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.