Health & Wellness

Don’t Let Flaring Up Burn You Out: Anti-Inflammatory Foods

By Heather Cunningham, RD, CNSC
April 15th, 2014
Heather Cunningham, MS, RD, CNSC

Heather Cunningham, MS, RD, CNSC – Registered Dietitian, Raritan Bay Physicians Group, South Amboy, NJ

Did you start the New Year off by trying a new diet and/or exercise regimens?  Whether you have started going to a hot yoga or kickboxing class, working different muscles and parts of your body can be painful (in a strengthening kind of way of course!).  By waking up muscle groups that haven’t been exercised before, sometimes you can experience soreness or tightness in that area that you haven’t felt previously.  In addition to proper warm up’s and cool down’s during your workouts, there may be some foods that have anti-inflammatory benefits that may be beneficial to incorporate into your meals.  Aches and pains, heart disease and also diabetes may also be related to the body being in an inflammatory state.  Sugar and saturated fat may actually trigger the body’s inflammatory response.  On the other hand, there are some foods that are higher in anti-inflammatory nutrients that may help ease post-workout aches and pains.

  1. Whole grains, in contrast to refined grains, are high in fiber.  Fiber has been studied for its effect on C-reactive protein, an inflammation marker in the blood.   When choosing a product made with whole grains, check the ingredient list to assure that it is first in the list (versus refined grain or flour) and that the item has no added sugar.
  2. Fatty fish, such as salmon, mackerel, tuna and sardines are high in Omega-3 fatty acids.  Omega-3’s have been shown in research to decrease inflammation although to reap this benefit, fish needs to be consumed several times per week.  Fish-oil supplements may be considered if increased consumption of fish is not achievable.
  3. Dark green leafy greens contain high amounts of vitamin E ~ a nutrient that may have a role protecting the body from cytokines (pro-inflammatory molecules).   Kale, spinach, broccoli and collard greens are all good sources of vitamin E.
  4. Nuts are another good food source of vitamin E, antioxidants and fiber.   Walnuts are specifically high alpha linolenic acid, a type of Omega 3 fat.  These nutrients can help the body fight the repair caused by inflammation.
  5. Beets contain high amounts of antioxidants ~ their bright, beautiful color should tip you off on some powerful plant pigments!  Betalains, a pigment found in beets, have been found to possess antioxidant, anti-inflammatory and detoxification support to the body.

These are just some examples of foods to “work in” to your diets due to their potential anti-inflammatory qualities.   With the New Year just starting, and for many, new workout routines, incorporating these foods into meal plans may help ease post-exercise aches.  Not only do many of these foods provide anti-inflammatory nutrients, but also contain other health supportive qualities too.

Nutrition Resources for Immigrants and Refugees

By Allison Koch, MA, RD/LDN, Clinical Nutrition Manager at Caldwell UNC Healthcare in Lenoir, NC
March 27th, 2014
Allison Koch, MA, RD/LDN, Clinical Nutrition Manager at Caldwell UNC Healthcare in Lenoir, NC

Allison Koch, MA RD/LDN, Clinical Nutrition Manager at Caldwell UNC Healthcare in Lenoir, NC

When I first moved from Michigan to North Carolina for my first job as a Registered Dietitian out of my Internship program, I had a lot of acclimating to do.  The over-abundance of delicious Southern cooking, the different dialects that almost seemed to change county to county, as well as actually having a steady dose of sunshine on a daily basis.  It has been a heavenly challenge.

During my first position at a small hospital in Hickory, NC, I was introduced to some local culture that was not prominent in my home community in Michigan, the Hmong.  In order to respectfully comply with and preserve their dietary habits, I needed some quick education on what their dietary preferences was, and how to obtain nutrition education in their native language.  Thankfully, I found the U.S. Committee for Refugees and Immigrants Food & Nutrition Outreach Toolkit.  The nutrition outreach toolkit provides nutrition educational materials for the Amharic, Arabic, Burmese, English, Farsi (Persian), French, Haitian Creole, Hmong, Karen, Kirundi, Nepali, Russian, Somali, Spanish, Swahili, and Vietnamese cultures.  The handouts help to provide basic nutrition education, and are great resources for patients who may have limited accessibility to nutrition education opportunities.

Immigrants are people who leave their country willingly to settle in another country.  Refugees are people who are forced to relocate to another place due to fear of persecution due to war, religious beliefs, political opinion, and other reasons that make it nearly impossible for them to ever return to their native country.  As nutrition professionals, we can help these people preserve their heritage by identifying local resources that encourage native cooking, such as local farmers markets or community gardens.

Resources for Nutrition for Immigrants and Refugees:

US Committee for Refugees and Immigrants:  www.refugees.org

UNHCR UN Refugee Agency:  www.unhcr.org (see Nutrition & Food Security)

Cook Time with Chef Remmi – Chicken with Grapes Recipe

By Chef Remmi Smith
March 26th, 2014

Chef Remmi Smith

March is National Nutrition Month and this is a campaign that is supported by the Academy of Nutrition and Dietetics. Their theme this year is “Enjoy the Taste of Eating Right.”  “Eating Right” may give you ideas of boring and tasteless food.  The key to exceptional tasty food is learning the skill of cooking to bring great tasting food to the dinner table.  And…I promise you the bigger the variety of fruits and vegetables you create from or add to your dishes will bring forth great flavors and tasty food.

Now let’s introduce the fabulous grape………..

Try this months’ recipe of “Baked Chicken with Grapes.” I think grapes are one of the most underutilized ingredients used in cooking.  If I offered you a recipe for “Baked Chicken” it would probably not entice you to go after the recipe. But, I have added grapes and this makes this baked chicken special! The grapes caramelize beautifully and add a great light sauce to the dish.

Did you know grapes are in the top 10 of the world’s favorite fruit?  And wow, the grape industry is the largest food industry in the world.  This fruit is so versatile.! Add grapes to vegetable salads for a natural sweet taste. Grapes can be baked, sautéed, grilled, and roasted. And, the addition of grapes to chicken or pork is YUM!

Grapes are heart healthy, can prevent cancers, treat headaches, and lower cholesterol.  The grape is a great snack because it is 80% water. It is also an energy booster.

Since March is National Nutrition Month it is a great time to think about trying new foods that are good for you. Adding fruits and vegetables to your cooking not only adds good nutrition, but it adds color to your dishes which makes them beautiful!

I hope you enjoy this dish and enjoy a different way to serve the fabulous grape!  I look forward to sharing my love of green beans when I cook up my “Green Beans and Potato Curry”!

Happy Nutrition Month.

Hugs and Veggies <3 Remmi

What’s Up with Wheat Berry?

By Linda Werkheiser MS, RD, LDN
March 10th, 2014

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As the largest employer of registered dietitians, Sodexo is supporting National Nutrition Month in their accounts through the use of the nutrition month promotion “Savor the Flavor of Health”.  This theme supports the Academy of Nutrition and Dietetic (AND) theme of  ”Enjoy the Taste of Eating Right” with more information available at eatright.org.   Initiated in March 1973, the event became a month long event in 1980 in response to growing public interest in nutrition.

Throughout the month RDs in hospitals managed by Sodexo will be supporting the Sodexo theme through 4 different weekly themes:  Healthiest Fruits and Vegetables, Great Grains, Super Herbs and Spices, and Perfect Proteins.  Each week’s theme has a handout specifically designed to educate consumers.

WHAT’S UP WITH WHEAT BERRY – You may think wheat berry is a berry, but that is certainly not the case. This whole grain is a wheat kernel that hasn’t been cracked, so it still contains its high-fiber outer bran layer and all of its wholesome nutrients. An unprocessed wheat kernel in its most natural form is where all wheat products start – and it’s right where you should start if you’re looking for fiber, folic acid, protein, B-complex vitamins, iron and Vitamin E.

Examples of recipes that support the various weekly themes include: Wheat Penne with Chicken and Red Pepper Sauce,  Mango Crusted Tilapia with Pineapple Salsa and Feta Leek Quiche.

To support the “Savor the Flavor of Health” theme, RDs have developed word search puzzles and games to share with customers.  RDs will be presenting “lunch and learns”, food tastings and other presentations for customers and staff. Displays will include banners, calendars and celebration letters with the theme on them.  To showcase their presentations, RDs may choose to participate in the photo contest.

Also in our accounts, RDs will also be celebrating the seventh annual RDN day on March 12,2014 through various ways such as “RDs out to lunch”, lapel pins, t-shirts and gift cards as well as personal thank you notes.  Registered Dietitians Nutritionists are committed to improving the health of their patients, clients, and community. This day commemorates the dedication that RDN provide in advancing the nutritional status of Americans and people throughout the world.

The best foods are full of delicious flavor and fortified with the necessary nutrients you need for good health. Choose immune-boosting herbs and spices, fiber-rich whole grains, wholesome dairy and lean proteins as well as colorful fruits and vegetables. Eating right helps you savor every bite. Contact a Sodexo RD for more information.

Written by Linda Werkheiser MS, RD, LDN who is a Regional Nutrition Manager who provides clinical support to the Sodexo Hospital accounts in the Midwest.

Are eggs really “Good Eggs” once again?

By Sara Lee Thomas, MS, RD, LD
February 18th, 2014

Sara Lee Thomas, MS, RD, LD

Over the years we’ve all seen a lot of flip-flops in nutrition… good… bad…then good again… and we’ve all heard the frustration, ‘Will they just make up their mind already?!!’

In the end, the truth about a food is never turns out as simple as good or bad. I’ve learned that if I can’t say what is both good and bad about something, I don’t know enough yet.

How and when a food is good/bad depends on how much and how often you eat it, who you are, what conditions you have, what medications you take, and what else you eat.

I’ve also found it’s important to remind myself that a food is always more than one thing: milk is more than calcium, coffee is more than caffeine, eggs are more than cholesterol. Eggs are also important sources of protein, choline, lutein and zeaxanthin.

So let’s see where we are on the topic of eggs, a frequent flyer for flip flopping facts!

Allergy Prevention?

Pregnant women should not avoid eggs out of concern for allergy prevention in the baby. It doesn’t help and may hurt since choline plays critical role in fetal brain development and risk of neural tube defects, 2-4 times more risk of NTD if choline levels are low.

Eggs and other common allergen foods no longer need to be delayed in infant diets. While they still shouldn’t be “first foods” they can start between ages 4 to 6 months with usual texture progression and observed for reactions. J Allergy Clin Immunol: In Practice, Vol 1 (1), 29-36. 2013.

Breast Cancer Prevention?

Emerging research is finding 18-44% less risk of breast cancer with higher egg intake. One study found 44% less risk eating ≥ 6 vs. ≤2 eggs a week. The most critical periods to benefit from eggs seem to be prenatally and during adolescence. In animal studies, choline appears to program genes in utero to resist breast cancer later in life.  Choline is also anti-inflammatory.

Cardiovascular Disease: The American Heart Association no longer puts a specific limit on eggs. They now say 1 egg a day can fit as long as other sources of cholesterol are limited.

  • Good evidence that up to 7 eggs a week is ok and does not increase risk of heart disease except for people with diabetes. Over 7 eggs a week did increase CVD risk, 23% in non-diabetics but 2-fold risk in people with diabetes. Check out USDA’s Nutrition Evidence Library at www.nel.gov.
  • Eggs can be enhanced with 35 to 350mg omega-3 fat per egg, about two-thirds of this is ALA.

Cholesterol: People are different; there is a 2 to 3 fold difference in how much cholesterol people absorb, how much they make, and how they respond to changes in dietary cholesterol.

  • Most cholesterol is made by our bodies, 11 to 13 mg/kg/day, so we make about 4-6 ‘eggs’ worth of cholesterol a day all on our own. (Squawk!) This is also why weight loss helps lower cholesterol levels about “a point a pound.”
  • Most people make less when they eat more and see little to no change in blood levels. But 15-20% of people are hyper-responders. Their LDL will go up about 3 mg/dl per 100mg dietary cholesterol instead of <1mg/dl. So when these people eat 500mg cholesterol a day, their LDL goes up 15mg/dl.
  • Everybody’s LDL levels are less responsive to dietary cholesterol when diet is low in saturated fat and more responsive when diet is high in saturated fat. Same with trans fat.
  • Eggs are unique; they are high in cholesterol but low in saturated fat. When eggs are eaten both LDL and HDL increase so the LDL:HDL ratio stays about the same. Remember LDL by “L” for Lousy Litter bug, the Lower the better and HDL by “H” for Healthy, Higher the better, or as I call it, “Hoover DeLuxe” J

Dieting: emerging evidence that “An egg a day keeps the appetite away”.

Eating an egg has a high satiety value, especially with breakfast. Eggs don’t cause weight loss on their own, but they may help people stick with a lower calorie diet and lose up to twice as much weight with 1 egg 5 days a week. They’ve also found that the egg yolk is important to the satiety effect, not just the protein.

Eyes and arteries? Lutein/zeaxanthin are yellow carotenoid ‘cousins’ found in the yolk in a highly bioavailable form—an egg a day can raise blood levels 26/38%. They also settle in eyes and block UV and blue light, protecting eyesight against cataracts and macular degeneration.

  • 60% less risk of cataracts with higher egg intake (Beaver Dam Eye Study, 1999)
  • 80% less thickening of carotid arteries with higher blood levels of lutein/zeaxanthin (Los Angeles Atherosclerosis study, 2001)

Eggs can be made even higher in lutein/zeaxanthin by feeding hens marigolds, corn, etc. Eggland’s best® eggs are ~40% higher than ordinary eggs (200 vs. 145 mcg per egg).

Food & Nutrition

  • Eggs are quick, easy, versatile, and cheap, only 12 to 25 cents each.
  • Ready-to-eat peeled boiled eggs now in stores!
  • Eggs are the gold standard for high quality protein.
  • Egg safety is still important, check out www.eggsafety.org
  • Egg yolks are the highest food source of choline, established as an essential nutrient in 1998 by the IOM. Only 10% of people have Adequate Intakes: 425/450/550 mg for women/pregnant/lactating and 550mg for men. Eggs have 125 mg choline per yolk. Choline is also in liver, beef, pork, poultry, salmon, shrimp, beans/legumes, milk, soy milk, broccoli, cauliflower, and Brussels’ sprouts.

Good-bye…for now! Hope you’ve all enjoyed our ‘egg-cellent’ adventure. :)

Cook Time with Remmi – Strawberry Salsa

By Chef Remmi Smith
February 13th, 2014

Chef Remmi Smith

Hi Friends………I am way too excited to present to you my famous Strawberry Salsa recipe! Why? Well because it’s awesomely good of course………but what is really great is that Strawberries are my all time favorite food. If you have read anything about me……..I eat these wonderful beauties every single day….Yes…I am telling you the truth. First thing I ask my mom when I am picked up after school is “Do we have strawberries?”

Valentine’s Day comes this month and aren’t strawberries the perfect food to serve!! My Strawberry Salsa is easy to make and it is a beautiful dish to serve.  Its RED, LUCIOUS and SWEET and HEALTHY!

Did You Know Strawberries are the first berry to open in Spring? How about this…the Strawberry is the only fruit that has seeds on the outside and not on the inside?  And did you know each berry has approximately 200 seeds?  Belgium has a museum dedicated to Strawberries…..can’t wait to go there!

Strawberries are a Super Food…a kind of food you should eat everyday!  My salsa is full of interesting ingredients….pineapple adds natural sweetness, jalapeno a bit of spice, crunchy cucumbers, and bell peppers full of vitamin C.

Strawberries are so awesome and they are so healthy for you. Strawberries help prevent cancer, memory loss, heart disease and diabetes! And….its packed with vitamin C. So let’s just say strawberries are an all-around winner.

Happy Valentine’s Day!  Hope you try this recipe….it is so so good.

Hugs and Veggies <3 Remmi.

Expanding your Reach: Positioning your Programs in a Digital World

By Nina Crowley, MS, RD, LD
February 3rd, 2014

In healthcare, there is a demand to increase time spent in direct patient care while also reaching patients in rural or remote areas via telemedicine and other means. Registered Dietitians are feeling the pressure to provide more services to more and more people, while still delivering high quality of life services that improve well-being. Using available resources, promoting your programs, and utilizing social media can help to reach more patients effectively, albeit in alternative ways.

The Medical University of South Carolina (MUSC) is located in Charleston, a beautiful city along the coast.  MUSC draws patients from all over the state and we are expected to maintain good follow up with those patients, no matter how far away they live. This can be a real challenge given the population breakdown in the state.

Traditionally, a majority of South Carolina RDs are located in the central and more populated regions, but the patients we are trying to reach are dispersed throughout the state. In South Carolina, about 14% of all the RDs in the state are located in ‘rural’ areas, while 86% are in the ‘non-rural areas’. We have roughly 1 RD for every 3500 people that live in South Carolina and we are committed to supporting our local communities even when they are not exactly “local”.

While there are some exciting developments and opportunities for billing and reimbursement for RDs, I wanted to discuss some best practices from our bariatric surgery program that may be applicable to other programs in other areas. Dietitians have the opportunity to use their creativity to meet the needs of the growing population of those in need for nutrition advice!

Debbie Petitpain and I have become resourceful at meeting the needs of our diverse patient population, and have worked to provide resources to our patients by making many of our resources virtual. Patients are always asking us what to buy, how to grocery shop, and exactly what brand and products to buy. We have led successful in-person grocery store tours, but we wanted to reach out to more people with this information.

We are excited about our new virtual grocery store tour which can be viewed on YouTube from anywhere!

Highlights of the tour include:

  • review of the recommended meal plan
  • where to find items based on a typical grocery store layout
  • nutrition facts label reading tips
  • how to interpret health claims
  • discussion about what belongs in each food group and what counts as a serving
  • what to choose and what to avoid
  • brand-specific products we love
  • discussion of specific ‘health halos’
  • general grocery shopping tips

My mantra has always been, “If I say it 10 times, I make a handout, and if I say it more than 50 times, I make a video or podcast”. Taking common messages that multiple patients need to hear and making them interactive, not only reaches more people, but may be speaking in a language they understand. I know so many people have a drawer full of ‘nutrition education handouts’ that they have been given in the past, but in the digital world, making your messages match how people like to learn will make them more likely to be implemented!

The ‘Virtual Grocery Store Tour for Bariatric Patients’ can be found on the YouTube Channel, DigestiveDiseaseMUSC: or on MUSC’S Bariatric Surgery Program’s Webpage, under Virtual Grocery Store Tour.

We have developed many innovative ways to serve our patients. Here are a few that you can read about or access online.

Nina Crowley, MS, RD, LD is a Registered and Licensed Dietitian who lives and works in Charleston, SC. Ms. Crowley is the past President of the South Carolina Academy of Nutrition and Dietetics, and works for Sodexo as a Bariatric Dietitian for the Medical University of South Carolina’s Weight Loss Surgery Program.

A Healthy Winter Warmer – Three-Bean Chili with Barley

By Chef Remmi Smith
January 27th, 2014

Chef Remmi Smith

I don’t know where you live, but if you’re like me and you are in the middle of a cold winter, you likely agree that nothing fights the chills and wintry weather like a big pot of hot soup.  In fact, I am getting warm just thinking about it.  Not only is January cold here, but it is also National Soup Month, so I thought it was the perfect time to share the recipe for one of my healthy and hearty soups featuring one of my favorite grains…barley!

Did you know barley was considered the most important grain in Europe up until the 16th Century? It was used as the measuring standard and it was also important enough to be used as money.  King Edward the First set the measuring standard with 3 “barleycorns” equaling an inch. Here is a site where you can learn more fun facts about barley.

Barley is considered a “super food” because of its high fiber content. It is also a very flexible grain as it can be served as a breakfast cereal, a great addition to soups and can also be a substitute for pastas and rice. It has a slightly chewy texture like pasta and a really creamy taste.

I used this grain in my vegetarian chili dish not only as a thickener, but also as a compliment to the hearty bean ingredients. Barley adds that creamy indescribable flavor I love!

This chili is full of some of my favorite vegetables like carrots and bell peppers. It is a super simple dish to make because many of the ingredients are canned and ready to go.  One pot, fresh veggies, and the tastiest grain on earth.

Barley is one of those fabulous foods that help to prevent cancer and heart disease with positive effects on high blood pressure and the power to lower cholesterol.  It’s a great source of Vitamins B and E.

As I am writing this blog I am so hungry for this dish….I’m off to make it for supper! And,, one last thing….don’t forget the garnishes as they make the dish special! Enjoy this dish….especially creamy dreamy barley!

Hugs and Veggies, <3Remmi!

Nutrition and the Net

By Christine Meissner
January 15th, 2014

Have you or a family member been recently diagnosed with a nutrition related illness? Like most Americans you may consult the internet for help with treatment ideas or to prepare for a doctor’s appointment.

Recent Pew Research found that 72% of internet users searched for health information online during the past year – including nutrition information. The web can be a valuable resource, but consumers need to become “cyberskeptics” in order to distinguish the good from the bad.
Christine Meissner, MS, RD, Clinical Nutrition Manager

How do you know if the website you are reading has credible nutrition information? The National Institutes of Health has several important questions you should ask when you are visiting a website.

1. Who is providing the website information?

When visiting a website, look for the “About Us” section. A credible health and nutrition website will have an editorial board with doctors, dietitians and nurses listed. Good sites use medical research provided by trained professionals, not opinions. Watch out for fake credentials and degrees. A qualified nutrition expert will have the title “registered dietitian (RD).”

2. Is the information timely?

A credible website will update information regularly. New nutritional treatments are developed as research evolves and web sites should include dates materials are posted, reviewed or updated. Dates are usually found at the bottom of the page. Find a more recently updated site if the information is more than a year old.

3. Is my privacy protected?

Use caution if a web site asks you for personal information. Each site should have a privacy policy for your review. Be careful if the site states it will share your information with other organizations.

Health on the Net Certification

Health on the Net (HON) is an agency that gives its endorsement to health websites that have been evaluated, using strict criteria. Once approved HON allows the site to use their seal of approval on the site. The sites are reviewed regularly to ensure that they remain true to the code of ethics. Watch for this seal on your internet searches.

Get Started Now

Still unsure how to get started with safer web surfing? Here are a few credible nutrition and health web sites to get you started.

In conclusion, finding credible nutrition information on the web requires a critical eye. If something sounds too good to be true, it probably is. Avoid miracle cures based on testimonials rather than medical research. Assess if the information is “too emotional” or “too good to be true.” Most importantly, check with your own physician, nurse or dietitian before trying any new treatments or therapies.

Reference: Medline Plus. http://www.nlm.nih.gov/medlineplus/
Accessed August 5, 2013

Be Thankful for Winter Squash Salad

By Chef Remmi Smith
November 7th, 2013

Chef Remmi Smith

It’s the start of the holiday season and Thanksgiving is just around the corner – what a perfect time to utilize a perfect fall dish with squash as the main ingredient!

There are a lot of varieties of squash and they fall into two categories of winter and summer squash.

Winter squashes have thick skins and this makes them last much longer than summer squash with thin skins.

Winter squashes can be stored up to 3 months.

I used butternut squash in my recipe for this winter salad recipe and its name reflects their flavorful buttery taste.

It is kind of unusual to combine squash with salad but this combination works well together and it has a nice surprising taste.

The strawberries and cranberries add a sweet tart flavor that mix well with the buttery squash.

And let’s not forget color, the squash and the berries bring beauty to the dish!

Winter squash (which includes pumpkins) are a rich source of beta carotene which fuels our bodies to make Vitamin A. This vitamin is important to our vision and bone growth.  It is also a great source for potassium which helps prevent and lower blood pressure.  And the deeper the color of the squash provides greater amounts of vitamins and minerals.

Thanksgiving is really one of my favorite holidays not only because of the food but I get to be in the kitchen all day having fun. I am up with my mom at 5:30 AM to create our feast of Turkey, Bread Dressing, Cornbread Dressing with Cranberries, Mashed Potatoes, Sweet Potato Casserole, Giblet Gravy, Green Bean and Tomato Casserole, Cranberry Sauce, Apple and Pumpkin Pies, My Dad’s Homemade Bread Rolls and finally, Winter Salad with Butternut Squash, of course!

Hope you enjoy the recipe and I wish you a Happy Thanksgiving.

Hugs and Veggies,

Remmi

Chef Remmi Smith is Sodexo’s Student Ambassador for Health and Nutrition.