Better Nutrition in the New Year: Setting Yourself up for Success

Intro: This is Weekly Dose of Wellness brought to you by MemorialCare Health System. Here's Deborah Howell.

Deborah Howell (Host): And welcome to the show. I'm Deborah Howell, and today we will be helping you get on better nutritional footing for the new year. Our guest today is Gretchen Perea, clinical dietitian and certified diabetes educator at MemorialCare Saddleback Medical Center. Welcome, Gretchen.

Gretchen Perea, RD: Thank you. Good to be here.

Deborah Howell (Host): So good to have you. Hey, right off the bat, what are the first steps in easing into a healthier diet, especially at the beginning of the year after all those holiday meals and sweets and, you know, all those treats?

Gretchen Perea, RD: One of the most important things you can do is try not to go from one extreme to the other, which is what everybody tries to do. They try to go from eating nonstop junk to eating perfectly. And that's a big change, and then people tend to fall off that. They sort of white-knuckle it for a few weeks, and then it just goes bye-bye. So what we found is it's much better to try to make small changes. You know, promise to eat three servings of vegetables a day, drink more water, and take a 15-minute walk. Start there and then work your way up as each month goes on, add something else new.

Deborah Howell (Host): Sure. Well, that's just reasonable. Now, sometimes people forget that many drinks are sugary and high in calories. So what types of healthy beverages should people be drinking?

Gretchen Perea, RD: Well, one is water, obviously. If you don't like it, a good thing is to buy one of those pitchers where you can infuse everything from mint or cucumber or maybe a little bit of fruit. All the new sparkling waters that are out now, without saying any brand names, the ones that have no calories and no artificial sweeteners, those are very, very tasty. And backing up with maybe some iced tea or whatever, but just it's the additions you gotta watch out for if you're looking for cold drinks. Bottom line is try not to add sugar.

Deborah Howell (Host): That's really interesting.

Gretchen Perea, RD: People don't realize how many calories are in those sugary drinks.

Deborah Howell (Host): Yeah, that's true. But why not hot drinks? Why are cold drinks more beneficial?

Gretchen Perea, RD: Well, I was just thinking of something refreshing. But yeah, hot drinks are fine. Yeah, that's fine. People do tend to like to add half and half and a ton of sugar when they're drinking a lot of hot drinks. That's the hard part. But yeah, sure. Some black coffee or what have you. And then that, every time we talk about things like this, part of the answer is always 'it depends' because, you know, I'm making sure I'm not recommending caffeinated drinks all day long if someone's got high blood pressure. So it just kind of depends on that person as to what would be better. But water is your safest bet for sure.

Deborah Howell (Host): Okay, and then there are beautiful teas that are good for you that don't have caffeine in them as well.

Gretchen Perea, RD: Correct. Yeah, you can get all kinds of decaf herbal tea, you know, make a big pot of it and put it over ice if you want something cold or of course hot as well, especially with the weather we've had recently, that would be perfect.

Deborah Howell (Host): As long as you don't add half a thing of honey to it.

Gretchen Perea, RD: Exactly. Exactly.

Deborah Howell (Host): Half a little bear of honey later.

Gretchen Perea, RD: People think eating honey is really, really, you know, healthy and it's not. It's just sugar, period, the end. Yeah. There's no improvement using honey. Correct. Yeah.

Deborah Howell (Host): You just shattered a big dream of mine, Gretchen.

Gretchen Perea, RD: I know. Yeah. No, that's why I let everybody know. There's no improvement whatsoever. Yeah.

Deborah Howell (Host): Alright. Well, can you share a few simple swaps that can make a big difference in nutrition?

Gretchen Perea, RD: Again, and that's, this is the one that I had the hardest, I was kind of looking through it, it's the hardest because this is a very much an 'it depends' answer. It depends on how the person is currently eating as to what change would make the biggest impact for them. So if somebody's eating out all the time, eating fast food, and that's just their lifestyle, asking them to stay home and cook their meals at home is an unrealistic change. But going to healthier places where things are grilled as opposed to deep fried. You know, Mediterranean eating is always extremely healthy. We're trying to get everybody more to a Mediterranean diet. So if you're eating out all the time, picking better places with grilled items as opposed to fried. If you're not a vegetable eater, maybe trying to add in a bunch of vegetables because that will really help fill you up, and then you end up just naturally curbing your calories more as a result. Not to mention all the antioxidants and phytonutrients that are all, you know, cancer prevention type nutrition that's going through you, plus all the fiber. Making sure you're getting half of your carbohydrate intake as whole grains, at least half. So that you're not using highly simply digested, quickly digested, nutrition-free carbs as opposed to whole beans or something a little more fibrous like quinoa, brown rice, sweet potato versus potato. You know, there's little swaps like that that can make a real big difference. And if you don't like it, you know, try mixing half brown, half white. It's an improvement.

Deborah Howell (Host): There you go. I do that when I go to Chipotle. I say half and half.

Gretchen Perea, RD: Yeah, you'd be surprised. Every time I always tell my patients, anytime you make a better decision, nothing bad can come from that. You know? You just don't have to be extreme to meet the goals you want to meet, whether it's some weight loss or just better nutrition, feeling better, more energy. Every time you make a good decision, it's going to impact you. You don't have to go to extremes, and extreme diets, eating salad all day and going to the gym for three hours is not a realistic plan at the beginning of the year, you know. It'll last a week.

Deborah Howell (Host): What's not to love there?

Gretchen Perea, RD: Well, that's what people think they're going to do. And they try it for a while, and then it just goes by the wayside because it's just not psychologically or physically sustainable.

Deborah Howell (Host): Right. There's also a step down like whole milk to two percent, and then if you're okay with that, maybe step down to skim after that. Or white bread to whole grain.

Gretchen Perea, RD: Yeah, but very few of my patients are drinking milk anymore, so that wouldn't be a huge impact or a huge improvement on anybody's health unless they're big milk drinkers. Everybody eats carbs, so we can switch the carbs. If you're drinking milk, if you're a big milk drinker, then going definitely, you know, two percent isn't a huge improvement by any means, but one percent is very doable and doesn't have appreciable amounts of saturated fat left at all if you don't like the nonfat. If you're a big milk drinker, then that does have an impact for you. If you're not, then that's not a change that would do much for you, right?

Deborah Howell (Host): Yeah. Well, we love our cereal in the morning, and it's always got to have that milk on it. What about almond milk?

Gretchen Perea, RD: I'm not a big cereal lover for people. Almond milk is, it's not good, it's not bad. It's being marketed as being a huge improvement in nutrition, and it basically just provides no nutrition. It just has a little bit of, it's not that it's bad for you. That's not the case. It does save on carbs. So depending on the person and their eating habits, if whatever that person likes to eat for breakfast, if I'm watching their carb intake, sometimes changing to almond milk might, if they really want the fruit and the cereal, maybe that's a swap is to go to almond milk so you don't get any carbs out of the liquid. It's basically a little almond fat with water, and then they add back in some vitamins and minerals to it. But there's no milk in almonds. So it's a processed liquid. It doesn't mean that it's bad for you, but it's not an improvement in nutrition per se. You do save some calories, but there's no protein in almond milk, that kind of a thing. So it's a different swap, but it's not necessarily an improvement depending on what your reason for changing is.

Deborah Howell (Host): And my last question on almond milk, I promise. Is there calcium in it?

Gretchen Perea, RD: They add it in. You don't absorb it as well as you do out of some of the dairy things, but I'll be honest with you, that's something I probably need to look up a little bit more. I didn't do a lot of background on almond milk. But it is added back in, but there's no calcium in almonds. What happens with calcium is you need a protein that comes with it to carry it across the cell membrane to be absorbed. And that isn't present in the almond milk. So the absorption may not be quite as high, but yeah, they do add it back in. And so you do get some out of there, for sure.

Deborah Howell (Host): Good to know. I promise, thus ends the grilling on almond milk, I promise.

Gretchen Perea, RD: No, no worries. It's not that it's bad. I'm not, that's not what I'm saying. I'm just saying people misunderstand the marketing on it. Yeah.

Deborah Howell (Host): For sure. What about snacks? Are they okay to eat?

Gretchen Perea, RD: I usually do recommend them for people. Healthier ones, obviously. Depending on what you're choosing. So, you know, a little piece of fruit and six or seven nuts. We make mistakes by eating huge handfuls of nuts. They're very high in calories if you're trying to lose weight. Also, something like a light yogurt or a plain Greek yogurt, put a drop of vanilla and add some berries to it, which will have fiber. Crackers, you know, whole grain crackers with a little low-fat cheese or natural peanut butter. There's all kinds of hummus and vegetables. There's some healthy snacks that are easy to pack and you can bring along and keep them in the fridge at work. Keeps you out of the break room with the donuts, you know?

Deborah Howell (Host): Oh yeah.

Gretchen Perea, RD: I usually do recommend snacks for people because typically, especially with everybody eating out so much, when you're ordering a meal at a restaurant or at a counter, you'll do a better job ordering when you're not as hungry. If you had that apple and string cheese two hours ago, it's easier to not order the fries, right? It's easier.

Deborah Howell (Host): You know humans very well, it seems. What are some tips for packing a better, healthier lunch for work or school?

Gretchen Perea, RD: Making sure that you get your whole grains, some lean protein, something with some fiber, you know, throwing in that handful of carrots or cherry tomatoes or leftover salad. Makes a big difference on how full you feel through the afternoon. Not to mention, there's one of your vegetable servings. People tend to skip vegetables all day and then they eat a bunch of them at night and totally skip their carbs. If you've ever seen the plate method, making sure you get like a quarter plate worth of, you know, your leftover chicken, meat, or fish from dinner the night before, a quarter plate of some whole grain carb, and then some vegetables. And if you're having that sandwich on whole grain bread with some mustard and lettuce, tomato, and onion and a little bit of leftover salad and bring a little apple. That's a really good lunch. And everybody's, nobody's eating sandwiches because for some reason everybody thinks bread is horrible for you. It's not. If you're buying a normal size piece of bread that's 100% whole wheat, that's a great lunch right there. You can make a quick sandwich. Making sure you have those food groups present is balanced. You have some whole grain carbs, you have some lean protein, and some vegetables and some fruit if you want it. Again, depending on the size of the person, how big the lunch is, right?

Deborah Howell (Host): Exactly. That's about lunch. What about breakfast? Is it really the most important meal of the day?

Gretchen Perea, RD: Yes and no. I mean, yes, for the most part, yes. You've been fasting for so many hours, and people tend to skip breakfast and run off to work and then they go out to lunch and all heck breaks loose because you haven't eaten in 16 hours except for that cup of coffee. What we have found is that by skipping breakfast, you actually, there's a lot of research showing this, you have a lot more calories later in the day to make up for it, and it's more calories than the breakfast that you skipped. So I can always tell when I'm questioning my patients and they're skipping breakfast, I always ask them, 'And let me guess, do you snack a lot at night?' 'Yeah, I'm always hungry.' And I'm like, 'Well, there you go.' So and then they get up because they snack late at night, they don't eat breakfast. So we need to kind of reset that. And I can't tell you how many patients have come back and they're down 5, 10 pounds because they've added in a meal, they added in breakfast. It starts your metabolism going, it keeps you from getting too hungry later in the day, and you just make better choices or better orders or preparing your foods, you do a better job of it the rest of the day when you're not starving. So getting again, it's the same thing, getting some whole grains, getting some lean protein, you don't need to demonize eggs anymore. Natural peanut butter instead of the commercial stuff. Get the kind of peanut butter, almond butter on some whole grain toast and half a banana. Make a little whole grain peanut butter banana sandwich in the morning and eat that in the car on the way to work.

Deborah Howell (Host): You make it sound like a party. I love it. And you know, to me, getting out of bed is like, ugh. But I go, oh, breakfast! It's a big motivator for me.

Gretchen Perea, RD: Well people think it has to be this complicated thing and I'm, you know, peanut butter banana sandwich or a light Greek yogurt, throw some berries in there. Just something to get some carb and some protein first thing in the morning and you'll find you'll set yourself up better for the rest of the day.

Deborah Howell (Host): Can you come live with me, Gretchen?

Gretchen Perea, RD: Well put it this way, when I take my own advice, I also meet my health goals. When I don't, I don't. So the psychology of this is that's your next podcast, is getting the psychologist on to tell us all how to keep on track, right?

Deborah Howell (Host): Well then I'd have to get another guest bedroom. Alright, well.

Gretchen Perea, RD: Well it's hard to make those changes, but that's where we always recommend starting small. Don't make such huge changes at the beginning of the year because it's just not, it's not a realistic goal to go from one extreme to the other. So you will make, you will get to the goals you want, whether it's weight loss or just improved nutrition or better energy level, what have you, by making those small changes and just building on them as time goes on.

Deborah Howell (Host): And don't beat yourself up if you fall off the wagon at a birthday party or something like that.

Gretchen Perea, RD: Exactly, absolutely. And that's a little analogy we use, I use that all the time when I'm counseling patients, is if you have a flat tire and you, you know, the bad thing happens, right? You get a flat tire. You don't go flatten the other three tires. You change the tire and you keep going. But we do that when we're trying to make health changes. It's this all or nothing mentality. And that's the part that stops us because it always ends up as nothing eventually if you're trying to do all all the time. Swapping out that cookie for an apple, again, adding the vegetables in at lunch, taking a walk at your lunch time, take a 15-minute walk, all that starts to build up, you know, and then you feel better, and you're more energetic, and it makes you want to do more as time goes on.

Deborah Howell (Host): Well you've made me want to go take a walk immediately, Gretchen. We're so grateful to have you on the program today.

Gretchen Perea, RD: You're welcome.

Deborah Howell (Host): For more information or to listen to a podcast of this show, please go to memorialcare.org. That's all for this time. I'm Deborah Howell. Thanks for listening and have yourself a great and healthy day.