When eating is not an option

When eating is not an option

Eating is by far one of life’s greatest pleasures and one that we take for granted on a daily basis.  Think of how exciting it is when your baby takes his or her first bite of food or when you experience a delicious food for the first time.  Eating is so important to living.

But what happens when you, a family member, friend or colleague can’t physically eat or doesn’t eat enough calories to maintain normal biologic functions?  Would they simply starve to death over time?  The answer is complex and often ethical in nature.

 

All of us need food and water in varying amounts to survive.  If you’ve ever had to fast for 8-12 hours for a blood test or for religious reasons, you recognize that it’s not exactly a picnic to go without food.  It’s short term and you forget about it.  But what happens when you can’t eat for a prolonged time due to medical reasons?

 

Say for example, your mom has a stroke and she can’t swallow safely.  Or your uncle is diagnosed with intestinal cancer and he can’t digest food appropriately.  What happens next?  In the case of a stroke, she may need to be fed “artificially” through a feeding tube until she can eat safely on her own. Tube feeding helps prevent or treat malnutrition and keep the gastrointestinal tract functioning. Without a functioning gut, intravenous feeding may be indicated.  This type of nutrition therapy is called nutrition support and can be used in any age and population.

 

Feeding tubes come in various shapes and sizes.  They can be used short term (< 4 weeks) or placed surgically for longer use.  The short-term type is called an enteroflex tube and is usually placed in the person’s nose.  It goes down the esophagus and into the stomach or duodenum (first section of the small intestine).  Dietitians work with doctors to come up with a feeding plan including the formula, amount and rate that the person will receive to prevent or treat malnutrition.  Long term tubes can be placed in the stomach or small intestine if a person is not expected to eat for a longer period of time (or God forbid, never again).  Tube feeding can be done in a hospital, residential home or personal home.  Formulas can be basic or highly specialized, depending on the person’s medical condition.  Each contains carbohydrates, fats, protein, vitamins and minerals to meet the RDAs (Recommended Dietary Allowances) for all nutrients.

 

In individuals whom cannot digest or absorb food appropriately (non-functioning gut) a type of nutrition support called TPN may be used.  TPN stands for Total Parenteral Nutrition and is provided through an IV catheter that is typically placed in the person’s subclavian vein (large neck vein) or through a PICC (peripherally inserted central catheter) in their arm.  TPN contains carbs, fat and protein, vitamins, minerals and trace elements in the form of dextrose, IV lipid and amino acids that are provided directly into a person’s bloodstream.  This type of nutrition is typically used for at least 1 week, but can be used longer if needed based on a person’s medical condition and function of their gut.  TPN is very specialized and requires a pharmacist, nurse, dietitian and doctor to monitor.

 

For more detailed information on nutrition support, check out https://www.nutritioncare.org/

Your food, your mood

Your food, your mood

Are you a bit depressed?  You’re not alone.  With the rate of depression in the US almost doubling in a decade, researchers have been busy looking for causes and treatments.  When many countries with a low rate of depression were found to have several dietary patterns in common, researchers started looking more closely at the role food may play in fighting depression.

 

Scientists found that populations that consumed diets with large amounts of fatty fish were less effected by depression.  How fish-based diets protect against depression isn’t understood but its thought that the omega-3 fatty acids may make it easier for some brain chemicals to pass through cell membranes and positively impact mental status.

 

Uridine, a compound known as a nucleoside, may provide the materials needed to speed up these chemical reactions. Studies found that when omega-3 fatty acids were combined with uridine they had the same effect on laboratory animals as an antidepressant medication.

 

Below is a list of foods that studies have shown may be effective in reducing depression:

 

  1. Amino acids. Low levels of serotonin are thought to be a cause of depression.  Researchers know that the amino acid, tryptophan is needed to make serotonin.  Several studies have found that depression is decreased by a diet high in tryptophan.   Eat foods high in protein – beans, eggs, fish and turkey. Bananas also contain tryptophan.
  2. B vitamins. Studies have shown that people suffering from depression tend to have high levels of homocysteine (a protein) combined with low levels of folic acid (a B vitamin).  Homocysteine levels can be reduced by B vitamins – niacin, folic acid, B6 and B12.  A diet rich in fruits, vegetables, legumes, nuts and whole grains can help you get more B vitamins.  B12 is only found in animal foods, so include eggs, low fat dairy and lean meat in your diet as well.
  3. Complex carbohydrates, fruit & vegetables. These high fiber foods will be broken down more slowly to produce a steady source of sugar to be used by your brain.  Simple sugars or a diet high in processed carbohydrates is broken down quickly and causes blood sugar levels to go up and down quickly.  These quick changes have been found to increase the symptoms of depression.  Eat a diet high in fruits, vegetables and whole wheat or whole grains (bread, pasta, rice, etc).
  4. Omega-3 fatty acids. The low rate of depression found in countries that eat high levels of fish combined with several clinical studies have led researchers to conclude that eating a diet high in omega-3 fatty acids can be protective against depression. Omega-3 fatty acids are found in fatty fish (salmon, tuna, & sardines), flaxseeds, walnuts and canola oil.
  5. Uridine-containing foods.  Researchers found that when uridine was combined with omega-3 fatty acids, a positive impact on depression was realized at lower doses.  Foods that contain uridine are sugar beets, sugar cane, molasses made from sugar beets or sugar cane, tomatoes, and organ meat.

 

The research linking foods and their effect on depression is still new and more studies are needed.  Including these foods in your diet is not a substitute for what is recognized as effective medical treatment for depression – medication and psychotherapy.  However, many medical providers believe that combining effective medical treatment with a healthy diet that includes foods rich in omega-3 fatty acids, uridine, B vitamins and tryptophan should not cause any harm and who knows, and just may help.

National Family Meals Month

National Family Meals Month

With the return to school in August comes National Family Meals Month!  Who knew this was a thing?  But- it makes total sense to me.  Did you know that families that dine together have children with lower rates of depression and drug use?  Or that family meals foster better eating habits with less risk of obesity?  Meal time is about the only time in my day where I have quality time with my girls and husband, so I honestly hate to miss it.

 

Below are some tips for a healthier family dining experience:

  1. Look at your weekly calendar and carve out at least 4 out of 7 days you can dine together.  More is better, but life gets busy with work, school, sports, etc.
  2. Involve the whole family in meal prep.  This lessens the burden on you and encourages your kids that they can actively participate in meal planning.  Dad can grill, kids can wash and/or cut veggies or stir grains on the stove.  It also teaches kids cooking skills.  Win wiin!
  3. Try not to have “food fights”.  If someone isn’t wild about the dish prepared, politely ask him/her to help themselves to leftovers.  For younger children, have a healthy back up if possible.  Try to limit use of “kid food” like hot dogs, mac n cheese and chicken nuggets.  Kids eat what you feed them. Start healthy first.
  4. Don’t force feed your kids!  Making them “finish their plate” in order to have dessert only encourages overeating.  It’s like saying, “if you eat ALL of this, we’ll feed you more”!  Small servings of food are fine.
  5. Include fruit or dessert as part of the meal.  Alternate treats and fruit so kids get used to having both as their end of meal treat.
  6. Keep the chatter positive.  Limit talk about politics, family illness and gossip.  This is a time to share good news and not bring everyone down.
  7. Ask each family member about their day- name 3 positive things that happened.  It will lift everyone’s spirits.
  8. Serve water or milk at meals.  Soda and juice add more calories and sugar to everyone’s meal, which most kids and adults don’t need these days.
  9. Keep a variety of frozen veggies on hand and microwave them for simpler meal prep.
  10. “Reuse” leftovers in other dishes.  Add black beans or chicken to salads or pasta dishes.  Add leftover salad to sandwiches.  Teach your kids that food is a resource and should not be wasted.
What to expect from a nutrition consult

What to expect from a nutrition consult

I am not proud to admit this, but recently, I had a very unsatisfied customer.  From the time she walked in from the time she left, I could tell she was going to be difficult.

 

Maybe she’d had an off day and was taking it out on me, or maybe she expected me to just give her some printed handouts of what to eat and what not to, but it made me think- what do my clients expect of me?

 

For starters, she showed up early and I hadn’t arrived yet. Normally, I am there before my clients, but traffic was heavy and she arrived 10 minutes before me.  Was I late?  Nope.  But she sure made me feel like I was.  Note to self- arrive earlier than early.

 

I asked a lot of questions (a lot).  I send a long, detailed client profile form that clients fill out before meeting me.  This includes medical history (if applicable), eating style, supplement use, shopping habits, reactions to stress and a 3-day diet history.  In her case, the diet history was left off, so I asked a lot about eating habits and food preferences.  I do this to find out where you may need help with your diet.  It’s a 2-way street.  I ask questions, and I expect answers in return (detailed if possible)!

 

I provide articles and handouts based on your interests and health goals.  Sometimes I obtain this information before we meet, but many times, our hour together is where I glean the most information.  It’s helpful to tell me why you’re there and what I can help most with (shopping, recipes, meal planning or information).  I may also give you coupons if I have them to try new foods.

 

After the visit, I put together diet materials suited to your situation or health goals.  If weight loss is desired, I’ll give you a 1-day sample blue print of serving sizes and foods to eat, based on what you normally like to eat.  It would be foolish for me to give you exact foods to eat on certain days as I know most people don’t eat this way and circumstances change from day to day.  Ideally, dietitians want to give you the tools to make your own food choices and provide meal and snack ideas instead of planning your whole meal schedule.  I also provide recipes and tip sheets to help with ideas.

 

Finally, after your visit, I write a progress note for your doctor or other care provider to let them know about what we covered.  Visits are often due to physician referral, so I keep them posted of your health goals and progress.  This also gives me an opportunity to market for more referrals.

 

A Night at Findlay Kitchen

A Night at Findlay Kitchen

I wish I could say I was working in Findlay Kitchen because I’m starting a small cupcake or empanada business, but alas, I am not.  I was there a few weeks ago because I volunteered to help with a program called “Cooking for the Family”.

 

The program is sponsored by St. Francis Seraph Ministries and Findlay Kitchen and provided by FarmChef.  The premise of the program is for families to learn to cook affordable, nutritious meals in a 2 hr, 5-week series.  You cannot beat the price of $10.00 for a 2-hour cooking class with hands on experience and food samples.  The families also take home a goody bag with a cast iron skillet, chef’s knife and cookbook after completion of the program.

 

It was so much fun to be in this large, commercial kitchen.  It is bright and bustling with entrepreneurs and lay people like me that just enjoy food.  This is how the night goes:  I show up, wash my hands and put on a hair net and apron.  The chef instructs us to chop some veggies, get out mixing bowls, wooden spoons and ingredients.  We set up stations based on how many families are participating.

 

The families come in at 5:30 or so.  They wash their hands and get ready to cook.  Our chef LaKeisha Cook teaches them how to chop vegetables or cook quinoa, while a few volunteers oversee their progress.  How ironic that her last name is Cook!  When bowls and utensils start piling up, we grab a grey cart and load it for the dish room.

 

The dish room houses the fastest cleaning dishwasher I have ever seen.  There are a few stationary tubs for washing and sanitizing pots, but everything else goes through the dish machine.  Your load of dishes is done in 1-2 minutes tops.  The dish room is where you may run into some of the small business owners that are creating ravioli or specialty cakes.  Each business is in a “pod” (small room) working on their craft, or in a larger, more open space in the facility cooking.  I love the energy in this kitchen!

 

After we’ve prepared our recipes, we put all the tables together and everyone sits down to eat. Bowls of sauteed vegetables and steaming quinoa are passed among strangers that have worked elbow to elbow all night making jokes and talking about food.  It’s a lovely experience.

 

Cooking for the family has a few other locations that are always in need for volunteers.  Bush Rec Center in Walnut Hills also holds a class as well as Community Matters in Lower Price Hill.

 

If you’re interested in attending the class, volunteering or donating to the project, here are a few links:

Spread the word: http://bit.ly/2nNAGBI

Volunteer: http://thefarmchef.com/how-to-get-involved/

Fund for another person: http://www.sfsministries.org/donate/

 

 

 

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