Post-Grad Plans

Hi Lemon Wedge friends! It has been a while, but I haven’t forgotten about my blog. I took a little bit of time off from blogging (even though that it is a little hypocritical based on my last post about how students should be blogging – oops! #guilty) because a lot and a little have all been happening at the same time.  After an incredibility busy last school year taking graduate classes and completing my Dietetic Internship, I was burnt out to say the least – just read almost any post I wrote about my internship…I was always talking about how busy I was. Anyways, I spent this semester enjoying a lot more free time with friends (and taking some exciting trips to Chicago, DC, Pittsburg, and Raleigh), testing out the ketogenic diet, learning more about nutrition (including integrative and functional nutrition—more to come in the next few posts), completing my master’s degree, and figuring out what’s “next”.

One of my post-grad goals is to have my own private nutrition consulting practice to work one-on-one with patients, but also maybe teach classes, do some corporate wellness, work with food and health brands, and continue blogging. The development of this is still in the works, but I will definitely be sharing as things being to develop.

Before I build a business or get a “real person” job as a dietitian, I will be taking a big trip around the globe! From January to around April I’ll be anywhere from India to New Zealand to Germany and quite a few places in between. I had to take advantage of this time in my life to see and experiences places I have only dreamed about.

Now, I am officially getting back on the blogging bandwagon, but with these big plans coming up, my blog posts might be changing a little bit. As my life changes, my blog posts will be evolving with me, but I’m honestly not sure exactly what that will look like yet. I’ll still keep it nutrition and health related but you might see some exotic foods and travel tips, plus maybe some business building updates and integrative and functional nutrition wisdom.

Anyways, I can’t wait for this next chapter of my life (and blog) and hope you enjoy being along for the ride. With only 5 days until graduation, the next time I post I will officially have a master’s degree and two more letters added to my name! à Dana Goldberg, (almost) MS, RDN

5 Reasons Why Every Student Should Have a Blog

Over the past year, I have been avidly posting on my blog/dietitian Instagram page (@DanaGoldbegRDN) which has somehow resulted in free goodies (aka healthy foods) being shipped to me from different food companies. Now, suddenly, a few of my friends are all interested in starting blogs because they think it is so cool to get free “stuff”. While free stuff (especially when it is food!) is wonderful, it is never what I intended to come from this blog, and while some people start a blog intentionally to get free stuff…or make a living for that matter, I strongly encourage all students to start a blog for other reasons…here are my top 5:

1. A blog allows you to reflect on experiences. I talked about my career confusion in a previous post and also shared my journey through my Dietetic Internship as well as my undergraduate and graduate classes and study abroad in many different blog posts. Having to sit down and write that post on all these different experiences really makes you think critically about what you have done. What did I get out of this and what should I share with other people? It is a good way to avoid just going through the motions of life.
2. You learn about new and different topics. Yes, the weekly posts have fallen off the train a few times over the past 3 years of blogging, but after putting out over 100 blog posts, I have to keep coming up with new and different content to share. Some of my posts are just life updates and others are things I learn in class, but others are topics family and friends mention that I have to go home and research. Not only does this allow me to share information with you, but I am also able to add to my personal bank of information to use in future careers and help future clients/patients.
3. It helps you figure out what you are passionate about. When I first started blogging, I shared lots of different recipes. I had just moved into my first apartment and was cooking all my meals for myself for the first time, and I even considered going to culinary school! But as time went on, I realized I didn’t love my posts about recipes. I didn’t want to be a food blogger…I wanted to be a nutrition I don’t love spending hours in the kitchen or trying to take the perfect picture of my food. Instead, I realized that I loved writing posts about the science and research behind nutrition recommendations, talking about popular diets and foods, and debunking nutrition myths.
4. You can become a better writer. I don’t claim to be Shakespeare by any means (nor do I ever aspire to be a magnificent writer), but I went through grade school DESPISING my English classes. No joke, I would come home crying from school because I hated writing and I was bad at it. I swore I would never end up in a job where I had to write, but in the end, no matter what job you end up in, you are going to have to write something at some point. Having to put words to paper every week writing posts, summarizing research and knowledge I have, is definitely a skill I can take with me wherever I end up.
5. It is something you can share with future employers. While I may have internships and volunteer opportunities on my resume, getting a job after graduation is probably not going to be a walk in the park. I’m not knocking the internships and other experiences that I have had – they have been great – but having a blog is something that is my own. I think it shows a little bit of my personality, it is evidence of my knowledge in the nutrition field, and it shows that I have gone a little bit beyond the classic summer internships that college students have. (Maybe I am chalking my blog up to be more than it is, but I like to think that it might help me get a job in a few months 😉 )

While I have shared my experiences blogging about food, nutrition, and health, these reasons can really be applied to students in any field of study (Spanish major? Practice your Spanish writing skills. Accounting major? Share some personal finance advice or some crazy number stuff that I don’t understand. Anthropology major? Teach me about another culture.). Even if you keep your blog completely private and don’t share it with anyone, you can still reap the many of the blogging benefits.

My 6 Tidbits of Advice for Dietetic Interns

Last year, before I started my Dietetic Internship, a girl in the class above me reached out to provide some advice and answer any questions I had about the dietetic internship that I would be starting.

She told me, “You will learn more about what you don’t like, rather than what you do like during the internship”.

This didn’t faze me as earth shattering advice at the time, but let me tell you, when 5 months of clinical rotations had passed and I couldn’t name a single area I really enjoyed, nor could I ever envision myself being a clinical dietitian, that advice was life saving. I still had a few moments of panic (I knew I still wanted to be a dietitian, but suddenly I had no idea what I wanted to do as a dietitian), but knowing that it is okay to not enjoy parts (or whole chunks) of the internship was very reassuring. There are so many areas of dietetics that you may not be exposed to in your internship, so there is still so many other opportunities to find where you fit in. And don’t worry- I’m still trying to figure out what that niche is for me.

Anyways, since I received that invaluable piece of advice prior to starting my internship, and now having completed an internship myself, I thought I would share a few pieces of advice for any RD2Be’s out there.

1. Going along with the advice I was given, I would tell people to find an internship with tons of different rotations/areas of experience – especially if you don’t really know what area you want to go into. I worked in more than 25 different clinical areas during my internship, and although a didn’t love any of them, there were definitely some I liked more than others and I discovered interests that I didn’t know I had. Even if you do have a specific area of interest, gaining experience in a number of different fields will make you a better dietitian all around.
2. Practice what you preach as a dietitian. Dietetic internships can be extremely busy and stressful, especially if you are also completing as masters degree at the same time (like me). It can be easy to slack off, skip workouts, and order pizza for dinner, but as future RDN’s, we all know that those choices aren’t the best for our physical or mental health. Make sure you have plenty of fruits and veggies to snack on and especially get a solid 7-8 hours of sleep every night.
3. Ask lots of questions! I was terrified starting my first rotation because I felt like I didn’t know enough. Guess what…you aren’t supposed to know everything – that is why you are there. I never had a preceptor who wasn’t willing to answer my oodles of questions – especially regarding areas of nutrition that I didn’t learn a lot about in undergrad.
4. Similarly, take advantage of all the knowledge your preceptors have to offer. This goes for nutrition knowledge (again, ask questions!), but I also liked to pick their brains about life and career advice. They all landed a job as a clinical dietitian and most had other jobs and experiences prior to their current job, so they have lots of valuable information to offer about careers in dietetics.
5. I know I probably don’t have to say this to a bunch of type A, aspiring dietitians, but say on top of your work and manage your time well. I guess this mainly goes for interns who are also getting their masters at the same time (like I did), but you definitely don’t want to fall behind and let the workload pile up. Start your assignments early, chip away at them every day, and you will definitely still have time to enjoy life!
6. Finally, your internship is the greatest study tools and experience to prepare you to be a dietitian. I remember worrying during the first few weeks of my internship that I needed to start taking notes or studying for the RD exam (this was when I still had 11 months of internship ahead of me!). Now, having passed the RD exam, I can confidently say that there is nothing to worry about. Those 1,200+ hours spent working during your internship aren’t for nothing and prepare you very well to be a dietitian and pass your exam.

Nutrition for Bone Health

Calcium
When you think bone health, what is the first nutrient you think of? I’m going to go out on a limb and guess that you said Calcium! Yep, calcium is crucial for bone health. It is the key component of hydroxyapatite, which makes of the mineral matrix that keeps you teeth and bones sturdy and strong. Our bones are also constantly breaking down and building up – and in order to properly build, they need adequate amounts of calcium. This “adequate amount” ranges from 1,000mg- 1,300mg per day depending on age and gender and mainly comes from dairy products, almonds, leafy greens, tofu, beans, lentils, and some fish fish.

Vitamin D
Now, while calcium is the key component in bone, it pretty much is no good without its partner in crime, vitamin D. Vitamin D is needed for calcium absorption, so no matter how much calcium you eat (or drink), your body isn’t absorbing much of it if you lack vitamin D. Vitamin also helps in that bone remodeling (breakdown and building) process I mentioned.

Vitamin D has become a pretty hot nutrition topic recently. In fact, vitamin D deficiency is on the verge of becoming a global public health issue. Why? Well, if you are reading this post right now, you are likely sitting inside staring at a computer or phone screen as opposed to soaking up the sun’s UV rays. Our primary source of vitamin D comes from the sun so the decreased time spend outdoors and the increased use of sunscreen that have been seen around the globe are causing vitamin D deficiency rates shoot through the roof!

There are a few food sources of vitamin D, including fortified dairy products, some fatty fish, and mushrooms, but these can’t really provide enough to meet our need of 600-800 IU per day (and most people need up to 2,000 IU per day if they are deficient).

Exercise
The final key player in bone health isn’t a nutrient; it is exercise!- specifically weight-baring exercise. Simply carrying the weight of your skeleton in activities like walking, running, jumping, and stair climbing all help in that formation of strong bones. Not to mention, exercise improves strength and balance, which can help decrease risk of falls and broken bones.

Other Nutrients
In addition to these top three, researches have also found that low vitamin C and vitamin K levels also put people at risk of poor bone mineralization. On the other hand, people who had diets high in fruits and vegetables were found to have stronger bones… just one of the millions of reasons to eat more fruits and veggies!

Controversy
A few studies have found that high calcium intake, greater than the recommended daily intake doesn’t provide any additional benefit when it comes to bone mineral density. There have also been associations between high calcium intake (especially from supplements) and heart disease risk. Moral of the story- more calcium isn’t always better.

Eggs: What do all the label claims mean?

$1 for 18 or $6 for a dozen? Standing in front of dozens of eggs (no pun intended) on the self at the grocery store makes for a very confusion decision. Free range or pasture raised? Cage free or Organic? – don’t worry, it confuses me too so I thought I would break down just a few of the many claims on egg packages to help you make a more educated decision the next time you pick up a carton.

• Cage free means that the animals don’t live in cages

You are all probably thinking..”duh”. But just because the animals aren’t in cages doesn’t mean they aren’t packed in a barn, and most of the time they never step foot outside.

• Free range means that animals have “access to the outdoors”.

While this “access to the outdoors” has to be government certified, there really aren’t any guidelines, criteria, or qualifications on the quality or size of the outdoor space. That means the area could be anything from a small cement square to a grassy field.

• Pasture Raised usually means that animals spent the majority of their time in a large open grass field – think the classic image of chickens in a field.

While pasture raised sounds the best, it isn’t regulated by the government so technically some unethical farmer could slap “pasture raised” on their conventional eggs and wouldn’t get in trouble for it.

• Organic requires that the chickens be raised in conditions that accommodate their natural behaviors.

This includes area to roam outdoors in fields, but the key word is “accommodate”. Yes, they may accommodate for natural habits, but that doesn’t always mean they actually have the ability to live naturally 24/7. On another note, “organic” eggs also come from chickens that are not treated with any antibiotics and they are fed all organic feed – all of which are tightly regulated by USDA.

This chart is a pretty good summary of all the different egg labels- but remember, while it shows that pasture raised is the best, that term isn’t regulated so anyone can use it willy-nilly. Do some research into the brands of eggs at the store to see how they actually treat their chickens.

So you choose…what kind of eggs do you buy?

The Official Trans Fat Ban!

Food/Health History Update:

Mark your calendars everyone because tomorrow is a very important day in United States nutrition history… Partially hydrogenated oils (also known as trans fats) will officially be illegal and will no longer be found in any food products sold in the United States.

Reminder- trans fats are a type of fat found in chemically produced partially hydrogenated oils, that, even in very small amounts, are responsible for raising cholesterol levels through the roof and increasing risk for heart attack, stroke, and diabetes. Frozen pizzas, solid margarines, frosting, packaged cookies and crackers, and fried foods like onion rings and fries are just some of the common foods where trans fats can be found.

Back in 2015, the FDA finally realized that trans fats were no longer safe for people to eat and removed them from the GRAS (“Generally Recognized as Safe”) list of ingredients. The FDA gave companies until June 18, 2018 (tomorrow!) to have them eliminated from all products. (See my post back in 2016 all about the ban.)

Now, the world is following suit (hopefully!). On May 14, 2018, the World Health Organization (WHO) launched an initiative to eliminate trans fats globally. While many westernized countries have already eliminated trans fats or are in the process of doing so, countries in southern Asia, Oceana, and Central/South America are still consuming dangerously high amounts of these processed fats. WHO can’t actually create any worldwide law or ban, but it will be part of their strategic plan to help countries around the world achieve a trans fat-free food supply. And guess what (this blew my mind)…WHO has never called to completely eliminate anything other than a specific disease! – Shows you just how bad trans fats are!

Happy Father’s Day!

 

*Note- unfortunately the FDA has extended the June 18, 2018 deadline for trans fat removal under some conditions, but for the most part, they will all be eliminated. Read more here: https://www.fda.gov/Food/IngredientsPackagingLabeling/FoodAdditivesIngredients/ucm449162.htm

Artificial Sweeteners: Not so sweet after all

The next time you are about to tear open that yellow, blue, or pink packet or reach for a diet beverage, you may want to think twice. Throughout the 1900’s, artificial sweeteners seemed to be the miracle food – all the delicious sweetness people enjoy, without any of the sugar or calories. But now this “miracle food” might not be such a miracle after all. Recent research has been showing that these artificial sweeteners may be doing more harm than good!

One study of over 400,000 people found that, even though artificial sweeteners don’t have any calories, they did not help people lose weight. In fact, they found consuming more artificial sweeteners lead to weight gain and obesity, diabetes, and heart disease.

How could this be possible? Less calories should mean more weight loss, right? Well, just because the sweeteners aren’t providing any calories, doesn’t mean we aren’t getting more calories elsewhere. One Harvard doctor explained that artificial sweetener consumption could cause overstimulation and desensitization of our sugar receptors, which causes people to crave sweeter and sweeter foods. It can also end up making un-sweet foods (such as vegetables) unpalatable. These sugar cravings and vegetable aversions lead to people eating more sugary and high calorie foods, which cancel out any reduction in calories from using artificial sweeteners.

Also, remember the gut microbiome I talked about in my post about Probiotics? Well, researchers found artificial sweeteners can change your gut bacteria…and not in a good way! The sweeteners increase the number of Bacteroides, an “energy hoarding” bacteria species that make it nearly impossible to lose weight. Other changes in the microbiome, caused by artificial sweeteners, make it more difficult for your body to breakdown sugar – leading glucose intolerance and diabetes.

If you are looking for any bright sides, using artificial sweeteners in place of sugar can decrease likelihood of cavities and tooth decay, and while there is a lot of hoopla around artificial sweeteners causing cancer, there haven’t been any concrete studies to prove this. But! We only have short-term studies…we don’t really know what the effects of long-term use are.

In the end, regardless of weight gain, cravings, and diabetes, artificial sweeteners are, well, artificial. I don’t know about you but I would rather avoid putting artificial chemicals in my body and stick with the real stuff (in moderation, of course) if I had the choice.

Back to the Beverage Basics

This week, I am going back to some basics. While I love writing about all the cool, new nutrition research I learn at work and at school, I sometimes forget that many people have a tough time making basic healthy choices – especially when it comes to what they are drinking.

In many of my rotations at the hospital, people overlook drinks as a source of nutrition. I have seen overweight patients who just can’t figure out why they aren’t losing weight while eating eggs for breakfast, a salad, for lunch, and grilled chicken for dinner. Guess what? These people also drink crazy chocolate-y, sugary Starbucks drinks, several glasses of orange juice per day, and bottle on bottles of pop/soda. I even had one patient who admitted to drinking over 2 liters of orange juice every day – that’s about 946 calories and 176 grams of sugar!! I know this is an extreme scenario, but it is so easy to lose sight of how easily those fluid calories can add up.

When I am working with patients who want to lose weight, my number one piece of advice is to switch to zero calorie beverages with no artificial sweeteners. Yes, diet coke is zero calories, but all the artificial sweeteners wreak havoc on your digestion and bacteria in your gut (more on this in a future post, but for now, avoid all artificial sweeteners).

So what type of beverages do I recommend?

Number 1 is always water! Hot, cold, with lemon, berries, or cucumbers…water is always the best option. I love mine ice cold with a wedge of lemon, of course!

If you aren’t a fan of water, try the unsweetened, flavored, sparking waters that are all over Instagram and Facebook, like LaCroix or Bubly. While these are all better options than pop or sugary drinks, I still encourage people to stick with fluids that aren’t sparkling. There is some newer research showing that all the carbonation can acid reflux and increase ghrelin levels (the hormone that makes you feel hungry).

You can also pick up a cup of coffee. No, not a double chocolate Frappuccino with umpteen pumps of flavor or even a cup with some Splenda…just a plain old cup of black coffee (maybe with a splash of milk). Two to three, 8 ounce cups of coffee per day has been found to decrease risk of many diseases and help you live longer. Unsweetened tea, hot or cold, is also a good option.

Ultimately, my top beverage recommendations are:
1. Water
2. Unsweetened tea
3. Black coffee
4. Zero-calorie flavored water
*1-2 glasses of milk each day (any variety) is also okay. There is lots of new and controversial research about milk, but I’ll save that topic for another day.

Stay away from:
1. Pop/Soda (diet and regular)
2. Juice (even the 100% natural kind)
3. Fancy, sugary coffee drink
4. Gatorade and other sports drinks (unless you are a competitive athlete)

I challenge you to cut out all fluid calories – that could add up to a few hundred calories per day or ½ pound per week!

 

Turmeric & Golden Milk

If you don’t have a trail of this yellow/orange powder around your kitchen, you might be missing out. Turmeric is a hot topic right now and for good reason – it has tons of health benefits.

Historically, turmeric was used in Ayurvedic, eastern medicine for pain and fatigue. Turns out they were on to something… Recent research has found that curcumin, the active compound in turmeric, has some serious anti-inflammatory effects.

Why is “anti-inflammatory” a good thing?

In a few cases, inflammation is a good thing – like healing cuts or wounds and fighting foreign pathogens in the body. However, when there is a chronic, low level of inflammation in the body it can increase risk for heart disease, cancer, metabolic syndrome, and Alzheimer’s, among many others. Stress, environmental toxins, and chemicals and preservatives in our food can all cause some of this chronic inflammation, which turmeric can help counteract.

Does turmeric sound appealing now?

If adding turmeric into your diet sounds more appealing now, here are a few things to consider:

1. Whether you’re adding turmeric to your stir fry, eggs, golden milk (see my favorite recipe below!), salads, or soups, make sure you add some black pepper – this boosts absorption of the curcumin in turmeric up to 2000%
2. While it is more of a pain to cook with, raw turmeric root more potent than the powdered spice form of turmeric

Remember…

Just like any other food or supplement, turmeric is not a magic pill. In order to get the real anti-inflammatory benefits of turmeric, it is also important to be eating a diet rich in whole, real foods (not the processed stuff), fruits and vegetables, and fiber.

My favorite turmeric recipe – Golden Milk

 

Emotional Eating & Food as Fuel

This past Sunday was commencement at Case Western, and even though I wasn’t graduating, I still got to do a lot of celebrating because two of my best friends from undergrad were graduating. What I really mean by celebrating was going out to a lot of nice and yummy restaurants. My friends’ families’ were kind enough to include me at dinner on Saturday and lunch and dinner on Sunday.

If you know me, you know that I love a good meal out at a restaurant (especially if it is somewhere I’ve never been), but this weekend was a lot… I am not use to going out so much! I stuck with healthy choices (mostly protein and veggies) at my meals and shared some dessert, but the whole weekend got me thinking about how we view food as a culture.

In the caveman times, food was merely fuel to keep us going. Today, we eat to celebrate (graduations and birthdays, for example), we eat when we are sad (cue the break-up pint of ice cream), we eat/munch out of boredom (like the popcorn while watching TV), and we eat when we are stressed (you should see the university library during finals!).

As you can see, we strongly associate food with emotions and feelings…no wonder so many people struggle with emotional eating! If you think about it though, most of us are conditioned from a very young age to associate food (usually unhealthy food) with our emotions or actions. For example, say little Billy keeps crying as he gets a shot at the doctor so he gets a lollypop to cheer him up or his mom says he can have ice cream if he quietly and patiently waits while she buys the groceries. In these cases, Billy now associates (again, unhealthy) food with unhappiness/pain and with doing something good/behaving.

Why do we always use unhealthy foods as rewards? That’s because sweet and salty foods cause our brains to release dopamine, the hormone that makes you feel happy. While this sounds great (of course we all want to feel happy), dopamine is also the hormone that can create addiction – just one of the reasons why so many American’s are addicted to sugar and salt. Also, remember that although those foods may cause immediate happiness, sugar and salt are ultimately not good for you. They can lead to high blood pressure, inflammation, and even throw off all sorts of hormones that could cause anxiety or depression (the exact opposite of the initial feeling of happiness!).

So while almost everyone may struggle with emotional eating (including me!), it is important to think back to what food is really for – to fuel our bodies. I don’t think you would intentionally put fuel in our car that you knew would clog the pipes, so the next time you are reaching for the bag of chips or box of cookies, ask yourself, is this fueling my body with good, healthy nutrients that won’t “clog the pipes”?

And if you are a parent of little kiddos, try not to use food as a reward or use food to fill a need other than hunger. It is, of course, part of life to have cake and ice cream on your birthday (don’t give that up!!), but try not to use foods (especially sweet and salty ones) as bribes or treats for desired behaviors. It can help prevent some of those food-emotion associations later on.