What does a Dietitian eat in a day?

Ever wonder what a dietitian eats in a day?

From people wondering how to improve their diets and eat healthier I get this question a lot- what on earth do I eat? The answer is that it’s going to look very different from person to person! There is no “one best way” to eat or any such thing as a “perfect diet”.

In general a healthful diet:

  • is abundant in a wide variety of fresh vegetables and fruits
  • contains foods from different food groups including vegetables, fruits, nuts and seeds, whole grains, legumes, proteins, dairy, and healthy fats
  • provides enough calories for an individual to thrive and maintain a healthful bodyweight
  • is tasty and enjoyable
  • is sustainable long term
  • focuses on water as the primary source of hydration
  • limits highly processed foods

Combining foods in different ways to make them tasty and enjoyable is one of the best ways to prevent food boredom and truly enjoy a healthy diet! One of my best pieces of advice is to get in the kitchen. The best, most nutritious meals can be made right at home using whole food ingredients and simple techniques.

Here is an idea of what I eat in a day- this is by no means prescriptive but instead a source of idea/inspiration on how fun and tasty it can be to eat healthy!

In the morning, the first thing I like to do is make myself a big jar of ice water and chug some. A couple of ways to make water more enjoyable:

  • make it extra cold by adding lots of ice!
  • add fresh or frozen fruit to add flavor- like strawberries, lemon, pineapple, mango, kiwi, limes
  • add fresh herbs like basil or mint
  • add a reusable straw (IDK why this helps me drink more but it does!)

Breakfast

Next comes arguably the most important meal of the day- breakfast! I hear from quite a few people that they don’t enjoy breakfast or don’t feel hungry in the morning. I’d encourage you to take a look at what other times of day you are feeling hungry. Are you extra hungry for dinner? Or find yourself snacking late in the evening? Evidence shows that eating a balanced breakfast every day can help prevent these feelings of “hangriness” later in the day. Breakfast eaters also have a lower incidence of obesity, heart disease, insulin resistance, and high blood pressure. Score!

For breakfast- I recommend including quality protein, heart-healthy fat, filling fiber and fruit, or vegetables! My breakfast this morning was (my fave!) a slice of toasted sourdough bread with smashed avocado, chopped green onion, red pepper flakes, a sprinkle of feta, and a fried egg. On the side, I enjoyed some blueberries and strawberries and of course, coffee. This is brewed black coffee with about ¼ cup frothed oat milk to give it a bit of creaminess.

This breakfast covers all of the previously mentioned bases:

  • Protein- egg
  • Healthy fat- avocado
  • Fiber- berries and toast
  • Fruit or vegetable- strawberries, blueberries, green onion, avocado
  • And also, it was DELICIOUS.

Lunch

After a few hours of work and a hard workout, I was more than ready for lunch. Today’s lunch is another one of my standbys and perfect for the approaching fall weather.

For those of you who have gotten tired of steamed, mushy veg may I strongly suggest roasted!? Drizzling veggies with olive oil and seasonings and roasting them at high heat (425) for about 25 minutes gives them crispiness and deeper flavor that is simply irresistible!

Today’s lunch bowl included:

  • quinoa (a fabulous high-protein grain)
  • roasted sweet potatoes and broccoli (roasted with olive oil, garlic powder, Italian seasoning, and kosher salt)
  • 1/2 of an avocado and a handful of Kalamata olives (gotta love that healthy fat!)
  • a sprinkle of dried cranberries for chew and roasted pumpkin seeds for crunch
  • a vinaigrette made with 1 tablespoon extra-virgin olive oil, 1 tablespoon fresh lemon juice, 1 teaspoon Dijon mustard, 1 teaspoon honey, and a pinch of salt and pepper

Snack

An afternoon of work flew by and I was feeling quite hungry by 4:30 pm. I knew I would be over-hungry if I didn’t have a little snack to tide me over till dinner so I snacked on some grapes and a Kombucha tea while making dinner. Kombucha is a fermented tea beverage that is very low in sugar and calories and rich in probiotic bacteria- aka those friendly little critters that promote gut health!

Dinner

For dinner, I made a delicious lemongrass noodle salad! Tons of fresh veggies like bell peppers, carrots, cucumber, and scallions, tossed with thin brown rice noodles, peanuts, crispy tofu, basil, cilantro, and a zippy lemongrass dressing. I will link to the recipe below, I highly recommend- it was so flavorful and filling!

Recipe from Pinch of Yum

Dessert

I almost always save a little room at the end of the day for a small sweet snack like a piece of dark chocolate, some toasted coconut chips or a few chocolate covered almonds. Today was a little more indulgent with a homemade chocolate chip cookie.

I strongly encourage including portion-controlled sweet snacks in your diet. Including these foods instead of restricting can:

  • help you feel more satisfied
  • prevent the urge to binge
  • promote a way of eating that feels sustainable and realistic
  • I ate this cookie and enjoyed every single bite!

And that’s a wrap! A full day of eating. I didn’t show it in every picture but I did keep refilling my yummy fruit-infused water all day long and ended up drinking 90oz. The recommended minimum water intake is 64oz/day but it is certainly okay to exceed this, especially if you are active!

My motto in life is to “count colors not calories”. Mindful eating, appropriate portions, and an abundance of colorful veggies and fruits is how I stay on track and lead a balanced lifestyle. I hope this visual and comprehensive day of eating helps picture what types of foods and meals you’d like to incorporate into your day-to-day.

Drop any questions you have in the comment section- we love questions!

by Erica Baty, RDN, CDE

Welcome Back to School!

As the temperatures outside start to cool off, we often start to see changing priorities for families. Time for school and a consistent daily schedule, time for some of our favorite sports and outdoor activities to start back up, and time to thinking about germs. Now I know everyone is already tired of talking about COVID-19 and the impact it has had on our lives but it reminds us that we are all in this together. Our decisions impact everyone around us, especially those that we love and care for.

Germs are and will continue to be part of our world but there are many everyday things we can do to protect others.

  • Wash your hands- Just because things look clean… doesn’t mean that they are. Always use soap and water (for at least 20 seconds) and when you can’t, try to use hand sanitizer.
  • Cover your cough or sneeze- There is much talk about masks these days and as a medical provider worried about colds, flu, and COVID I recommend wearing them, especially during this time. We know from the time that we are small children that many germs come from our mouths. Covering our mouths to prevent spreading our germs to others is just one more step we can take to protect those around us. 
  • Be careful what you touch- Germs, although microscopic, can have a huge impact on our health. Germs exist in the air as well as on surfaces. Think about those things that you touch all of the time… and try to sanitize things that are touched all of the time by many people.
  • Flu vaccine- This year more than ever we need to consider what a fever will mean for those around us. The more we can do this fall to prevent illness will really help get and keep our lives on track. Consider getting your child in for their annual Well visit or even getting in when appropriate to keep them up to date with vaccinations… your Pediatricians thank you!

– Dr. Dan Moorman

Card Games Save the Day

Hey guys! 

We are all facing increased time at home these days.  For our kids, grandchildren, nieces, nephews – six weeks is a long time to be away from school, friends, and the overall ability to be social.   Everyday activities can only engage and last for so long before inevitable boredom sets in.  Can you hear the restlessness growing? 

With a little research (and maybe some shopping), I found some really inexpensive card game options that you can order to the comfort of your home.    I am all about budget-friendly so everything listed is $10* or under.  Amazon is still filling orders!  Any non-essential orders are not a high priority – but they are still shipping (it is just slightly delayed).  

Engaging family fun is always an amazing time so enjoy and game on!

Games for Kids under $10 (brought to you by Amazon’s current inventory and pricing):

  • Ages 3+

Hoyle 6 in 1 Fun Pack – $5.97

The Cat in the Hat I Can Do That – $7.31

  • Ages 4+

The Sneaky, Snacky Squirrel Card Game – $7.52

Charades for Kids – $5.97

  • Ages 5+

Red Light, Green Light Card Game – $6.29

Guess Who Card Game – $4.44

  • Ages 6+

Smack IT! – $8.99

Scavenger Hunt for Kids Travel Edition – $5.96

  • Ages 7+

Blink Card Game – $5.39

Uno Dare! – $5.39

  • Ages 8+

Qwixx – A Family Friendly Dice Game – $7.99

Clue Card Game – $4.44

Man Bites Dog – $7.85

  • Ages 10+

Mad Gab Card Game – $5.00

60 Second Slam – $7.50

  • Ages 12+

Relative Insanity – $9.99

*Given that this is Amazon, prices and availability are subject to change at the drop of a pin. 

By Stefanie Sproule, Administrative Services Project Manager

Resources for Parents At Home During COVID-19

With area schools closing for the next six weeks and more at home time happening for everyone, we wanted to provide some resources for parents and folks who are self-quarantined alike. There are many free resources available right now to learn and also free lunches available to any child 18 years or younger.


A couple of tips before we get into the resources:


Remain calm and reassuring.

Children will react to and follow your verbal and nonverbal reactions.

What you say and do about COVID-19, current prevention efforts, and related events can either increase or decrease your children’s anxiety.

Let your children talk about their feelings and help reframe their concerns into the appropriate perspective.

Make yourself available.

Children may need extra attention from you and may want to talk about their concerns, fears, and questions.

It is important that they know they have someone who will listen to them; make time for them.

Tell them you love them and give them plenty of affection.


Resources

First of all, be sure to check in with your school and school district. They may have excellent resources for what your child is currently learning in class. Your student’s teacher may have plans already prepared to help you navigate this time, be sure to be in contact if possible.

Below are some resources we’ve found that may help you to navigate learning and fun:

Comcast Offers Two Months Free Internet

If you don’t currently have access to internet, Comcast is offering two free months of internet service. https://www.internetessentials.com/covid19#thingstoknow&all_DoIliveinaComcastarea

Storyline Online

Storyline Online, streams videos featuring celebrated actors reading children’s books alongside creatively produced illustrations. Readers include Viola Davis, Chris Pine, Lily Tomlin, Kevin Costner, Annette Bening, James Earl Jones, Betty White and dozens more.

https://www.storylineonline.net/?fbclid=IwAR3xPu5j5B6FheORc5rgO6qts_X43x9-pnYEPD55sULYYUDwqt3_YvW_zkw

Kennedy Center Education Artist-in-Residence at Home

Mo Willems invites YOU into his studio every day for his LUNCH DOODLE. Learners worldwide can draw, doodle and explore new ways of writing by visiting Mo’s studio virtually once a day for the next few weeks. Grab some paper and pencils, pens, or crayons and join Mo to explore ways of writing and making together.  https://www.kennedy-center.org/education/mo-willems/

Explore the National Parks virtually thanks to Google

We went there so you can too. Follow rangers on a journey to places most people never go. Experience the sights, sounds, and adventures of Kenai Fjords, Hawai’i Volcanoes, Carlsbad Caverns, Bryce Canyon, and Dry Tortugas in stunning 360° video. https://techcrunch.com/2016/08/25/google-now-lets-you-explore-u-s-national-parks-via-360-degree-virtual-tours/

Other fun resources:

  • The Cincinnati Zoo and Botanical Garden are doing live safaris via Facebook Live at 12pm they highlight one of their amazing animals and include an activity you can do from home. (this is also available afterward on YouTube):
https://www.facebook.com/cincinnatizoo/
  • This iconic museum located in the heart of London allows virtual visitors to tour the Great Court and discover the ancient Rosetta Stone and Egyptian mummies. https://britishmuseum.withgoogle.com/
  • KiwiCo is a STEM kit delivered to your door. However, they just launched a really cool free online resource page to learn at home. Check it out: https://www.kiwico.com/blog/

Other Ideas

Connect with family—right now is a great time to connect with family members near and far.

  • Call/Skype/FaceTime/Zoom with family members
  • Look at photo albums and discuss family heritage
  • Create a family tree
  • Write letters to/create cards for relatives (Perhaps an overdue thank you note for that really nifty gift you received?)

With the cancellation of playdates, birthday parties, and other activities, your calendar is likely wide open. Which allows for some fun family activities to take place, here are some suggestions for fun things you can do with your family:

  • Play card and board games
  • Make art or do crafts together
  • Cook and bake together—talk about math as you prepare the recipe
  • Build forts, design a marble run, or other fun STEM project
  • Sort through bookshelves, revisit favorite titles and make a pile to donate
  • Change family picture frames and revisit memories as you change photos
  • Make a photo book together
  • Make up a play
  • Sing, play recorder or other instruments
  • Have a dance party, do fitness activities together, and play in the yard as a family

Read Trusted Sources:

Seek accurate information and limit exposure to social media and news reports that provide no new information or inaccurate information. Here are some reliable sources of information:

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

https://srhd.org/news/2020/learn-more-about-coronavirus-disease-2019-covid-19


Top 5 Things You Need to Know About Coronavirus | COVID-19

CHAS Health is dedicated to the health and wellness of the communities we serve. Recent global events have raised questions about the coronavirus (COVID-19) and how to stay healthy. Below are answers to frequently asked questions. If you still have concerns for your health related to the coronavirus, please call us for more information at 509.444.8200 or 208.848.8300.

1. What is coronavirus aka COVID-19?

COVID-19 is the official name of the disease that is causing this 2019 coronavirus outbreak, first discovered in Wuhan China. The virus likely originated in animals and spread to humans. There are many types of human coronaviruses, including some that cause mild, cold-like illnesses. Some coronaviruses can cause illnesses in certain types of animals, such as cattle, camels and bats. This was the case with SARS and MERS. In rare cases, animal coronavirus cases can spread to humans.

2. How is the virus spread?

The way this virus is spread is not yet fully understood. However, based on other coronaviruses, it may spread between people by coughing and sneezing into the air, close personal contact, such as touching or shaking hands, touching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your hands, and rarely through stool contamination with the virus present.

3. What are the symptoms of COVID-19 infection?

Symptoms include fever, cough and shortness of breath. Other symptoms can include runny nose, headache, and sore throat, and rarely digestive problems such as diarrhea or stomachache.

4. How can I protect myself from getting the virus?

The most important thing you should do is clean your hands frequently, especially before touching your face or eating. When you wash your hands, use soap and water for at least 20 seconds. Use alcohol-based hand sanitizer if soap and water are not available. Avoid close contact with people who are sick, and cover your mouth and nose with a tissue when you cough or sneeze, then throw tissue away and wash your hands. Clean and disinfect objects and surfaces. Stay home and away from others if you are feeling ill.

5. I think I’m experiencing symptoms of coronavirus, what do I do?

If you have traveled from a high-risk area (currently identified by the CDC as China, Japan, South Korea, Italy and Iran) or you have symptoms of fever, cough, or shortness of breath and feel you may have been exposed to this virus:

• Do not go to Urgent Care or the Emergency Room

• Call you doctor if you’re experiencing symptoms

• Washington CHAS Health Patients: 509.444.8200

• Idaho CHAS Health Patients: 208.848.8300


Learn more FAQs about coronavirus (COVID-19) at https://chas.org/health-alerts

Quick Tips to Keep Your Kiddos Teeth Happy!

Healthy teeth are an important part of a healthy body. Spending a few minutes each day taking care of your teeth keeps your smile beautiful and your body happy. Here are recommendations from our dental and pediatric team to keep you and your children’s dental health in check: 

Keep Those Pearly Whites Shining Bright

  • Clean teeth twice daily with a soft toothbrush
  • Brush for two minutes each time (sing the ABCs in your head three times!)
  • Start flossing once per day as soon as teeth begin to touch
  • Parents should supervise brushing until kids are able to tie their shoes

A word about fluoride:

  • Use fluoride-containing toothpaste for all children with teeth. For children less than three years, use an amount the size of a grain of rice.  For children over three, use an amount the size of a pea!
  • Most of the water in the Spokane area is non-fluoridated; consider a fluoride supplement. Ask your doctor!
  • Have fluoride painted on your teeth as often as recommended by your dentist or doctor

Watch What You Eat – Your Teeth Are Counting On It!

  • Frequent snacking and sugary beverages during the day may increase the risk of dental decay
    • If you plan on snacking on a sugar-containing beverage (soda/juice/sports drink), drink it within a limited time instead of slowly sipping during the day
    • Try to give your mouth a three-hour break between sugary foods/drinks
  • After sugary foods and beverages, rinse your mouth with water or chewing sugarless gum
  • Watch out for: hard candy, gummy candy/vitamins, cough drops, and fruit leathers

Did you know?
Children who visit the dentist before they are four years old are less likely to need dental procedures (crown placement, restorations, tooth removal) compared with children who start seeing the dentist at a later age.

For the really young ones:
The first tooth usually appears around six months of age. Think about scheduling the first dental visit when your child turns one. Start a training cup (sippy cup) at six months.  Plan to ditch all bottles by one year.

Factors that increase the risk of developing dental decay: Bottle use beyond 12 months of age using a sippy cup throughout the day (especially for juice/sugary drinks)Exposure to secondhand smoke using a bottle at bedtime breastfeeding past 12 months if nursing overnight
Want to help spread the word about dental health? Share our posts on FacebookInstagram, and Twitter this month. 

NOW OPEN! John R. Rogers High School Clinic

Healthcare can be complex, especially in today’s busy world. Many provider hours are limited to the school day, and offices may be located far from the school. That means students have to take time away from school and possibly find a ride, making it difficult to get the care they need while maintaining academics.

School-based health centers (SBHC) tackle that problem directly by adding an on campus clinic, making getting the care you need as simple as walking to the other side of the building.

Why school-based health centers?

Essentially, school-based health centers is an extension of your neighborhood health clinic in the school.

Healthy students are better learners. When students don’t feel well, it’s much harder to learn and pay attention in class. Not to mention days where students may be too ill to come to class at all, making it harder to catch up on materials.

School-based health centers aim to tackle this by offering an easy–to-access clinic where students don’t have to take time off to be seen by a provider.


According to data from the School-Based Health Alliance, school-based health centers:

  • Help students do better in school
  • Increase high school graduation rates
  • Decrease school discipline cases

How is a SBHC different from the school nurse’s office?

A SBHC is a fully-licensed primary care facility, providing a range of physical and mental health services, with limited dental services.  SBHC’s and school nurses work closely together, with school nurses able to refer students to the SBHC to resolve student health problems.

What services will CHAS Health at John R. Rogers -based health centeroffer?

This new clinic will be for students and school staff only, and will provide the following services:

• Primary medical care

• Answers to your health questions and concerns

• Treatment of common injuries and illnesses (allergies, rashes, sore throat, etc.)

• Counseling (help with emotional and social issues)

• Sports physicals

• Vaccinations, including flu shots

• Reproductive health services

• and much more

CHAS Health at John R. Rogers High School be staffed by Jeff Hayward, Family Practice Physician Assistant; Kristie Stolgitis, Pediatric Nurse Practitioner; Michelle Timmerman, Behavioral Health Proivder; Kelsey Kienbaum, Medical Assistant.  Johnnie Beans serves as the School Outreach Specialist, and is actively engaged in connecting with the students and staff.


Hours of operation will be Monday – Friday 7:30 am to 4:00 pm with both scheduled appointments and same day walk-in appointments available. 


School-based health centers often are operated as a partnership between the school and a community health organization, such as a community health center, hospital, or local health department. The specific services provided by school-based health centers vary based on community needs and resources as determined through collaborations between the community, the school district and the health care providers.

CHAS Health at John R. Rogers High School is made possible thanks to funding from Kaiser Permanente, in partnership with Spokane Public Schools.

For a more in-depth look at studies on school-based health centers:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3770486/

What you need to know about Juuling (and other electronic cigarettes)!

Juuling has quickly become very popular in our high schools, colleges, and even middle schools.  While electronic cigarettes were created to help people quit smoking, in young people they are actually becoming the introduction to tobacco use.  Here are some key things to know:

Safer does not equal safe.  Yes there are no studies linking e-cigarettes to cancer.  Just because e-cigarettes are safer than traditional cigarettes does not mean they are safe.  They still contain many chemicals that we know are airway irritants and carcinogens.  They contain nicotine.   We have no long term studies of the safety of e-cigarettes.

Nicotine is addictive. The Juul pods contain the same amount of nicotine as a pack of cigarettes.    Some e-cigarettes juice is even stronger.  Studies have shown e-cigarette fluid that claims to be nicotine free often contains nicotine.  We also know nicotine affects the developing brain leading to difficulties with attention, learning, impulse control, and mood.

Teens are the target of advertisement. Juul, the most common e-cigarette used among teenagers, began advertising on Youtube, Instagram, and Twitter.  There is a huge social media presence of Juul and Juul is starting to show up in TV shows and movies.  #doitforJuul is a common hashtag that people use to show them using a Juul.  This affects teens, even if they do not realize.

People vape a variety of substances. On youtube you can find videos of people using a variety of fluids including caffeine, alcohol, and Marijuana. Anytime someone is breathing in a substance, it is likely to irritate the airwyas.  There have even been cases of people dying after vaping synthetic cannabinoid.

Juul use is increasing tobacco use among teens. Starting in the 1990s there was a steady decline in tobacco use among teenagers, reaching as low as 12% of all teenagers ever using tobacco.  With the advent of Juul, as many as 35% of teenagers admit to using nicotine containing products.  Unfortunately, many of these Juul users go on to smoke traditional cigarettes.

Juul and other ecigarette companies create fruit flavored fluids that appeal to young users.  Juul can be easily concealed and has become a trend among high school students.  Our teens are getting addicted to nicotine and we must do our best to prevent this!

By Dr. Ashlee Mickelson

Parenting Through Puberty

I know when my oldest let me know about the changes, I wasn’t ready.  I had prepared my child with what to expect, gotten her some nice books about it that we read together. But, when the time arrived, I thought, “already?”

The changes of puberty are different for every child, but there are some points that help know what’s ahead, just around the corner.

Physical Changes

 

For girls, the changes of puberty start between 8 and 13 years old.  Usually the first sign is breast development.  It commonly takes about two years to get from there to the first menses, or period.  Along the way, development of pubertal hair and a growth spurt usually ensue as well.  When girls start menses, it can be irregular in the first year, but it tends to become more regular with time.

For boys, the changes of puberty start between 9 and 14 years of age.  This starts with genitals enlarging, followed by pubertal hair.  Then they will develop increased muscle mass and voice changes, with the start of these averaging at 13 ½ years old. The peak height for boys is usually reached by 17 years old, 2 years past that for girls.

Both girls and boys will have other changes as well, including hair growth, acne, and body odor.  If you have questions or concerns about whether your child’s patterns are normal, it’s important to ask your healthcare provider.

Emotional Changes

 

Along with the physical changes, there are many emotional changes with puberty as well. Adolescent youth begin to become more independent and less interested in having the attention of their parents.  Some will lose their temper more easily and have more mood swings.  It’s important to keep the conversation open with these changes, both physical and emotional.  Being positively and proactively involved in your child life, even when it’s not invited, helps them know you support them when they need it.

Puberty is Starting Earlier

 

Despite the normal ranges of puberty described above, the onset of puberty has gotten earlier over the years. The cause is unclear, but we know several factors can lead to an earlier start.  Trends from lifestyle factors include an earlier start for girls with more sugar intake (independent of weight), also an earlier start for girls with obesity.  There are differences in the start of puberty with different racial background as well, with puberty often occurring earlier in African-American children.


Booklist

 

Some books that may help open the conversation with you and your child include “The Care and Keeping of You: A Body Book for Girls” by Valerie Lee Schafer and “Guy Stuff: the Body Book” by Dr. Cara Natterson.  These are appropriate for kids 8 years old and up according to Common Sense Media, a website with recommendations on books and movies for kids that are age appropriate.


Are My Child’s Changes Normal?

 

If your girl starts showing signs of puberty before 8 years old or your boy before 9, it’s worth bringing up with your provider to discuss further.  Similarly, if your girl has not started these changes by the time she reaches 13 or your boy by 14, that’s a good reason to discuss as well. Your annual well-child visits are a great opportunity for providers to evaluate these development milestones and make sure things are on track. Please make sure to keep up-to-date on these important visits.

Entering into the next stage can be an intimidating phase for parents and kids alike, but it’s all about being there for your child in an open and honest way.

By Dr. Deborah Wiser, Chief Medical Officer