Clean Eating

Posted on December 30, 2010 by marylbrandt

If you want to lose weight, or just to eat “better” you might want to consider looking into the concept of “clean eating”.

Although eating clean works to lose weight, it’s not really a “diet” in the usual sense of the word. Clean eating is a lifestyle and way of eating that is medically very sound. It’s getting rid of the junk food, eating often enough to maintain your energy and “shopping the periphery” of the grocery store. (Think about it – the food being sold on the periphery of the grocery store is mostly non-processed.)

Everyone has had the (horrible) experience during a call day of not eating anything all day, having a big meal in the evening (often McDonald’s or an equivalent) and then being brain-dead from lethargy for 2-3 hours. In addition to helping you control your weight (and preventing weight gain during medical school and residency), “eating clean” will prevent the on-call lethargy you get from eating junk food and can give you sustained energy during long work days.

In a nutshell, here are the “rules” for eating clean (Revised from lists published on ehow.com and cleaneatingonline.com)

How to Eat Clean

1. Eat 5-6 small meals a day: breakfast, lunch, dinner and 2-3 snacks – and don’t skip meals! This means taking a cooler with you to work and/or having choices like meal replacement bars in your pocket. It’s important to eat every 3-4 hours to keep your insulin levels (and energy levels) from waxing and waning too much. It’s really important to never skip breakfast!

2. Eat a serving of complex carbohydrates at every meal (about the size of your fist). Grains should be unprocessed as much as possible (more fiber = more satiety) like brown rice or quinoa .

3. Minimize or (preferably) completely eliminate processed food, soft drinks and alcohol.

4. Eat fruits and/or vegetables at every meal.

5. Eat a serving (about the size of your palm) of lean meat, chicken or fish at (almost) every meal. Vegetarian options are fine, too (beans, tofu, etc).

6. Read labels. Try to avoid foods with white flour, sugar and sugar substitutes, saturated fats and trans-fats.

7. Take good snacks (like premeasured servings of nuts) with you to work so you don’t get tempted by vending machines and breakroom junk food.

8. Don’t beat yourself up if you cheat – in fact, you’ll probably need to have a cheat day (on purpose) every once in a while. But recognize it’s a cheat day and not a permanent change from your new way of eating.

9. Keep things interesting by checking out recipes and cooking for yourself. You can subscribe to Clean Eating Magazine or at least pick up an issue to check it out. The Diet Rebels Cookbook: Eating Clean and Green, Clean Food: A Seasonal Guide to Eating Close to the Source with More Than 200 Recipes for a Healthy and Sustainable You and Tosca Reno’s Eat Clean Cookbook: Delicious Recipes That Will Burn Fat and Re-Shape Your Body! are cookbooks with good recipes for clean eating. Here’s some websites with recipes, too: cleaneatingonline, eatcleandiet, cleaneatingmag

Easy Fast Recipes: The Six O’Clock Scramble

Posted on December 2, 2010 by marylbrandt

One of the keys to eating well as a resident is to plan your meals. I’ve posted before about how to cook for yourself in medical school and residency (i.e. how to plan) but came across a site this morning I thought I should share. The Six O’Clock Scramble is a service you can subscribe to that sends you recipes (with shopping lists) for the week. Most importantly, the recipes follow my “pizza rule” i.e. they take less time to cook than it takes to order a pizza. You can customize it for vegetarian or other specific diet needs and also for the number of meals you want in the week.

For those of you that “don’t cook” – here’s a FAQ from the Website:

I am not a very good cook and I actually hate cooking! How can the Scramble® help someone like me?

Scramble® recipes are designed to be EASY with all instructions clearly spelled out and few, simple ingredients. Most importantly, the Scramble® takes the stress out of planning for meals by designing a week’s worth of balanced menus complete with healthy sides.

I have used this site myself in the past – the recipes are good and they are easy! They also come with complete nutritional information, so if you are trying to control calories, limit fat or increase protein, you will have the information. This service is a good compromise for students and residents that want to plan their meals, but don’t have the time.

The main reason I am posting this today is I came across a deal to subscribe at a discount if you do this before December 25^th: http://www.snack-girl.com/snack/healthy-dinner-recipes-six-oclock-scramble/ This would also make a great holiday gift for a busy medical student or resident!

Writing an “Exercise Prescription”

Posted on November 20, 2010 by marylbrandt

According to exercise physiologist Michael Hewitt, PhD, health can be viewed as a four-legged stool. The four legs are physical activity, optimal nutrition, stress management and sleep. If any one of them is missing, the stool will wobble. If two are missing, it will fall. For practicing physicians and trainees, sleep is often the hardest of the four to manage. Stress is next – it is part of our job, but can be reduced with with meditation and exercise. Paying attention to what you eat (especially on call) and cooking your own food will help improve your nutrition. The fourth “leg” may be the most important (and most neglected) aspect of physician health – physical activity.

It doesn’t matter how healthy (or not) you are – if you add more physical activity to your week you will improve your health. We all learn this in medical school – exercise helps prevent and treat a wide variety of chronic diseases like diabetes, hypertension, myocardial ischemia, arthritis… the list goes on and on. Exercise is medicine! The message is clear, we should be increasing our own physical activity and “prescribing” activity for our patients.

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Dr. Hewitt suggests that it’s not that hard to write an actual prescription for exercise. First, decide what “dose” is needed – disease prevention, basic health level, enhanced fitness level, or performance level and then – literally – write a prescription that includes each of the 5 components of exercise.

Here is what the prescriptions would look like (below). You can actually write them on prescription pads for your patients. (Don’t forget to write one for yourself… this is a really good exception to the rule that we shouldn’t write prescriptions for ourselves or our families.)

Disease Prevention

Cardiovascular Exercise: Accumulate 30-60 minutes of physical activity most days

Strength Training: Include weight-bearing activity most days

Flexibility: Maintain range of motion by bending and stretching in daily activities

Body Composition: Men <25% body fat, Women <38% body fat

Balance and Agility:

Basic Health Level

Cardiovascular Exercise: Play or large muscle repetitive activity 20+ minutes 3 times a week

Strength Training: Leg press or squat,chest press, lat pull down or row 1-2 sets 2x/week with enough weight to challenge your muscles

Flexibility: 2-4 limitation-specific stretches after activity, hold 20-30 seconds

Body Composition: Men <25% body fat, Women <38% body fat

Balance and Agility: “Act like a child” – balance line, “step on a crack”, brush teeth standing on one foot

Enhanced Fitness Level

Cardiovascular Exercise: Play or aerobic activity 40-60+minutes 4-6 times per week

Strength Training: Balanced whole-body machine or free weight program, 2-3 sets, 3x/week to “functional failure”

Flexibility: 6-10+ whole-body stretches after activity, 1-2 reps

Body Composition: Men: 12-20% body fat, Women 20-30% body fat

Balance and Agility: Recreational sports: tennis, bicycle, tai chi, dancing, stability ball training

Performance Level

Cardiovascular Exercise: Add interval training and/or competition

Strength Training: Add muscle endurance or power training, add pilates work, add ascending or descending pyramids

Felixibility: Add yoga, pilates, facilitated stretching with a partner

Body Composition: Men 8-15% body fat, Women 17-25% body fat

Balance and Agility: High level sports: ski, skate, surf, yoga, martial arts

Other resources:

How to Write an Exercise Prescription – Uniformed Services University of Health Sciences

Measuring body fat (caliper and tape measure calculators)

Easy Fast Recipes: Cheap, Healthy, Good

Posted on October 17, 2010 by marylbrandt

Medical students and residents don’t have a lot of money to spend on food. I was happy to find a new site for easy and healthy recipes that also addressed the cost of the food. Cheap, Healthy, Good is a website maintained by Kristen Swensson Sturt and some guest writers. They describe their recipes as “mostly simple, delicious dishes made of whole foods. And love. But mostly whole foods.” There are a lot of recipes that meet my “pizza rule” (i.e. <30 minute rule) and would be great for busy students, residents and practicing docs.

Baked Eggplant with MushroomTomato Sauce

Pasta Puttanesca

Make Your Day Better Lentil Soup

Easy Fast Recipes – The Blue Jean Gourmet

Posted on September 28, 2010 by marylbrandt

I was recently introduced to The Blue Jean Gourmet by a resident on our rotation. The site’s byline is “Unfussy food from a fun-loving kitchen”. I thought it would be a great addition to the “pizza rule” list. For those that aren’t familiar with my “pizza rule”, it refers to any recipe that can be made in less time than it takes to order a pizza.

Cooking for yourself as a medical student, resident or practicing physician is key to eating well. Let’s be honest, there aren’t good choices in most hospitals and clinics. If you want to feel well you have to eat well… and that means making the effort to cook for yourself!

Green Bean Lentil Salad

Tomato Bread Pudding

Grilled Halloumi

Recipes for Medical Students and Residents

Posted on August 12, 2010 by marylbrandt

I love when I find new websites that provide great “pizza rule” recipes (recipes that take less time to prepare than it takes to order a pizza). I just discovered Keep Your Diet Real, a site run by Corrine E. Fischer, MS, RD, LDN. She’s not only a dietician, but she’s a professional food photographer, so the site is beautiful. Her recipes are healthy, straight-forward and are great for the busy life of docs, medical students and residents.

Ten Healthy Breakfasts in Ten Minutes or Less Spring Roll Soup Wheatberry and Edamame Salad

Recipes for Medical Students and Residents

Posted on July 28, 2010 by marylbrandt

In keeping with the “pizza rule” (everything we cook needs to take less time than it takes to order a pizza) and the hot weather…. Here’s some new recipes from a site I just discovered www.danispies.com.

Some of you don’t cook or, put more positively, are learning how to cook. Dani Spies not only has fabulous, healthy and easy recipes but has also posted “Cooking 101” videos like this one called Egg 101. These are a great resource if you are trying to learn the basics.

Here’s three recipes that meet the “pizza rule” and will make great dinners or on call lunches.

Chunky Greek Salad Topped with Sardines

Clean and Simple Asparagus Pasta

So, so Simple Shrimp Tacos

Salads

Posted on July 13, 2010 by marylbrandt

For medical students in basic sciences, a salad can be a great “energy” lunch that lets you stay alert in class. For students on rotations and residents, a fresh salad is a great lunch and an even better middle of the night meal when you are on call.

The concept couldn’t be easier – put lettuce, spinach, or the greens of your choice in a big container. Top with protein, cheese, veggies, nuts and/or fruit. If you don’t care what it looks like, it’s also really easy to dump it all in a big zip-lock bag. When it’s time to eat, pour the salad dressing in the bag with the salad, shake, and then serve yourself from the bag.

Protein: Beans from a can, beans you make yourself with a crockpot or pressure cooker (which saves money and avoid excess salt and additives), canned tuna, cooked chicken from the deli, prepackaged meats (look at the labels to make sure you aren’t getting a lot of additives you don’t want), shrimp, etc.

Cheese: Shredded cheddar, Monterey jack or Mexican cheese (reduced fat or regular), feta, goat cheese, thin slices of parmesan

Veggies: Any leftover in your refrigerator! Another good idea for this is to buy what you need for a mirepoix when you do your once a week shopping. A mirepoix is the basis of French cooking and is one part onions, one part carrots, and one part celery. The Cajun trinity is similar but substitutes green bell pepper for the carrots. If you buy the ingredients for a mirepox (or trinity) and chop it up on the weekend, you can use handfuls in salads, omelets, soups, etc all week. (You can add other things, too, like mushrooms, red bell pepper, etc – anything that can be eaten raw). If its a really busy week and you don’t have time to chop up vegetables, you can used canned green beans, corn, beets… whatever vegetables you like.

Nuts and/or fruits: Adding some dried fruits and nuts, sunflower seeds, etc, will add some extra nutrition. Fresh fruits like blueberries, strawberries, sliced peaches are delicious in salads. Canned fruits, especially mandarin oranges, are good, too.

Salad dressing. Don’t put the dressing on the salad until you are ready to eat. (The French say it “cooks” the salad… but the result in any language is soggy salad.) My favorite dressing is a homemade vinaigrette. Start with vinegar (red wine, white wine, sherry or balsalmic), a clove of diced (not crushed) garlic, a healthy teaspoon of good Dijon style mustard, salt and pepper. Stir these all together until the salt is dissolved and the mustard is blended with the vinegar. Add olive oil while you are stirring (or shake it up at the end.) The classic ratio is 1 part vinegar to 2 parts oil, but you can add less oil to taste. I usually squeeze a little lemon juice in, too.

The easiest thing by far is bottled salad dressings. Be careful about calories (if you are watching your weight). If you take salads to work regularly, you may want to leave the bottle there (unless the food snatchers raid your refrigerator on a regular basis).

http://allrecipes.com/Recipes/Salad/Green-Salads/Top.aspx

http://hubpages.com/hub/Favorite-Salad-Toppings-Lessons-From-Restaurant-Salad-Bars

http://www.fitsugar.com/Nutritional-Information-Salad-Toppings-7598444

Starting Medical School – What To Do This Summer

Posted on May 23, 2010 by marylbrandt

I’ve had several new college graduates ask me what they should do this summer to prepare for medical school. It’s easy – don’t worry about it! There is no studying or preparation that will improve how you do. Seriously, you’ve been accepted and you will do fine. I know you are anxious, but I can absolutely guarantee you don’t need to study anything to get ready! That being said, I do have some advice about what to do this summer:

Take a vacation (or two or three…).

Visit family and friends – take a road trip and connect with people you haven’t seen in a while
Hang out on a beach, go for some great hikes, read some great novels
Sleep late, eat well, and just rest

Develop (or strengthen) an exercise habit.

Use this summer to develop a daily exercise routine that you can take into your busy medical school life. Overall, your goal for the summer should be to develop a balanced exercise program (cardio, strength training and flexibility). If you’ve never done any strength training, hire a trainer and learn about it. Your goal during medical school should be at least 30 minutes of cardio 4-5 times/week, 2-3 strength training sessions (that cover all the major muscle groups) and stretching everyday. If you develop a balanced exercise routine this summer, it will be much, much easier to continue this once you start medical school.
Commit to doing at least 30 minutes of exercise a day this summer. Running is by far the best cardio exercise for medical students. Use this summer to become a runner. http://wellnessrounds.org/why-you-should-run-and-how-to-get-started/

If you don’t know how to cook, learn.

Learn some basic skills to cook simple things. If you have good cooks in your family, have them teach you.
If you don’t have family members who can teach you, find cooking classes on the internet. Here’s a site I found that links to cooking classes across the country. http://www.localcookingclass.com/
Many high end grocery stores offer simple classes. For example: http://www.centralmarket.com/Cooking-School.aspx , http://www.williams-sonoma.com/customer-service/store-events.html , http://www.wholefoodsmarket.com/stores/cookingclasses.php

Pressure Cookers

Posted on May 4, 2010 by marylbrandt

You may have read the title and thought this might be about work and stress… but, no, it’s not about the pressure cooker at work, it’s about cooking!

If you are trying to save time cooking (which is an essential part of cooking as a student or resident) you should really think about buying a pressure cooker. This is a foreign cooking appliance to most people, but it is an incredible time saver. Do not listen to your mother/grandmother/aunt who says they blow up… they don’t! I use mine more or less weekly to make garbanzo beans. Buy dry garbanzo beans (which are really cheap), soak them for 4-8 hours and cook them with a little spice (or not) for 12 minutes on the second ring. (You can skip the soaking and cook for about 15 minutes instead) They make a great snack (instead of peanuts) right out of the refrigerator. Another really good use for pressure cookers is to make stock. When you peel carrots, cut the ends off onions, etc just throw the pieces into a bag in the freezer. Ditto for leftover bones and bits from fish, chicken, beef (if you want a meat stock). When the bag is full, put the frozen bits in the pressure cooker with water and cook for 20-25 minutes. This saves a lot of money and tastes tons better than store bought stock/broth.

Here’s a list of other things you can cook in a pressure cooker

A whole chicken in 15 minutes
Beans (from dried) in 5-10 minutes
Artichokes in 10 minutes
Potatoes in 5-10 minutes

Although the classic pressure cooker is still an amazing and wonderful kitchen tool, it has been a little eclipsed recently by the Instant-Pot. This is now top of my list for gifts for medical students and residents. It is a combination pressure cooker, rice cooker, slow cooker….and more.

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