1. Spot the problem
2. Get the facts
3. Seek support

As a pregnant woman, you are likely receiving lots of advice about what to do, including what to eat. There is an overwhelming amount of information from friends, family, television, magazines, websites, and more. No wonder it can be a struggle to figure out what you should be eating for a healthy pregnancy. One common question is whether fish is safe to eat during pregnancy.

1. Spot the problem:

There is confusion about fish in pregnancy. Is it safe to eat fish while pregnant? How much, and what types of fish are recommended?

2. Get the facts:

Fish can be a healthy source of protein, fat, and omega-3 fats for mom and baby. Omega-3 fats such as EPA and DHA are important for the healthy development of baby’s brain, nerves and eyes. Pregnant women are recommended to eat two servings of low mercury fish per week. One serving of fish is about 75g (2.5 oz), ½ cup, or the size of the palm of your hand.

Pregnant women should choose low mercury fish such as basa, arctic char, herring, salmon, sardines, trout, or canned light tuna. Clams, mussels, scallops and shrimp are low in mercury too. Avoid large predator fish such as shark, marlin, pickerel, and tuna steak as they contain high mercury levels.

Some people also wonder if raw fish is safe in pregnancy. The main concern about raw fish is the risk of food-borne illness. Raw fish can be safe to eat in moderation as long as it is coming from a reputable source, stored and handled safely, and eaten within a few days. It is still important to choose a low mercury fish whether raw or cooked.

3. Seek support:

To learn more about mercury levels in fish, take a look at this information sheet from Toronto Public Health.

For more information about food-borne illness, read this statement from Motherisk.

To speak to a registered dietitian for trusted advice on nutrition, you can contact Eat Right Ontario at 1-877-510-510-2, or visit their website at eatrightontario.ca

Want more information about nutrition and pregnancy? Nutrition is one of the topics that will be covered at Sunnybrook’s Family Medicine Obstetrics Community Open House on Saturday, June 10. Learn more and register.

The post Eating right for two: Is it safe to eat fish while pregnant? appeared first on Your Health Matters.

1. Vegetarian fare

Consumers are becoming more aware that vegetarian proteins offer a lot of benefits for their health and the environment. Some of the healthiest diets we know of feature vegetarians proteins such as soy and legumes. These diets include those supported by the Canadian Diabetes Association such as the Mediterranean, DASH, and vegetarian diets. Try incorporating some meatless meals into your diet by replacing meat with legumes or soy.  For example, you can change regular tacos to a vegetarian version by using firm crumbled tofu instead of ground meat.

2. Leafy greens – and not just kale!

Move over kale, it is time to share the spotlight with all the other healthy leafy greens on the market. Leafy green vegetables are great sources of micronutrients such as vitamins A, E, K, folate, calcium, and magnesium, just to name a few. Think outside of kale, and consider swiss chard, collard greens, rapini, and bok choy for your next salads or stirfrys.

3. Purple food

Have you tried a purple potato? How about purple cauliflower? If not, you are not alone. These purple versions of popular vegetables are sprouting up in farms and supermarkets. We have long known about the power of purple. The colour purple indicates high levels of the anthocyanins, a group of healthy antioxidants that can be important for heart health, cancer prevention, and cognitive function. Add purple to your colourful plate to ensure a healthy and nutritious meal – think eggplants, cabbage, blueberries, plums, and maybe even try a new purple food.

The post Healthy food trends for 2017: a dietitian’s top picks appeared first on Your Health Matters.

There are many ways we might neglect lunch. Sometimes we work though lunch, postpone lunch, or skip it all together. Or perhaps we multitask our way through lunch, eating at the desk or on-the-go. Other times we just don’t give it the time or attention it deserves. So lunch becomes a quick bite – a coffee shop run, soup and crackers, or a slice of pizza.

Improving the quality of your lunch will not only help shape your daily nutrition intake, it can boost your energy and concentration for the rest of the work day. Lunch can even curb some of that evening hunger that creeps up when we fail to satisfy our earlier hunger.

Below are my top three tips for healthy eating at lunch time:

Enjoy a balanced meal for lunch

That’s right, balanced meals aren’t just for dinner! Keep the below plate model in mind when packing your lunch. Include some lean protein, lower glycemic index starch, and ensure half of your meal comes from vegetables. You may adjust portions according to your energy needs, or add a fruit/yogurt to finish off your lunch if you are still hungry.

How to portion your meals: 1/2 plate veggies, 1/4 plate lower glycemic index starch, 1/4 plate lean protein

Examples

Sandwich and vegetable salad

Veggies: Raw vegetable sticks such as carrots, cucumber, celery
Starch: 2 slices of whole grain bread
Lean protein: 1/2 can tuna

Bean & whole grain salad

Veggies: Mixed leafy greens with diced onion, peppers & herbs
Starch: 1/2 cup cooked quinoa
Lean protein: 3/4 cup chickpeas/lentils

Leftovers: Sweet potato, chicken, mixed vegetables

Veggies: Stirfry with eggplant, zucchini, snow peas, mushrooms
Starch: 1/2 sweet potato
Lean protein: 3oz skinless chicken breast

Take time for mindful eating

Start the process to a more mindful eating experience by allowing yourself space to savour your meal away from distractions. Sit at a table, turn away from the computers and cell phones, and take at least 20 minutes to enjoy your meal.

The Center for Mindful Eating describes mindful eating as:

• Allowing yourself to become aware of the positive and nurturing opportunities that are available through food selection and preparation by respecting your inner wisdom.
• Using all your senses in choosing to eat food that is both satisfying to you and nourishing to your body.
• Acknowledging responses to food (likes, dislikes or neutral) without judgment.
• Becoming aware of physical hunger and satiety cues to guide your decisions to begin and end eating.

Give yourself a break – think 80/20

The 80/20 rule is all about moderation. Trying to follow a healthy eating plan — or any plan — 100 per cent of the time is unrealistic. A very strict dietary regimen can also feel daunting, and make it easy to slip up. Instead, aim for balanced, mindful meals 80 per cent of the time. Give yourself permission for a 20 per cent buffer zone for those unexpectedly busy days, or for celebrating your colleague’s birthday with some cake.

Planning for some cake or chocolate once in a while can be a part of a well-balanced diet. Food is primarily meant to nourish our bodies, yet it can be a source of fun and pleasure too. We can make room for an occasional small treat while maintaining an 80/20 balance between healthy nourishment of our bodies and joy in eating.

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1.     Pulses are incredibly nutritious.

Pulses have been referred to as a “superfood” for many reasons.  They are an excellent source of protein, making it a suitable replacement for meat in vegetarian and vegan meals.  Unlike most proteins, they are also rich in fibre.  One-half cup of pulses provides 7-17g of dietary fibre, a nutrient that most Canadians are lacking (fibre requirements are 25-38g per day).  In addition, pulses are a good source of B vitamins, iron, potassium, magnesium, and zinc.

2.     Pulses are quick to prepare and affordable.

In our fast-paced society, what can be more appealing than a fast, yet healthy meal?  Dried pulses can be soaked overnight and ready to eat the next day.  Canned pulses just need to be drained of the liquid and rinsed under the tap to reduce the sodium content.  And if that doesn’t have you convinced, maybe its price will.  Given the rising food prices, using pulses in place of meat could help reduce your grocery bills.  Enjoy them as a part of your soup, salad, humus, falafel, dahl, chili, burrito, and more!

3.     Pulses are key foods in healthy diets.

Thanks to its high fibre and protein content, low fat, and low glycemic index, pulses have been scientifically proven to be beneficial for our health.  Pulses are featured in some of the best evidence-based dietary patterns including the DASH, Mediterranean, low glycemic index, and vegetarian diets.  In these diets, pulses are usually included at least 2-3 times per week.  These diets can help prevent and manage cholesterol, blood pressure, metabolic syndrome, and diabetes.

4.     Pulses keep our soil fertile and healthy.

Pulses are the edible dried seeds from the pods of legume plants.  These plants are natural nitrogen fixers, meaning they take nitrogen from the air and replace them in our soil.  Many are concerned about the quality of our soil as it can affect the nutritional quality of our food. Less fertile soil also requires more use of nitrogen fertilizers to grow our crops.

5.     Pulses contribute to a sustainable world.

Sustainability and climate change are hot topics and will continue to challenge each and every one of us if we choose to ignore it.  Pulses play an integral role in supporting environmental and social sustainability.  It requires less non-renewable resources such as water to grow, and has a smaller carbon footprint compared to other proteins such as meat which helps to reduce greenhouse gas emissions.  Choosing pulses over meat more often also supports food security for more people.  Over 8% of Canadians are food insecure, meaning they do not have access to the healthy, accessible foods they need.

The post March is Nutrition Month: Celebrate with pulses! appeared first on Your Health Matters.

But there’s a downside to these types of lofty resolutions — they simply don’t work. These goals are often drastic, and leave little room for compromise. They are often all-or-nothing plans that set people up for failure, and once you fall off the wagon so to speak, you can’t help but feel discouraged.

This year, I propose we scrap the New Year’s resolution mentality. Instead of making a brand-spanking new plan that calls for a major change, how about we try small changes? Baby steps?

When we create all-or-nothing plans to change our diets, here is what usually happens. Evelyn Tribole, a dietitian and expert in intuitive eating describes this see-saw:

As we start our new diet plans, we create some sort of deprivation — cutting out sweets, caffeine, alcohol, sugars, carbohydrates, fats, or [insert any new trendy diet]. The more we stick to the deprivation, the better we feel about ourselves for following the rules. Eventually though, we break that rule, because life happens. Maybe you didn’t have much choice at a restaurant, at your friend’s house, or you just craved that food. And so the deprivation side falls, and you no longer feel good, but instead that feeling is replaced with guilt. When the guilt rises high enough, we deal with it by getting back on the deprivation side again. And so the see-saw continues up and down.

So how do we stop the see-saw? Get off of it all together? We need to get rid of this idea of deprivation. Banish the all-or-nothing thinking style. Without deprivation, we will also reduce the guilt associated with eating. Instead of setting major diet plans that require cutting something out, start making small changes that you can likely actually sustain for the long term. In other words, set yourself up for success, not for failure.

Try creating a SMART goal instead.

Specific

Measurable

Actionable

Realistic

Timely

Specific

When creating your SMART goal, ask yourself What will I do? When will I do it? How often? The more detail that goes into your plan, the more likely it is you will follow through.

Measurable

Choose an action plan that is measurable, it will be a way to track your success. For example, if you are planning to increase your fruit intake, instead of planning to eat “more,” plan to have 2 fruits each day.

Actionable

The best goals are ones based on actions, not results. All too often, people set goals to feel better, or to lose weight. These are examples of results. Think about what you want to do, and what behaviour you will change in order to achieve the desired results.

Realistic

In order to set ourselves up for success, it is important to be realistic in what you do. If you have not exercised in a long time, now is not the time to start training for a 10k. Start with increasing your physical activity in a way that will be achievable and enjoyable, like adding a walk at lunch, or taking a dance class.

Timely

Having an end point in mind can be motivating. Set your goal within a short period of time so you can look back and reflect on how you did. You can take that opportunity to evaluate if the goal was easy and you can continue it, or if it was too challenging and you may need to revise your next SMART goal.

Compare these goals:

“I will try to get more sleep this year.”

“I will be in bed by 11:00pm 3 nights per week for the next month.”

The first statement is vague and not measurable. The second statement is specific, measurable, action-oriented, realistic, and can be re-evaluated after one month. You can use a journal or calendar to track the days you have completed your goal. Telling somebody else about your goal, or writing it down can even further increase your commitment.

Above all, your SMART goal should be something you want to do. Find something you are truly motivated to do, and you will be more successful. Extrinsic motivation does not go very far. There have been research studies that tried motivating people to exercise by paying them. It worked only for the short term, but if you truly did not enjoy the exercise, you would not likely continue. We all crave personal growth and good health, and setting SMART goals has been proven to be more effective that making a drastic change cold turkey.

Dr. Mike Evans has a great video about New Year’s resolutions. People who make them tend to be more ready for change, and end up more successful at maintaining their change after six months. He also recommends making small changes at a time. Remember, building a healthier lifestyle is like a marathon, not a sprint. You are in it for the long run, so choose behaviours that are enjoyable and sustainable.

Check out the video by Dr. Mike Evans:

Happy New Year!

The post Doing away with the New Year’s “resolution” appeared first on Your Health Matters.

The last update to Canada’s Food Guide was in 2007. One of the most notable changes was that the Vegetables & Fruits group replaced the Grain Products group, to take the top spot in our diet. It currently represents the largest arc of the food guide rainbow, which means that vegetables and fruit should represent the majority of what we eat. I often encounter people who do not realize this, and are not getting enough vegetables in their diet. The Food Guide was also lengthened to be a six page document, with extra nutrition tips for children, women of childbearing age, and men and women over 50 years of age. There is even a small section on physical activity and label reading.

One of the most talked about proposed changes to Canada’s Food Guide is to remove juice as an example of a serving of fruit. The current recommendations suggest the consumption of 7-10 servings of vegetables and fruits per day for adults, with examples such as ½ cup cooked vegetable, 1 cup raw vegetables, ½ cup fruit, or ½ cup juice. Those in favour of removing juice claim that it is an unhealthy beverage, and that we should be aiming to eat whole fruits instead. Those who defend the current food guide agree that juice is not the healthiest choice, but it is included as an option to help meet fruit intake. What do I think? I agree that juice should be removed from the Food Guide. Juice is a source of free sugars that can raise blood sugars, triglycerides (a blood fat), and contribute to dental caries. It displaces much healthier whole foods we could be eating, and perhaps worst of all, it wears a health halo – giving the false illusion that it is a health food. While it could be an option in some people’s diets, and if consumed infrequently in small amounts it can be a part of a healthy diet, I do not think it belongs in our national food guide as an example of what to eat.

If I could have my way, I would make a few more changes to Canada’s Food Guide. Here are a few points to consider:

• Separate vegetables and fruits into two distinct categories
• Move potatoes and corn to a Grains/Starch food group, instead of keeping in the Vegetables and Fruit group
• Increase the recommended number of servings in the Meat and Alternative group
• Place more emphasis on leafy greens, whole grains, and meat alternatives
• Encourage Canadians to steer away from processed, refined foods, and choose more unprocessed whole foods
• Offer recommendations around healthy options and portions for fats and oils

Perhaps the biggest complaint about Canada’s Food Guide is that it is complicated. Its table of recommended servings per food group requires using arithmetic to understand. It encourages Canadians to count, weigh, and measure food servings – not a realistic, sustainable, or enjoyable way to eat. It does not depict what a healthy meal or day would look like. In other words, it does not describe how to enjoy food.

The revised version of Canada’s Food Guide would do well to take some pointers from other eating guidelines such as the Dietary Guidelines for the Brazilian Population. In Brazil, the guidelines focus on how to enjoy eating food as a healthy way of life, rather than how to count servings and nutrients. Here are some examples of their recommendations:

1. Make natural or minimally processed foods the basis of your diet.
2. Use oils, fats, salt, and sugar in small amounts when seasoning and cooking.
3. Limit consumption of processed foods.
4. Plan your time to make food and eating important in your life.
5. Be wary of food advertising and marketing.

Eating should not be so complicated. Eating should be about enjoying the pleasure of food, in good company, in a healthy way.  Unfortunately, our society has placed a lot of attention on eating nutrients – getting the right vitamins, enough protein, less fat, counting calories, and counting servings. I do not envy the task of the committee who has to put together a national food guide.  There is so much to say about food and nutrition, yet sometimes the best strategy is to KISS – Keep It Simple…Seriously!

To speak with a Registered Dietitian at the Sunnybrook Academic Family Health Team, call 416-480-6100 ext. 61658.  To speak with a diabetes dietitian, call 416-480-4805, or click here to learn more.

The post Eating well with Canada’s Food Guide: my two cents appeared first on Your Health Matters.

Soy protein has been shown to help lower LDL (lousy) cholesterol, yet a lot of people are not sure how to incorporate it into their diets. To lower cholesterol, aim for 25g of soy protein each day. Even if you are not looking to lower cholesterol, soy is high in protein and isoflavones, and is recommended as a part of a healthy diet.

Here are examples of food sources of soy protein:

Give this recipe a try to start incorporating some soy into your diet!

Tofu Stirfry

Serves 3

Ingredients:

• 3 tsp olive oil
• 1 package extra firm tofu (397g), rinsed and patted dry with paper towel, and cubed
• 1 onion, chopped
• 1 clove garlic, minced
• 1 bell pepper, chopped
• ½ package mushrooms (75g), chopped
• ¼ cup water
• 1 tbsp low sodium soy sauce
• 1 tsp sesame oil
• 1 scallion, chopped
• ¼ cup cashews
• Black pepper, to taste

Directions:

1. In a non-stick pan, sauté tofu in 2 tsp oil over medium-high heat until golden brown, and set aside.
2. Over medium heat, sauté the onion, garlic, and vegetables (except scallion) in the remaining olive oil.  Add water and cook until vegetables have softened.
3. Return the tofu to the pan, and stir in soy sauce and sesame oil.
4. Add scallion, cashews, and black pepper.  Cook for 2 more minutes.

For a healthy and balanced meal, enjoy with leafy greens and brown rice!

Nutrition Information (per serving):

268 kcal, 18g fat, 19g protein, 19g carbohydrate, 5g fibre, 195mg sodium, 335mg calcium, 9mg iron

Click here if you are interested in attending our next Healthy Heart, Healthy You group education session with a registered dietitian.

To connect with a registered dietitian, patients of the Sunnybrook Academic Family Health Team should ask their family doctor for a referral. If you have prediabetes or diabetes, you may call SUNDEC at 416-480-4805.

The post Add soy protein to your diet to help lower cholesterol appeared first on Your Health Matters.

Medical Nutrition Therapy and Diabetes

Medical nutrition therapy provided by a registered dietitian can lower your blood sugars (HbA1C) by 1-2%.  One of the tools recommended by the most recent 2013 Canadian Diabetes Association guidelines is using the glycemic index. Glycemic index, also known as GI, measures how quickly a carbohydrate food raises your blood sugar levels. The GI is measured on a scale up to 100. The higher the number, the faster it raises your blood sugars. Choosing low GI foods can therefore help people manage their blood sugar levels.

Fun fact: The glycemic index has a Toronto connection – it is based on the research of Dr. D. Jenkins and colleagues from the University of Toronto!

Here are some examples of high and low GI foods. Try replacing one of your high GI foods with a low one to improve your meal.

Oats are one of our favourite low GI foods, but it is the slow cooking type that is low GI.  Instant oats are often packed with sugars, and may still raise your blood sugars quickly since they score higher in the glycemic index.

Here is a new way to prepare your oats – no cooking required!

Overnight Oats  

Serves 1

Ingredients: 

• ½ cup rolled oats
• 1 cup milk* and/or yogurt
• Toppings** (optional)

Directions:

1. Combine ½ cup oats and 1 cup of milk into a bowl.
2. Cover bowl and refrigerate overnight.
3. Add desired toppings.  Serve cold, or reheat for a warm bowl of oatmeal.

*You can use any variety of milk/alternative such as soy, almond, etc.

**Ideas for toppings: berries, apples, peaches, banana, sunflower seeds, hemp seeds, chia seeds, slivered almonds, walnuts, dried dates, peanut butter, cinnamon, etc.

To connect with a registered dietitian, patients of the Sunnybrook Academic Family Health Team should ask their family doctor for a referral. If you have prediabetes or diabetes, you may call SUNDEC at 416-480-4805.

The post Foods that help manage blood sugar levels appeared first on Your Health Matters.

Prepared by The Food Institute at the University of Guelph 12/02/2014

Meat, fish/seafood, and vegetables will be the main contributors to the price hikes at the supermarkets.  While meat prices are not expected to increase as much as last year, the trend towards flexitarian diets and responsible proteins will likely continue.  Flexitarians are those who follow a mostly meat-free diet, similar to vegetarians, but less rigid.  Flexitarians replace most of their meats with vegetarian alternatives, such as legumes, soy, nuts and seeds, eggs, and dairy.  Reducing meat intake would not only help to lower food costs, but it also supports animal welfare, and environmental sustainability.  Another movement that is expected to continue is the trend towards “responsible protein.”  This is leading consumers toward supporting programs that promote healthy and humane treatment of livestock, and sustainable fishing practices.

Eating less meat may actually help stabilize costs of vegetables in the future.  The report pointed to climate change as the main cause for increasing vegetables prices.  The meat industry contributes an incredible amount of greenhouse gases to our atmosphere, even more than the emissions from our total transportation system.  Since one of the greatest contributors to climate change is the meat industry, eating less meat can actually help our crop production, and the environment.

As the rise in food prices will surpass that of inflation in 2015, Canadians may have to pay more attention to their food budgeting.  On average, less than 10% of the Canadian household budget is dedicated to food costs.  Food, especially healthy food, is often a discretionary item that gets compromised to pay other essential bills, such as rent.

So, in preparation for the new year, consider these tips to help with food budgeting.

• Check the flyers. Fruits and vegetables that are on sale usually mean they are also in season. For example, look for peaches in the summer, apples in the fall, and squash in the winter.
• Consider frozen fruits and vegetables. Frozen produce are just as nutritious as their fresh counterparts, and they are quick to prepare.
• Choose local food when possible. Choosing local foods often means spending less on costs of transportation and packaging. Not only will this reduce your ecological footprint, it will support the Canadian economy.
• Reduce your meat intake. Choosing smaller portions of meats, or vegetarian proteins is not only a healthy choice for most Canadians, but it will also help save some money and fight climate change all at the same time.

Click here to read the full University of Guelph’s Food Institute Food Report 2015

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