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Fresh Focus

Author: Department of Veterans Affairs

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Fresh focus is a podcast delivering bites of nutrition information to veterans and their family between visits. Whether you are busy with a family, retired, or more isolated, you can stay connected for you. Dietitians from the Marion VA Health Care System will deliver evidenced based, consistent information to take on today's hot topics while promoting positive health outcomes.

The Department of Veterans Affairs does not endorse or officially sanction any entities that may be discussed in this podcast, nor any media, products or services they may provide.
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As Dietitians with VA, our job is to help take the mystery out of good nutrition habits. We want to make it as simple as possible for you to make the healthy choices you need to reach your nutrition and lifestyle goals. And it’s with that goal in mind that we are going to be taking a deep dive into a personal meal planning tool called the Healthy Plate. Put very simply, the healthy plate is a visual guide that shows what types of foods, and how much of each type, you should eat at each meal, using the space on a standard 9 inch dinner plate as our guide. You separate each circular plate into 4 equal quadrants, like 4 pieces of a pie (just kidding, I’m not recommending you eat pie). So at each meal, all you really need to do is focus on filling half of your plate, or 2 of those 4 quadrants, with non-starchy vegetables. Then quadrant 3 you will want to fill with grains, beans, or starchy vegetables, and quadrant 4 with minimally processed meats or other proteins. And that’s it. For example if you plan to have porkchops for tonight’s meal, that would be your protein source, so you would have a 4-6 oz baked porkchop,  add a ½ baked potato for a starch/carbohydrate section, and add some cooked broccoli or mixed veggies to fill ½ your plate complete the healthy plate model. In our MOVE program, at VA we teach our veterans to utilize a 9 inch plate. So that could be your goal for the next meal to use a smaller plate.We want to review these simple guidelines so you can plan a meal that you can be confident will move you one step closer to your fitness and nutrition goals. Beth Blair, RDN, LDN is a Registered Dietitian Nutritionist.  She serves veterans out of the Evansville Healthcare Center within the Marion VA Health Care System. She received her education from Western Kentucky University and completed Dietetic Internship at Indiana University Medical Center.   She has been at the VA for over 8 years.  She enjoys teaching the MOVE! Weight Management Program and helping veterans focus on attainable goals to help jump start their health and wellness journey.  
So often when we think about eating healthier or getting to a healthier weight or lowering blood sugars so much we hear is “cut back on this” or “eat less of that”.  There is a category of foods we all need to focus on eating MORE of! That category of foods is non-starchy vegetables.  In the healthy plate planning method we are shooting for filling HALF of your plate with non-starchy vegetables.Non starchy vegetables have much lower carb content than starchy vegetables (think potatoes, corn, beans, etc), have a ton of inflammation and disease fighting vitamins and minerals and fiber, and are very low in calories.  So what are some examples of non-starchy vegetables?? ·         Broccoli·         cauliflower·         green beans·         peppers·         spinach ·         kale·         asparagus·         cabbage·         cucumbers and so many more, click the link below for a full detailed listThe dietary guidelines for Americans recommends we get 2.5 cups of vegetables per day, but in this situation the more the better!  A serving is considered 1 cup raw vegetables or ½ cup cooked vegetables. My top 10 tips and tricks for increasing your intake of non-starchy vegetables are:1. Stack sandwiches high with veggies.2. Veggies as an appetizer 3. Mix cooked veggies into your scrambled eggs/omelets or potatoes 4. Buy fresh raw veggies for snacking.5.  Mix cooked chopped veggies into any starch-based side dish.6. Try veggie-based recipe swaps. 7. Mix chopped veggies into meats like hamburgers, meatballs, or meatloaf.  8. Add veggies to your pizza.9. Experiment with new veggies. 10. Try roasting veggies! Or any new way to cook vegetables. Tune into our podcast episode on Non-Starchy Vegetables for more information on these 10 tips and tricks and more ways to increase your non-starchy vegetable intake to make your plate a healthier one!Non-starchy vegetable list15 ways to increase veggie intake hand out from websiteHow to cook veggies handout from website Host Bio: Lauren Hocking, RD, CD is Registered Dietitian Nutritionist serving veterans out of the Vincennes, Indiana CBOC within in the Marion VA Healthcare System.  She received her Bachelor’s Degree in Human Nutrition and Dietetics at Southern Illinois University Carbondale and went on to complete her Dietetic Internship at the Memphis VA Medical Center in Memphis, TN.  She has been at the VA over 8 years where she covers PACT clinics at Vincennes in addition to Home Based Primary Care. She assists our nations heroes make strides toward living a healthier life by helping them make lifestyle changes while taking it one step at a time.
Whole grains and starchy vegetables are great sources of antioxidants, vitamins and minerals.  But what they are best known for is their carbohydrate and fiber.  The healthy plate method of meal planning recommends that you limit 1/4 of your plate to grains or starchy vegetables.  This is to make sure you leave room for those non-starchy vegetables that should make up half of your plate.  Examples of starchy vegetables include potatoes, corn, peas, winter squash, pumpkin, yams and sweet potatoes. The healthy plate method also recommends that at least half of your grains should be whole grains.  Whole grain refers the complete intact grain with none of the nutrients or fiber removed.   There are two types of fiber that occur naturally in foods.  Both types of fiber are important for overall good health, making it important to choose a variety of fiber-rich whole foods.  Familiar examples of whole grains include 100% whole grain bread, 100% whole wheat pasta, brown rice, and oats. Some tips for replacing processed grains with whole grains include:Choose foods with as few ingredients and as close to their natural states as possible.  Check the nutrition facts label and ingredient list for the words “whole” or “whole grain.”  The amount of fiber in whole grain foods vary, so choose those with the most. Aim for at least 3 grams of fiber or more per serving.   For grain-based snacks choose air-popped popcorn, and rye or other 100% whole grain crackers.  Change up familiar meals by substituting ancient whole grains or seeds in casseroles and grain-based salads, such as pasta salad or rice pilaf.Tune into our podcast episode on Grains and Starchy Vegetables for more information on how to make your plate a healthier one! 
Fat has had a very strange, political, and controversial history. In order to get down to what’s important, we need to navigate through the confusion. Fat is one of our macronutrients (along with protein and carbohydrates), and it is an essential part of our intake. It has many functions within the body, including organ protection, providing fuel, coating nerve cells, making up organs (our brains are roughly 60% fat), making up cells (lipid bilayer), nutrient & phytochemical absorption, skin/hair/nail health, hormone balance, etc. As with anything diet related, the first step is to evaluate the source of your food. Are you eating mostly real, whole foods from nature, or processed, refined foods from the grocery store shelf? Good sources of fat are going to come from those whole food options. Step one- Continue to eat real, whole foods, and follow a system (such as the healthy plate) to guide you to a balanced intake. Step two- Include good sources of fat, such as olives & olive oil, avocados, nuts & seeds, fatty fish, coconut oil, eggs, dairy, minimally-processed meat, and even butter (especially if it’s grass fed and organic). Remember that, although we shouldn’t fear fat from animals, we should still get plenty of our fat from antioxidant-rich plant-based foods. Balance is important. Step three- Avoid the following sources of fat: fast food, fried foods, heavily processed meats, processed/packaged foods such as TV dinners and box meals, refined sugars & sweets  (including sugar from fluids), highly processed vegetables oils such as soy, corn, and safflower, as well as Crisco and other hydrogenated oils. The sources we choose to get our fat from, as well as the overall quality of our diet & lifestyle, will make a huge difference on whether that fat will be helpful or harmful. Eat well!Host Bio: Sieger Giroux MS, RD, LDN is a registered dietitian with a dual-master’s degree in exercise science from SIU Carbondale. Sieger also worked as the sports nutritionist for Saluki Athletics during his second year of graduate school. He has been with the VA since 2015, and has helped cover various positions & programs such as MOVE!, RRTP, outpatient, inpatient, Home-Based Cardiac Rehab, etc. He enjoys all aspects of nutrition, but specializes in helping Veterans simplify the process of achieving better health through positive lifestyle changes. 
Protein is considered the building block of life and is found in every cell of our bodies. It has many important functions and benefits. It helps with muscle tissue repair, growth, and maintenance. Protein also prevents muscle loss. It helps keeps your blood sugar balanced, and protein and amino acids are essential for the formation of hormones, enzymes, neurotransmitters, antibodies, transport proteins, nucleic acids (DNA, RNA), and structural proteins (which are found in hair, nails, connective tissue). Protein plays a huge role in weight management.  Protein helps reduce appetite and curb cravings.  Protein also requires the most calories to digest. Furthermore, since protein helps preserve lean body mass, it can help to make sure that weight you lose is mostly fat.  While protein has clear benefits, there are certain sources of protein that are better for you than others.  Good sources of protein include foods such as meat, dairy products, legumes, grains, nuts, seeds, and some vegetables. Some less healthy sources include foods like processed meats, fried foods, and highly processed protein-enriched foods.  The amount of protein you need in order to feel your best will depend on several factors- your age, activity level, goals, and underlying health conditions.  Meeting your optimal protein requirement is necessary for good immune function, a healthy metabolism, satiety, weight management, and performance. A good rule of thumb is to get at least ½ your body weight (in pounds) in grams of protein.  A simple way to make sure you are getting an adequate amount of protein in your diet is by making sure you are including a good source of protein, which would be at least 25-30 grams, in each of your meals. When relating this to the healthy plate method of eating- you want to fill ¼ of your plate with quality protein. Be sure to listen to the Fresh Focus Podcast episode on protein to learn more! Host Bio: Tori Stewart, MS, RD, LDN, CPT is a Registered Dietitian and Certified Personal Trainer and Group Fitness Instructor. She serves veterans through facilitating a Home Based Cardiac Rehab program. Tori received a Dual-Master’s Degree in Food & Nutrition and Exercise Science from SIU Carbondale and has been at the VA for over two years. She is passionate about helping patients learn how to take control of their health and live a healthy and fulfilling life.
The healthy plate method is not a diet but a strategy to focusing on making healthy choices one meal at a time. This concepts can be modified and tailored to your individual needs and that’s where Dietitians can help.   Here are some actions you can take now to put this method into place.  1. Veggies for breakfastIncrease your intake of colorful vegetables that are full of vitamins and minerals. The goal is filling ½ your plate of non-starchy vegetables three times a day to be on the right track. Try adding pico to your eggs! You can make it yourself or find in the produce section.  2. Let’s talk noodlesMoving on to one of the most talked about topics I hear on a regular basis is carbohydrates. I would recommend first making the switch from enriched white grains to a whole grain. Then after you cook your pasta consider reducing the size on your plate so you can fit those non-starchy colorful vegetables on half of it. Grilled asparagus are a favorite! 3. Adding the fatSalad dressings are a great way add some good fats and breath some life to those leaves. You can experiment with a variety of oils, vinegars, herbs and spices. Here is a basic recipe we love:o   ¾ cup oil (olive, extra virgin olive, grapeseed, or avocado oil)o   ¼ cup vinegar (apple cider, balsamic, red or white wine)o   1 tsp garlico   1 tsp oreganoo   1 tsp basilo   Salt/pepper/onion powder/red pepper as desired 4. Hide the goodsDrinking smoothies is a great way to get that healthy plate in. Think about the plate when you build the blender. I recommend the single serve blender for this because it keeps portion size on target. Add a leafy green, small handful of fruit, and protein source.  5. Bulk up your proteinCook your meat in bulk. For example, if you and your spouse decide to grill chicken Sunday. Try cooking chicken for three meals vs just one since you already have the grill out. What if you have a change of plans and don’t eat those extras? No problem, toss those in an air tight bag and freeze for later.  Host Bio:Lindsey Purcell, MS, RD, LDN is a Clinical Nutrition Supervisor and Registered Dietitian. She serves veterans out of the Mt Vernon, IL CBOC within the Marion VA Health Care System. She received her education from SIU in Carbondale and has been at the VA for over nine years. She specializes in helping veterans transition into eating healthier one step at a time. Making simple modifications to current meal favorites and debunking diet culture myths using an intuitive eating approach. 
In this season of the series we are covering the entire maternal diet…from what to eat when you are thinking of starting a family to feeding your newborn!   How exciting to think about becoming a momma! As you are thinking about starting a family and making that decision to try to get pregnant, we want to help you prepare now to allow for a smoother transition to a healthy pregnancy.   There is a ton of information out there and trust me, it can be overwhelming and confusing.  I want to be the first to tell you that you definitely do NOT have to wait until you have that little bundle of joy to start eating well for YOU.  Now is the time to review your eating habits.  It is both beneficial and easier to overhaul your habits prior to becoming pregnant.    It is always a good idea to add in nutrient dense meals and snacks for everyone.  In this episode we review 10 Tips that can be followed. Whether you are planning for your first time or if you are an experienced mom wanting to expand your family. Healthy tips prior to pregnancy·         Getting off birth control and ensuring essential nutrients ·         Assess your current weight. ·         Assess your current meals and snacks·         Ensure Healthy Hydration·         Ensure healthy supplementation  ·         Daily Exercise·         Reduce Stress·         Get enough Sleep·         Start healthy eating practices now·         Take Care of YOU! The Marion VA dietitians are here to help you answer your nutrition related questions.   Stay tuned for the rest of this podcast series to gain more valuable to ways be and stay healthy.  Resourceshttps://www.move.va.gov/docs/Resources/BMIchart.pdfhttps://www.womenshealth.va.gov/WOMENSHEALTH/outreachmaterials/reproductivehealth/pregnancy.asphttps://www.womenshealth.va.gov/WOMENSHEALTH/OutreachMaterials/GeneralHealthandWellness/maternity.aspBio:  Beth Blair, RDN, LDN is a Registered Dietitian Nutritionist.  She serves veterans out of the Evansville Healthcare Center within the Marion VA Health Care System. She received her education from Western Kentucky University and completed Dietetic Internship at Indiana University Medical Center.   She has been at the VA for over 8 years.  She enjoys teaching the MOVE! Weight Management Program and helping veterans focus on attainable goals to help jump start their health and wellness journey
What happens if you’ve tried and tried and can’t get pregnant? What happens if you’ve done everything “right”, but it’s still not happening? You may be in the 12% of couples who struggle with infertility. Infertility is the failure to achieve pregnancy after 12 months of unprotected sexual intercourse. Infertility can be attributed to the female partner ~30% of the time, the male partner ~30% of the time and both partners ~30% of the time. The other 10% of cases are considered “unknown” or “unexplained” infertility.Diet is a modifiable risk that can improve or even reverse infertility. Consider these 5 action steps you can take to improve your fertility. 1. Eat more fiber. Aim for 25-30gm daily. Fiber is found in plant-based foods such as fruits, vegetables and whole grains.2. Eat the right fats. Pay attention to 3 different categories of fat when it comes to fertility. Eat more unsaturated fat. Limit saturated fats to a few choices per day. Avoid trans fats.3. Watch what you drink. Limit caffeine. Avoid alcohol and sugary beverages.4. Stay away from sugar. Check food labels and product ingredient lists to avoid foods that list sugar as the first or second ingredient. Daily recommendation for women is 25gm sugar, and for men is 36gm sugar.5. Achieve a healthy weight.  Aim for a BMI between 20-30. Make dietary changes and incorporate physical activity to jump start your weight goals. If you have a specific infertility diagnosis, consider talking to your provider or a registered dietitian about individual nutrition tips that might be helpful for you. Listen to the podcast to hear more in-depth information regarding nutrition for infertility and personal experiences from VA dietitians who experienced infertility first hand. Host Bios: Loran Morris, MS, RDN, LDN is a Registered Dietitian Nutritionist serving Veterans within in the Marion VA Health Care System. She received her Bachelor’s Degree in Human Nutrition and Dietetics and Master’s Degree in Food and Nutrition at Southern Illinois University Carbondale. She started her career with the Marion VA Healthcare System as a Dietetic Intern in January 2014 and transitioned into a PACT Dietitian later that year. She is passionate about meeting each Veteran’s healthcare needs through counseling, education, and support.Gaya Hart, RDN, LDN is a Registered Dietitian Nutritionist serving veterans within in the Marion VA Health Care System. She received her Bachelor’s Degree with an area in Dietetics from Murray State University. She completed her internship through Morehead State University. Gaya has worked for the VA for 5 years. Prior to coming to the VA, Gaya worked in acute care, long term care, at an HIV clinic and home health. She and her husband have a six year old son they adore! She enjoys spending time with family, gardening, swimming, hiking, crafts, and putting Legos together with her son. She has a passion for helping veterans as her husband, father and grandfather all served.
Basic pregnancy nutrition is important to keep you and baby healthy. When you get that positive pregnancy test, your body is already undergoing many changes. Right from the beginning, hormones can cause some unpleasant side effects. The most common being morning sickness.  Morning sickness can be different for everyone and can happen during any time of day. The most important thing is to make sure you are getting adequate nutrition. Ideally you want to be getting good sources of folic acid, calcium, iron, vitamin B12 and omega 3 fatty acids, but if morning sickness is a problem, getting these nutrients might be the last thing on your mind. Always take a prenatal multivitamin to cover all your basic micronutrition needs.  If you are unable to keep anything down due to ongoing morning sickness, try these 5 tips: Avoid an empty stomach by having small meals or snacks frequently.Use herbs and spices that combat nausea such as ginger, peppermint, and lemon.Focus on easy to digest foods that you know you are able to stomach.Drink at minimum 64 oz of water or non-sugary beverages daily. Give yourself some slack. Although you may not be getting well-rounded meals at this point, you will be getting the calories you need to avoid unintentional weight loss. As you are assessing your food intake, remember that some foods need to be completely avoided during the pregnancy. Meat, poultry, eggs or seafood that are raw or undercooked should not be included in your diet. Avoid any unpasteurized soft cheese. Lastly, if choosing deli meats, make sure you heat them until they are steaming hot.  Weight can be a tricky topic during pregnancy.  Some women have difficulty gaining weight, others seem to gain too quickly and some have no difficulty at all following the guidelines. Try not to get discouraged if you have gained a little more or a little less than you are supposed to. The important thing is that you are eating balanced meals packed with nutritious foods. Now is NOT the time to start restrictive eating or binge eating to try and match weight gain goals perfectly.  Listen to your body- it knows what to do.  As you near the end of pregnancy, swelling and fluid retention can be  noticeable in the feet, hands, and face. Tips to help reduce swelling include resting with feet elevated, staying cool during hot weather, drinking plenty of fluids, wearing loose, comfortable clothes, staying active to help circulation and lastly, monitoring your sodium and potassium intake. Excessive or rapid swelling may also be a sign of an underlying issue, especially if paired with high blood pressure. Keep an eye on rapid weight gains you may have and report them to the doctor to rule out any serious conditions like pre-eclampsia.  As you near birth, remember to continue a balanced diet and staying active. Pregnancy is such an amazing experience and a life changing event. Embrace every moment as it truly is grand!Host Bio: Loran Morris, MS, RDN, LDN is a Registered Dietitian Nutritionist serving Veterans within in the Marion VA Healthcare System. She received her Bachelor’s Degree in Human Nutrition and Dietetics and Master’s Degree in Food and Nutrition at Southern Illinois University Carbondale. She started her career with the Marion VA Healthcare System as a Dietetic Intern in January 2014 and transitioned into a PACT Dietitian later that year. She is passionate about meeting each Veteran’s healthcare needs through counseling, education, and support.
While pregnancy may seem like the perfect time to eat extra portions of dessert and veg out on the couch, it is actually one of the most important times to prioritize your health! There are many contributors to your health, but one very important one is physical activity and exercise. In fact, the American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women participate in 150 minutes of moderate exercise each week.  Regular physical activity during your pregnancy is incredibly important to support a healthy pregnancy and birthing experience. There are many amazing benefits of physical activity during this transformative time of your life! Some of these benefits include: ·         Reduction in back pain·         Improving constipation·         Decreased risk of gestational diabetes and preeclampsia·         Decreased chance of needing a c-section, pain relief, or Pitocin·         Promoting healthy weight gain·         Improvement in overall general fitness·         Strengthening your heart and blood vessels·         Helping you lose the baby weight more quickly after baby is bornFurthermore, benefits for the baby may include:·         Increased blood volumes·         Leaner builds·         Better tolerance to the stress of pregnancy and delivery·         Improved brain developmentPregnancy is such an exciting time, but it can also be intimidating with all of the changes going on in your body. While simply being active is important, when participating in a pregnancy exercise program, it is equally important to discuss with qualified professionals to determine the best level of activity and to make sure you are able to complete the exercises with proper form.  The goal is for you to feel empowered to take charge of your (and your baby’s!) health and to help you feel the best you can so you are able to enjoy this time.  As always, if you have any questions, contact your local VA dietitian and we will be happy to help you!  Host Bio: Tori Stewart, MS, RD, LDN, CPT is a Registered Dietitian, Certified Personal Trainer, and Group Fitness Instructor. She serves veterans through facilitating a Home Based Cardiac Rehab program. Tori received a Dual-Master’s Degree in Food & Nutrition and Exercise Science from SIU Carbondale and has been at the VA for over two years. She is passionate about helping patients learn how to take control of their health and live a healthy and fulfilling life.
Breastfeeding can be an awesome bonding experience with your baby.  Although it provides baby with great nutrition, it can be overwhelming, frustrating, and brings up many questions for mamas and their support systems. Eating healthy does not affect the quality of nutrients in your breast milk, but it is important for new moms to eat healthy to maintain energy levels (hello lack of sleep from midnight feedings).  In order to take the best care of your baby, you have to take care of yourself as well, which includes eating a well-balanced diet.  Check out our previous series on the Healthy Plate Method for balanced diet tips.Many moms find themselves worrying about producing adequate milk for their baby. So often, how to increase supply is a common question. Below are three tips to help with establishing and maintaining a good milk supply.  If you are concerned with your supply try these tips while looking for a lactation consultant in your area for a one on one appointment to discuss your specific situation.1. Initiate breastfeeding early.  The sooner the better after delivery getting baby to latch will help signal to your body that it needs to start milk production!  2. Frequent nursing sessions based on baby’s hunger cues.  Breastfeeding is all about supply and demand.  The more often and consistently you nurse or pump to empty your breasts signals your body to make milk in order to replace what has been used.3. Try to manage and reduce stress.  There is A LOT going on in those first few weeks of a baby’s life and lots of those things can increase stress!  Managing stress is so important because being over stressed can affect the letdown reflex and poor letdowns could affect your milk supply.  The old saying “the days are long but the years are short” is completely true for pregnancy and breastfeeding.  Even though you feel all 24 hours in the day, at some point your nursing journey will come to an end.  Listen in on this podcast episode as Dietitian Lauren Hocking interviews Caitlin, a nursing mom of two for her advice. Host Bio: Lauren Hocking, RDN, CD is Registered Dietitian Nutritionist serving veterans out of the Vincennes, Indiana CBOC within the Marion VA Healthcare System.  She received her Bachelor’s Degree in Human Nutrition and Dietetics at Southern Illinois University Carbondale and went on to complete her Dietetic Internship at the Memphis VA Medical Center in Memphis, TN.  She has been at the VA  8 years where she covers PACT clinics at Vincennes in addition to Home Based Primary Care. She assists our nation’s heroes make strides toward living a healthier life by helping them make lifestyle changes by taking it one step at a time.
Congratulations! You have just delivered your adorable baby! Now you are faced with the decision on breastfeeding vs. formula-feeding. There can be a lot of pressure to do one or the other. I think new moms don’t necessarily expect the opinions that come with making that choice. Just remember a fed baby is best, no matter your planned choice of feeding.  Although breastfeeding and nursing are often described as “natural,” it might not feel that way for everyone.  For some it comes very easy, “like riding a bike,” but for others it is a struggle. Maybe the baby doesn’t latch well, you have a low milk supply, your nipples are super sore, you don’t have much support in the home, you have a demanding job, or there are medical issues that make breastfeeding more difficult. Remember, even breastfeeding moms who seem to have it all together, often find it difficult and overwhelming at some point or another.   What if breastfeeding or pumping doesn’t work out or you are only able to breastfeed for a short period of time? It happens, and it happens to the best of us. It is a great accomplishment to provide your baby with even a little bit of breast milk even for a few weeks or days. Think of breast milk like a vitamin supplement, small amounts can give a boost of nutrition.  Even if your baby only gets an ounce or a few drops a day it can still be beneficial to their health.   This episode of Fresh Focus shares several different stories and struggles of our Registered Dietitians. It also discusses benefits of breastfeeding, history of formula, seeking help from a lactation counselor, and provides encouragement no matter what path you choose to feed your baby.The key point to remember is everyone’s journey is different. Sometimes what we anticipate, plan for, or expect is not possible or turns into a different path entirely. Whichever route you choose or need, whether it is breastmilk, formula, or a combination, your baby will flourish. Seek advice when you need it, but remember, do what is best for you and your family.  Host Bio:  Melaina Lane, MS, RD, LDN, CDCES is a Registered Dietitian Nutritionist and Certified Diabetes Educator serving veterans enrolled in the Home Based Primary Care program within the Marion VA Healthcare System. She received her Bachelor’s and Master’s Degree from Southern Illinois University in Carbondale, Illinois. Melaina has worked for the VA the past 9 years. Prior to coming to the VA, Melaina taught nutrition at a local community college, worked in the acute care setting at two nearby hospitals, and has provided menu review for several local senior citizen facilities since graduating. Melaina also published a children’s book following the birth of her first child. She enjoys long distance biking, time spent on the water, and home interior design. Melaina feels very blessed to work with our nations heroes each day and provide the care they deserve for all the contributions made to our country. 
The holidays can be a magical time, but how often do you get excited and then when they roll around fears about your health start to creep into your head?  If you are a person with Diabetes you might also worry about controlling blood sugars. These are completely common thoughts, but the holidays don’t have to be a time for throwing in the towel on all the hard work you’ve done the rest of the year. Season three of the Fresh Focus Podcast was created by Marion VA Healthcare System Diabetes Educators to help you tackle the holidays of 2020! We understand it is a challenging one, and there are new modifications this year that will include smaller gatherings for 2-6 people. This year, instead of making a large turkey, you might find yourself utilizing an herb roasted turkey breast instead. The same way you could try mini pumpkin pie-lets for a change to reduce the overall calories and carbs while still getting your pie fix.   For people with Diabetes, when you choose to eat all of your calories and carbohydrates at one meal you are taking a chance of having hypoglycemia or low blood sugar during the day. Then there is a possibility to have hyperglycemia or high blood sugar after eating too much that night with one large meal. Take a listen while Kerri goes through these key points in controlling that type of blood sugar roller coaster!   1.       Eat consistently and not skip meals during to prevent overeating at that holiday meal due to not eating the rest of the day. 2.       Remember to always take your medications as ordered. 3.      Utilize the healthy plate method even on the holidays to help fill your plate with all those good foods. Bring a delicious holiday inspired salad to the meal for a pop of green and bright red at the meal.   
Are you hosting a holiday meal or party this year? Don’t get overwhelmed! Our Marion VA Health Care System Diabetes Educators are able to assist in the meal planning if your guests include people with diabetes in episode 14 of the Fresh Focus Podcast.  Just remember no one food or beverage is necessarily excluded for someone with diabetes.  It is important to balance between starchy foods like stuffing and yams and non-starchy vegetables such as green beans, asparagus, broccoli. And to be mindful of alcohol intake.   Meals or appetizers can easily incorporate dietary needs without distracting any flavor, but find out more tips as a host one what the best strategy for creating a diabetic-friendly gathering! Key holiday hosting tips:1.       Hosting for the holidays for people with diabetes doesn’t have to be overwhelming. Plan the menu with a balance between starchy foods like stuffing and yams with non-starchy vegetables like broccoli or green beans.2.      Allow guests to dress and sauce their own food. This helps those who are counting their carbohydrates which might impact their insulin injections.  3.      Alcohol consumption can interfere with blood sugar as well as the hormones needed to maintain healthy blood sugar levels. 4.      In your pre-party preparation, you might get some fruit juice or regular soda to have on hand in the event someone may experience a hypoglycemia (or low blood sugar).5.      A vegetable tray or appetizers such as cheese, apples, or black bean dip will provide healthy options for individuals with Diabetes to keep blood sugar stable while waiting on the holiday meal. 6.      Focus on keeping things simple and cost efficient to have a smooth, successful party.  Remember the holidays are meant to represent the spirit of giving, understanding, and compassion, and there’s nothing that better signifies these principles than being aware of all guests needs.
It’s been a whirlwind of a year and whether you live alone or are continuing to practice social distancing, the holidays are going to look a little different this year. Whatever this year’s holiday season brings, you can certainly scale it down while still enjoying some of those traditional favorites in a smaller group.  Pair down the meal with these tips:   Protein: Unless the protein source is breaded or fried, it will not raise your blood sugars.  If it is breaded and fried, then allow for about 10-15 grams of carbohydrate for that particular portion of the meal. This year, a small turkey or even a whole chicken is a good option.  If cooking is not your strong point, then purchasing a rotisserie chicken from your grocery store deli is an excellent option.   Starches: Some of the traditional holiday starches include potatoes and the stuffing/dressing. Potatoes are also a good option as they are a good source of vitamins, minerals and fiber, so we’re going to acquire more nutritional benefits than the stuffing. Whether you prefer regular or sweet potatoes, you can dice them up, place in a pan or casserole dish, toss in olive oil and sprinkle with sea salt. They can be roasted in the oven at 400 degrees for about 25-45 min.   Remember, it’s the extras such as the condiments, sauces, gravies, etc. that we forget to count as part of the total carbohydrate intake for a meal and the result is a high blood sugar reading after that particular meal.   Vegetables: Filling half your plate with vegetables that are low in calories, high in fiber. Fiber is not only good for our heart and digestive system, but it can also help with blood glucose control. A popular holiday vegetable dish is green bean casserole. While this dish isn’t too terribly labor-intensive and can be made in smaller quantities, it does require some preparation and cooking time. Although the green beans themselves are a non-starchy vegetable and therefore very low in carbohydrates, the mushroom soup and fried onions will add some carbs to that dish.  A paired down version would look more like frozen or canned green beans with butter or olive oil, sea salt and pepper. Other fall vegetables include brussels sprouts, carrots, parsnips, cauliflower, and acorn squash. If purchasing the fresh versions of these veggies, they can be roasted in the oven. If purchasing frozen or canned versions of these veggies, then less preparation is needed as they can be warmed or steamed on the stove or in the microwave.  For persons with diabetes, scaling down could potentially make the mealtime more simplified and less stressful in the sense of timing of the meal as well as knowing how to count the carbohydrates in the meal. Listen into episode 15 of the Fresh Focus Podcast for more holiday menu tips. 
What if we told you that smart grocery shopping actually starts before you leave the house? And this year you may not even need to leave the house.  On-line shopping is a great option for anyone who has small children, is pressed for time, or has health concerns.  Important steps in making a shopping list: ·         Start by checking over your menu and preparing a list ingredients and food items you need, including amounts.·         Second, take an inventory of what you have on hand.·         Keep pantry items such as dried or canned beans, spit peas and lentils, canned vegetables with no salt added, canned fruit in 100% fruit juice, nut butters, tuna, salmon and sardines on hand.·         Whole grains such as brown rice, quinoa, oats, and whole-wheat pasta can also be included in a healthy meal plan and are essentials in the pantry.  ·         Consider stocking your freezer with non-starchy vegetables such as broccoli, riced cauliflower, carrots and Brussels sprouts, and don’t forget the fruit such as berries and cherries. Shopping from a list whether online or in the store will help you to avoid unhealthy impulse purchases saving you time and money. It’s also a good idea to go grocery shopping after a meal or snack. It’ll be easier to stick to your list and can reduce your risk of having a low blood sugar if you are doing more walking than usual.  When reading food labels, pay attention to the Total Carbohydrate per serving not just the amount of sugar when you are shopping for someone with Diabetes. It’s always a great idea for the whole family to look for foods with the fewest ingredients, and ingredients that you can pronounce.Tune in to episode 16 of the Fresh Focus Podcast for some suggestions about what to place in your cart, and ways to have a more successful shopping experience. 
Whew, you are back from the grocery store and your countertop is full! Now, what to do with all the food you just purchased? Episode 17 of the Fresh Focus Podcast dives into meal prepping and give tips on how to be successful with the process during the upcoming holidays. Remember when you get home from the grocery store, try to get the prep-work already done so you can simply open the fridge and enjoy your produce throughout the week.  Here are some tips on produce as you put away those groceries. ·         Several items like potatoes, bananas, and tomatoes need to be kept cool, and dry, but not in the fridge. ·         Mushrooms should only be washed right before use. ·         Apples should actually be stored in the fridge. If left at room temperature, they will soften ten times faster. ·         Carrots like the fridge and seem to do better when peeled right before use. Berries are the same way.  Freezing fruits and vegetables is quick and easy, plus the colder temperature helps to preserve the produce at its peak maturity and maintain nutritional quality. There are a few foods not recommended for freezing. These would be lettuce greens, eggplant, potatoes, radishes, and sprouts.  Bananas are delicious but quick to ripen. A solution is to peel and freeze overripe bananas in a clean Ziplock bag. The frozen bananas can then be used later in baking or in a yummy fruit smoothie. Papaya and mangoes work well this same way. Remember that fruits are naturally sweet and do contain carbohydrates.  As you put all the groceries away, grab one of those handy fruits or veggies and think about the meal possibilities for the holidays. Perhaps you have already been thinking about what to take to Aunt Betsy’s this year, or maybe you are expected to prepare the same dish every holiday as it is requested by the entire family.  Tune in to this episode as we put a Fresh Focus on some holiday meal ideas or recipes that you could prepare and know that you WILL have lower carbohydrate options on that buffet at Aunt Betsy’s home this year.
The holidays can be a whirlwind, even if this year with just a small household group. After the dust settles and the dishes are washed, it can feel like such a crash of adrenaline. After hours of cooking over the holidays, you probably don’t want to cook for the rest of the week. We’ve all found ourselves in that boat a time or two.  Thankfully, when you open up the fridge all you see are leftovers! Eating out of your normal routine during the holidays can make individuals with diabetes feel uneasy after seeing a change in their blood sugars. It’s understandable to find yourself feeling this way. However, the key to getting blood sugars back on track is to focus on the basics. There is absolutely no need to do a fast, fad diet, or to sit around and binge on leftovers. Basically, don’t throw in the towel on your nutrition just because the “new year” is right around the corner.  Remember the BasicsThere are many ways to utilize a post-holiday Healthy Plate Method for getting things back on track and to eat up those leftovers. Fill one quarter of the plate with protein, the other quarter with grain and starches. That leaves half of your plate to load up with colorful, high fiber, lower carbohydrate vegetables. Add olives, nus, seeds, coconut oil and other fats to your completed plate. Individuals with Diabetes pay more attention to the carbohydrate portions (exchanges) of the plate, which have the biggest impact on blood sugars. A favorite post-holiday leftover meals is “fancy grilled cheese”. It’s about 45 grams of carbohydrates and I’m betting you have a few of the ingredients on hand. All you need is leftover turkey, cranberry sauce, a mild cheese of your choice, and bread. Our house is a big sourdough bread and provolone, mozzarella, or Havarti cheeses, but you can choose whichever options you love. While your skillet (or grill) is heating up, put butter on the outsides of each slice of bread.  Place the turkey, cheese, and cranberry sauce inside and close up the sandwich.  Grill both sides just like you would a traditional grilled cheese sandwich.  Once your bread is toasted it is ready to eat!  Dip your leftover raw veggies in some hummus or an olive oil based salad dressing.  Now your healthy plate meal is complete.  Consistency is the Best StrategyThe truth is you can enjoy foods with carbohydrate as long as you are mindful of portions.  It is important to be as consistent as possible in your intake, especially if you are on a set medication or insulin routine. Certain diabetes medications such as Glipizide, or rapid acting insulin, like Novolog work quickly.  If you do not eat carbohydrates when you take them, you may end up with hypoglycemia, or low blood sugar levels. Being consistent with your carbohydrate intake can help prevent the rollercoaster of blood sugar levels (when you have highs and lows).  
MOVE! Weight management program is a lifestyle intervention for weight management. In this episode, we are going to refer to it as our blueprint for success. MOVE isn’t just a “diet” or an exercise program its really 3 combined components of nutrition, behavior change, and physical activity. Listen in as Dietitians Lindsey and Beth discuss how we make the plan to come to life
Physical activity is a very popular topic, but oftentimes it is made to be overcomplicated and overwhelming for those trying to learn more about it. Being active is about so much more than just losing fat, gaining muscle, and looking good. It’s also important to focus on how it can improve overall health, function, and quality of life. This episode gets you active in reaching your goals with Dietitians Tori, Sieger and Lindsey.
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