Friday, August 26, 2011

It's a BOY!!!

I was stunned to find out this morning we are having a little boy! I was sure he was going to be a girl. Surprise! That kind of made it sweet though, to have it be so surprising and M. was THRILLED. He really wanted a boy and had convinced himself it would be a girl, so he was over the moon at getting his wish. We are so excited to meet this guy! M and I look alike (brown hair, blue/green eyes, fair skin) so we know kind of ballpark of what he might look like, but the big family question now is whether he'll have red hair, as we have that recessive gene (my brother, M's mom) on both sides. Finding out the gender weirdly made it feel that much more real-- instead of an abstract baby in there, it's a little boy, whom we named months before he was even conceived. (Sorry, not going to tell you what his name is yet but he does have one). As of Sunday we will be 20 weeks-- half way through, though I'm convinced he will be late (best to believe he won't be on time then be stomping my feet when the due date comes and goes, which is what happened to my friend who recently gave birth and was sure her son would be early and was instead a week late!)

I've been having major allergies or maybe a bit of a cold, causing me a runny nose, sore throat and congested lungs, and increasing my nausea-- I threw up this morning making M eggs because I cracked an egg that had gone bad. Just recounting it here makes me gag.

A lot of food things still sound bad-- the "good" kind of sausage from my local co-op is the most palatable protein and I just finished the best batch of nectarines so far this year. Lunch was ground beef and beans in a brown rice tortilla, which did not digest very well-- bread based stuff really sits in my stomach in an acid kind of way. We are having chicken salad for dinner-- hopefully I can get that down as I could definitely use some veggies. I actually keep craving soup, probably because I've fallen off the wagon with my chicken stock consumption (I have some that's been in my fridge for over a week with the bones still in it-- wonder if it's still good?), but it's 80 degrees outside!

Tuesday, August 23, 2011

Pretzels, Potential and Puking

We are in a state of controlled chaos around here. Because what else would rational people do at nearly 5 months pregnant, but buy a property that needs a lot of work and try and sell a house? We are currently in an inspection process for a property that has two very small houses on it in Seattle. Both need work to be livable, but the plan being we will live in one and rent out the other once they are finished. We have been running around like mad getting our current house clean and organized to put on the market ASAP, meeting with Real Estate Agents, meeting with architects and inspectors and generally doing 18 things at once. M. says if it all falls through at least we'll have the cleanest house ever! It really never has been this organized-- all but one closet left to do are completely clean. I had a vague plan of getting more organized before the baby comes but this put that plan on fast forward-- my office is now officially a baby room after I spent all weekend cleaning out old school stuff and boxing everything else up.

I've also unfortunately had a resurgence of a lot of foods sounding bad, especially the protein ones. I've tried several times to explain to baby that eggs are good for us and free but he or she is not interested. I also seem to still be averaging once a week of either throwing up or near misses and THAT is getting very old.

Baby seems to have had a growth spurt in the past week or so. After gaining a pound a week for several weeks I suddenly gained 3 practically overnight which was kind of scary, but my bump got a lot bigger in that time too so I think it's all baby. I thought my bump was pretty obvious, but with all these realtors we've been meeting they have either been surprised that I'm pregnant (wearing looser shirts seems to confuse people) or else not quite sure if I'm pregnant or just have a little pot belly. Weird how depending on what I have on it changes completely. But since I lost so much weight in the beginning, technically I've only gained 6 pounds above my pre-pregnancy weight (though I lost and regained another 6 and can't decide how that counts in the total-- it either puts me on the high end or low end of normal--before the 3 pound surge I was hanging out slightly below the charts if you don't include weight re-gain, so maybe we were just catching up). The whole process is very fascinating to me. On Friday we have an ultrasound, and will hopefully find out the gender! I can't wait.

The other annoying thing is I really don't have a lot of stamina. I'm not as constantly tired as I was in the first trimester, but I also get worn out pretty easily. Doing all this massive cleaning in our house has knocked me out-- I tried to work out yesterday but it was kind of half-hearted. Today I went to the mall to buy new towels for staging our house and after an hour or so I just came home empty handed because I was too tired to do any more. I'm also constantly either hungry, too full, or grossed out by food-- sometimes all three at once. Unfortunately I discovered these gluten free pretzels that are really good-- all refined garbage but they go down so nicely. I think I might ask the midwife to check my iron levels-- perhaps I'm becoming anemic.

At any rate big things are happening around here. Cross your fingers for us our house sells quickly... I really hope to move before the baby comes, but it's all very much up in the air.

Wednesday, August 17, 2011

18 weeks: I'm not sure I know how to do Paleo + Pregnant

I really have been trying to eat paleo, and I'm definitely eating better than I did during the first trimester, but I can't say it's 100% Paleo, and I am not sure I can get there. One of the reasons that paleo is so great for losing weight is eating vegetables and protein as your primary meal is very self-limiting in terms of calories. Most people can't significantly overeat chicken salad. The problem is that during pregnancy, your body naturally wants less meat-- the kidneys process urea (a by-product of protein breakdown) more slowly, and so excess just is unappealing for most people-- I can eat a smallish portion three meals a day, but I just can't get down more than about a palm sized amount. That leaves vegetables, mainly salad for me at the moment since it's summer and I have more lettuce than I know what to do with in the garden, and tomatoes are in season so I'm taking advantage of that. I do eat fruit, probably 2-3 pieces a day-- peaches, grapes and cherries especially. At dinner most nights we have potatoes or yams. But all of that rarely adds up to more than about 1600 calories a day, which is just not enough and I find myself eating handfuls of chocolate covered almonds or occasionally worse treats instead of more nutrient dense food. Grains really don't agree with me all that well, so I don't want to add those back in-- I really wish I could tolerate dairy as I'd love to eat yogurt, but that's out. It ends up being very limiting and I'm not quite sure what to do about it. I often find myself very tired mid-day and often it is because I haven't eaten enough.

Exercise is not as consistent as I'd hoped either-- I only seem to find the energy a couple times a week, and a workout wipes me out. Today I walked about 2 miles and while it was nice to get outside, I was for one thing very slow (I usually walk the whole 3 miles of this particular trail and I only did about 3/4 and it still took me longer than the whole thing usually does!) I do a bit of weight work when I make it to the gym too, but it's pretty inconsistent.

Besides all that, we are discussing selling our house and moving closer to work. Our original plan was to do that next summer, but it is possible we could do it earlier if a bunch of things fall into place, but it adds a whole other element of stress and complexity to our impending parenthood as we ponder not only moving, but moving to a much smaller house!

A week from Friday we get our first real ultrasound-- I am hoping baby wants to show us whether it's a he or a she-- I have had a very definitive feeling about it since very early on, and I will be really thrown for a loop if my intuition was wrong! But either way I'm looking forward to making sure everything is going well.

Wednesday, August 3, 2011

16.5 weeks-- update

This picture is from last Friday, at not quite 16 weeks. I definitely have a bit of a bump going on now, and I swear it popped out there in a matter of days last week! I've regained the 6-7 pounds I lost in the first trimester, and no more yet, so I'm not sure whether to say I've gained 6 pounds or zero. It's definitely distributed differently then it was 16 weeks ago!

I've been trying to eat mostly paleo now that I've been in the second tri-- but I can't say it's going all that well. Last weekend M. and I took a little road trip to Portland and back and I twice, in two separate restaurants ordered cobb salad without cheese (my go-to food choice) and twice had HORRIBLE meals. The first one I got a massive gluten contamination-- I was coughing and wheezing for a half hour afterwards-- I might as well have eaten a sandwich for how bad I felt afterwards (it also wasn't a very good salad). The next day I ordered a cobb salad again at a deli, and despite the 90 degree weather it came with big chunks of hot, unseasoned chicken on it. It was gross. (But as a bonus it didn't make me sick, but I couldn't eat much of it. I think they were relying on the blue cheese to provide all the flavor, but since I got it without, it was pretty bland.).

Yesterday morning I had my usual breakfast of chicken sausages and a peach, but unfortunately, I think the sausages were bad (I had bought them and then did errands in a hot car for 1-2 hours) and back up they came about in a hour later. Oops. The rest of the day was kind of starchy because I couldn't face more meat after the vomit fest. As a result I was exhausted all day.

I did just switch to a more comprehensive supplement routine. Previously the only thing I was taking was my Thorne prenatal vitamin, and for awhile in the first trimester I even gave that up because of the nausea. Now I'm phasing out the Thorne for Innate, which is a food based vitamin and has a few more fun things like probiotics in it (though the Thorne is a perfectly good supplement). Also I am taking a high DHA fish oil supplement, which I bought in strawberry flavored capsules since I can not get down liquid fish oil anymore. DHA is particularly important for baby's brain development, which is why I got the highest DHA per capsule I could find. (These ProDHA supplements from Nordic Naturals have 900 mg in two capsules. I'm taking two for now-- in the third trimester and while breastfeeding I'll probably double that.) I'm still taking 5000 IU of vitamin D most days- I'm working on a whole post on D I'll share soon.

Other than that I'm eating a lot of chicken/chicken sausages, drinking lots of bone broth (I just ran out! I need to make more tomorrow), and having steak or burgers every few days, with mostly salad for veggies, and lots of peaches and cherries. I'm trying to mostly avoid grains- my vices are dark chocolate covered almonds and coconut ice cream, which have a fair amount of sugar, but at least no grain. I'm taking things one day at a time, sometimes, like yesterday and the day before I'm really tired and other days, like today I have energy (I cleaned my whole house top to bottom today!).

At least we are finally getting sunshine and pleasant temperatures most days-- better late then never! (And I infinitely prefer our 75-80 degrees to the rest of the country's 95+ degrees!)

Wednesday, July 27, 2011

A mountain adventure

Rocky Mountain State Park

I'm home after a hot weekend in Boulder, CO. I went to see my two good friends from graduate school, Ryah & Laura. It was so much fun to see my friends-- I hadn't seen Laura in two years, and Ryah in one year so it was great to spend some time together instead of a rushed phone call every couple of weeks. Laura and I were virtually inseparable when she lived in Seattle and I miss her all the time. What was also fantastic is that Boulder has some amazing local food, especially meat and my friends cooked for me just about every meal, which was a wonderful break from being the sole cook and food shopper at my house! Both Ryah & Laura are getting into a Paleo-ish slant, partly because of my proselytizing, so we were all on the same page. I didn't do a very good job of taking pictures of our meals, but we had steak, chicken, amazing sausages, eggs, and bacon all at various meals that were all local and fantastic. We added salad or kale, yam or fruit and on a couple of nights a few not so paleo treats of coconut milk ice cream or a few chocolate covered almonds to finish it off. The only 100% not paleo meal I had was the only one I took a picture of! On my last day L and I had brunch at a restaurant called Tangerine that had a gluten free option for almost everything on the menu. I had buttermilk pancakes, gluten free of course, and a side of chicken sausage. L had a sample platter of the different pancakes (hers weren't gf) and also chicken sausage, but it was way too much food, though really yummy.

We drove through Rocky Mountain State Park and saw the beautiful mountains, some elk, many stupid tourists parking their cars in dangerous places to get pictures, and the best part was-- we drove so high we found snow and 65 degree temperatures. Why was this so exciting? Because every day I was there it was between 95-100 degrees. When you are used to less than 70 degrees that is a bit of a shock. Add to that the altitude and pregnancy and I found myself often hot and tired and occasionally (especially on top of the mountain at 12000 feet) headachey. Thank goodness both L's car and her apartment had air conditioning or I might have melted into a puddle. I admit I have never been so glad to see rain and 65 degrees when I got back to Seattle!

The other really fun thing we did was tour the Celestial Seasonings Tea Factory. It is a huge and impressive operation, and while the tea ingredients are sourced from all over the world, they are all processed and packaged in Boulder. The whole place smells amazing, like a big mix of herbs and fruit, though our favorite might have been the mint room, which was a bit like walking into a tub of vic's vaporub or a vat of toothpaste- it was really strong, but also refreshing. (The mint is so strong they have to keep it in a separate, double walled room, or everything in the whole place would be minty!) We also got to taste some teas, and we each bought one of CS's new Kombucha lines-- it was really good, but it has added prebiotics in it and my stomach felt a little funny so I didn't drink it all (plus I had to throw the rest away when I got to the airport anyway).
Here we are with our lovely hairnets. Sorry it's a little blurry....

Lately I've been having vague milk cravings which are surprising since I'm pretty sensitive to dairy and haven't had milk in probably 7 years, though I can get away with a couple bites of cheese or butter in something. This morning I tried a half cup of goat yogurt and it was a no go. I was coughing and wheezing within 5 minutes. So much for that. So instead I made a big cup of chicken stock (figuring what I'm craving is calcium). It's a little bit not paleo because I made it Japanese style, adding Ume Plum Vinegar, based on a suggestion from my friend Katrina (so handy to be friends with so many great nutritionists!) and a spoonful of miso because I love miso soup and because I could use some good friendly bacteria in there (miso is made from fermented soybeans, hence the not so paleo-ness of it). But it is very satisfying on this cool, feels like autumn morning.

I'll try and take a picture of my little bump this weekend-- at 15.5 weeks pregnant I've got a bit of a bump, but still don't really need maternity clothes yet. It's the sort of thing where, depending on what I'm wearing, you might or might not even be able to tell. Apparently after the first time you are pregnant, subsequent pregnancies pop right out there much faster, or so I'm told.

Monday, July 18, 2011

Chipotle Chicken Stew

I apologize if you are reading this from somewhere other than the Northern West Coast-- I realize that for most of America soup is not exactly something you want to contemplate. To you I say file this away until Fall. Here in Seattle where we are lucky if we top 68 degrees and see the sun at all so far this summer, it feels more like September. I have been thinking about making this soup for a couple of weeks, but didn't have the energy until now (fair warning, there is a lot of chopping involved). This soup is adapted from this recipe at Nourishing Meals. Ali does an amazing job of coming up with delicious recipes with whole food ingredients-- I also have her cookbook and absolutely every recipe I've tried of hers has been delicious. However, while gluten free, her recipes are not at all paleo, in fact this recipe started out as a vegetarian stew-- I started adding chicken and kale to it long ago, but this is the first time I also omitted the beans and it was just as yummy.


2 tablespoons extra virgin olive oil
1 medium yellow onion, chopped
3 teaspoons ground cumin
1/2 teaspoon dried oregano (I used 1 Tablespoon of fresh oregano since I had it handy)
3/4 teaspoon chipotle chili powder
1 Tablespoon sea salt
2 medium yams, peeled and diced
4 cloves garlic, crushed
2-3 pounds chicken breasts or thighs, diced into bite sized pieces
1 head kale, de-stemmed and chopped small
other veggies as desired (I used a couple chopped zucchini)
6 cups water or chicken stock
1 medium red bell pepper, diced

Heat a large 6 or 8-quart pot over medium heat. Add olive oil then add onions and saute for 5 to 7 minutes.

Then add the chicken and continue to cook until chicken starts to brown. Add spices, and vegetables and saute a minute or two more. Add the water/chicken stock (I used half and half of each). Simmer covered for 20 to 30 minutes or until yams are tender and chicken is fully cooked.

Top with Cabbage-Slaw (this recipe is fully Ali's except I use parsley instead of cilantro)

Cilantro-Cabbage Slaw

4 to 5 cups thinly sliced Napa cabbage
2 cups chopped cilantro
2 to 3 green onions, sliced into thin rounds
the juice of one lime
1 to 2 tablespoons extra virgin olive oil
1/2 teaspoon salt

Place all ingredients into a medium-sized mixing bowl and toss together. Be sure to make only what you will eat with you meal. Otherwise it will become soggy and unappealing for your next bowl of stew. (The stew gets better as it ages, this doesn't).

Sunday, July 17, 2011

14 weeks: transition

After an awesome energy day last Sunday, I spent most of the week back on the couch barely able to move (either that or at my desk at work watching the clock until I could go home to the couch). This weekend my energy has returned again-- hopefully for good, as at 14 weeks I am now by all calendars in the second trimester. I am definitely in a transitional period. Food wise, I am doing better eating more protein, but overall still eating too much sugar and processed things I don't need. The problem in part seems to be that I can't eat more than a few bites at a time of real food-- I likely shrunk my stomach during the seven or so weeks I wasn't really eating. Add to that, if I can eat a real meal, it sits in my stomach like a rock for HOURS which is very uncomfortable. I have tried my trusty Super Enzymes, but really all that works is to eat small amounts every few hours which I find annoying. When I was a teenager and in college I was definitely one of those 5-6 meals a day people, but somewhere in the last 4 or 5 years I realized it is much more satisfying and satiating for me to eat until I'm full 3 or 4 times a day. It is unsatisfying to switch back to eating smaller meals and it's been an adjustment-- really processed stuff (we had gluten free cookies around for awhile-- I know! bad) goes down easily and I am not used to being hungry all the time-- I just need to plan better.

Because I'm not eating as well as I should, I found myself in a pregnancy hormone induced panic yesterday. After weeks of my weight dropping, it has been steadily coming back up (as it should-- I'm growing a person!) But my overindulgence in the wrong kind of calories has me a little panicked that I'm gaining the wrong kind of weight (mind you, I'm still down 4 pounds from pre-pregnancy weight so it's a rather irrational concern). The solution is simple-- stop eating the crap! I'm working on that-- if my energy remains it will help a lot with food prep. Also what will help is some exercise, which I haven't had in over two months. Tomorrow my Crossfit trainer extraordinaire, Jesse at Lynnwood Crossfit is going to come up with a pregnancy routine for me because I'm not comfortable attempting even modified WODs given my inexperience and how long I've been away from the gym-- getting into a regular routine of activity will be very important in keeping me to a healthy weight gain and strong enough for what lies ahead. (My friend told me to look at pregnancy as training for the marathon of birth and months of sleepless baby care-- I think that's a good attitude).

I am at that funny stage where I'm getting a bit of a bump, but don't quite look pregnant-- just like I'm gaining weight (though when I gain weight it normally isn't all in my stomach!) I bought some maternity capris on Friday and they are so comfortable! Elastic waist bands are miraculous. Both M. and I are just in awe of this process-- I swear my belly gets bigger every day and it's extraordinary. I'm trying as much as possible to savor these moments-- I only expect to be pregnant two, maybe three times in my life and next time I'm pregnant I'll be busy with a toddler, so it's kind of amazing to just sit back and experience it.

Everyone pretty much knows now as I told my office this week-- it's nice to have it out in the open. My good friend that works with me has a one year old and she's become kind of a mentor to me-- it's nice not to have to sit in the corner and whisper about it at work now.

Meanwhile, Seattle seems to be skipping summer this year. It is currently 57 degrees and pouring down rain at my house. Next weekend I'm escaping to Boulder to see the sun and two dear friends. I can't wait!

Sunday, July 10, 2011

Robb Wolf Seminar!

Yesterday I had the great fortune to attend Robb Wolf's second to last paleo solution seminar-- he has one more in Boston and then he's not doing them anymore! The seminar was in Vancouver, BC-- a 3 hour or so drive from where I live, depending on how long you have to sit at the border and Vancouver's epic traffic. M. and I drove up Friday and spent the afternoon wandering around Granville Island and downtown-- it happened to be sunny and beautiful and we had a nice day.

I had two amazing meals at a restaurant downtown called Milestones. One was paleo, one was not. The dinner menu has a small but delicious gluten-free section and they will make any pasta dish with brown rice noodles. Dinner on Saturday night I had a simple but amazing brown rice spaghetti with chicken and goat cheese. It was one of the best things I've eaten in a long time.

I went back there on Sunday for lunch during a break from the seminar and had a much more appropriate chicken salad with strawberries and pecans that was also excellent.

As for the seminar itself: it was a bit like going to a movie based on a book you read and loved. It was surreal to hear the man himself speak after listening to hours and hours of podcasts-- when he came into the room talking to someone when my back was turned I recognized his voice immediately. There weren't really many surprises, but I still enjoyed myself-- Robb is an entertaining and charismatic speaker. He kept apologizing to us during the parts of the seminar that went over biochemical mechanisms, but I found it to be a helpful review-- since most people there had read his book I don't think anyone was too overwhelmed, but then maybe that's just me. Looking over my notes, I don't think I picked up anything new big picture wise, though I took a lot of notes as having visuals helped me understand some mechanistic details better-- it is really hard for me to keep all of the biochemistry details in my brain, so constant review is good.

This seminar came at an ideal time: now that I am at 13 weeks pregnant I am FINALLY feeling better. My appetite has returned and I am no longer grossed out by meat and healthy food. In fact after weeks of barely eating enough, M. was astonished to see me eat almost every bite of my restaurant meals in Vancouver, and go back for seconds tonight on our steak, salad and potato dinner (the first real meal I've cooked in quite some time). I'm hungry without accompanying nausea! Hooray! I even was able to run around doing errands and cleaning house all day without having to spend a good part of the day laying down-- a first in many weeks! Tomorrow I will attempt some kind of formal exercise-- after so long without Crossfit when I was already still so new to it I'm not quite sure if that's the best option or not, but certainly some kind of weights and exercise is needed.

Thursday, July 7, 2011

Oh baby!

I have a confession to make: for the past six weeks I haven’t really been eating paleo, but I have a good excuse: I’m pregnant!! I am about 12 and a half weeks pregnant. And ever since about 6 weeks pregnant 90% of the foods I usually eat became absolutely disgusting. Even thinking about yams, most meat, all cooked vegetables and coconut milk made me retch, let alone trying to eat those things! You might have noticed I never did a follow up to my experiment with the Autoimmune protocol—that’s because I found out I was pregnant three days in to that, and I made it two weeks before almost everything sounded disgusting. Eggs are one of the few protein foods I can sometimes get down, so I will have to re-attempt that plan at a later date. It’s pretty hard to blog about food when the thought of most food is completely nauseating! So what have I been eating? Mostly cold, raw food: a lot of salad, often with chicken on it (obviously the chicken is cooked) although I can’t eat more than a few bites of that, lots of fruit, nuts, and unfortunately, gluten-free bread, some rice/beans/corn, (one of my good friends knew something was up when we had lunch recently and I was eating the chips at a Mexican restaurant), and the occasional non-dairy ice cream and worse, which we won’t get into. Unfortunately, I’ve noticed the more processed and nutritionally deficient the food is, the easier it is to eat, though I try not to go too crazy on the junk. Ironically one of the only proteins that I have no trouble with is fish, and it’s the only one I have to limit, because of the mercury issue! It’s not been the greatest, and I would love to be 100% paleo, but my body rejects too many foods and as it is I lost about 7 pounds in the first trimester, because I had such strong aversions it was hard to eat anything, and I’m sure some of it was muscle. I had to put crossfit on hold since I was barely eating enough to get through my day without exercise. My legs have gotten so skinny! At 8 weeks pregnant, M. and I went on a little hike—it wasn’t really epic, there were plenty of families with young kids walking it, but I was so undernourished that I completely ran out of steam about a mile from the top (which was unfortunately the end where the car was) and we had to stop every 20 feet for me to rest. Obese smokers were passing me! If I can’t do that, I definitely would not get through any sort of crossfit workout! I hope to get back to some version of Crossfit soon. I did manage to escape my Midwife’s attempt to make me take an early glucose tolerance test—she wanted to do one at 8 weeks because my Dad is diabetic (though type I) but I told her I didn’t want to and she agreed to do just a regular blood glucose test and only make me do the evil test (which I would have had to do AGAIN at 20 weeks) if my numbers looked bad. Thankfully they were fine, despite the all carb breakfast I had that morning! I’ve been testing my blood sugar at home and I hope to talk her out of the 20 week test as well when it comes up. I’m sorry but drinking 100 grams of straight glucose sounds like my own personal nightmare.

Other thoughts: I haven’t had it too bad in the first trimester. I’ve been somewhat nauseated almost all the time, occasionally VERY nauseated, and with very strong food aversions, but I’ve only thrown up once. I’ve been definitely tired—though that slowly seems to be improving. Where before I could go to the mall for three hours, then the grocery store, then come home and cook dinner, now I can take maybe an hour of errands before I need to rest. I’ve been drinking tons of ice water because for whatever reason it takes the edge of my nausea, which means I’m constantly freezing cold, since Seattle didn’t even sort of start looking like summer until last weekend. The only day I felt really horrible is the day I had my first midwife appointment—my blood pressure was already really low (98/70) and then they took 5 tubes of blood for all the tests. I felt nauseated, dizzy and exhausted for the rest of the day.

I am very excited to share this with all of you, because now hopefully I will be feeling better, and can report on my paleo pregnancy as it progresses!

Saturday, June 25, 2011

Paleo-ish Strawberry "Julius" recipe

When I was a kid I loved getting a strawberry-orange Julius at the mall. I'm sure it was loaded with scary ingredients and I don't think I have had one for at least 15 years. (Is that company even still in business?)

Pre-paleo I was very into green smoothies. I got out of the habit, in part, because in the winter the last thing I want is a cold drink, and partly because Robb Wolf is very anti-liquid food.

But now it's summer (well sort of-- in Seattle summer doesn't really come until July-- it's still rainy and 60 degrees here). I've actually been sick for the past few weeks (more on that in an upcoming post), M had strep throat, and going back to my last post about a Paleo "Template" I enjoy green smoothies, they are easy to digest and so they are coming back into rotation. If what works best for you is a very low fructose/low carb sort of paleo approach, then ignore the following recipe. If a bit more fruit and carbs are your friends then here is my Strawberry julius-esque recipe:

1 cup coconut milk (I used light)
1/2 an orange
1-2 cups kale
1-1/2 cups frozen strawberries (I didn't measure, so I'm guessing)

optional ingredients:
1 tsp sweetner (I used a few drops of stevia, honey would work or you could do without)
a pinch of citric acid-- (I know that sounds bizarre, but another nutritionist told me she adds this to her smoothies to make them a bit sour and I find it delicious. )
protein powder- this is not very paleo, but I like my smoothie to be a meal. If you are not dairy sensitive, whey protein is probably best. I can't tolerate dairy so I use pumpkin seed protein powder-- it's just the protein not the fat from the seeds so I'm not getting a bunch of omega 6s at least.
Cod liver oil/fish oil: the only way I can get this down is to mix it in my smoothie
Vitamin D: if you have a high powered blender or you use liquid vitamin D, might as well throw it in too.

So there's my recipe. It's only sort of paleo, but it works for me and it was delicious so I thought I'd share!

Friday, June 17, 2011

A Paleo "Template"

I just read and loved this post by Chris Kresser at the Healthy Skeptic. In it he talks about having a "paleo template" rather than a strict diet in which you can have some room to find out what works best for your body. There are a lot of variations out there in paleo-land, and a lot of people insist their way is the only right way. While I read a lot of blogs and other people's books on the topic, what I really appreciate about Robb Wolf is that he tends to be in favor of tweaking the diet to see what works best for the individual, and is willing to admit when new research comes out that he may have been wrong in the past about something.

I have always believed that there is no one perfect diet for everyone-- there are definitely elements of what is healthy and some foods are not good for anyone, but particularly in terms of macronutrient breakdowns, some people do really well on a lot of carbs, like my friend L, who is a distance runner, and has been a size 2 since high school-- clearly, what she is doing works for her. Other people I know really only thrive when they cut out most carbs from their diets. I'm somewhere in between-- I don't feel very good on an extremely low carb diet, but too many carbs is also a recipe for disaster. I do best usually around 100 grams of carbs a day, give or take a few-- assuming they are good carbs and not the high processed ones, which don't make me feel good, but yet sometimes I still eat them because they taste good!

Sunday, June 12, 2011

Data Collection

I don't often talk much about my job here, but this week was a big one for me. I am the Project Director for a study on bone health in active duty soldiers. Wednesday, Thursday and Friday we were scheduled to collect data on 200 Soldiers.

What I mean by data collection is something like this:

Soldiers scheduled to arrive at 6:30 am (which meant I got up at 4am every day-- so much fun).
From 6:30-7:30 I would give a powerpoint presentation outlining what we are studying, what they would have to do, making sure they are eligible (they have to be about to deploy, 30 years old or under, and not have any current bone diseases or fractures-- oh, and if they are female they can't be pregnant, but normally pregnant women don't deploy so that wasn't too much of an issue). They also can just choose not to participate if they don't want to.

After that I spent about 20 minutes going over very basic nutrition information: i.e. soldiers rely on their bodies to perform, and the department of defense is very specific about how much body fat they can have etc. I talk briefly about the healthy plate model, how you can tell if a food is healthy (basically, the closer it is to how it came from the ground, the better. They all laugh when I tell them there's no such thing as a twinkie tree). Then I talk about bone health, how things like smoking, too much alcohol, not exercising and not eating properly is bad for their bones, and talk about both dairy and non-dairy sources of calcium. I wrap that up with some tips on making better choices in a fast food restaurants. It isn't very comprehensive-- just a baseline of tidbits. Fortunately I could talk about whatever I wanted so I didn't have to cover the food pyramid, but I also couldn't really do paleo-- it had to be somewhat mainstream and extremely basic, especially since these guys are really only going to have access to whatever is in the cafeteria when they deploy and most of them eat so much crap anyway that we are starting from an extreme baseline.

Next we collect their blood to measure things like blood calcium, thyroid hormones, vitamin D and a few other markers of bone turnover.

Then in groups of 10 they go through the following stations:
-filling out 2 surveys on exercise and diet, which are extremely long
-getting their height/weight/waist circumference measured
-body fat measurement
-measuring their resting energy expenditure using an indirect calorimeter-- a small device you breathe into for 10 minutes and it uses how much oxygen you expel to estimate how many calories you burn at rest.
-Heel Bone density, which is measured with a machine that takes an ultrasound of the heel (my bone density is not good, by the way! Likely from years of absorption issues. I have mild osteopenia, which is apparently common in people with gluten intolerances/celiac.)

At the end of all this they get a gift card for $25 and are sent on their way. When they return from deployment we will do it all again. Half of them will receive online diet coaching by yours truly for the year they are deployed. The other half will not. At the end of the year we will be able to see if the coaching made any difference in their health.

The first day everything went beautifully. The 50 soldiers we expected showed up, on time, only 4 were ineligible, all of them returned when I told them to (since we could only handle 10 soldiers at a time they were assigned to come back at various points of the day). I had a great team of my boss, two co-workers, four army nurses, four dietetic interns and their instructor helping run all the teams. It went perfectly. Unfortunately the next two days we only had 20 soldiers show up each day, late,-- Thursday we expected 50 and Friday we were supposed to have 100! So that was disappointing-- I thought we would be totally done by now, and instead we have to do another group in a couple of weeks to get enough participants.

It was absolutely exhausting. I didn't really have any way to refrigerate anything and I was staying in a hotel since my house is quite far from base and I had to be there at 5:30 in the morning so my food options were not great. I mostly ate trail mix to keep me from passing out and then after we finished for the day I'd go to Panera or Chipotle and get some kind of chicken salad. I had wished I'd brought beef jerky, but didn't think of it-- next time I definitely will.

Fortunately this week will be much more mellow and I can get back to my normal routine.

Friday, June 3, 2011

The new food "plate"-- not perfect, but much better!

First of all, I would just like to say a big thank you to Jenn at Girl Heroes, who featured me on her blog this week. I am honored and delighted to be part of her girl hero series!

As for the new food "plate" model:

The good: it is much, much simpler than the food pyramid, which was nearly impossible to understand and was far too heavy on grains. This one takes grains back to a more modest 25% of the plate, leaving 50% of the plate for fruits and vegetables, which is a significant improvement. Also, using a plate is a lot easier to visualize then a pyramid-- Great Britain has used a version of the plate for many years, which I always thought made more sense than the pyramid. I was taught to educate people via the "healthy plate model" which looks very much like this, and I would often draw it for patients during their appointments. It is visually very easy to grasp.

The bad: in trying to make it simple, it leaves a lot of unanswered questions (as my friend asked me when I posted this on facebook-- where's the pie group?) There is no category that discusses sugar or fat, types of fat etc (which is just as well since the current recommendations are backwards anyway). Dairy alternatives aren't suggested, and most of all-- it implies that the only thing that counts as starch is grain, which means conceivably you could have beans, a potato, a cup of white rice, lettuce and a banana, and it would all fit on the "plate", but you would have a huge dose of refined carbohydrates and almost no fat or protein.

What I would change: grains should be changed to "starch" (so grain, or starchy vegetables would fit there) and I'd make that square a little smaller, or even optional. I would change the fruit/vegetable parts to just saying fruit AND vegetables, with an emphasis on green veggies. If you are getting lots of non-starchy veggies, fruit is not as important. And of course, no adult needs dairy-- some people do okay with it, many people don't-- it does not need to be a staple of the food recommendations.

I've seen a lot of paleo people bashing this as being no different then the food pyramid, ("just the food pyramid in a circle!") but I do think it's a step in the right direction. Given the amount of conflicting information in the main-stream and the difficulty in explaining nutrition simply to the general public, this is a great stride in helping people understand what foods are appropriate in what amounts.

Wednesday, May 25, 2011

Low fat propaganda

I've been a student member of the American Dietetic Association for three years (last year I was still a student when the new membership was due, even though I became an RD a month later!) This year, I will not be renewing my membership, largely because of things like this:

I get fun little bits of dietetic propaganda or advertising (as the ADA shamelessly shares my contact information with all kinds of food producers) in the mail at least once a week. My favorite one was a couple months ago promoting eating eggs-- little did they know I have an egg factory in my backyard so I get them for free:) Today's fun little number was made available by the sub-group I belong to called SCAN, which stands for Sports, Cardiovascular and Wellness Nutrition, which I thought would be a group to discuss sports nutrition, but doesn't seem to do much at all (as opposed to the Dietitians in Functional Medicine group I belong to which is actually useful-- I will be sorry to see that one go).

First of all, this helpful "resource" was sponsored by Promise/Country Crock/I can't believe it's not butter-- i.e. makers of scary non-food butter substitutes made of refined vegetable oil and tree fiber. Lovely. "Keep the taste, lose the saturated fat! Swap butter for a delicious soft spread!" it claims. 1. Margarine tastes nothing like butter 2. Butter is REAL FOOD your body can recognize as opposed to the scary crap in the margarine and 3. Believing saturated fat causes heart disease is so 1994! Even the ADA national conference made mention that saturated fat isn't as bad as they once thought-- why do they continue to spout this nonsense? Oh right, because they are sponsored by makers of margarine (other sponsors include Diet Coke and Hersheys-- wonderful).

The pamphlet lists 10 simple steps to make the new 2010 Dietary Guidelines work for you and your family:

1. Size your servings right:
While I agree generally that people tend to eat too much, I think the issue has more to do with poor food choices-- are you really going to overeat salmon, salad and fruit? Probably not.

2. Switch out the saturated fat
Come on people! So many other bloggers have covered this well, Gary Taubes has written a two books on the topic-- saturated fat does not cause heart disease. It just doesn't.

3. Make good habits more delicious at home: simple recipes for a healthier lifestyle
This section features a bunch of protein/veggie recipes that would probably be pretty good if you used a good fat instead of scary Country Crock.

4. Fit fruits and vegetables into your diet
No complaints here in general, though the specific recommendations, like to add fruit to pizza was ludicrous. (I'm healthy because my pizza has pineapple on it! Please).

5. Eat less salt
I have mixed feelings on this one. I don't think we need to be getting salt from processed foods-- if you cut out processed crap you will automatically eat less salt. But only a small portion of the population has salt-sensitive high blood pressure. Most people do fine with some sea salt in cooking-- salt brings flavors together in cooking and makes things taste better.

6. Watch out for solid fats (isn't this the same as #2?) and added sugar
First of all, margarine is a solid fat, so there goes that reasoning! But naturally occurring solid fats are very heat stable so they are your friends for cooking! Nasty vegetable oils tend to go rancid and turn to trans fat pretty quickly. I concur on the added sugar though-- keep that to a minimum.

7. Enjoy more seafood and choose a variety of protein foods
The title is fine-- I like fish a lot, and I agree with a variety of protein foods, however on the detail page they go on and on about low-fat, drain off all fat, fat phobia that is ridiculous. They also don't mention that while fish is awesome, you also have to limit consumption due to mercury toxicity.

8. Make half your grains whole
This is just stupid. Let's ignore the fact that many people don't do well with grains at all. If you believe that whole grains are superior as the ADA does, given their lack of processing and fiber content, why would you only push for people to make HALF of them whole grains? Given that the food pyramid wants you eating 6-11 servings of grain a day, that means you could be eating 4-5 servings of white bread a day and be totally within their recommendations. Oh, and you could put margarine on it! SO STUPID.

9. Keep your food safe
Tips on food safety-- no complaints here, lots of people have sinks full of salmonella. I probably do too.

10. Move More!
I think we are all in agreement that more moving, less sitting is good.

Between the inappropriate corporate sponsorships, the endless propaganda like this I get in the mail, and the useless "research" they publish in their journal, I don't seem much point in spending $200 a year for a membership, though I still have to do "approved" continuing education courses. I'm trying to figure out a way to get credit for the Robb Wolf Seminar I'm going to in July!

Saturday, May 21, 2011

How does your garden grow?

After a month of saying every weekend that we really need to get our garden planted, we finally did it today. In the past I've started some or all of my vegetables from seed but this year we just bought starts. We aren't very good gardeners, mainly because after we first get it planted we tend not to be super consistent with maintenance, thus the purchase of starts because it doesn't involve thinning out the plants. (Last year I never got around to thinning out the lettuce and it was a huge mess).

The whole garden-- the stuff on the ground is hay, to try and combat the weed problems we had last year-- it rained all summer and we had out of control weeds!

We started out the day at the best nursery ever: Flowerworld. If you live in the Seattle area I highly recommend Flowerworld, even if you aren't gardening. The store area alone is 3 acres, and they also have chickens, peacocks, geese, swans, goats and sheep you can visit, along with nearly every kind of Northwest growing plant you can think of. It's one of our favorite places.

We just recently put up some heavy duty net fencing to keep the chickens out of the garden-- they dig everything up and love rainbow chard in particular so much that there's never any left for me! They were very frustrated watching M dig in the garden and not able to get in to "help."

We planted a few sweet peas, and corn (though in 4 years we have never had a successful corn harvest-- the squirrels tend to get it all), rainbow chard, several kinds of lettuce, bell peppers, tomatoes, and collard greens. They did not have the kind of kale I like at Flowerworld, probably because it's more of a cool weather crop, so we skipped that. When it gets warmer I want to plant some basil in a pot by the back door-- last year we had a cold summer and all the basil died-- the deck gets warmer so perhaps we'll be more successful with a pot.

Thursday, May 12, 2011

A few random updates

Ack! It's been 10 days since I updated my blog! Terrible. Work has been really busy lately and I'm going through a weird phase of not being able to sleep in when I have time so I've been tired. I wake up at 6am whether I am going to work or not. Maybe because it's getting lighter outside-- I need to look into blackout curtains.

I am still eating the autoimmune protocol for the most part-- I'm definitely avoiding eggs and nightshades-- I admit nuts may have slipped in a couple times.

I'm kind of in a food rut this week-- I've been eating tons of ground beef and canned fish. Today I'm making pulled pork so maybe that will shake things up a little.

Things I'm working on:

I've been slowly making my way through Good Calories, Bad Calories by Gary Taubes for the past few weeks-- I will attempt to do a full review when I finish. It's an amazing piece of work-- over 400 pages of extremely detailed analysis of how we came to believe some of the things we do as a country about health (fat is bad, high cholesterol = heart disease) and whether those ideas actually have scientific evidence (hint, they don't). It's so dense I can only read a little at a time in order to process the information and I already feel like I need to read it again, and I'm not even finished!

I just listened to this podcast over at the Healthy Skeptic about the intimate neural connections between the brain and the gut and loved it-- I need to contemplate this and listen to it again when I'm not driving in pouring rain to get all the nuances of what Chris is saying but it's so fascinating!

My friend Stevie is helping me out with a webpage for private nutrition practice, but I'm stumped on what to call it. Any ideas? I was considering Paleo RD, but I kind of want something more generic so as not to put off people with predisposed negative ideas about paleo.

My husband has gone off the deep end this week eating almost exclusively gluten and dairy (sandwiches, cake and pizza) and I've been too tired and busy to fix it. Ack! Last night I did get him to eat eggs and yams for dinner at least.

I'm officially now obsessed with this stuff: Kevita is cultured coconut water. I used to be into Kombucha, but ever since they reformulated it after the recall it hasn't been the same. This stuff tastes better to me-- it comes in several flavors but all except original have sugar in them and taste too sweet to me. We did a tasting with some of my nutritionist friends a couple weeks ago and they all preferred the lemon ginger to the original. M thinks they all taste disgusting as he hates anything fermented. They are expensive though, just like kombucha-- over $3 a bottle! I'm going to try and make my own-- I had success in the past with kefir grains in coconut water-- I'm going to give that a try again.

Finally I have a recurring issue with my IT band. In case you didn't take anatomy or it's been awhile, "The iliotibial band is a thick band of fascia that extends along the lateral thigh from the iliac crest to the knee" in otherwords, in runs from the hip to the knee down the outside of your leg in that indent between your quad and your hamstring if you are fortunate enough to have that kind of muscle definition:

My right hip is really tight, or maybe even one leg is longer causing my right hip to get bunched up. At any rate, it's actually very noticable and has been that way for awhile--whenever I get a pair of pants hemmed the tailor comments on it because they are not the same length and when Jesse (awesome trainer at Lynnwood Crossfit) was teaching me to deadlift it was so obvious my right hip was higher he told me not to max deadlift until I get it sorted out and then called another trainer over to look at how messed up I am. Anyway, that wouldn't be a big deal, except that when your hip is tight, it pulls on that fun IT band we just talked about, which pulls the knee out of alignment which hurts. When I hurt my knee a couple weeks ago doing medicine ball squat cleans I thought it was just because I had been sloppy in my form, or that it was combined with running (which often makes my knee hurt). But then on Monday we did a workout with those squats again and I was very cautious, had Jesse show me again how to do it properly and STILL my knee hurt so much the next day I couldn't hardly walk up the stairs in my house and my right hip felt tight while sitting. Using a foam roller along that side helps some, but it's getting really annoying having to miss crossfit for several days after every workout because I keep hurting my knee. So for now, I'm foam rolling the heck out of it, avoiding those specific squat cleans and avoiding running in hopes to sort this out, but I kind of think I might have a structural issue since I remember as far back as 6th grade when they test you for scoliosis being told one hip was higher, which makes me think it's more complicated than a slight muscle imbalance. Of note, however: M. pointed out that I pretty much always sleep on that side, which might be contributing, so I'm trying to sleep on the left to see if that helps.

Monday, May 2, 2011

Paleo for Autoimmune Disorders

General Paleo is awesome for the majority of people and is a good starting point for getting healthy. For people with autoimmune disorders like Celiac Disease, Hashimoto's Thyroiditis, Fibromyalgia, Rheumatoid Arthritis and others, a slightly more restricted version may be necessary.

First, a little background on autoimmune disease: autoimmune diseases, in a nutshell, are where the body's immune system attacks its own cells, mistaking them for foreign invaders. Which type of disease you get is dependent on which cells get attacked. A number of autoimmune conditions have been linked to gluten intolerance, dairy intolerance and or leaky gut (Rhumatoid arthritis, Celiac and Type I Diabetes have all been linked to one or more of those intolerances). I just read this paper over the weekend which made it pretty clear rheumatoid arthritis and leaky gut caused by lectins have a significant correlation and the paper lays down a number of suggested mechanisms for why this occurs.

A few quotes:

"Approximately 20% of all patients with inflammatory bowel diseases are complicated by joint inflammation" (suggests a link between gut inflammation and joint pain)
"legume and cereal lectins alter the microflora of the gut causing both inflammation and increased intestinal permeability..."
"wheat containing diets can increase intestinal permeability and thereby allow the gut-derived antigens to access to the periphery"

The main point of the article was that in people who are genetically susceptible, these foods pass through the intestine in bigger pieces than they are supposed to, and then some kind of viral or bacterial infection (even the flu) can be the trigger for this chain of events, causing the immune system to overreact and start attacking "self" because the particles bind to proteins that are similar in structure to parts of "self" so the immune system gets confused. (It is even more complicated than this so if you are a biochemist and I am not explaining this well, please correct me-- trying to keep it simple!) So it explains why some people can go their whole lives eating grains and legumes and never have problems, but some are prone to this "leaky gut" and it causes different types of autoimmune diseases depending on which cells are mimicked.

The only way for the gut to fully heal is to remove the offending foods. What I am not clear on, is whether or not you have to remove these foods for life, or only until the gut heals. Matt LaLonde, biochemist extraordinaire, was on Robb Wolf's podcast recently and he said eggs, grains, alcohol, nightshades, nuts and seeds, and NSAIDS (like Advil, which are murder on your gut lining) to be eliminated FOR LIFE. (In a subsequent podcast over at the Healthy Skeptic he went even further saying that basically just grass fed meats and vegetables were all that were appropriate for people with severe autoimmune disorders!) Robb Wolf does not seem to take it so far. He has Celiac Disease, an autoimmune condition, and I know he has said he eats eggs and occasionally gluten free grains. I sent him a question for the podcast to clarify his position on this, but he gets so many questions we may or may not ever get a response. (Incidentally the Mat LaLonde podcast was my favorite ever and I've already listened to it at least twice! Definitely check it out).

As far as I know I don't have an autoimmune disease (I have blood work pending on the state of my thyroid) but I am definitely at genetic risk: my mom and both my grandmothers have Hashimoto's Thyroiditis and Rheumatoid Arthritis, and my dad has late onset type one diabetes, also an autoimmune condition. I also believe that as a nutritionist, I should never recommend something to a client without trying to myself so for the month of May, I'm doing the autoimmune protocol. This means in addition to my paleo diet, no eggs, no nightshades (tomatoes are the only ones I've been eating), no nuts (been eating a few too many of these since we came back from Hawaii with bags of macadamias!). I'm also going to cut WAY back on chocolate and fructose for a month, which is not necessarily part of the autoimmune protocol, I just have been overdoing it on those.

In the mean time I did something bad to my right knee last Thursday at Crossfit so I'm going to have to miss a few days, which doesn't make me very happy! But if I'm having trouble going up and down the stairs in my house, I'm probably not ready for the WOD.

Friday, April 29, 2011


I've been laying low the last couple of weeks, getting caught up at work after being out of town, trying to get myself back on Seattle time (getting up at 6am in Hawaii is 9am in Seattle) and I admit, eating too many nuts. I got back to Crossfit this week and feel SO weak after being gone almost two weeks. The first day back we did 2000m row. I didn't break any records (our trainer said if you haven't done it before, just "survive it". I could have pushed harder but now I know).

Yesterday I swear the warm up was worse than the workout: run 400m (I'm getting better-- I can run it now without stopping, though my lungs still HATE it), then 3 rounds of 15 pushups and 15 medicine ball squat jerks (I think) and then another 400m run. I could not believe how quickly I lost my push-up strength! Two weeks ago I could have done this much more easily. This activity was in partners and my buddy was a guy who told me he's already lost 40 pounds doing crossfit. Afterwards I wished I had asked him if he changed his diet too. He was helpful, encouraging me to get all the way through that second 400m without stopping, even though I wanted to.

Our regular workout was 5x5 banded deadlifts. Except my form on deadlifts has never been awesome and I was out of practice, so I ended up doing the regular kind (banded deadlifts are where you attach the barbell to the ground with giant rubber bands which gives much more resistance at the top. If I had kept with those I definitely would have hurt my back). I did five sets with pretty low weight-- I could have probably done more weight, especially given that this morning only my quads are sore from the warm up-- no soreness from the deadlifts! But my left knee was kind of hurting and my right hip is chronically tight (I'm working on that) so I'm always scared of getting hurt deadlifting. I also was feeling slightly nauseated because I ate too close to class, and a little dizzy, probably because I think my new contact lenses are too strong, (excuses, excuses) so it probably wasn't the best workout ever, but I don't mind easing back in. I started going to class earlier than the one I used to go to and there were a lot of women there who were all so nice to me! I wish I was better at remembering names, but I felt very welcome, which is what I love about my gym!

I'm working on a post for my plan for May: a new month long experiment to fine tune this paleo-liciousness in my life.

Oh! And I am going to see Robb Wolf LIVE! I am so excited! Mr. Wolf himself is doing a seminar in Vancouver, BC on July 9th, which is a mere 3 hour drive and a border crossing away. I can hardly wait. I will of course give a full accounting here after the fact.

Sunday, April 24, 2011

One pan meal

For dinner this evening I made steak, fried yams and kale all in the same pan that I made bacon in this morning. First of all I love this pan. I have the 5 1/2 quart version and love it so much I may eventually get the smaller one as well. Last year for my birthday I got all new pots and pans after my 10 year old non-stick cheapo set from my wedding registry started to peel teflon at alarming rates. My mom had done a lot of research a couple years ago on pots and pans and the Cuisinart Multiclad Pro had great reviews and she loved the one pot she has of this type, so I bought all new pans of this variety and highly recommend them. This particular skillet is really big-- at least 12 inches (maybe 14) about 2 inches high with a stainless lid making it good for just about anything! When I first got it in the mail I was alarmed at how big it is, but I actually use it more than any other pan.

But back to dinner:

The pan had a little residual bacon fat in it (I poured most of it out into a jar), and I cooked the steaks, which I seasoned with salt and pepper in the pan first. (not pictured)

When those were finished, I set them aside to rest (after you cook meat it's good to let it sit quietly for a few minutes-- it initially loses juices and then will suck them back up again). I added a couple of tablespoons of coconut oil to the pan and when it melted I added thinly sliced yams-- turning them after 3-5 minutes (it's easy to burn them!) both of these were over medium heat. When the yams were finished I added a couple cloves of minced garlic to the pan-- stir fast so the garlic doesn't burn!

And then a whole head of de-stemmed and chopped purple kale to the pan along with about a half cup of water to de-glaze the pan (de-glazing is where you add liquid to a hot pan that has yummy goodness also known as fond stuck to the bottom of the pan. The liquid, combined with a gentle scraping with a spatula helps get the tasty bits to mix in with the food and as a bonus, makes the pan easier to clean later). I added a bit of salt to the kale but I learned the hard way last time to taste it first! Since I salted the meat, last time when I cooked greens in the same pan as the meat with no yams between there was still salt in the pan and I over salted the greens. This time it came out perfectly!
The whole process took maybe 20 minutes and now I only have one pan to clean up!

Friday, April 22, 2011

How to become a Paleo Dietitian (and is it worth it?)

On Robb Wolf’s podcast I occasionally hear people write in to ask him where they should go to school to become a dietitian that has a paleo slant. Robb tells them there is no such place and that if they want to become an RD they are going to suffer through a lot of food pyramid nonsense and that they might be better off just taking some biochemistry classes to get a better background. He is not wrong. My experience though, was better than it would have been at most places. Now granted, I am new to paleo, but in the late 90s I read the original Zone Diet books and Barry Sears’ detailed explanation of the biochemistry of what food does in the body is what inspired me to study nutrition. It was the first time I had ever had an interest in science—it lit a fire in me like few things ever have (all this from a commercial diet book!). Throughout the early 2000s I experimented with the Zone, Atkins, Fat Flush (which is actually fairly paleo) and eventually the Weston A. Price foundation. I had a few years experimenting with being a vegan, but even then it was the grain-free variety as described in Eat to Live by Joel Fuhrman. Paleo made all of that information make SENSE. It was with this background that I entered Bastyr University, a natural health oriented University that trains Naturopaths, Midwives, Acupuncturists, Herbalists and Nutritionists, located Northeast of Seattle. Obviously the Bastyr curriculum is not teaching a paleo diet--but it does teach a whole food, local food approach that is skeptical of the food pyramid. Bastyr graduates are not afraid of saturated fat or red meat, and even sometimes scan the farmer’s market for lard (my friend spent an entire summer trying to figure out the perfect ratio of lard to butter for a pie crust). It was because of my education at Bastyr that I learned how to do an elimination diet and learned of my allergy to gluten (I already knew about the dairy). I learned about leaky gut (granted, not about Robb Wolf’s assertion that legumes and all grains can lead to it, but I did learn what it is and about the 8 most common food allergies and that I most likely had it). I took whole foods cooking classes, I had four intense quarters of biochemistry, both of the macro and micronutrient variety and maybe even most beneficial—I learned how to read scientific articles critically. This is a skill that is missing from a lot of people in my field—they simply take the conclusions of a scientific article as fact (if they read them at all), without being able to evaluate whether the study was well conducted or biased.

Now for the bad parts: sometimes you have to memorize things you do not believe in and other things that are horrendously boring (I’m sorry but Food Service Management was the bane of my existence). Particularly if you are going to become a Registered Dietitian, there are things you have to do because the American Dietetic Association says so, particularly doing a 1200 hour internship after you get your degree, which is fiercely competitive to even get into, during which time you will learn all about how to be a hospital dietitian and calculate how much corn syrup and soybean oil based liquid food sick people should be administered, you will probably have to teach a class on the food pyramid (that was not fun—the curriculum told me to tell people that soybean oil is good because it lowers cholesterol. I think I said it really fast so no one heard me). You will spend anywhere from 4-8 weeks learning about how hospital kitchens are run and a couple weeks having your heart broken at WIC educating low income young women about how to use government coupons that are mostly for dairy products and juice how to feed their children. It was a rough year and ultimately I use very little of what I experienced in that year in my job. You then have to take an expensive and scary exam on all of the stuff you wish you weren’t required to know in order to get your credential. The only thing that was really great about my internship (through Washington State University) was that our clinical instructor was a whizz in biochemistry and our lecture portion had a good review of those topics. That instructor also ultimately helped get me my current job, which is in research at the hospital where I did my internship and that made it all worth it, but seriously, it was a torturous year.

Then if you do become an RD and what you want to do is help people with paleo you are going to need to go into private practice, which is no guarantee of making any money, at least for the first five years. This is something I would eventually like to do, but right now I need to work and pay off my student loans and anyway I really like my job—but I don’t see patients on a day to day basis so I’m not really spreading the paleo word. If you think you are going to be able to instruct people in paleo at your average hospital outpatient clinic though I would take pause. You *might* be able to get away with some level of that, but I guarantee you if anyone overseeing your work got wind of you telling people not to eat grain or even worse, that saturated fat is not the devil, you will probably get fired. (The outpatient clinic where I did a rotation was still telling people they could have no more than 2 eggs a week and had a whole wall of cholesterol lowering margarine product examples. One of my friends heard a dietitian tell a patient that if a food was fat-free and cholesterol-free it didn’t matter what it was. Yikes!) Your best bet is to partner with a gym, probably of the crossfit variety to get clients.

Have I scared you off this endeavor? I hope not because there aren’t that many of us out there with this slant and I could use some company! (Note: one of my good friends from my internship is a hard core paleo crossfitter, so other RDs out there do exist—and she was into paleo way before I was!).

In some states (Washington is one) you can also practice as a “Certified Nutritionist” with a Master’s Degree in nutrition, without having to do the RD internship process. I have a couple friends who went this route and it was definitely tempting. If you know you will only ever have a private practice and will only ever live in a state where this is allowed do it. (But know that the Washington State Dietetic Association is pushing hard for licensure, not just certification for RDs, which depending on how the legislation ends up being worded, could cause problems for CNs down the road). Many states only allow you to practice as a licensed dietitian. It’s also very hard to get a job as a CN, thus the need for private practice.

I do really recommend the Bastyr Masters Degree program if you are going to take this on (I didn’t do an undergrad degree there so I can’t speak to that program). You will find a more open-minded, whole foods approach there, even if they are pretty enamored with grains, at least they tend to be on the whole grain, gluten free side of things. You can’t have everything!