Nutritionist in New York

Immediately following the climactic and much celebrated completion of my dietetic internship last week, I headed to NYC.  I’m not sure how it happened, but I have never been to the city prior.   What really stood out to me about New York was the diversity – so many different languages being spoken, so many races and ethnicities interacting together.  Many places in the US I have visited or lived (if they have diversity), so often the communities remain segregated. 

One aspect that fuels this interface in New York may be the emphasis on public spaces; parks, benches, outdoor seating for restaurants, street markets – the city is set up for positive public contact and I loved the positive energy this created.

Of course one feature of New York I was particularly impressed with was the food.  Following advice from friends, family, or fellow bloggers combined with the help of Yelp and iPhones, my food experience was fantastic.  The first afternoon, we found ourselves in the West Village in need of a rest from our miles of walking.  Luckily, we stumbled upon the Blind Tiger  (281 Bleecker Street  New York, NY 10014).   As we entered the small, crowded restaurant, we were immediately greeted by a bearded, long-haired host/server who kindly invited us to have a drink at the bar while we waited for a table to clear.  The beer list is original, diverse and best of all, they served my favorite Pumking beer by Southern Tier Brewing Company which every other restaurant in existence so unimaginatively only offers around Halloween.    Though a very casual restaurant (because of our timing we missed table service and instead ordered at the bar from the chalk boards written on the wall), the service we received was very, very good and contributed to our great experience.  The ambiance was fun and relaxed, the food was good and the beer selection was fantastic.  

That night, at the suggestion of many, we had a late dinner at Supper in the East Village (156 E 2nd St New York, NY 10009).    Intimate, warm, candle-lit, brick-walled with an open kitchen - the ambiance was perfect.  Two in our party ordered dishes that were good, but nothing particularly amazing and two of our party ordered very memorable and unique dishes which were based on server recommendations.  My Pappardelle Wild Mushrooms was creamy, savory and filled with a generous portion of mushrooms that everyone wanted to taste, but my friend’s Spaghetti al limone was unbelievable.  I would love to know how they made it; the dish was so simple but incredibly light and flavorful.  The lemon complemented the pasta perfectly and it was a fantastic suggestion that I would definitely order next time I go.   Please note that they are cash only and you likely need to make a reservation ahead of time. 

Finally, we had dinner at Schiller’sLiquor Bar on the Lower East Side (131 Rivington St
New York, NY 10002).  Again, the atmosphere was energetic and fun with wine bottles lining the walls and small picnic-style metal tables and chairs for their seating.  Other reviews keep noting that it has a Parisian or European feel, and I got that in some ways.  We were glad we made reservations as Schiller’s was quite busy.  The house cocktails were very imaginative and the wine selection was interesting and affordable (options include: Cheap, Decent, and Good).   The “continental” cuisine offers something for everyone – our table ordered a Cuban sandwich, Rotisserie chicken, Vegan roasted cauliflower, and grilled chicken Paillard.  The food was good, but the service was the best – our server was so kind, helpful, and professional, plus he broke the stereotype of the person I would assume may work here as he resembled a linebacker I knew during undergrad at the University of Washington.  He moved with grace and really made our experience memorable.   One last suggestion: please get the caramelized banana split for dessert – YUM!!!

Nutrition Legislation

As part of my outpatient dietetic experience where we counsel patients one-on-one for hour-long appointments I have several additional assignments.  Recently I presented current legislative topics to fellow dietitians in an effort to keep us all abreast of current topics that concern our profession.  However, I believe that this legislation affects all Americans, not just those of us in healthcare.  Here is a sample of what I presented on last week at the hospital:

 

Senate Agriculture Committee Passes Farm Bill

On April 26, the Senate Agriculture committee passed its version of the *Farm Bill by a 12:4 vote which could save $24.7 billion over 10 years, partially by making changes to commodity and/or nutrition titles (including $395 million in new program investments).  The downside is that it would be paid for by cutting $4.9 billion from the Supplemental Nutrition Assistance Program (SNAP) over 10 years. The committee has proposed some changes to the existing program including: changing SNAP retailer requirements and reforming SNAP eligibility (e.g. ending SNAP eligibility for lottery winners). The bill does include increased funding for Community Food Projects, Farmers Market Promotion programs and new incentives for SNAP participants who purchase local fruits and vegetables. Both the Fresh Fruit and Vegetable and SNAP-Ed programs would be reauthorized without cuts through 2017, which affects dietitians who are actively involved in the “Ed” part of this nutrition education.  The next step is a full vote in the Senate which could happen in the next couple of weeks.

(FYI) *The farm bill is the agriculture/food bill that Congress passes every five years that deals with agriculture and other laws and policy for commodity programs, trade, conservation, food and nutrition programs and food safety. The current bill, called the Food, Conservation, and Energy Act of 2008, replaced the previous bill which expired September 2007.

 

Prevention Fund Targeted

The U.S. House of Representatives has now targeted the Prevention Fund (provides communities around the country with money to support prevention efforts like childhood obesity prevention and tobacco cessation) to create $18 billion in savings next year to meet requirements of the new 2013 budget resolution. House leadership is requesting savings be created through "health programs" which include elimination of the Prevention Fund and directly affects those of us in health-care involved in prevention education and programing. The House voted to eliminate the Fund to help pay for the lower budget level and/or using the Fund to help pay for extending current interest rates for student loans.  This is only a preliminary bill which would have to move to a full committee vote, full House vote and then on to the Senate in order to become law.

"Know this Chart"

As I draw near to the end of my 9-month dietetic internship in Chicago, things are getting very busy!  I am currently in "staff relief" where I function as a real Registered Dietitian by taking over 2 entire wards (under RD supervision of course).  It is a huge challenge and I feel the weight of responsibility for these patients.  I have a feeling that once this experience is over, I will feel confident about going out on my own for my first real job as a dietitian. 

That being said, we are starting to study for the upcoming national RD exam and had a 2-day test prep this weekend at the hospital.  In the words of our speaker:  "Know this chart" (picture of said chart provided here) and pretty much "Know this entire book"....

In case you don't recognize it, this is the infamous Krebs cycle; aka your metabolism.   When you go to an an RD for your healthcare, you can be sure that they have learned, studied, and passed a test including information on:

• Food science
• Nutrient composition of food
• Education and communication
• Research
• Management
• Nutrition Screening, assessment, and diagnoses
• Community nutrition
• Clinical normal nutrition
• Financial management
• Marketing and public relations
• Menu development
• Sustainability
• Safety and sanitation
• Nutrition and support science
• Equipment and facility planning

I am about to join the ranks of professionals that have passed this test, but not before I spend some serious time reviewing and studying the material.....once again....wish me luck.  

5 Reasons to Eat Seasonally As We Come Into Spring

1.  Seasonal foods can be fresher and travel less distance to get to you which helps with eating locally as well.

If you eat with the seasons of your geographical area, then conceivably the food is traveling less distance with less impact on the environment (carbon footprint) and supporting a more local economy.  Eating seasonally often means eating locally. There is a nice seasonal map on Epicurious.  

2.   Eating seasonally can be more affordable.

When food is in season, there is more of it and it probably has less far to travel to get to you and so the prices will likely be lower.   Eating seasonally can save you money as well. 

3.   Eating with the seasons gives you appreciation for savoring the foods you love.
 
If you eagerly await asparagus season, go crazy on the vegetable when spring comes, experiment with new recipes and feel some regret to see it go, then you are eating with the seasons.   With appreciation, we create a deeper respect for food, the way it is produced, and the way it tastes.  
  
4.   Eating seasonally can promote food safety.

Of course food can come into contact with contaminants at any point, but if you buy with the seasons from a more local source, it cuts down on the contact the food has with other locations,  travel, storage conditions, hands and germs.  
 

5.   Seasonal foods foster a sense of community. 

The more we learn about the foods that grow seasonally in our geographical location, the greater connection we have with farming and food practices in our area.  If you take the time to visit farmers markets in your area, you can get to know the people who grow your food which fosters a sense of community. 

National Nutrition Month

Did you know that March is National Nutrition Month?  This year's theme was "Get Your Plate In Shape" which features a giant red heart-shaped plate lifting a barbell while displaying an example of healthy food compartments on its belly.  The month is now coming to a close, but I was fortunate to be included in several NNM projects during my internship rotations.  In fact, I wrote some tips for my last rotation to include in their newsletter.  Strangely, it is more focused on fitness (being more active at work), but physical activity is another topic I am passionate about as well as a huge contributor to living a healthy life. Below is my fitness advice for National Nutrition Month:

Many people are challenged trying to fit physical activity into their day, but studies have shown that time spent sitting during the work day is associated with a greater proportion of overweight or obese workers. 

Current recommendations suggest a goal of 30 minutes of moderate activity per day.   Here are some tips to get you on your feet when you are working.  Remember, even a combination of three 10-minute sessions can meet your daily goal!

•  Spend 10 or 15 minutes of your lunch break walking.  Inviting a co-worker for support can keep you both motivated.
• Use a restroom or water-fountain on a different floor and use the stairs to get there.
•  Set an alarm each hour of the work day as a reminder to stand up, stretch, and give your eyes a break.  Swinging your arms, flexing your legs, and stretching your neck can help you feel more alert.
• Keep a small set of hand-weights or stretch bands under your desk.  On a short break, do some bicep curls and triceps extensions.  Start with 5 of each per side and work up to 20.
•  Stand straight and raise both heels off the ground so you are standing on the balls of your feet.  Start with 10 and work up to 30. 
• Watch the clock to time 1 minute of jumping jacks in your office.  
•  If you have a stable chair, do some dips off the front of it:  extend your legs, balance on your heels, slip your body off the front of the chair and lower yourself gently towards the floor 10 times with elbows pointing straight back.
•  Do walking lunges across the room. 
• Sit up straight in your chair and extend 1 leg straight in front of you, hold for 10 seconds then switch legs.  Start with 3 sets and work up to 10.
•  Be sure to stretch out your chest and wrists several times throughout the day, especially if you use a computer. 

Any increase in movement during the day can increase your weekly activity level. 

Small changes can really add up when it comes to improving your health! 

*Ginger Hultin, Hines Dietetic Intern

Back to Basics - Cooking Chicken 101

I have had the privilege this week of working at clinics around Chicago that assist HIV positive patients in obtaining food, nutrition counseling, and shelter assistance.  Being a part of the compassionate and dedicated staff as well as working with many committed volunteers from around the city, country and world has been incredibly inspirational to me.  I have been a hunger-advocate for years, both participating in hunger action legislation as well as volunteering regularly at local food assistance programs, but I have never been able to counsel patients one-on-one before like I have during this rotation.  The challenges of living with chronic disease are especially frustrating when transportation, family support, medical support, and finances are limited or non-existent.

On my first day at a clinic, I encountered a really great question from a young client:  how do you prepare chicken?  He reported he had been boiling it in a pot, but wasn’t sure how to know when it was done or how to make it taste good.  Without having access to cook-books, supported by family, friends, or schooling that teaches cooking skills, or having the resources to purchase spices and ingredients, how could a person obtain basic cooking skill support?

Because of this great client, I created a hand-out on the very basic principles of cooking chicken (a commodity that is provided at many facilities) in a simple way for those who may have never attempted it before.  I also adapted two recipes involving items commonly acquired at a local pantry, or easily attainable and affordable at a grocery store.  Instead of a traditional recipe format, I chose a more simple lay-out with step-by-step instructions.  Do you think it works?  Check it out below! 

 

   Preparing Chicken

Baking

Preheat the oven to 350°F.

Pour a very light layer of vegetable oil in the dish and on the meat.

Place pieces of chicken in a baking dish.

Sprinkle meat with salt and pepper.

Cook in oven for 25-30 minutes (until white in the middle and juices run clear).

Poaching (Boiling)

Place chicken in a single layer in a pot.

Cover chicken with broth or water.

Bring to a boil; then reduce heat to low so that the water is at a low simmer (not very bubbly).

Cover and cook for 10 minutes.

Turn off heat completely and allow chicken to stay in hot water for 15-20 minutes.

Sautee
Cut raw chicken into bite-sized pieces or thin strips (don’t let raw meat touch other foods).

Place small amount of cooking oil in a non-stick skillet or pan over medium-heat.

Add meat and cook on medium for 3 to 5 minutes or until browned. 

*Raw chicken can make you very sick!  If you have a meat thermometer, chicken should reach 165 degrees inside to be safe.  Always be sure that the chicken is cooked until it is white and no longer red or pink inside.  If you pierce the meat with a fork, the juice will runs clear (not pink) if it is done.  Cut open the meat to be sure it’s cooked through before you serve it.   Raw chicken carries bacteria:  be sure not to let it touch other foods and to wash your board, knife, and hands carefully after handling the meat.  

 

Recipes

Orange Chicken Drumsticks

1.      Coat 8 chicken drumsticks (skin removed) in a bowl with ½ teaspoon salt and 2 teaspoons vegetable oil.

2.      Heat a large nonstick skillet to medium-high, coat pan lightly with cooking spray and add chicken.  Cook for about 6 minutes or until meat is brown on all sides.

3.      Add 1 can of mandarin oranges with its juice, 1 teaspoon of sugar, 1 tablespoon of soy sauce and 1 tablespoon of lemon juice to pan and meat, cover and simmer on medium-low for 10 minutes. 

4.      Remove chicken from pan and place on a plate. Bring sauce in pan to a boil over high heat.  Cook sauce for about 5 minutes, return chicken to pan, and stir to cover meat in sauce.

5.      Enjoy with rice and vegetables for a complete meal.

Stuffed Chicken Breast

1.      Pre-heat oven to 350 degrees.

2.      Flatten chicken breast with a meat tenderizer or the heel of your hand to make it thin.

3.      Put a small amount of lunch meat, ham, cheese, sauce, herbs, or greens on the breast.  You can choose the ingredients; use whatever you think sounds good!

4.      Roll the ingredients inside the meat and hold the rolled-up chicken with toothpicks so it doesn't come undone while it's baking. 

5.      Rub the chicken meat lightly with vegetable oil and place in a baking dish. 

6.      Cook in the oven for 40-45 minutes.  Check that chicken is completely done by checking the temperature (at least 165 degrees) or cutting it to be sure there is no pink color left.

7.      Enjoy with rice, potato, noodles or bread and vegetables for a complete meal.

*Created by Ginger Hultin, Dietetic Intern

5 tips that motivate dinner at home every night of the week

         With just a little planning up front, you can remove hours of stress from your week as well as gain control over what you will eat.  Believe me, it took a long time for me to get to this point; I used to marvel at people who planned ahead and cooked dinner at home every night instead of grabbing food on the go or just giving up and going out most nights of the week.   By getting in the habit of planning ahead, it has actually saved us time and hassle after work in the evenings.  

1. On Sunday, brainstorm about what you will make each night of the week.  If you get a brain-block, grab a cook-book and pick out some recipes that sound good.
2. Make a list that includes all ingredients you will need to prepare dinner each night.  I suggest planning on making extra servings each dinner that you can pack for lunch the next day.
3. Grocery shop with your list to make sure you have everything you need for the week.
4. Do any necessary prep (chop veggies, cook grains) that evening if you have time to help speed dinners later in the week.
5. Store all your ingredients properly and base your menu on what needs to be used first (i.e. the avocado is very ripe, so let’s make tacos tomorrow but the eggplant will hold until Thursday). 

We tried a new recipe tonight; it was incredibly easy, especially since we had gone shopping the night before and had everything on hand.  It took me about 20 minutes to chop veggies and 20 minutes to bake them in the oven while the quinoa was cooking on the stove. 

Garlic Quinoa with Roasted Veggies

Ingredients:

• 2 medium sweet potatoes, peeled, cut lengthwise, then sliced
• 1 eggplant, peeled, cut lengthwise, then cubed
• 1 tomato, cut into thin wedges
• 1 onion, cut into thin wedges
• 1 bell pepper (of your favorite color), sliced
• 1 tablespoon olive oil
• 1 teaspoon sea-salt
• 1 teaspoon black pepper

• 2 cloves garlic, minced
• 1 teaspoon olive oil
• 1 cup quinoa, rinsed and drained
• 1 teaspoon dried thyme
• ½ teaspoon parsley
• 2 cups veggie or chicken broth (plain water is ok, too in a pinch)

Instructions:

1. Preheat oven to 450 F; spread chopped veggies on a foil-lined sheet, drizzle with olive oil, salt and pepper and mix to coat evenly.  Bake ~30 minutes or until potatoes are soft.
2.  When the veggies go in the oven, heat olive oil and garlic in a sauce-pan for 2-3 minutes.  Add quinoa, spices and broth.  Bring to a boil then reduce heat, cover, and simmer for ~20 minutes (until water is absorbed).  Check quinoa often and stir.
3. Combine quinoa and veggies in a large bowl.  Enjoy! 

*Adapted from “Favorite Brand Name, Vegetarian 3 Books in 1”