Setting an Example: Eating Well

Posted on August 5, 2012 by marylbrandt

At some point all physicians give advice to their patients about dietary changes to improve health. Let’s be honest. We don’t do so well ourselves. The “classic” fare of residency (donuts or muffins for breakfast, pizza for lunch, and some fast food on the way home) doesn’t really give you much credibility when you are talking to patients.

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No medical student or resident is going to be able to eat perfectly, exercise regularly, and do all the other things that lead to a healthier lifestyle. But every little change you make now will pay off. You’ll feel better and have more energy. You’ll be less likely to gain weight. And – you’ll be able to talk to patients – with specific examples – about what they can do to improve their own health.

In the crazy busy life of medical school and residency, it’s hard, if not impossible, to spend time and energy to shop, cook and eat really well. It doesn’t get much better once you start your practice. What is possible, no matter how busy you are, is to realize that there are some simple things you can do to improve what you are doing now.

My top 10 tips for better eating in medical school and residency

1. Eat fruits or vegetables with every meal or snack. This may mean buying a bag of apples once a week and just eating apples twice a day (boring but effective). Even better, follow the “USDA plate” recommendation – ½ fruit and vegetable, 1/4 protein 1/4 grain/complex carb on every plate of food you eat.

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2. Eat breakfast. If you are up too early to really eat, make a smoothie the night before to put on the blender when you wake up and take it with you in the car. My personal favorite: ½ cup plain Greek yogurt, ½-1 cup of fruit, ¼ cup egg whites (pasteurized, in a carton), 1-2 Tblsp honey.

3. Eat more eggs (especially egg whites). Eggs have gotten a bad rap, but they are very cheap and very easy to cook. Cook hard boiled eggs on the weekend to eat for breakfast or snacks during the week. Make omelets or huevos ranchero for dinner. Go ahead and spend a little more to get cage-free eggs to do the right thing.

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4. Don’t skip meals. Even on the worst call day you can keep a meal replacement bar or two in your pocket.

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5. Pack the food you need for call days the night before so it’s ready to go in the morning.

6. Chop up a bunch of veggies on the weekend to throw in salads, soups or in wraps.

7. Cook or buy one good meal on the weekend that will last for part of the week. A good stew or soup? Lasagna? Look for good recipes on the web. If you really don’t want to cook, find a healthy caterer or restaurant to buy it instead.

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8. Take a good sandwich to work for one or more meals. Peanut butter on whole wheat may be monotonous, but a) it doesn’t have to be refrigerated and b) it beats McDonald’s.

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9. Free pizza isn’t really free. It’s incredibly high calorie and the ingredients in the cheap kind aren’t good for you. (Same for take out Chinese, donuts, muffins, etc)

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10. Skip the liquid calories. Cokes may give you an energy boost, but you are better off with real calories from a piece of fruit, a sandwich and some coffee or tea. (but learn how to use caffeine effectively)

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Fast, Easy Recipes: The Gracious Pantry

Posted on August 21, 2011 by marylbrandt

The Gracious Pantry is written by a full time student who “creates simple, clean eating recipes with everyday ingredients.” The recipes are healthy, simple and beat eating fast food when you are on call. This website has a lot of delicious looking, healthy recipes that meet the “pizza rule” for medical students and residents (i.e. recipes that take less time to prepare than it takes to order a pizza).

Butternut Squash Soup with Coconut Milk and Cilantro

Southwest Breakfast Muffins

Weeknight Spaghetti

What To Do This Summer

Posted on May 22, 2011 by marylbrandt

This week approximately 16,000 US medical students are going to receive their diplomas and become physicians. There are also about 16,000 college graduates who will start medical school later this summer or early in the fall. Congratulations to you all!

Nearly all of you have a well-deserved month (or two) to rest and get ready for the next step in your training. So, I thought it might be helpful to pass on a few words of advice on how to spend your time this summer.

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Do NOT study!

If you are starting your residency and you think it might help relieve your (normal) anxiety, here is what to do: Buy one of the major textbooks and use it to get excited about what you are going to learn. If you want to, plan how you are going to study for the year. Skim the book if you really have to do something to feel less anxious, but don’t spend hours studying.
If you are getting ready to start medical school – step away from the books! Seriously, there is nothing you can do that will make it any easier, so just enjoy your time off!

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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

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Develop (or strengthen) an exercise habit

Use this summer to develop a daily exercise routine that you can take into your new (and crazy) schedule. 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 should be at least 30 minutes of cardio 4-5 times/week, 2-3 strength training sessions/week and stretching every day. If you develop a balanced exercise routine this summer, it will be much, much easier to continue this once you start medical school or your internship. Commit to doing at least 30 minutes of exercise a day this summer.
Running is one of the best (and most convenient) cardio exercises for medical students and residents (because it’s cheap, efficient and effective) Use this summer to become a runner. If you hate running, find another good cardio exercise habit to develop instead – but pick one!
If you don’t own a bicycle, think about getting one that you can use to commute to school or the hospital.

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If you don’t know how to cook, learn.

Unless you want to gain a lot of weight, have poor energy and feel bad, you are really going to have to cook for yourself (or at least plan for good food cooked by someone else). You won’t be able to eat what you need, particularly as an intern, unless you bring the food with you.
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 near you and sign up. Many high end grocery stores and gourmet stores offer classes for beginners – look on line for classes near you.

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Easy, Fast Recipes: Stone Soup

Posted on May 8, 2011 by marylbrandt

I found another great recipe site to share – Stone Soup. Jules Clancey, who developed her blog to share recipes, also runs a cooking school and has authored an ecookbook. The site has a great collection of recipes with only 5 ingredients – and that are usually well within the parameters of the “pizza rule”.

Zucchini “surprise” pasta

Chickpea and Rosemary Fritatta

Simple Salmon Kedgeree

Super moist carrot cake

Healthy Habit: Eat Breakfast Every Day

Posted on April 30, 2011 by marylbrandt

One of my New Year’s resolutions was to come up with monthly “resolutions” for myself and for anyone who follows this blog. Cooking Light magazine (which is one of my favorite sources of recipes and ideas for healthy living) had the same idea, so I am shamelessly borrowing their healthy habits!

Cooking Light’s 12 Healthy Habits

It’s a lot easier to commit to 30 days of a new habit than a full year. So this month’s goal is to eat breakfast everyday.

Granola with Yogurt & Berries from zestycook.com

Most residents and medical students start their day early. At 5 am, no one wants to eat a big breakfast. But, you really should eat something as you are heading out the door. By 9 or 10 am, you’ll be hungry – and the muffins in the surgeon’s lounge (or breakfast at MacDonald’s) will be calling out your name. You have to have a strategy to manage this rise and fall in insulin (and accompanying “starvation”). If you don’t, you’ll end up eating nothing but fast food (and the box it comes in).

Physicians in practice and training should probably make a commitment to eat two breakfasts, not just one – an early breakfast to literally “break the fast” from the night before and a second breakfast in the mid morning. (aka “Elevenses”)

A good breakfast should give you a balance of protein and carbohydrate, with a little fat. Here’s a list of suggestions for breakfast that provide the right mix of nutrients and are easy (fast) to prepare:

Cold cereal with milk
Yogurt with cereal and fruit
Oatmeal or other whole grains with milk +/- toppings
Leftovers from last night’s dinner
Frozen waffles or toast (whole grain is better) with peanut butter
Bagel or toast with cream cheese and salmon
Rice (or other grains) with eggs
Energy bars
Sandwiches
Egg mugs
Smoothies
Breakfast tacos (see below)
Scrambled eggs (plus whatever you want) in a tortilla
Healthy fast food
Homemade muffins or breakfast bars (make a batch on the weekend)
Hardboiled eggs and fruit

Healthy breakfast sandwich from foodnetwork.com

MLBs Breakfast Tacos

These breakfast tacos are my “go to” breakfast for hectic mornings. I make them on the weekend in a big batch to freeze for the week

Buy 10-12 whole wheat tortillas, 1 can of fat free refried beans, 1 bag of reduced fat shredded Mexican cheese. (if calories aren’t an issue for you, use regular refried beans and shredded cheese)

Spread all the tortillas out on the counter and divide everything up between them.

Add whatever else you want:

cooked chicken or turkey (grilled in the deli is best)
Sausage (regular or veggie)
Corn
Rice
Bell peppers or Roasted red peppers (from a jar)
Fresh or canned green chiles

Put the tacos in the freezer in individual freezer bag . Put the individual bags in a big freezer bag if you want to further limit freezer burn.

2 minutes out of the freezer and into the microwave = breakfast.

Breakfast taco from cleananddelicious.com

Other links to ideas for fast, healthy breakfasts

Why You Should Eat Breakfast from wellnessrounds.org

Healthy breakfast: Quick, flexible options to grab at home from mayoclinic.com

10 Quick, Healthy Breakfast Options from thedailygreen.com

10 Tasty, Easy and Healthy Breakfast Ideas from zenhabits.com

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 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 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

Healthy Sandwiches

Posted on July 8, 2010 by marylbrandt

Making a healthy sandwich for lunch is a great way to insure that you don’t eat the leftover pizza from last night’s call team. A really good sandwich which balances protein and carbs is also a great way to get through a long call night. Keeping your energy up when you are up all night on call is difficult but there are tricks to maintain energy for call. The most important way to have good energy on call is to eat good quality food every 3-4 hours. Sandwiches are great for call because they are so easy to make, easy to store and easy to put in a pocket to eat on the go.

Pick good ingredients whenever you can. It’s worth paying a little more to have food that is just food (and not a lot of fillers, corn syrup, transfats, etc). Make sure you get high quality bread – 100% whole wheat is best, but if you really don’t like whole wheat, at least try to get as much whole grain in the bread as you can. Whenever possible, add veggies to add nutritional value.

Peanut butter sandwiches have the advantage of not needing refrigeration. You can keep them in your white coat pocket if you want to (an advantage on a busy day). You can stay traditional (i.e. peanut butter and jelly), or up the nutritional content by adding banana (or other fruit) or with other unusual combinations.

Egg salad sandwiches are great in the middle of the night when you are on call. 101cookbooks.com egg salad recipe is a pretty classic recipe which is really wonderful. If you want to up the protein and decrease the fat leave out some or al of the egg yolks and use lowfat mayonnaise. There are other options for traditional egg salad recipes, too

Tuna or chicken salad sandwiches can be made with classic recipes, or less traditional ingredients that up the nutritional content such as spicy tuna salad, or other unique tuna salad recipes.

Lean meat (chicken, ham, pork, beef) makes a great, high protein sandwich. Add cheese, tomatoes, spinach, shredded carrots or other veggies to increase the nutritional value. If you are watching your weight use low-fat cheese and avoid mayonnaise. If you use hummus or avocado instead of mayonnaise or other spreads you’ll also make the sandwich more nutritious.

Here are a few other sites to help you be creative with your sandwich ideas:

Healthy Sandwich Recipes & Tips

Love Your Lunch: 10 Healthy Sandwich Recipes

Good Nutrition is in the Bag: Healthy Sandwich Alternatives

Farmer’s Markets

Posted on May 22, 2010 by marylbrandt

I just got back from my weekly (when I’m not on call) trip to the farmer’s market. I’m going to try to convince you why buying food at a farmer’s market should be a regular habit for any medical student or resident (although I think it applies to everyone else, too).

What the heck is a farmer’s market?

In general, farmer’s markets are open air markets where local farmers bring their food to sell. They usually take place once a week (often on Saturdays). If you want to know more about farmer’s markets, check out the website of Urban Harvest, which is responsible for the market I go to in Houston.

How do I find out where they are?

The best way is to search the internet for your city. Local harvest is a web site that covers most farmer’s markets, but there may be smaller (and possibly more convenient) markets in your city that aren’t listed here: http://www.localharvest.org/farmers-markets/

If it doesn’t look like there is a farmer’s market near you, another option is to buy a share in a CSA (Community Supported Agriculture). If you buy into a CSA you will pick up a fairly large quantity (usually a good sized box) of whatever is being grown at the time – usually once a week. If you can find a group of friends to split this with, its a great option http://www.localharvest.org/csa/

What should I do to look cool if I’ve never been to a farmer’s market before?

Bring your own bags. This isn’t an absolute requirement, but it’s much cooler than relying on the vendors. They often have small paper or plastic bags, but it will be easier if you bring your own. In the big picture, you should do this no matter where you shop (good environmental karma!). Fortunately, the “give away” bags at medical meetings are perfect for this! A lot of grocery stores sell reusable shopping bags or you can find them on the internet.

Bring cash. Some vendors may take credit cards but don’t count on it.

Does it cost more?

Yes (but not a lot more). But don’t let that stop you! Value isn’t always measured by money – even if you are poor student or resident. It’s not going to be a lot more and it’s completely worth it. (see below)

If it costs more and it takes more time, why should I bother?

The food absolutely and unequivocally tastes better. The first time I bought potatoes at a farmer’s market was a revelation for me. I knew that tomatoes and peaches would be better, but I had no idea that a potato would be in the same category. The produce you buy at a farmer’s market was in the ground (usually) less than 24 hours ago. It is incredible how much better it tastes!

The food is probably better for you. Most farmer’s markets sell organic or near organic food. There’s good data that organic plants are higher in many nutrients and it’s intuitively obvious that avoiding pesticide residues on your food should be beneficial.

You’ll eat with the seasons. There are no data that this is better for you, but it really makes sense. If nothing else, it will taste better and you’ll be helping the environment by not eating things that traveled thousands of miles to get to you.

You’ll get to know the people growing your food. This sounds trivial, but it’s really cool. You can ask them about how they grow the food, and you’ll hear stories about what’s happening on their farms. One of my favorite vendors, Blue Heron Farm, pictures brings pictures (usually baby goats) which she also shares on Twitter and Facebook. There is also something intangible (but cool) in knowing that someone (not just a big corporation) cares enough to grow your food.

The farmer’s market is a once a week “sanity break”. You are outside, surrounded by beautiful food and happy people. At the market I usually go to, there is always some live music, too. It’s a great experience and, combined with the fact that you are doing something healthy for yourself, it’s a once a week mood changer!