Mood-Boosting Foods

Posted January 30, 2024

Woman standing in cold.We all know it can be difficult to thrive in a cold climate like Chicago during the winter months. We do choose to live here for a reason, right? (even if you’re currently questioning that reason!). The good news is that your winter months can improve with some intentional support. Here are five tips from a dietitian for navigating the winter blues:

Seasonal Affective Disorder SAD Causes

Low Vitamin D levels have been shown to contribute to Seasonal Affective Disorder (often known as S.A.D). The importance of sunshine for health is two-fold: it signals to our bodies that we are awake and helps to reset our circadian rhythms to allow for better sleep, and in the warmer months, it allows for absorption of the sunshine vitamin – Vitamin D.

Research shows that in the winter months (around October through April), one cannot make and absorb enough Vitamin D from the sun. This is because the sun’s UVB rays, which are required for Vitamin D synthesis in the skin, are weaker. As a dietitian, I usually recommend a food-first approach over supplements. However, getting the daily suggested amount of vitamin D from food alone can take effort. The highest food sources are fatty fish (like salmon, sardines, and tuna), liver, cod liver oil, egg yolks, and irradiated mushrooms. If these are not common in your diet, supplementation is recommended.

Vitamin D supplementation

Most people do well with 1000-2000 IU of Vitamin D3 (rather than D2) daily throughout the winter months. I recommend checking that all your supplements are third-party verified (with a USP or NSF label) to ensure the product contains what it says it contains and is without harmful contaminants. Always check with your doctor first before starting.

Get Daily Sunlight Exposure

Get outside for at least 15 minutes during the daytime to get some sunlight. Getting outside during the daylight hours has proven benefits for mood and sleep. If you cannot get outside, consider light therapy – this involves exposure to bright light through a light box, which mimics the effects of sunlight and can, therefore, have the same mood-boosting benefits. These are increasingly available these days – consider asking your therapist or doctor for recommendations for affordable and effective options.

Focus on Omega-3 Rich Good Mood Food

Focus on eating sources of omega-3 fatty acids, such as fatty fish (see above), for their mood-altering benefits (if you are vegan, consider a good quality algae supplement with omega-3s). Aim for about 12 ounces/week of fatty fish to reap the benefits of these omega-3 fats. For sustained energy levels throughout the day, focus on foods with fiber, unsaturated fats, and lean proteins, such as whole grains, fruits, vegetables, nuts/seeds, legumes/beans, avocados, dairy, and eggs.

Keep warm with hot drinks and hot food! Enjoy hot cocoa, tea, and hot soups and stews.  

Stick with a Daily Routine – Including Sleep & Wake Up Times and Movement

It can be challenging to keep a good routine with shorter days, but going to bed and waking up at the same time can be instrumental in managing the winter blues. Practice good sleep hygiene by maintaining a relaxing bedtime routine – try taking a warm bath or shower, practicing yoga or stretching, and avoiding electronic devices for at least 30 minutes (preferably closer to an hour) before bed.

Similarly, stick with a morning routine to get up simultaneously every day. If you are having difficulties waking up, try moving your phone across the room so you have to get up when the alarm goes off, or if you will just bring your phone back to bed with you (guilty!), consider an alarm clock that slowly wakes you up with gradual light, mimicking a sunrise, before the alarm goes off.

As mentioned above, try to get out during the daylight hours. Finally, consider a regular movement routine – whether it’s walking on the treadmill, biking, yoga, weightlifting, or group exercise classes – getting your blood flowing and your heart pumping will lead to mood-boosting endorphins and help you to feel tired at night to reinforce your bedtime.

Stick to Your Social Plans!

While it can be incredibly tempting to cancel plans when feeling down, it is even more essential to seek out and commit to regular plans with friends or family who you know tend to boost your mood. Try to stick with these commitments, even if it’s just for a short time, at least once a week. You will likely thank yourself once you get there and begin to engage in social connections with your loved ones.

Seeking More Support: CBT and/or Medication

If the above are not enough to get you out of the winter funk, you are not alone. You may be experiencing a more significant seasonal depression (S.A.D). If this is the case, it is important to seek further support from a therapist, psychiatrist, or both. You may benefit from CBT (Cognitive Behavioral Therapy) or medications that have been proven to help with S.A.D., such as SSRIs or SNRIs (which help to boost the good mood chemicals in your brain). There is no shame in needing extra support.  

References:

https://www.sabinorecovery.com/how-to-help-seasonal-depression/

https://www.nhsinform.scot/healthy-living/mental-wellbeing/low-mood-and-depression/beating-the-winter-blues/

https://www.nytimes.com/2022/12/06/well/live/vitamin-d-deficiency-winter.html

Expert Dietitian Guidance on Managing Common Digestive Issues: From IBS to Food Intolerances

Posted January 24, 2024
Man holding stomach with waffles on tableAround 20% of Americans suffer from chronic digestive issues, and many do not seek help until it gets bad enough to disrupt daily life. Digestive issues can come and go, with seemingly no rhyme or reason, making it difficult to identify patterns independently.

According to the American Gastroenterological Association, it is common for those with digestive issues to avoid talking about their symptoms unless their provider brings it up. This is troubling when you consider that around 40% of Americans with chronic digestive distress have had to stop or reduce daily activities (such as exercise, errands, or social time) due to the extent of their discomfort.

As a dietitian and a long-term sufferer of digestive issues, I can personally relate to how difficult it can be to both endure the symptoms and to talk about it. If this is you, too, let me tell you how a dietitian can be supportive in working with you on digestive concerns:

Understanding The Basics of Digestive Distress- Possible Causes

First, while working with your dietitian, it is important to see a Gastroenterologist (GI) doctor to rule out more serious causes of digestive issues:

Irritable Bowel Disease (IBD)

Irritable Bowel Disease (IBD) is an autoimmune disease that targets the digestive tract, with two subtypes – Crohn’s Disease and Ulcerative Colitis. 

Crohn’s Disease and Ulcerative Colitis

They lead to inflammation and irritation of different parts of the digestive tract, causing diarrhea and poor absorption of nutrients. If left untreated, this can lead to permanent damage to the intestines and a higher risk of intestinal and colon cancers.

Celiac Disease (CD)

Celiac Disease (CD) is an autoimmune disease that causes damage to the intestines with the ingestion of gluten, the main protein in wheat, barley, and rye. Over time, untreated CD can lead to malnutrition and weight loss and an increased risk of other autoimmune diseases, intestinal cancers, and heart disease.

Small Intestinal Bacterial Overgrowth (SIBO)

Small Intestinal Bacterial Overgrowth (SIBO) is when the small intestine has an abnormal amount of bacteria present, leading to malabsorption of nutrients, damage to the intestinal lining, and possibly weight loss or malnutrition. It is normal for the large intestine (the colon) to have many bacteria, but not the small intestine.

Infections of the GI from SIBO

Infections of the GI tract can be bacterial, viral, or parasitic. These typically require treatment with medication and cannot be fixed through dietary changes.

Common SIBO testing

Common testing to rule out the above diagnoses includes a Hydrogen Breath Test (SIBO), stool sample (infections), upper endoscopy or small bowel endoscopy (imaging and biopsies of the esophagus, stomach, and small intestine), colonoscopy (imaging and biopsies of the lower small intestines, colon, and rectum). Your doctor will determine which are most essential based on your symptoms.

Food allergies

Although more common in children than adults (only about 4% of adults have them), they are still essential to rule out due to the potential severity. A food allergy occurs when your body perceives the proteins in a specific food as a (false) threat, therefore launching an immune response against them. It is possible to suddenly develop an allergy to a food you’ve long tolerated.

The only way to diagnose one is to work with an allergist. They can perform skin-prick and/or blood tests to indicate whether food-specific immunoglobulin E (IgE) antibodies are present in your blood.

Food intolerances

Food intolerances are different than an allergy because they do not involve the immune system. They have similar (but often less severe) symptoms to food allergies – digestive concerns (cramping, nausea, bloating) and others such as headaches or skin rashes. There is currently no valid testing for diagnosing food intolerances, despite many companies now offering “food sensitivity” testing. These blood tests target IgG, a food–specific protein; its presence in the blood is likely a normal response of the immune system to food exposure, and higher levels may be due to tolerance of foods, not the other way around.

Irritable Bowel Syndrome (IBS)

If your doctor rules out the above, they may diagnose you with Irritable Bowel Syndrome (IBS). This is a functional disorder of the digestive tract, classified by its cluster of symptoms rather than a physical abnormality of the digestive tract. It has three subtypes – IBS-C (constipation), IBS-D (diarrhea), and IBS-M (mixed subtype). While it does not cause an increased risk for cancer over time, it can lead to serious distress and affect the quality of everyday life, with symptoms such as urgent bowel movements, watery stools, blood in the stools, chronic constipation, bloating, and abdominal pain.

Evaluating Overall Health with Your Dietitian

Gut issues are complex. There are often many causes, and therefore, a multifaceted solution is needed during the process of working with a GI doctor, and after, your dietitian can support you in navigating your diet and lifestyle. A dietitian will look at all aspects of your health – nutrition of course, but also sleep, stress, physical activity, potential food intolerances and triggers, supplements/medications, etc.

For instance, if your dietitian identifies that your diet is lacking in essential nutrients (such as healthy fats, fruits, and vegetables, etc.), they can explain what is missing, where to get these nutrients, and how to grocery shop for and cook these foods in an enjoyable way.

A dietitian can also help differentiate conflicting information on the internet for treating digestive concerns because symptom management for these issues is not always the same. For example, while a high-fiber diet can improve constipation, it may worsen or trigger symptoms of diarrhea. A dietitian can help you find the right balance of fiber and other nutrients for your specific condition.

Coming Up with a Personalized Plan

Many people believe that food sensitieves or intolerances are the causes of their digestive issues, and this is true in a small percentage of cases. However, for most, their overall pattern of eating and lifestyle habits tend to matter more. For instance, a client with IBS-D may have persistent diarrhea that worsens with trigger foods when they are in a flare-up, but they may be able to tolerate some of those trigger foods when they are not in a flare-up.

When food intolerances are present, a dietitian can help you identify them over time with detailed food recalls, targeted elimination, and, more importantly, reintroduction of foods. The goal is to eliminate as little as possible from your diet over time. Why? Because food variety is one of the keys to long-term gut health!

Keys to Gut Health

A dietitian can help you target this list specifically to your needs, but here are a few essentials for building up your gut-health overtime:

Include Fiber in Your Diet

Fiber* is in plant foods, including fruits, vegetables, whole grains, and beans/legumes. It is known as a pre-biotic in the digestive health world, which acts as fuel for the abundant bacteria in your colon. When they are well-fed, the healthy bacteria in your colon can thrive. Research shows that variety in plant foods – different colors, types, and ways of eating them – is the most beneficial for gut health.

*If you have chronic diarrhea, your dietitian can help you navigate the amount and types of fiber you consume. For instance, many folks with chronic diarrhea tolerate cooking better than raw vegetables.

Manage Stress, Anxiety, Depression, and other mental health concerns:

There is a strong connection between your brain and the gut, which is mediated by the bundle of Vagus nerves. These are the main nerves of your parasympathetic nervous system. This system controls body functions such as digestion, heart rate, and your immune system. If you are chronically anxious or stressed, your brain will send these messages to your gut, which can cause disruptive symptoms. Likewise, if your gut health is poor, it can affect your mental state.

Work with your dietitian to discuss techniques for managing stress, including yoga, meditation, and work-life balance, and ask for a referral to a therapist or psychiatrist if needed.

Consider Probiotic Foods, but be Wary of Supplementation

We have no good way of knowing what specific probiotics (or healthy bacteria) are needed for overall gut health. Therefore, I do not often recommend probiotic supplements to my clients – it’s essentially a “shot in the dark” and can be more expensive than helpful. Instead, getting probiotics from various food sources may be more beneficial. They are abundant in yogurt and fermented foods such as kefir, kimchi, cabbage, and more.

Drink Enough Fluids; Reduce Alcohol

Focus on water, tea, and coffee (<400mg/day, or <4 cups) to improve your gut health. Try to reduce alcohol (1 drink a day for cis-woman, 2 drinks a day for cis-men, and avoid/reduce binge drinking – which is 4-5 drinks in one sitting) or abstain from it if needed.

Increase movement

Movement helps with stress management, and digestion (especially for constipation), and works to reduce the body’s overall inflammation.

References:

https://gastro.org/press-releases/new-survey-finds-forty-percent-of-americans-daily-lives-are-disrupted-by-digestive-troubles/#:~:text=Trust%20Your%20Gut%20comes%20at,diagnosed%20by%20a%20medical%20professional.

https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/definition-facts

https://www.verywellhealth.com/how-to-get-tested-for-sibo-4125868

https://www.crohnscolitisfoundation.org/what-is-ibd/ibs-vs-ibd

https://celiac.org/about-celiac-disease/what-is-celiac-disease/

https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/small-bowel-bacterial-overgrowth#:~:text=Definition,grow%20in%20the%20small%20intestine.

https://acaai.org/allergies/allergic-conditions/food/

https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/igg-food-test

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682924/

https://www.allergy.org.au/patients/food-other-adverse-reactions/food-intolerance

Adrienne DinkArticle by Adrienne Dink, MS, RD, LDN
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A Dietitian’s Top 6 Health & Wellness Activities for the New Year (that don’t involve weight!)

Posted December 21, 2023
Woman looking at phone and computerIt is understandable why people turn to weight loss as a resolution in the New Year. In our weight-focused society, there is endless pressure to be a smaller size. If you’ve heard our practice philosophy at Healthier Tomorrows, you know we promote a weight-neutral, non-diet approach to health. 

This means we help our clients focus on health-promoting behaviors rather than try to change the number on the scale. Weight is not a behavior; it doesn’t always change when you adopt more health-promoting habits!

 Picture this: you have been adding fruits and vegetables to meals and starting a walking routine. You are noticing improved energy, mood, and digestion. Then you step on the scale – the number is higher than two weeks before you started these habits. What happens next? If you’ve been here before, you know the answer: you feel discouraged. You may skip your walk the next day or stop cooking as much. See what is happening here? Focusing on the ever-elusive lower weight makes it hard to stick with these long-term goals.

What if this year could be different? If you’re interested in setting non-weight focused health-aligned resolutions, here are six recommendations from a dietitian:

1.    Cook At Home More Frequently!

Many of my clients have goals to cook at home more often – not just for health, but for budgeting, too – eating at home more often can help you save significantly on food costs. From a nutrition perspective, cooking at home allows you to add more nutrition, whether tossing an extra handful of spinach into the soup, adding a side of roasted vegetables or a salad to meals, or snacking on more crunchy vegetables and fruits.

2.    Commit to a Sleep Routine

All other health goals can suffer without proper sleep. Good sleep provides the energy to care for ourselves, get in touch with hunger/fullness cues, and deal better with life’s stressors. The National Sleep Foundation recommends sleeping 7-9 hours a night. Consider discussing a nightly wind-down routine with your dietitian or therapist, investing in a good sleep mask and noise machine, and ensuring your bedroom is cool (around 65-68 degrees). Avoid screens at least 30 minutes before lying down.

3.    Schedule Regular Visits with Your Medical Providers

Taking care of your physical and mental health are equally important. Having routine yearly checkups with your doctor allows you to monitor your health status and practice disease prevention. Keeping up with your therapist and/or psychiatrist regularly is essential for your mental health and managing stress levels. 

Your dietitian can help you set and achieve health-promoting habits to make you feel better in the short term, reduce your disease risk in the long term, and heal your relationship with food. Important note: if you’ve had problems with weight-biased medical care in the past, ask a trusted provider for a referral to a HAES-aligned physician or provider. 

4.    Reduce Screen Time

 I’m sure this isn’t the first time you’ve heard this suggestion – easier said than done, right? Being on our phones too much (especially on social media) can lead to enhanced body dissatisfaction and exacerbate stress or low mood. Like any other habit you’d want to reduce, try replacing some screen time with another habit, preferably one that provides joy or relaxation! 

Screen Time Healthy Replacement Activities

You could replace 30 minutes of screen time each night with 30 minutes of reading, talking on the phone with a loved one, cuddling your pet, or stretching. Reducing screen time can allow you to be more present, less stressed, and sleep better over time.

5.    Drink More Water and Fluids and Consider Less Alcohol

We know staying hydrated is important for health, but how much fluid do you really need in a day? According to the National Academy of Medicine, 9-13 cups, or 72-104 ounces, is the daily recommendation for the average adult, with variation among individuals. For instance, those who are regularly active, living in hot climates, pregnant or breastfeeding, etc., will need more.

In the short term, even small amounts of dehydration can cause fatigue, mood changes, and difficulty concentrating. Long-term, it may contribute to constipation, UTIs, and kidney stones. 

Moderate Coffee Consumption for Hydration

Fun fact: it is a myth that caffeine dehydrates you, at least in moderate amounts. Research shows that up to 180mg (or ~2 small cups) of coffee/day won’t cause you to urinate much more than usual. 

Therefore, tea and coffee (in modest amounts) can contribute to hydration! Alcohol is dehydrating, though, so make sure to consume water alongside it and/or reduce or avoid alcohol intake if you are able.

6.    Buy Fewer Material Items and Consider Experiences Instead!

In our consumer culture, keeping up with the latest fashion trends, home décor items, and more can be tempting. However, clutter in the home can cause stress (along with a dwindling bank account). 

Experiences Over Material Items

Consider investing in experiences more often than material items – for instance, planning a trip or weekend getaway, seeing your favorite artist in concert, or learning a new skill (such as a pottery or cooking class). If you need budget-friendly experiences, consider reading or a picnic in a park on a nice day, walking through a nature preserve, watching a movie marathon with a friend, or enjoying live music at a bar or restaurant. 

These experiences may be more likely to contribute to your overall well-being and happiness in the long run versus material items that will lose their value (and your interest in them) over time. 

Resources:

The Sleep Foundation. Effects of Sleep Deprivation. https://www.sleepfoundation.org/sleep-deprivation/effects-of-sleep-deprivation#:~:text=Long%2Dterm%20sleep%20deprivation%20can,get%20the%20rest%20they%20need. Access 12/4/2023.

The National Academy of Sciences. Dietary References Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. https://www.nap.edu/read/10925/chapter/6#102. Accessed 12/1/2023.

Adrienne DinkArticle by Adrienne Dink, MS, RD, LDN
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5 Dietitian Tips on Managing Stress & Health During the Holidays

Posted December 12, 2023
Holiday Table SettingAs a dietitian, I believe that feeling well can and should extend into the holiday season. While it is a lovely time for many reasons, it can also put us out of our normal routine, making it difficult to prioritize ourselves physically and emotionally.

This year, I challenge you to abandon an all-or-nothing holiday approach. You can enjoy rest from exercise while also fitting in some time for joyful movement to avoid feeling sluggish. Similarly, you can enjoy fun foods without stress and guilt, while also intentionally adding some fiber and protein to support energy and digestion. Your priorities may change depending on the plan that day. The following are a few tips for feeling your best this season– take from them what resonates with you!

Prioritize eating regularly

I bet most dietitians would agree with me on this one- it is difficult to eat mindfully and enjoy your food (and to stay sane around your quirky relatives) if you are not eating enough. Holiday meals can be larger than usual and occur at odd hours of the day, but this isn’t an excuse to skip meals. Eating regularly allows for blood sugar stability, which results in more even moods and energy levels.

If your holiday meal is at midday, treat it like lunch. If it’s midafternoon, treat it like an early dinner. Yes, that means I still recommend eating your regular meals and snacks surrounding the holiday meal. And yes, they can be leftovers from the meal itself!

Manage Mental Health – Set Boundaries, Identify Support

While the holidays can be fun and joyous, they can also be stressful, with numerous plans and commitments. It’s important to set boundaries with your time and energy. For instance, if you know you max out your ability to socialize with family after 10 hours, set boundaries ahead of time on when you need to leave. 

It may also be helpful to step away for a moment –bundle up and take a walk, offer to run an errand, or call a friend. This may involve having a go-to support person to contact if the conversation starts to get stressful with political dialogue or worse, your relative’s dieting plans for the new year.

Get Adequate Sleep

Sleep is especially important when the rest of your normal routine is out of whack. Along with regular eating, getting adequate sleep (7-9 hours a night) allows you to feel more stable in mood, get better in touch with hunger/fullness cues, and manage your emotions when faced with a lot of social time. You could also consider naps as an opportunity to rest or take a social break – turn on a movie and have a quick snooze.

Stay Hydrated and Mindful of Alcohol

Staying hydrated is important for feeling well during the holidays. When we travel, eat different foods, and are off our normal routines, our digestion can be affected. Staying hydrated is one way to keep things regular. It also can keep energy levels and mood stable. 

I recommend bringing a reusable water bottle along to holiday celebrations, especially if traveling. Along these lines, consider being mindful of alcohol. This could look like an intention to drink a glass of water in between alcoholic beverages, to limit the total intake of alcohol, or to take breaks/days off from alcohol intake altogether.

Set Gentle Boundaries Surrounding Food & Diet Talk

One of the trickiest parts of the holidays can be how, all of a sudden, everyone you know – from the coworker you sit next to at the office to your great aunt who you haven’t seen in a year – is talking about their upcoming diet for the new year. 

There can also be more subtle comments about being “so bad” for getting that second slice of pie or unsolicited advice about food, your body, or how you look. Whatever it may be, you have options:

Change the Subject: 

“It sounds like you’re feeling happy about that choice. Anyway, did you watch the new season of [insert tv show]? What did you think about…”

Gently set boundaries: 

“It makes me uncomfortable when you comment about my food choices (and/or body). Let’s talk about something else.”

Call it out:

“My food choices don’t reflect on my moral value or worth. Getting seconds of mashed potatoes is morally neutral.”

Happy holidays! Enjoy the people you love and your favorite foods!

Adrienne DinkArticle by Adrienne Dink, MS, RD, LDN
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7 Tips on Navigating the Holiday Season with Type 1 Diabetes

Posted December 6, 2023
Christmas Cookies on PlateThe holidays are an exciting time of year. Still, for many of us living with a chronic disease like type 1 diabetes, the holidays can add even more stress and decision-making to our already chaotic lives. Did you know that people living with type 1 diabetes make an additional 180 decisions a day on average?!

Debunking Diabetes Myths Around Festive Meals

Added stress for those with diabetes could be from dealing with the insensitive food comments others make about sugar-causing diabetes, which isn’t true. A person with diabetes may have to navigate how to handle comments others make about what the person with diabetes should or shouldn’t be eating since they have diabetes. 

For example, “You have diabetes, so you shouldn’t be eating Christmas cookies.” Some people with diabetes may have their well-meaning family or friends make sugar-free alternatives that the person with diabetes may or may not have asked for. Yes, people with diabetes can have the “regular versions” of foods and keep their blood sugar stable. It depends on the person with diabetes and their preferences!

Managing Holiday Routines and Blood Sugar Levels

On top of the food comments and special versions of foods being made, changes in our sleep, eating, movement routines, increased travel, and eating different or new foods can make carb counting tricky. All these factors can cause it to be challenging to enjoy ourselves, keep up with regular routines, and manage blood sugars.

Dietitian’s Tips for a Diabetes-Friendly Holiday

As a dietitian living with type 1 diabetes, here are some of my tips for navigating diabetes during the holidays.

Stabilizing Blood Sugar Through Consistent Nourishment

Nourish yourself all day. I don’t recommend “saving up” for the big meal. Eating consistently throughout the day will help keep your blood sugar, energy, and mood stable.

Indulging Mindfully: Enjoy Your Favorite Holiday Treats

Enjoy the food! If your favorite dish is being served, have some, and take home some leftovers! You can incorporate your favorite dessert into breakfast or a snack the next day by having the dessert with Greek yogurt, your favorite nut butter, chia or flaxseeds, fruit, etc. Also, you can just enjoy the leftovers by themselves!

Smart Dessert Strategies for Better Blood Sugar Control

Eat dessert with your meal. This is not a requirement, but if you have the option, it may benefit your blood sugars to have dessert with your meal because the protein and fiber from your meal may help stabilize the carbohydrates in the dessert.

Educating Others and Advocating for Diabetes Awareness

If you have the capacity, educate others about diabetes. This could be like explaining how your diabetes technology works or challenging diabetes stigma by providing education.

Connecting with Others for Emotional and Social Support

Connect with friends with diabetes, “diabuddies,” in person, online, or share with those in your life who are open to listening. Diabetes can be isolating. You don’t have to deal with it all on your own!

The Importance of Self-Care During the Holiday Rush

Practice self-care. Self-care can look like having low-blood sugar snacks on hand, designating time for rest, staying hydrated, practicing saying no, and having boundaries. No one can do it all!

Embracing Imperfection: Managing Diabetes During the Holidays

Go easy on yourself. It is okay if your blood sugar isn’t perfect. The holidays can be a busy and emotionally challenging time of year. Try to give yourself grace and be present.

Brianna BechererArticle by Brianna Becherer MS, RD, LDN, CPT
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5 Healthy Prepared Meal Delivery Services in Chicago

Posted October 16, 2023
Vibrant plate of bow tie pasta, with tomatoes and greens underneath.One of my missions as a dietitian is to simplify food decisions and to reduce shame around not always wanting to cook. Most of my clients live busy, robust lives with many obligations and hobbies, and time or desire to cook can become deprioritized.

Instead of beating yourself up or relying on expensive takeout, it can be helpful to use other tools at your disposal, like meal delivery services. While they are more expensive than cooking, compared to frequent takeout, you can save money in the long run.

Here are a few meal delivery services I recommend to my clients* and some highlights of each. All involve prepared meals ready to heat, serve, and deliver to Chicago.

Territory foods

Territory Foods’s registered dietitians work with local chefs and restaurants to craft healthy meals within your dietary restrictions. All meals are dairy and gluten-free and contain no refined sugars, nitrates, chemical preservatives, or artificial colors.

Typical Meals: 

Balanced meals that include all food groups. Creative, colorful meals with variety. Entrees (mostly lunch and dinner) and individual meal components – e.g., “family style” grilled chicken breast, roasted broccoli, or roasted sweet potatoes.

Pricing & Delivery 

  • Price point: Moderate-Pricey: $15-18/meal.
  • Pick 6, 8, 10, or 12 items per delivery.

Dietary Intolerances & preferences: 

All meals are dairy and gluten-free; some vegetarian/vegan options.

Website: 

 https://territoryfoods.com

MyoMeals

MyoMeals is based out of Chicago and only delivers to the Chicagoland area. They offer healthy, affordable meals featuring ingredients mainly sourced from local Chicago vendors. They believe meals created with macronutrients in mind lead to more nutritious meals and provide this information on each meal. MyoMeals also incorporates an assorted menu with international dishes.

Typical Meals: 

Balanced meals that include all food groups at a reasonable price point. Both classic and more unique options are available.

-Entrees (including breakfast, lunch, and dinner)

Pricing & Delivery 

  • Price point: low $13-15, with “MyoClassics” offered at even lower prices, $10-13/meal.
  • Pick 4 meals or more per delivery.

Dietary Intolerances & preferences: 

MyoMeals doesn’t mention meals for dietary intolerances or restrictions. Limited vegetarian options; no information on allergens or intolerances exists, but ingredients are listed.

Website: 

https://www.myomealsprep.com/

KitchFix

Chef-owned Chicago-based meal delivery company offering ”delicious, mindfully-prepared meals throughout the Chicagoland area.”. KitchFix’s chefs and nutritionists create a rotating variety of healthy, unique meals for various diets. KitchFix partners, donates, and volunteers with many local charity organizations.

Fun fact! During graduate school, I worked at their storefront in the Gold Coast (which has since closed – they now operate 100% online). I can vouch for how delicious their meals are!

Typical Meals: 

Balanced meals that include all food groups. Unique, colorful meals with variety. Entrees include (breakfast, lunch, and dinner), and individual meal components – e.g., grilled chicken breast, sweet potato wedges, or herbed salmon, and dessert options (e.g., brownie bites).

Pricing & Delivery 

  • Price point: high $15-20+/meal; offers discounts for 5, 7, or 10 meal bundles.
  • $60 minimum purchase required.

Dietary Intolerances & preferences: 

Kitchfix Caters to dietary intolerances or preferences: all meals are dairy and gluten-free, although only a few vegan/vegetarian options are available. Meals are non-GMO, gluten-free, dairy-free, peanut-free, and refined sugar-free.

Website: 

https://kitchfix.com/

Veestro Meals

Veestro Meals is the best option for vegetarians and vegans, as all meals are plant-based. They create meals using fresh ingredients and are chef-prepared. Meal options list all ingredients and nutritional information.

Typical Meals: 

All plant-based (vegetarian or vegan) meals. A variety of delicious and creative options. Regular entrees (mostly lunch and dinner) are available, and individual meal components – e.g., roasted broccoli, potato wedges, buffalo cauliflower- and dessert options (e.g., fudgy brownies and chocolate chip cookies).

Pricing & Delivery 

  • Price point: moderate- all meals $15, with a higher minimum number of meals for delivery.
  • Pick 8 or more meals per delivery.

Dietary Intolerances & preferences: 

Veestro Meals offers plant-based (vegetarian or vegan) meals. The website doesn’t mention other dietary restrictions or allergies.

Website: 

https://www.veestro.com/

CookUnity

If you’re looking for a culinary-focused meal delivery service, CookUnity is an outstanding option. It boasts a roster of over seventy chefs, including Food Network alums and James Beard award winners. They use modified atmosphere packaging technology, allowing fresh meals to last longer in the fridge. CookUnity is sustainability-focused and launched a returnable packaging program in NY and LA to reduce waste.

Typical Meals: 

Balanced, tasty-looking meals made by local chefs. Each meal has a rating (out of 5 stars), so you can see which meals other customers have preferred—regular entrees (breakfast, lunch, and dinner) with many options.

Pricing & Delivery 

  • Price point: moderate-to-low; the price per meal ranges from $11-15, with the price decreasing the more meals you purchase at once.
  • Pick 4 or more meals per delivery.

Dietary Intolerances & preferences: 

Able to filter by vegetarian, gluten-free, etc., or specific ingredients needing avoidance.

Website: 

https://www.cookunity.com/

Special Note for People in Eating Disorder Recovery

If you are recovering from disordered eating, please note that most of these websites and meals contain calorie and macro information, and if this is triggering for you, please consider avoiding it.

Adrienne DinkArticle by Adrienne Dink, MS, RD, LDN
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Navigating a Plant-Based Diet: A Comprehensive Guide

Posted October 4, 2023

Plate of brightly colored vegtablesIntroduction to Plant-Based Eating

I’ve always been passionate about believing that all foods can fit into a healthy eating pattern. However, there are many reasons why people may seek out a more plant-based style of eating.

Understanding the Different Types of Plant-Based Diets

Within plant-based diets, there are different subcategories: vegetarian diets include eggs and dairy but do not include meat and fish, whereas vegan diets involve abstaining from animal products altogether. Many folks choose to follow these patterns of eating for ethical reasons, such as supporting animal rights and protesting the harms of factory farming or environmental reasons (meat and dairy contribute more significantly to environmental pollution than most plant foods).

The Health Benefits of Plant-Based Eating

There are pros and cons to any dietary pattern. The pros of a plant-based eating pattern include reduced saturated fat intake, which can help improve or reduce the risk of metabolic disease. Another possible advantage is the extra fiber intake, mostly from plant foods. Research has shown that diets rich in plant foods have been associated with longevity and lower disease risks. That being said, you don’t have to eliminate animal products to get these benefits completely, but rather, include more plants in your diet!

The benefits of plants extend well beyond the benefits of fiber. For example, plant foods also contain phytochemicals, which are powerful chemicals that can help decrease the risk of developing certain cancers, as well as heart disease and Diabetes.

Addressing Nutritional Concerns in Plant-Based Diets

Whenever you cut out certain foods or food groups, you run the risk of nutrient deficiencies. It is very possible to have a well-balanced diet as a plant-based eater; it simply requires more thoughtfulness and planning. The key is variety—including plenty of diverse vegetables, fruits, starches, plant-based proteins, healthy fats, and sources of omega-3s and fortified foods/supplements. The main nutrients to watch closely include protein, Vitamin B12, Vitamin D, iodine, calcium, omega-3 fatty acids, iron, zinc, and selenium.

Vitamin D Supplementation

Despite the long list, only a few supplements and fortified foods are needed. The rest can be obtained through a well-thought-out diet. Most of us don’t get enough Vitamin D from food or the sun (and sunscreen blocks its absorption). Therefore, most people should supplement with a small dose a few times a week, year-round.

Vitamin B12 Supplementation

For vegans, another common supplement is Vitamin B12, as it’s not found in plant foods except for nutritional yeast, which is a plant-based source of Vitamin B12 that imparts a cheesy flavor and texture to dishes.

Iodine Supplementation

Iodine is a mineral found inconsistently in plant foods, and similarly, commercial and processed foods (and sea salt) are not typically iodized. One can cook with salt labeled “iodized” or take a multivitamin with iodine to supplement. Iron, zinc, and selenium are minerals found abundantly in animal products but are also available in plant foods in smaller amounts, so they need to be included more intentionally.

Enhancing Nutrient Absorption

There are also ways to enhance absorption. For example, iron from plants is best absorbed with Vitamin C (e.g., lemon juice) and when avoiding tea, coffee, red wine, and calcium supplements within an hour of meals. Sources of these minerals include legumes, tempeh, nuts/seeds, cooked green vegetables, fortified breakfast cereals (iron), legumes, nuts/seeds, oatmeal, bread, tempeh, and miso (zinc), and Brazil nuts (selenium).

The Protein Myth in Plant-Based Diets

Contrary to popular belief, getting enough protein isn’t a difficult task if you include awide variety of protein options, such as soy products (e.g., tempeh, tofu, seitan, veggieburgers), beans and lentils, high protein pasta such as chickpea and lentil pasta, nuts/seeds, and grains such as quinoa and oatmeal. To ensure you are getting the nine essential amino acids that cannot be made in the body, include different types of proteins and grains within these categories.

Boosting Omega 3 Intake on a Plant-Based Diet

Omega 3 fatty acid intake can be trickier. While plant-based foods contain omega 3s (e.g., chia, flax, walnuts, and soy foods), it can be difficult to get the optimal recommended daily amounts from these foods when compared to fish. Some, therefore, opt to take a vegan omega-3 (algae–based) supplement, although the research on the necessity of this is conflicting.

Transitioning to a Plant-Based Diet: Tips and Strategies

If you want to change your diet towards a plant-based eating pattern, especially for a climate impact, I recommend taking it slow. For instance, you could start with just one plant-based meal a week. You could also consider reducing the portions of animal products at meals (e.g., having a smaller amount of steak and adding beans).

Small Changes, Big Impact

The bottom line is that when it comes to the influence of dietary patterns on the health of our planet, having more people eating fewer animal products is a lot more impactful than having a small minority of people eating none. Small changes in all our individual diets add up to big differences.

Sources:

Adrienne DinkArticle by Adrienne Dink, MS, RD, LDN
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10 Common Eating Disorder Symptoms: How to Recognize Them Early

Posted September 26, 2023

Two hands holding loaf of breadUnderstanding Eating Disorders

Eating disorders are serious mental and physical illnesses that involve disturbances in eating thoughts and behaviors. This can include restricting one’s food intake and/or compensating for intake through purging, over-exercising, laxative abuse, or other harmful behaviors, with the goal of reducing one’s body shape or size. 

This can also involve feeling out of control around food, eating larger amounts of food in one sitting than feels nourishing, and experiencing high levels of guilt and shame for these behaviors. Eating disorders can affect any person– regardless of body size, race, culture, socioeconomic status, or gender identity.

Eating disorders are, unfortunately, one of the deadliest of all mental illnesses, second only to opioid overdose. While the typical image we see in the media of someone with an eating disorder involves being in a thin and frail body, only 6% of people with eating disorders are medically considered “underweight.” 

As a result, it is common for people to go without treatment or to experience delayed treatment, despite the fact that the sooner one receives treatment, the better the prognosis. Here are some of the common symptoms to be aware of that may indicate an eating disorder:

10 Alarming Signs of an Eating Disorder:

1. Constant Thoughts on Food and Body Weight

Those suffering from eating disorders often experience constant “food noise.” This is when food, eating, or other related concerns – such as how food affects one’s body weight, shape, or size – take up a significant portion of daily thoughts and lead to high levels of distress.

If food or body thoughts are taking you or your loved one away from essential aspects of life, such as focusing on work or school or enjoying hobbies and relationships, this may be a sign focus on food has become excessive.

2. Abrupt Dietary Changes Masking Disordered Eating

Some decide to make dietary changes based on values or ethics, for example, becoming vegetarian for environmental or animal rights concerns. However, these dietary changes could also be used to mask abnormal eating behaviors. For instance, avoiding carbs, gluten, or animal products can also make it easier to avoid eating certain foods when in social situations – those deemed “unhealthy” or “bad.” It can be helpful to ask yourself about your intentions before making any sudden dietary changes.

3. Reluctance to Eat in Social Settings

Those suffering from disordered eating may feel uncomfortable eating around others due to fear of judgment (related to their own preoccupations with food and body) or fear of being pressured to eat more than they want or to eat specific foods. If you or your loved one suddenly withdraws from social events involving food, consider this as a potential sign there may be an eating disturbance occurring.

4. Mental Fatigue and Mood Instabilities

Food has calories, and calories are our body’s main energy source – this can be easy to forget in today’s dieting-focused culture – “calorie” has almost become a bad word! Therefore, if someone is restricting food, this is going to affect their fuel reserves negatively. This can lead to energy conservation – the body’s attempt at saving remaining fuel reserves for essential processes needed to keep them alive. This doesn’t leave enough energy to fuel optimal brain function, which can lead to poor concentration, low mood, and overall inability to carry out one’s usual daily tasks.

5. Gastrointestinal Issues from Irregular Eating

When someone isn’t eating enough at meals or isn’t eating regularly (it’s recommended to eat about every 3-5 hours), this can significantly impact digestion. The movement of food through the digestive system will slow down, and the stomach will produce less acid (or overproduce acid when a meal does finally enter the system). This can lead to constipation, abdominal cramping, bloating, acid reflux, and other gastrointestinal-related problems, and these symptoms can cause a lot of distress as well as further hinder eating.

6. Compulsive and Overzealous Exercise Routines

Those who struggle with eating often tend to compensate for perceived transgressions with food to avoid weight gain, to “balance out” energy intake, or to reduce guilt. One way this can manifest is through excessive exercise routines. Some signs of being overly rigid with activity include if it is difficult or impossible to take rest days – or you are riddled with guilt and food thoughts when you do – or if you tend to push exercise despite unsafe weather conditions, illness, or injury.

7. An Increase in Concern About the Health of Ingredients

The recently coined term “orthorexia” has been used to describe an extreme focus on ingredients. It is, of course, okay to want to eat in a healthful manner and to take care of and nourish your body, but this can quickly take an unhealthy turn if it becomes an inability to eat anything except for a narrow group of foods that are deemed “healthy” or “clean.” This could lead to guilt when eating foods that are not deemed clean, not eating enough calories overall, or missing out on key nutrients due to cutting out food groups.

8. Unexplained Weight Shifts

Significant and sudden weight changes can indicate that someone struggles to maintain a consistent eating routine. Not only is criticizing weight gain damaging but so too is complimenting weight loss – you never know what is going on behind the scenes or what has caused those weight changes.

9. Physical Dizziness and Hair Loss

As mentioned above, when energy intake is consistently low, the body slows down all non-essential processes to conserve energy. This can include a reduction in blood pressure or heart rate so that the heart muscle isn’t working as hard (leading to dizziness when sudden changes occur with standing), cold hands and feet due to the body prioritizing keeping your core warm but not the extremities, and hair loss – because protein is more essentially needed in other bodily processes!

10.  Avoiding Friends and Activities

Of course, with all these internal battles and physical symptoms occurring, it’s no wonder why someone may become withdrawn from their friends or loved ones. Eating disturbances can also co-occur with other mental health conditions, such as anxiety and depression, making reaching out for help all the more challenging.

Additional References on Eating Disorders:

https://anad.org/eating-disorders-statistics/

https://www.nationaleatingdisorders.org/what-are-eating-disorders

Adrienne DinkArticle by Adrienne Dink, MS, RD, LDN
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5 Tips for Feeling Your Best During Summer Activities & Exercises

Posted August 3, 2023
Feet with athletic shoes outsideIf you live in a state with seasons—especially cold winters—you do not need me to tell you how enjoyable it is to be active and participate in outdoor activities during the warm summer months! Whether you are engaging in more casual movement like walking or swimming, or more strenuous activity like playing sports or hiking, there are a few things to consider to help ensure your safety and that you feel your best while outside in hot summer temperatures.

Here are a dietitian’s top five tips for getting the most out of your activity during the warmer months:

1. Make Sure to Fuel and Hydrate Before Your Planned Activity

The body needs energy to perform optimally, regardless of the activity, including whether it’s just for fun or exercise. Before you engage in movement, aim to eat something that contains simple forms of carbohydrates — like a banana, pretzels, crackers, bagel, or toast — about 30-60 minutes prior. 

This pre-workout fuel, especially when it’s coming from quick-acting carbohydrates (broken down into sugars), allows you to feel more energized and can improve your performance. Your body can break down these simple carbs into sugars more quickly than a meal that contains complex carbs (think whole grains with fiber, which slows down the digestion of the sugars) or a lot of protein or fat (which also slows digestion).

2. Avoid Midday Workouts When Engaging in Outdoor Movement

The heat can be very exhausting on the body and can even increase cortisol levels (a stress hormone), leaving you feeling depleted after your workout. It can also increase your risk of dehydration due to excessive sweating. To feel better during your workouts, consider getting outside for your activities in the early morning, late afternoon, or evening when the outside temperatures are cooler. This reduces the sweating and stress on your body from the heat and allows you to feel more comfortable during your workout.

3. Get Enough Sleep the Night Before Your Activity

Getting enough sleep is a great way to make sure you have enough energy to engage in movement that you find joyful. This may also make it easier for you to get up earlier to engage in activity before your day starts, or could allow you to have more energy to be active later in the evening. Sleep is also when our bodies go into a state of rest and repair, allowing your muscle tissues to regenerate for your next activity.

4. Fuel and Re-hydrate After Your Workouts

Try to consume foods that contain both a carbohydrate and a protein source after your workouts. After a workout, you want both quick carbs to restore the depleted glycogen (or energy stores) in the liver and muscles and you want protein to repair your muscles. In fact, it is important to get both because carbs are “protein sparing” – that is if you get enough protein but no carbs, your body will convert some of that protein into carbs for energy, so less of the protein will go to repairing and building muscle!  

A few great post-activity snack options include Greek yogurt with fruit, a fruit smoothie with protein powder, or a granola bar with added protein for a quick on-the-go option.

If engaging in movement outside in the heat, especially if you are sweating a lot or outside for long periods, consider refueling with electrolytes (think sodium and potassium), which have been depleted from sweating, through sports drinks or electrolyte powders/tablets.

5. Even Small and Low-Impact Movement Counts as Physical Activity!

Adding in 5-10 minutes of yoga, stretching, or walking can make a big difference in how you feel and in your overall health. This could be as simple as using a standing desk or taking a five-minute break to walk around the house or stretch. Just breaking up the stillness of sitting or lying down can benefit our health by allowing our blood to flow properly and our muscles to be engaged.

Adrienne DinkArticle by Allison White, MS, RD, LDN
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