Category Archives: Healthy Diet

Image of a salad in a heart shaped bowl with a stethoscope near it and the words: The Basics of Heart Healthy Eating, Alexia Lewis, Real Deal Nutrition

The Basics of Heart-Healthy Eating

Diet, Dietitian, Healthy Diet, Heart Healthy, , , , , , , ,

Updated 01/30/2025 to included reducing added sugars and ultra-processed foods to “the basics of heart-healthy eating.”

Picture of colorful heart-healthy foods on a heart-shaped plate with the words: Still Delicious!

The Basics of Heart-Healthy Eating.

You may hear about magical foods or failproof techniques that are touted as the way to improve heart health.  Yah… no. If they existed, then heart disease would not have remained the number one killer of Americans for over 100 years. WHAT? Yes, heart disease first topped the charts back in 1921 (1).

If you know me (Hi, I’m Alexia, a dietitian and heart attack survivor!), then you know I like to simplify nutrition. While nutrition can become incredibly complex and nuanced, most people benefit from big-picture, easier-to-implement steps. To that end, here is my take on the basics of heart-healthy eating. 

TL:DR:

  1. Increase fiber.
  2. Change up your dietary fats.
  3. Decrease sodium.
  4. Decrease added sugars.
  5. Reduce ultra-processed foods.
  6. Bonus basics of heart-healthy eating.

Of note: I do mention weight in this article. I am a strong believer that people can be healthy at many body sizes – and confident and beautiful (2). I promote and respect every individual’s choice regarding their weight. I believe we should continue to work towards doing better with providing non-biased health care. More on the weight and heart disease below.

Increase Fiber.

Dietary fiber plays many roles to help with heart disease. It helps with managing cholesterol, blood sugar, and with satisfying appetite, which can lead to reducing weight, which can lead to reducing blood pressure.

Many people would benefit from increasing dietary fiber intake. Unless, of course, you have health conditions or other concerns that limit your fiber intake. If you need to limit fiber, talk to a qualified nutritionist and skip on down to the next basic of heart-healthy eating.

This excellent article from Mayo Clinic shares more about fiber, why to eat it, and when to avoid it (3).

Since we eat foods, not fiber: dietary fiber is found in fruits, vegetables, whole grains, and legumes (beans and peas).

Okay, true. There is also fiber in nuts, however, you would need to eat a lot of them to significantly contribute to your fiber intake, and they are the most calorie dense of the choices. In other words, one measured cup of dry roasted mixed nuts comes in at 9 grams of fiber and a whopping 595 calories (4). Absolutely include nuts in your diet for heart health… just not because of the fiber content!

Bottom line:

  1. Eat at least one of type of food with fiber with every meal and snack.
  2. Choose non-starchy vegetables for most of those food choices to load up on fiber without loading up on calories.
  3. Which type of foods you choose depends on your preferences, health, and goals.

You have lots of choices for foods to include, so… no excuses! And I say this because according to the 2020-2025 Dietary Guidelines for Americans, a distressingly low 10% of women and 3% of men are eating enough the recommended amount of fiber (5).

You don’t eat grains, fine! Eat a starchy veggie.

You don’t eat vegetables, fine! Eat some beans. (Well, kinda “fine” on the veggies, I mean, eat some, yeah?).

You don’t eat beans, fine! Eat some fruit.

Need help including more foods with fiber or navigating all the confusing information on food packaging?

Change Up Your Fats.

The type of dietary fat you eat can have an impact on heart health. This happens because the type of fats you eat helps to reduce LDL (bad) and increase HDL (good) cholesterol. This has a positive impact on heart health.

Notice I didn’t say reduce your fat intake? (Unless, of course, you have a condition that requires eating a low-fat diet, then reducing dietary fat intake is also important.)

That’s because fats are delicious (#noshame), needed for some types of cooking, and needed for your body to absorb fat-soluble nutrients. Eating a fat-free salad? You are missing out on absorbing some of that salad’s nutrition!

Reducing saturated fat, on its own, has been shown to reduce LDL cholesterol.

Increasing unsaturated fat, on its own, has been shown to decrease LDL and increase HDL cholesterol. In incredibly simplified terms, HDL’s job is to help get rid of LDL (6). Boom.

Doubling down by replacing saturated fats with unsaturated fats can reduce LDL and increase HDL all with one dietary swap. It’s as easy as replacing butter with avocado oil for sautéing.

In addition, specific unsaturated fats, omega-3’s can reduce triglycerides and blood pressure. Your body cannot put together omega-3 fats (or omega-6s), so getting foods with these types of fats in your diet is important.

The Australian Heart Foundation has a great overview with more details and food examples (7).

Bottom line:

  1. Eat more meatless/plant-based meals and use lower fat dairy foods to reduce saturated fats.
  2. Enjoy nuts, seeds, olives, and avocados often including cooking with oils made from these foods to boost unsaturated fats. Just be mindful of portion sizes due to being high in calories and/or sodium – I’m looking at you delicious salty olives.
  3. Add a meal with a food high in omega-3′ fats once or twice a week.

I struggle to cook salmon, but it always comes out well when I make this amazing salmon recipe (8).

Image of a piece of salmon on a plate topped with dill sauce, fresh dill, sliced almonds, and pomegranate arils.

I didn’t mention trans fats because they were banned from our food supply in 2018 and food manufacturers were given until 2021 to get them out of their foods (9). So, you likely won’t see trans fats in most foods you buy now.

But it’s worth checking the back of your pantry to make sure older foods you may have do not have trans fats on the label (or partially hydrogenated oils listed in the ingredients). And, um, it’s 2025 as I write this, so yeah, check those use by and expiration dates too.

Need help with a virtual pantry and kitchen cleanout?

Decrease Sodium.

While most of us aren’t eating enough fiber, we are eating too much salt. On average, Americans eat 1,100 milligrams more than the recommended amount, which is 2,300 milligrams a day (10).

Do you remember from your early biology classes that water follows salt. I remember really struggling with osmosis. Who knew it would actually be relevant when I grew up?

So, water follows salt. If your salt intake is high, your body holds water to keep all things in balance. More water in your blood vessels makes your blood pressure go up, and that is a risk factor for heart disease.

Most of the salt in the Standard American Diet (yes, the acronym is SAD, which fits) comes from packaged foods, including canned foods. We know salt enhances flavors. It is also a preservative and a binder in foods, and it keeps the foods holding water too, which keeps them *insert the m-word here* so this tracks.

For more info, check out this list of 16 high sodium foods (11) and tips for lowering sodium (12).

Bottom Line:

  1. Check food labels to choose brands with less sodium.
  2. Rinse canned foods when you can.
  3. Choose more whole/unpackaged foods.
  4. And salt really does wonders to improve foods flavor, so use it. Just stop shaking the shaker after a few shakes, whether used at the table or while cooking.

One very interesting piece of info is that not everyone is salt-sensitive. That means reducing salt in the diet will not impact blood pressure for those who are salt-resistant. Even so, reducing sodium is a positive food choice for many (10).

Of note, there are instances and conditions that may require limiting or consuming a specific amount of salt. In those cases, this info does not appy.

Need help making sure your meals are still delicious without salt?

Decrease Added Sugars.

Just like salt, most of the added sugar in our food isn’t added by us. It’s added by food manufacturers. And just like salt, sugar makes foods delicious. That’s likely why we are also eating too much added sugar in our foods.

Well, that and its “hiding” in many foods that aren’t especially sweet.

The recommendation from the American Heart Association recommends 6% of intake of added sugars, or 6 teaspoons a day for women and 9 teaspoons a day for men (13). The Dietary Guidelines allow for 12 teaspoons (if you eat 2,000 calories a day) (5). One study based on 100,000 people over 9 years found the highest risk of heart disease hits around 24 teaspoons of added sugar (14).

And, of course, as always, people managing specific health conditions or others may need to have different recommendations.

So, drumroll please… We eat 17 teaspoons of added sugars on average (15).

Sugar contributes to heart disease as it can increase blood pressure, inflammation, weight gain, and make it more difficult to manage diabetes/prediabetes.

Bottom line:

  1. Do your best to reduce added sugars down to the recommendations.
  2. Continue to enjoy foods with natural sugars.

Yes, you can eat fruit (and unsweetened dairy foods). Foods with natural sugars have other nutrients (fiber, protein, fat) which slows digestion, and the research doesn’t show that these increase heart disease risk.

This Harvard Health article on The Sweet Danger of Sugar is a nice resource for more info (16).

Need help on finding the added sugars in your foods?

Reduce Ultra-Processed Foods.

In the hurry up, stay busy, no time to relax kind of culture that many of Americans live in, processed foods make it easier to get food on the table. #noshame. They are also generally less expensive. With a store-brand dozen of eggs now costing over $4.00, we all could use a little help with our food budgets.

While processed foods have been around for 1.5 million years. After all, cooking with fire is a form of processing. The 1800s saw the inventions of the tin can for foods and pasteurization (17). Then the 1900s saw a big boost in demand for processed foods, with Swanson’s frozen meals hitting the market in the 1920s and fast food starting to hit its stride in the 1950s (18).

Fast forward and we have gone from minimally processing foods (cooking, canning, salting, smoking, freezing, etc.) to the ultra-processed powdered meal replacement drinks of today.

Did I mention there is no food shaming allowed here?

So, yes. Ultra-processed foods can have a place in an otherwise generally healthy dietary approach. And yes, it’s going to be in moderation. Nutrition is not so unforgiving (for most of us!) that eating a small amount of these foods will wreck health. What matters is what we do most of the time.

Speaking of most of the time, ultra-processed foods now make up 60% of the foods we eat (19). So, yeah, that’s more than “in moderation” and that makes for a different conversation.

That being said food exists on a spectrum of processing, and while processing can improve nutrition with fortification, they have been starting to get linked to many negative health outcomes. For example, increasing inflammation and reducing gut health. In terms of heart health, these foods can raise triglycerides, blood pressure, and body weight (20).

Bottom line:

  1. Work to reduce ultra-processed foods that are of low nutrition quality as your time and budget allow. For heart health, assessing foods for the nutrients mentioned in this article may be a good start.
  2. Look for processed foods that positively impact nutrition. For example, adding vitamins or fiber.
  3. Eat whole and minimally processed foods when you can.

On the flip side, it’s also entirely possible to eat a diet of whole/minimally processed foods that have a negative impact on heart health. Food choices matter. And a healthy diet can include ultra-processed foods. After all, store-bought bread and flavored yogurt are both ultra-processed food under the NOVA classification system (21).

PS – Research is ongoing to learn more about if it is the quality of ultra-processed foods (high sugar, salt, fat, etc.) or the actual processing of the foods that matter most for health.

Need help with meal planning and/or prepping to reduce ultra-processed foods?

Bonus Basics of Heart-Healthy Eating.

For some extra steps to add to your basics of heart-healthy eating, you may also add more berries, nuts, avocado, and plant sterols and stanols (22) to your food choices.

And, while weight on its own does not cause heart disease, losing 2% to 5% of excess weight (if overweight) or gaining weight (if underweight), can also help to reduce risk of cardiac disease and its management for those with existing heart disease (23).

Next Steps.

Credible information is important. And putting that information into action is where the magic happens.

Small changes done consistently over time add up to big results. So just pick one or two changes to make right now. When you’ve got that down, add another 1-2 changes.

Work with Alexia on your heart health.

She can work with people in multiple states in the USA and accepts some health insurance plans through her partnership with Nourish. Learn more and start the scheduling process to see if your insurance is accepted and get an estimate of your out-of-pocket costs. (Note that Nourish handles the health insurance stuff, not Alexia!)

If she can’t work with you, you can choose another dietitian who can, or reach out for help getting connected with the right RD for you.

References & Links.

  1. American Heart Association Newsroom: More Than Half of US Adults Don’t Know Heart Disease Is Leading Cause of Death Despite 100 Year Reign, posted 01/24/2024.
  2. Alexia Lewis RD article: Weight Does Not Equal Health, posted 06/05/2017.
  3. Mayo Clinic: Nutrition and Healthy Eating: Dietary Fiber: Essential for Healthy Diet, posted 12/11/2024.
  4. USDA: Food Data Central: Food Details: Mixed Nuts, posted 04/01/2019.
  5. USDA & DHHS: Dietary Guidelines for Americans: 2020-2025, posted 12/2020.
  6. Harvard Health Publishing: How It’s Made: Cholesterol Production In Your Body, posted 02/06/2017.
  7. Heart Foundation (Australia): Fats, Oils, and Heart Health, updated 03/19/2024.
  8. Keeping Healthy Simple Club: KHSC Festive Salmon recipe, posted 01/2025.
  9. US FDA: Trans fat, current as of 04/30/2024.
  10. Harvard T.H. Chan School of Public Health: The Nutrition Source: Salt and Sodium, reviewed 03/2023.
  11. Fresenius Kidney Care: 16 High Sodium Foods, n.d.
  12. US FDA: Sodium in Your Diet, current as of 03/05/2024.
  13. American Heart Association: Added Sugars, reviewed 08/02/2024.
  14. Hartford Health Care, St. Vincent’s Medical Center: Not-So-Sweet Link Between Sugar and Heart Disease, posted 02/22/2023.
  15. Harvard T.H. Chan School of Public Health: The Nutrition Source: Added Sugar, reviewed 04/2022.
  16. Harvard Health Publishing: Heart Health: The Sweet Danger of Sugar, posted 01/06/2022.
  17. Automated Process Equipment Corporation: The History of Food Processing: How We Got to What We Eat, posted 10/05/2023.
  18. Institute of Food Technologists: Food Processing, n.d.
  19. Diabetes: Volume 72, Issue Supplement 1: 1374-P: Ultra-Processed Food Consumption and Cardiometabolic Risk in Individuals With and Without Type 1 Diabetes Mellitus, published 06/20/2023.
  20. British Heart Foundation: Ultra-Processed Foods: How Bad Are They For Your Health? updated 04/12/2024.
  21. News-Medical Net: The NOVA Method of Food Classification, updated 10/17/2024.
  22. Cleveland Clinic: Phytosterols, reviewed 07/30/2022.
  23. Clevelend Clinic: Health Essentials: How Weight Affects Your Heart, posted 02/19/2024.

Huevos Delicioso

Five Food Group Friday: Huevos Delicioso

Dietitian, Eggs, Healthy Diet, Heart Healthy, Recipe, Vegetarian, , , , ,

Planning a heart-healthy balanced meal can be a challenge. To help with the concept of balance, I bring you a Five Food Group (FFG) Friday meal.

I’ve based these FFG meals on the Choose My Plate model, which is the US Government’s initiative to promote healthy eating habits. MyPlate is an easy-to-understand visual of a healthy plate of food incorporating the five food groups: protein, grains, fruit, vegetables, and dairy.

Choose My Plate
Add balance to your meals with Choose My Plate

The rationale behind including all five food groups on the plate is that each food group provides different nutrients, all of which our body needs in order for us to be at our best. This is a very heart-healthy way of eating since it includes a nice amount of fiber by incorporating three food groups with fiber (fruits, vegetables, and grains). Making heart-smart choices for protein and dairy by choosing lean or reduced fat foods and including heart-healthy unsaturated fats kick the heart-healthiness of MyPlate up a notch.

It is not, however, always easy to get all five of those food groups on every plate. I counsel my clients to eat the food groups they miss at their main meals as their snacks. For example, if they have cereal with a banana for breakfast (grains, dairy, fruit), then to include a protein and vegetable snack (celery with peanut butter). That way, over the course of the day, all food groups end up in balance.

I am bringing you FFG Fridays to help with the difficult challenge of building a plate with all the food groups.

Introducing the FFG Omelet Sandwich – Huevos Delicioso!

Huevos Delicioso
Huevos Delicioso – A Five Food Group Friday Meal

This hearty breakfast is made from egg whites (protein), mushrooms, onions, salsa (vegetables), reduced fat cheddar cheese (dairy), a Flat Out fold-it (grain), and avocado (fruit).

Using egg whites and reduced fat cheddar make the dish more heart healthy by reducing the amount of saturated fat and cholesterol, while the avocado adds a nice amount of heart-healthy monounsaturated fats.

To make this yummy dish, use a non-stick pan to sauté 2-3 medium mushrooms and a thin slice of onion (both chopped) in a spritz of canola oil until soft then remove from pan. Add another spritz of canola oil and slowly pour in 1/2 cup of egg whites – if you pour down the side of the pan, you will reduce the places were the egg sticks. Once the egg starts to cook and set, add the cooked mushrooms and onions and sprinkle 1/8 cup shredded cheddar on one half of the egg only. I also add some ground pepper and garlic powder at this point. Use a spatula to loosen one edge and flip one half of the egg on top of the other to make the omelet. Slide out of the pan onto your Flat Out and top with 2 Tbsp salsa and 1/4 sliced avocado.

Per serving: 320 calories, 12 g fat, 3 g saturated fat, 0 g trans fat, 10 mg cholesterol, 835 mg sodium, 35 g carbohydrate, 10 g fiber, 26 g protein.

Suggestion: This dish may be a little high in sodium for some people due to the salsa. To reduce the sodium, use sliced tomatoes instead of salsa.

Heart

Vegan Challenge – The Final Day

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I did it! I ate completely vegan for five days! Well, except for that one bite of celery with ranch dressing that snuck into my mouth before my brain thought about it…

There are no pictures or foods listed for this day because it was an exact repeat of yesterday. There is a joy that comes with the easiness of using leftovers and I took full advantage! The only minor change was to my smoothie, in which I simply used pineapple and strawberries.

This final day was the first day that I was a little bit hungry between meals. The first four days, I was eating so often that I didn’t really move into full-on hunger; but on this afternoon, I did. I think I am learning to better meet my body’s needs for protein and calories and I have finally (yay!) adjusted to the increased amount of fiber in my diet.

Overall, I feel really good. I feel a little slimmer because of how my clothes are fitting, which may or may not be due to the vegan diet. It could be that this challenge has motivated me to keep up with my food journal and workouts. I also have slept through the night the last two nights, which is not at all typical for me.

Now that this challenge is ending, I am actually considering continuing a no-meat diet. I very much miss cheese, eggs, and milk so I will definitely add dairy back into my meals. I also, as an RD, am not comfortable with cutting out an entire food group. However, I’m not sure I want to go back to my old eating habits because I have found that I get to eat so much food and the nutrition quality of my diet has been stellar while eating like a vegan.

Initially, my vegan diet was low in protein, calories, and B12. By the end of the challenge, I was eating adequate amounts of these nutrients without using specialty foods. This has also reaffirmed my belief that vegans/vegetarians should consider a multi-vitamin since it can be difficult to obtain all the nutrients in the recommended amounts.

My vegan diet was also very low in cholesterol (obviously since it’s found in animal products), saturated fat, and sodium. These are the three main things to limit to eat heart healthy and reduce risk of some chronic diseases. Another heart- and cancer-healthy guideline is to focus on fiber and, as I’ve shared, this diet was definitely high in fiber.

I’m very happy that I decided to take part in this challenge. My goal was to better understand the challenges faced by vegans in planning for an optimally nutritious diet. I wanted to do this to help me when I counsel my vegan and vegetarian clients. I feel I have reached this goal. I think I will be a better nutrition counselor to my clients because of this challenge.

My final day was on May 24th and since then I have not yet eaten meat. I have been following a lacto/ovo vegetarian diet for the past week. I am one very happy camper to once again have cheese! I love cheese. 🙂 I’m still uncertain if I want to return to my previous omnivorous ways. Right now, my plan is to continue lacto/ovo and add seafood back in when I feel ready (there was an advertisement for a local restaurant’s deal on oysters that definitely peaked my interest!). But once I transistion into pescatarian, I may just stay there.

Don’t tell my husband! But he’ll probably read this blog…

Featured image from: http://office.microsoft.com/en-us/images/

Roasted Spicy Chickpeas

Vegan Experiment – Day Two: Ranch Dressing!

Diet, Dietitian, Healthy Diet, Recipe, Smoothie, , , , , , , ,

Today, I realized that there is more to think about when following a vegan lifestyle than just meat and dairy foods. I have to admit to an unintentional slip today – ranch dressing! But I’ll get to that as I go through my meals in pictures.

Breakfast: Kashi Cinnamon Harvest cereal with almond milk, coffee with almond milk and splenda.

An easy vegan breakfast
An easy vegan breakfast

Snack: Roasted spicy chickpeas.

Roasted Spicy Chickpeas
Roasted Spicy Chickpeas

This was a time-consuming recipe; but I’m working on stretching my food dollars so it was worth the effort. I started with a bag of dried garbanzo beans (chickpeas) and soaked and cooked them one day. The next day, I tossed the half of the cooked beans with a tablespoon of canola oil, a pinch of salt, and a fair amount of paprika, cumin, and a touch of cayenne pepper. Then I cooked them in the oven at 400 degrees for about an hour on a baking sheet lined with tin foil and sprayed with canola oil cooking spray. Cook the beans in one layer because the goal is to dry them out until they are a crispy crunchy treat. If you don’t cook them long enough, they will be mealy. I know this from my first attempt at this recipe! Per 1/2-cup serving: 135 calories and 7 grams of protein.

Post-workout snack: granny smith apple courtesy of my gym’s member appreciation day offerings.

Lunch: Last night’s dinner leftovers: Quinoa with red/green bell peppers, red onions, garlic, pineapple, sliced almonds, and a dash of sriracha sauce served with a side of roasted vegetables (beets, carrots, onions) seasoned with canola oil, garlic powder, oregano, and red pepper flakes.

Quinoa bowl and roasted garden vegetables
Quinoa bowl and roasted garden vegetables

Snack: Sweet Peanut Butter Smoothie!

I typically make my smoothies with either milk, yogurt, or almond milk depending on what I have on hand and how much protein and calories I would like to have. This time, I used water and ice instead of a milk or yogurt. I blended banana, pineapple chunks, and peanut butter with water and ice (adjusting to fill my cup and be the consistency and I wanted).

Snack: Celery and snap peas.

This is where I inadvertenly fell off the vegan wagon. I had an evening meeting to attend. The good news is that I brought the snacks and so could bring vegan alternatives. One thing I brought was a veggie tray with ranch dressing. I grabbed a celery stick and dipped it in the ranch dressing and as I was chewing, it hit me that the dressing was probably not vegan! I checked and I was correct – buttermilk is the second ingredient. This made me realize that there are more foods to limit that I realized. I wanted the convenience of the pre-made veggie tray… If only the grocery stores packaged veggie trays with hummus instead of dressing.

Dinner: Portobella mushroom sandwiches (mushroom, lettuce, avocado, mustard on sandwich thin) and Alexia sweet potato fries with ketchup.

Portobella sandwich with sweet potato fries
Portobella sandwich with sweet potato fries

When making the Portobello sandwich, I was reaching for the mayonnaise when I realized that was also not vegan! This is more difficult than a vegetarian diet.

So, how am I feeling? Gassy! There is so much fiber in my diet now!

Otherwise, I’m feeling good and have energy for working out. I’m getting plenty of carbohydrates and calories; but I am still lacking in protein. I love how incredibly low my saturated fat, cholesterol, and sodium intake is following a vegan diet. Even with my one unintentional slip, I’m still going strong and feeling good about sticking with this challenge!

Nutrition information: 1360 calories, 204 grams carbohydrates, 43 grams fiber, 35 grams fat, 3 grams saturated fat, 0 trans fat, 0 cholesterol, 43 grams protein, and 725 milligrams sodium. For the daily values, my numbers were 60% calcium, 63% iron, 25% vitamin D, 8% zinc, and 0 vitamin B12.

All images are personal photographs. You may use them as long as you credit me (my name and a link back to my Web site).

no meats

Planning for Vegan Eating

Dietitian, Food, Healthy Diet, Protein, Vegan, Vegetarian, , , , , ,

I’ve been planning meals for my Vegan Experiment. As I mentioned in my last post, there are certain nutrients that vegetarians (and vegans) tend to eat in lower than recommended amounts.This may lead you to ask two questions. One – What exactly are nutrients? Two – Who makes these recommendations?

Nutrients are the nutritional substances we get from foods: carbohydrates, proteins, fats, vitamins and minerals, and even phytochemicals (or plant nutrients like resveratrol in wine/grapes).

The recommendations are made by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences. They are based on years of population studies and research. They have drafted the DRIs (dietary reference intakes), which include the RDAs (recommended daily amounts), AI (adequate intake) and TULs (tolerable upper limits) for specific nutrients.

In plain language, these all tell the general population (or health professionals who translate it!) how much of the nutrient meets the needs of the 98% of the healthy population over age 2 in order to prevent deficiencies. For certain nutrients, there is also an upper level to prevent toxicity. Personally, preventing deficiency and toxicity sound good to me. Remember though, if you are under two (and you’re reading this, I’m impressed!) or have any health condition, these recommendations may not apply to you. There’s some good information on the USDA’s Food and Nutrition Information Center. If you want to know the recommendations specifically for you, there’s an interactive tool; but I wouldn’t get too caught up in all those numbers if I were you!

Any person who cuts out entire food groups is going to be lacking in certain nutrients. There is a reason there are food groups as the basis of the ChooseMyPlate method of eating. It’s because different food groups provide different nutrients and our bodies function best when we eat all of them. Whether it’s grains (breads and other carbohydrate foods), proteins (meats), fruits and vegetables, or dairy (milk, cheese, and yogurt), cutting out a food group cuts out specific nutrients. Those who cut out meats are taking away a large chunk of the foods in the protein group and most of the sources of complete proteins (proteins that have all the amino acids our body needs and cannot make on its own).

Image from ChooseMyPlate.gov
Image from ChooseMyPlate.gov

Finally, on to my point!

For optimal health, I recommend that over the course of the day, vegetarians include foods that, when put together, make complete proteins and plan to eat enough foods that provide iron, calcium, zinc, omega-3’s, and vitamins D and B12. Iodine may also be a concern if iodized salt is not used in cooking or flavoring foods.

How to do this?

Complete proteins: Examples of foods that make complete proteins include: tofu and rice, corn and beans, rice and beans/peas, peanut butter and whole wheat bread, granola and soy milk, or a green salad with garbanzo beans and sunflower seeds. The idea is to match grains/seeds/nuts with beans/peas or to match vegetables with  both grains/seeds/nuts and beans/peas. Simple enough! And to make it even easier, soy and quinoa are already complete proteins.

For the other nutrients listed, here are some examples of where a vegan can find these nutrients to include in their meals.

Iron: Beans (pair with vitamin C foods and avoid pairing with calcium foods to absorb more iron!) Examples might be: beans and rice with lime (vitamin C), cilantro, and salsa or a “loaded bowl” (see image below) with quinoa and black beans and vegetables including tomatoes (vitamin C).

Calcium: Fortified imitation milks (almond milk, soy milk, etc.) or dark leafy green vegetables (althought we don’t absorb as much from the vegetables!).

Zinc: Beans, peas, and nuts (I’m personally a huge almond fan and usually have a handful a day as a snack).

Omega-3’s: Walnuts and ground flaxseed. Add ground flaxseed to to smoothies, sauces, or sprinkle on salads – just watch out because it gets gummy when mixed with liquids, which is why it’s a great vegan egg replacement in baking.

Vitamin D: Sunshine! Fortified foods (milk imitators).

Vitamin B12: Fortified foods.

Iodine: Iodized table salt.

Quinoa Loaded Bowl
Quinoa Loaded Bowl

I also recommend that someone who is following a vegetarian or vegan lifestyle, ask their physician to pull a “vitamin panel” to check their levels of vitamin D and B12 (and others) every now and again just to make sure that deficiencies are being kept at bay!

I hope you found this helpful. If you have other ideas or ways to incorporate these important nutrients, please post your thoughts, meal ideas, and recipes!

Images from: ChooseMyPlate.gov, Microsoft Free Images, and personal photographs.

Woman with basket of fruits, vegetables, and bread

The Vegan Experiment

Dietitian, Food, Healthy Diet, Vegan, Vegetarian, , , , ,

The gauntlet has been thrown down and I said, “Challenge accepted!” The Academy of Nutrition and Dietetics has issued a challenge to dietetics professionals to live a vegan lifestyle for five days.

I am not doing this for the Vitamix blender that is the prize in this contest (although I would gladly accept it). I am doing this because I believe that a vegetarian or vegan diet can be just as healthful and complete as a diet that includes animal products. In my work as a wellness dietitian at a university, I always make my cooking demonstrations vegetarian, and vegan when possible, to show the community that vegetarian/vegan meals can be yummy and satisfying. I decided I would “walk my talk” for five days.

I mean, anyone can do anything for a mere five days, right?

Let’s start with the basics: what is veganism?

There are many levels of vegetarianism. I think the definition that many people think of for a vegetarian is a person who eats no meats. However, some vegetarians still include fish (pescatarians) and some still include dairy and/or eggs (lacto/ovo-vegetarians). If carnivores (meat-eaters) on one very end of the scale, then vegans are at the other end. Vegans do not eat any animal products – meat, poultry, fish, dairy, eggs, cheese, or butter. As a friend pointed out on my Facebook page, vegans may even decide not to eat honey since animals make honey.

For more information, see the Academy’s Web site, which includes a link to a PDF document that is their position on vegetarian diets. There is a wealth of information in the position paper.

Personally, I could easily become a pescatarian. For my health, since I have heart disease, I would choose to include fish due to the nice heart-healthy omega-3 fatty acids in some fish. But cutting out cheese and milk? I think I could live on tomatoes and cheese alone… so this will present a challenge.

Finally, since I am a registered dietitian, I am concerned about the nutritional quality of my vegan choices. I will have to do some planning. There are two things that I will be thinking about when I follow a vegan diet. One is to make sure I am combining foods in a way that makes complete proteins and the other is to get all the important nutrients about which vegans must be concerned (see the link to the Academy’s Web site above). Some nutrients are found mostly in animal products so vegans must have the knowledge to plan meals that include these nutrients.

I also personally tend to eat as clean as I can, so I doubt I will be including the packaged vegan alternatives. I have to look at the food labels; but the way I remember it, these products have a long list of ingredients that are not whole foods or natural flavors or preservatives. This is a personal choice; not a part of veganism.

I am beginning my planning this week. So far, I think I will try silken tofu as a scrambled egg replacement and I just bought a few bags of dry beans to play with. I would love any ideas so please post your comments and tell me about your favorite vegan recipes.

Wish me luck!

(Note: Free images from http://office.microsoft.com/en-us/images/)

Serve in a small bowl surrounded by lettuce leaves

Quinoa Lettuce Wraps

Dietitian, Food, Grains, Healthy Diet, Recipe, , , ,

I love quinoa. It is so versatile, it cooks quickly, and it’s a grain that is a complete protein as well! A complete protein has all of the essential amino acids that our bodies need, which is important for those who do not eat meat or other animal products (which are naturally complete proteins).

So, yesterday I was faced with a dilemma, what to do for lunch… I had quinoa and some vegetables sitting around so I threw together one of those “kitchen sink” recipes and it turned out so good that I decided to share it.

Can you guess all the goodies in here?
Can you guess all the goodies in here?

Quinoa Lettuce Wraps
By Alexia Lewis, MS, RD, LD/N

1 1/2 cups cooked Quinoa
1 raw zucchini, diced
1 slice red onion, diced
2 carrots, diced
1 large stalk celery, diced
2 slices nitrate-free turkey breast (optional)
Handful of sliced almonds
Handful of raisins
Red wine vinegar, to taste
Black pepper, to taste
Romaine lettuce leaves, rinsed

Simply mix together everything except the lettuce leaves, adding the red wine vinegar and black pepper in small increments until the dish has a flavor that you enjoy. Serve a spoonful on the raw romaine lettuce leaves. You can also serve with kale leaves, bok choy, or any other leafy vegetable that can act as a holder for the quinoa mixture.

I did not measure out the number of servings or do a nutrition information breakdown; but it makes a large amount (see below) and it includes the grains, protein, vegetables, and fruit so you have many food groups represented in a colorful dish – which equals nutritious!

The finished mixture of yum!
The finished mixture of yum!

I served this up on a plate with the quinoa mixture in the middle and a ring of lettuce leaves. This dish is also husband-approved! Enjoy!

Serve in a small bowl surrounded by lettuce leaves
Serve in a small bowl surrounded by lettuce leaves

A day's work for an RD

Vegan Oatmeal Cookies

Baking, Dessert, Dietitian, Healthy Diet, , , , , , , ,

Today, my mission was to rework an oatmeal cookie recipe to be more heart-healthy and vegan. Oats are already a heart-healthy food so I didn’t have much work to do there; but I have not done much vegan baking. This was going to be a challenge! I ended up making two batches of oatmeal cookies. One is low-fat and the other is vegan. You decide which one fits into your healthy eating goals better.

I started with a basic oatmeal cookie recipe and focused on the ingredients that needed to be swapped out.

Ready to make oatmeal cookies!
Ready to make oatmeal cookies!

First up, vegetable shortening. Great for flakiness and flavor in baking; but it contains trans fat which is about as far away from heart-heatlhy as you can go. For the low-fat recipe, I swapped 3/4 cup vegetable shortening with 1/4 cup butter and 1/2 cup mashed banana to retain moistness and flavor. In my experience, when I replace more than half the fat in a recipe with a fruit puree, the final product loses some “yummy.” This wouldn’t do for the vegan version however since butter is a dairy/animal product, so I chose refined coconut oil. The refining removes some of the coconut flavor and leaves you with a solid fat that is good for baking. This swap removes the trans fat; but it adds some saturated fat. I think I could find a better option; but this is at least a baby-step towards heart-healthier.

Next replacement was the egg for the vegan version. Mixing 1 tablespoon ground flaxseed with 3 tablespoons of water makes for a nice egg replacement. If you buy flaxseed from the bulk bins, it is much cheaper! I was about to spend $4 for a bag of ground flaxseed and ended up spending $0.65 on a small amount of seeds from the bulk bin. Shop smart!

Flaxseed - before and after grinding
Flaxseed – before and after grinding

Ground flaxseed mixed with water is a great egg replacer
Ground flaxseed mixed with water is a great egg replacer

Finally, I wanted to add more fiber. I swapped half the all-purpose flour for whole wheat flour and called it a day.

Rolled oats coated with all-purpose and whole wheat flour and baking soda
Rolled oats coated with all-purpose and whole wheat flour and baking soda

There was a difference in the batters as well as the final cookies when they came out of the oven. The vegan batter was drier than the low-fat batter. If I were to recreate the vegan recipe, I would add more water for a more moist batter and cookie.

Vegan Batter
Vegan Batter

Low-fat Batter
Low-fat Batter

Into the over for a quick 14 minutes and both cookies spread a little while baking. I didn’t adjust cooking times at all from the original recipe.

Vegan Cookie
Vegan Cookie

Low-fat Cookie
Low-fat Cookie

I was a little disappointed in the nutritional changes. The low-fat and vegan cookies both had fewer calories than the original and no trans fat. These are both heart-healthy changes. The vegan cookies had the same about of total fat and a more saturated fat that the origial due to the coconut oil. I still think that’s more heart-healthy than having a cookie with trans fat. The catch is not to eat so many cookies that the fat starts adding up! Finally, the fiber content didn’t increase as much as I’d hoped.

 Per 1 cookie Original Low-Fat Vegan
Calories 70 60 50
Fat 2.6 1.5 2.5
Saturated Fat 0.6 0.5 2
Trans Fat 0.3 0 0
Cholesterol 2.6 4.5 0
Sodium 11 11 8
Carbohydrate 11 11 8.5
Fiber 0.7 1 1
Protein 1.4 1.5 1

The important thing is how they tasted, right? I preferred the vegan cookies because they had a sweet brown sugar flavor, are more oat-ey, and have a nice crispness. The low-fat cookies are softer and moister; but they had a bit of a banana flavor. I don’t know about you; but I’m not looking for banana in my oatmeal cookies! In the future, I’d consider adding dark chocolate chips or walnuts to boost the heart-healthy properties of these cookies.

Whichever cookie you prefer, I hope you now have some strategies for adjusting recipes when baking and that you will enjoy that occasional cookie, even on your heart-healthy diet!

A day's work for an RD
A day’s work for an RD

 

 

 

 

Make your own pizza!

Skinny Pizza? Go For Homemade!

Dietitian, Healthy Diet, Recipe, , , , , , , ,

A new product, The Skinny Pizza, was announced in the latest issue of Food and Nutrition magazine. The information provided states this is a small thin crust margarita pizza with only 390 calories. Since it was listed in the “new products” section of a US-wide publication of the Academy of Nutrition and Dietetics, I assumed it was a new packaged food that would be available to most consumers.

I decided to blog about the nutrition content of this new product and to suggest alternatives for a whole food, non-packaged, homemade, low-calorie pizza because I know from experience that it’s fairly easy to make a mean homemade pizza!

It turns out this is not a packaged food. This is a menu selection from a pizza chain that has 25 locations. Only 18 of these locations are in the United States and 11 of them are in South Florida. Now, this called into question for me why this was listed as a new product in a magazine for dietitians with a demographic that covers the entire United States… But this is a topic for another day.

Let’s talk about “nutrition made easy” with a healthier homemade pizza!

Start by toasting either an English muffin, a pita, or this dietitian’s favorite, a Flat Out or other flat bread. You just want this to get a little bit crispy or the sauce will make the pizza soggy.

Once crispy, top with a little low-sodium tomato or marinara sauce, and by a little I mean a lot less than you think you need even if you like your pizza saucy like I do! If you want to keep it even more “clean,” then saute some chopped plum tomatoes in a little olive oil, garlic, and onion, mashing the tomatoes as they cook to make a bruschetta-like sauce.

Top with some shredded cheese, lean proteins, and as many vegetables or fruits as your pizza will hold and throw it back in the oven or toaster oven to warm the ingredients and melt the cheese. You may want to also saute the vegetables if you prefer a softer, cooked texture over a crunchy texture.

One of the favorite combinations in this household is chicken breast, BBQ sauce, red onions, mushrooms, a Mexican cheese blend, oregano, cumin, paprika, garlic powder, and red pepper flakes or Hot Shot! Another favorite is pineapple chunks and mushrooms.

The sky is the limit with combinations for this pizza and every person can get their own favorite combination! By limiting the portions, the amount of cheese used, and focusing on lean meats, vegetables, and fruits as toppings, you can keep this pizza low calorie, fiber- and nutrient-rich, and most importantly delicious!

I’m always looking for new flavor combinations and ideas so let me know what you put on your homemade pizza.

References:

Pizza Rustica Launches Skinny Pizza. Available at: http://www.food-business-review.com/news/pizza-rustica-launches-skinny-pizza-081112. Accessed January 27, 2013.

Pizza Rustica Locations. Available at: http://www.pizza-rustica.com/locations. Accessed January 27, 2013.

Image from: http://office.microsoft.com/en-us/images/.

healthy bread on table

Macronutrients – Those Confusing Carbs!

Carbohydrates, Dietitian, Grains, Healthy Diet, , , , , , , , ,

Carbohydrates

Sources:

Carbohydrates come from plant and animal sources. The food groups that contain carbohydrates include grains, fruits, dairy, and vegetables.

There are two main types of carbohydrates: simple carbohydrates (sugar) and complex carbohydrates (starch and fiber).

Sugar:

There are two types of sugars that people typically think of when talking about sugar in the diet. One type is the natural sugars that are found in foods in their natural and whole state. Examples are fructose and sucrose (in fruits) and lactose (in milk). The other type of sugar is the added sugars that are added to foods during processing or created from refining natural foods, Examples are high fructose corn syrup (in many products) or sucrose (refined into table sugar).

Starch:

Starches are long chains of sugars. Our bodies break down these long chains into simple sugars that our body can absorb to provide us with energy. Many foods that are starchy need to be cooked in order for our bodies to be able to digest them. Examples are potatoes, corn, and grain products such as bread, pasta, and rice.

Fiber:

Fiber is the indigestible part of the plant. Fibers are also long chains of sugars; but the way the chains are held together prevent our bodies from being able to digest them for energy. Fiber is important for health for many reasons. Fiber can be fermented by the bacteria in our gastrointestinal tract which promotes colon health. Insoluble fiber helps promote regularity and prevent constipation. Insoluble fiber includes whole grains (the outer bran layer) and the strings in celery. Soluble fiber can help to lower cholesterol and regular blood glucose levels. Soluble fiber includes oats, beans, and citrus fruits.

Functions:

The functions of carbohydrate include:

– Energy! Carbohydrates currently have a bad reputation; but they are the main and preferred source of energy for the body. Our bodies need carbohydrates to be at our best health.

– Help to lower cholesterol and regulate blood glucose levels (soluble fiber)

– Maintain digestive tract health (fiber)

Recommendations:

For a generally healthy adult, the range for carbohydrate intake is set between 45% and 65% of daily calories. A person consuming a 2,000 calorie diet would have a range of 900 – 1,300 calories. Since 1 gram of carbohydrate has 4 calories, this is a range of 225- 325 grams of carbohydrate per day. The minimum number of carbohydrate grams per day is 130 grams to promote good brain function.

Those trying to build muscle should be sure to consume enough carbohydrates to “spare protein” to be used for muscle growth.

Many people restrict carbohydrates due to the belief that “carbs make you fat.” In healthy individuals, carbohydrates trigger insulin and insulin lets the sugar into our body and cells. People mistakenly believe that this always means weight and fat gain. This is not true!

When we eat the appropriate amount of carbohydrates for our bodies, the sugar is used as a fuel source and burned. It is only when we overeat carbohydrates that weight gain results. Carbohydrates do not make you fat. Carbohydrates are an important part of the diet. Without carbohydrates, the body begins to break down fat storage and then body proteins. In extreme cases, metabolism slows drastically and both health and life can be jeopardized.

People with specific health conditions or concerns may need a different amount of carbohydrate in their daily diet or to time the consumption of carbohydrates throughout their day.

Other guidelines:

Whole grains: Consume whole-grain carbohydrates whenever you can. Recommendations are to make half of your grains whole. Read the food label and be sure the first ingredient is listed as a “whole” grain (example: whole wheat, not wheat flour).

Fiber: For those between 19 and 51 years old, females should consume 25 grams and men should consume 38 grams of fiber a day. Those over 51 should consume 21 grams (women) or 30 grams (men) per day. If you are increasing your fiber intake, do it slowly and drink lots of water or you may end up with a bout of constipation!

Added sugar: Limit the amount of added sugar in your diet. Many health risks are associated with added sugars and in general, Americans consume too much added sugar. The American Heart Association recommends no more than 100 calories (women) or 150 calories (men) of added sugars per day. Most natural sugars are generally not associated with health risks as these are consumed along with fiber which slows down the absorption of sugar and other vitamins, mineral, and phytochemicals which promote optimal health.

Original publication date: October 1, 2012 at http://newmotivationcoaching.blogspot.com.

Reference: Nutrition Concepts and Controveries, 12th ed. by Sizer and Whitney, 2012. ISBN-13: 978-1-1133-62818-7.