It’s not often I share a single recipe, but this one is so delicious, so healthy and so easy that it warrants a separate post.
Although the recipe as written has spinach filling, you can use other fillings. Just to give you a few ideas…
- Sausage (regular or vegetarian), bottled red peppers, cheddar cheese
- Canned artichoke hearts with parmesan cheese
- Ham with Swiss cheese
- Fresh tomatoes, mozzarella and basil
- Any leftover veggies and/or meat in your refrigerator
This “quiche” makes a great dinner, but can also be put in your bag for breakfast or lunch for a busy day or call night. Quiche freezes well, so you can make several, freeze them and have breakfast/lunch/dinner for days!
It’s hard for those that haven’t been there to understand how medical school, residency and/or long hours in the hospital changes what and how we eat. There isn’t time to sit down to eat, there aren’t good choices and often, the only thing to eat is the “free” food at conferences. But…. Free food isn’t free. There’s a reason it’s cheap (poor ingredients) and that it “tastes good” (lots of fat, sugar and salt)… but it makes us feel terrible after we eat it. (Beware the middle of the night french fries!) More importantly, we aren’t providing the nutrients we need to take care of other people and ourselves. So, what’s the answer?
Spend the money and the time to invest in your health! Grabbing donuts or bagels in the surgeons’ lounge in the morning, pizza at noon-day conference and a hamburger at MacDonald’s in the middle of the night is terrible. (You know it’s true).
So what’s the alternative? Here’s a five-step, easy plan that will let you eat better, feel better and avoid gaining weight in medical school and residency. This is predicated on cooking your own food but you can use this plan if you don’t cook by buying prepackaged foods. But really…. If you can learn how to take out a gallbladder or care for ill patients in the ICU don’t you think you can learn how to sauté a few vegetables???
- Make a plan
- Make a shopping list
- Shop once for the week and (when you can) prep ahead
- Use your day(s) off to cook things that might take a bit more time and freeze some for other days
- Keep a few “instant” healthy meals in your pantry
Make a plan
Map out your week’s meals and snacks using the “pizza rule” (nothing you cook should take longer to cook than it takes to order a pizza). Pay special attention to call days. It’s important to have really delicious food which can be grabbed in a minute when you are on call. I use Evernote to make my list for the week so I can share it with my family:
If you like to cook, you probably already know where to find recipes you’ll like. If you don’t cook regularly, I post recipes on @drmlb with #CallFood that meet the “pizza rule” and would be delicious on call. Here are few other sites I use regularly: Eating Well, Cooking LIght, My Recipes, Food Network, Kayln’s Kitchen, Skinny Taste. If you use Evernote to organize your list, it gives you one other advantage – you can download their add-on and clip recipes from the internet directly to Evernote. Each “note” (i.e. recipe) in Evernote can then be shared with whoever you cook with (i.e. whoever gets home first can start dinner!). It also lets you search all your notes so you can easily find your recipes in the future.
Make a shopping list
I use Grocery IQ for my shopping list. This app lets you organize your grocery list by the aisles in your favorite stores to make shopping faster. It also allows you to share the list with your significant other which means that whoever is able to get to the store first has the updated shopping list! I don’t really use the “coupon” feature or the barcode scanner, but if you choose to use these functions, please use the FoodEducate app with it to make sure your choices are healthy!
Shop once and (when you can) prep ahead
Planning lets you spend less time in the grocery store and absolutely means less food wasted. When you get home from the store think about the meals you are going to cook later in the week. If your carrot soup on Tuesday calls for sliced carrots, diced fennel and chopped onions, chop them when you get back from the store on Sunday and put your “mise en place” in baggies or containers in the refrigerator. Cooking is not that time consuming…. but prepping is!
One other good trick is to make “mirepoix” on the weekend for the week. Diced onions, carrots, celery, bell peppers, etc can be prepped and put in a bag. It can be an instant stir-fry on nights when you need something fast. You can also put a handful in soups, omelettes, or wraps to get extra vegetables in your day. Mix it with leftover rice or other grains to make an instant salad (you can add tuna, if you want, too).
Use your day(s) off to cook things that might take a bit more time and freeze some for other days.
You need good “comfort food” when you are working hard, but it can be both comforting and healthy. For example, this recipe for spaghetti squash lasagna. The preparation for this recipe isn’t that hard (you can steam the spaghetti squash in the microwave instead of roasting it in the oven, for example) but it’s a little too long for nights when you get home late and are really tired.
Learning to use a pressure cooker (my favorite) or a slow cooker like a crock pot is a great way to cook up a batch of something when you are home and doing other things without spending a large amount of time in the kitchen
No matter what you make or how you make it, make enough to freeze individual portions and then store them so they will stay fresh. Don’t forget to mark the containers with a Sharpie and eat them within 3-4 months!
Keep a few “instant” healthy meals in your pantry
Despite my best efforts to plan, there are weeks when I’ve miscalculated amounts, don’t have enough time or just don’t want to eat what I had planned. When that happens, it’s great to have a go-to “instant” meal, which usually comes out of the freezer and pantry. Here are some to get your list started!
Moroccan Lentil Stew – (particulary good with harissa and served over couscous)
The senior class ends their formal education at Baylor with a capstone course called “APEX”. In addition to reviewing critical medical information, communication skills and other important aspects of becoming an intern, there are also wonderful lectures from faculty on “how to be an intern”.
One of the APEX speakers this year was Dr. Sally Raty, who stressed how important it was to take time to care for yourself.. but that you had to look for efficient ways to do it! She promised to share recipes that are easy and take very little time to cook. I’ll share the rest of the recipes on future posts… but here is the first one (which she adapted from this recipe).
These bars have a ton of ingredients, but they are easy to find, and this bar is way better for you than those processed, chemical blobs you’re spending $2+ on. I keep all of the dry ingredients for these bars in a basket in my pantry. I just pull the basket out and make the bars. The crumbs are amazing on vanilla ice cream….not that I would ever do that, but I’ve heard it is good.
3 cups raw oats (nothing fancy. Quaker 3 minute (not instant) oats are fine)
1/2 cup whole sesame seeds, or shelled sunflower seeds
1/2 cup shredded coconut (unsweetened is best, but sweetened is easier to find)
1 teaspoon ground cinnamon
1 teaspoon salt
1/4 cup brown sugar
1 cup vanilla Greek yogurt
1/4 cup + 2 tablespoons pure maple syrup or honey
1 cup peanut or almond butter
1 teaspoon vanilla extract
1/4 cup coconut oil, liquefied if solid (or just use canola oil)
1/2 cup chopped chocolate chips (> or = 70% cacao is best)
1/2 cup chopped nuts (almonds, walnuts or pecans)
1/2 cup chopped dates, raisins, figs or other dried fruit–optional (I don’t typically add these)
1 cup vanilla or chocolate whey protein powder– Garden of Life Raw Protein is a good one and is available at Whole Foods Market
½ cup egg whites (or add a 3rd egg)
Heat oven to 350F. Spray an 11 X 7 inch glass baking dish with nonstick stuff. Throw everything in a big bowl. Mix well with your hands. Place in the baking dish, press into the pan to eliminate bubbles and try to get it level. Cook for about 20-25 minutes. Let cool completely to room temp. Refrigerate for a few hours before cutting into bars. Cut into about 48 bars. Refrigerate the cut bars.
“Downside, I skipped lunch and it is still in the work fridge. Upside, I don’t have to pack a lunch tomorrow!” – tweet from an intern on her first day
It’s hard to eat well when you are crazy busy taking care of patients. Doctors really do know about nutrition, and we know we should set a good example. So why do we eat so poorly at work? I can’t do better than the list of reasons from this post:
1. The ”I don’t know when I’ll get to eat again” Phenomenon
2. The “Graham Crackers and Peanut Butter” Phenomenon
3. The “It’s free, therefore I must eat it” Phenomenon.
4. The “I’m so tired I have to eat something to stay awake” Phenomenon
5. The “I’m on call so I deserve a giant cookie” Phenomenon
Why it’s important to make conscious choices about what you eat at work
1. You actually hurt your patients if you don’t eat well.
Physicians that don’t eat at work have slower simple and complex reaction times. You don’t think as clearly or respond as quickly. Start thinking about your own nutrition as a part of good patient care.
2. If you are like most people, not eating at work will result in gaining weight.
Even if you don’t gain weight, you will likely have a detrimental change in your body composition. (i.e. you’ll get flabby)
3. Not eating at work will result in losing weight for some people.
For some people stress leads to appetite loss. These are the residents that aren’t hungry even though they are not eating enough. The message here is that your weight during residency is a decent barometer of your stress level and how well you are coping. If you are losing or gaining, notice it early and adjust how you are eating, working out and coping with the stress of your job.
There’s no question that the best option is to plan, prepare and bring your own food to work. Even though it takes time to do this, you’ll save time in the hospital by knowing what you have and where it is. (A good point made in the article “Strategies Resident-Physicians Use to Manage Sleep Loss and Fatigue” which you can download from http://med-ed-online.net/index.php/meo/article/download/4376/4558). Food choices in the hospital are limited, often poor, and not always available. Make time on the weekends to plan for the upcoming week and shop for good food. If you can, choose one healthy recipe to cook on your day off and make enough that you have plenty of meals in the refrigerator for when you get home.
- Eat at least every 6 hours. It’s probably better if you eat smaller amounts every 3-4 hours. Eat even if you are “not hungry” if it’s been 4-6 hours since your last meal.
- Make sure you are getting plenty of protein. Eating simple carbohydrates makes you less alert and creates bigger swings of insulin levels.
- Don’t drink your calories. (But do drink enough water)
- The processed comfort foods that appear like magic in hospitals (doughnuts, pizza, etc) seem delicious when you eat them, but are terrible for you.
- Plan, plan, plan. It’s worth it.
- Eat fruits and/or vegetables with every meal.
- Bring good food from home. If you don’t cook, buy good food to bring.
- Make sure you have “pocket food” in your pocket at all times. (Food that fits in your pocket and doesn’t need refrigeration.) You may not be able to stop for a real meal, but you’ll be able to eat something.
Examples of “pocket foods”
- Kind bars. Many meal replacement bars might as well be candy bars when you look at the ingredients. Clif, Larabar, and Odwalla are all good choices. Kind bars have no added sugar, a fair amount of protein and are made of only real food.
- Peanut butter and jelly sandwich. (Whole wheat bread, fruit spread, peanut butter without transfats)
- Cabot 50% cheese or string cheese (higher protein, lower fat than most cheese)
- Edamame (shelled is easier)
- Homemade Trail mix – mix different nuts and dried fruits together and put in snack bags
- Baked or steamed sweet potatoes with a little salt
It’s 2am on call. All of a sudden you are starving, not to mention craving comfort food. The only thing available is MacDonald’s or (on rare occasions) the leftover pizza from the noon conference. It’s a problem. Eating that kind of food at 2am will almost certainly result in food coma, not to mention that you really know it’s not healithy or what you would recommend for your patients.
Here’s the answer.
Start by chopping up the veggies you want to put in the tacos. My “go to” is one red bell pepper and a poblano pepper. Corn and rice work well, too. You can change the taste by using different cheese and different veggies (broccoli, carrots etc with Monterrey Jack, for example).
Buy the cheese you want already shredded. Lowfat Mexican is my usual choice, but any cheese is fine. I’ll often cut up a block of 50% Cabot cheddar cheese which is a great tasting low calorie cheese.
Put 10 whole wheat tortillas on the counter and divide one can of refried beans between them. Use nonfat if you are watching calories. Black beans, pinto beans, spicy or not – your choice!
Divide up your veggies and cheese onto the 10 tacos.
Roll them up and put them in snack size plastic bags.
Put the little bags in a gallon freezer bag (important to prevent the bad taste of freezer burn) and put them in the freezer. They last for weeks.
Two minutes in the microwave directly from the freezer gives you a great breakfast, snack, or middle of the night comfort food!
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.
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.
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.
4. Don’t skip meals. Even on the worst call day you can keep a meal replacement bar or two in your pocket.
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.
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.
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)
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)
I’m always looking for good websites for recipes that are healthy, simple and easy to make. In other words, the kind of food that makes it easy to avoid eating fast food when you are on call. Kalyn’s Kitchen is a fabulous website for delicious, healthy, and often low calorie 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). She also really goes out of her way to teach each step in the recipe, so if you are new in the kitchen, this is a fabulous website for you!
It’s summer and it’s hot. I’m on call this weekend. That combination made me think about cold comfort food I could take to work.
Chocolate (in any form) is always the answer… but I decided maybe I could find something a little more healthy (and a little less caloric) that could serve as the “treat” we all crave when we are working hard on call. I’m thinking the team will like a little Salpicon mid afternoon tomorrow…
This soup looks delicious, but with the heavy cream probably isn’t in the “low calorie” list. You can substitute milk or yogurt to cut calories (without too much sacrifice of taste). But, then again, as an on-call treat this still beats McDonald’s! This is just one example of cold soups – which are great for summer on-call days.
Smoothies are great comfort food – but logistically not easy when you are on call. If you love smoothies, you might want to invest in an inexpensive single-serve blender. Take the fruit in a baggie, put some yogurt and ice cubes in… instant smoothie. Alternatively, you can blend your smoothie at home and put it in a container in the refrigerator that you can shake up before drinking.
I’m beginning to think that Clementines are the perfect winter food item for busy people. They are very portable, easy to peel and usually seedless, which makes them very easy to eat. They are small, so they can fit in a white coat pocket. Two or three make a great fruit portion so you can feel righteous in your good food choices. They are really sweet, too, so eating them feels like a real treat. You can buy them by the pound in some stores, but more commonly they come in a box.
Clementines are hesperidiums (a subset of citrus fruit). They are a small type of mandarin orange. (the same as you get in the cans). They are more perishable than oranges, so keep them in the refrigerator crisper drawer.
“The origin of clementines is shrouded in mystery. Some attribute their discovery to father Clement, a monk in Algeria, who tending his mandarin garden in the orphanage of Misserghim, found a natural mutation. He nurtured the fruit tree and subsequently called it “clementino”. Others, like Japanese botanist Tanaka, believe that clementines must have originated in Asia and found their way through human migration to the Mediterranean. Whatever their origin, the fact is that clementines found their natural climate and soil in Spain, where they developed their particular aroma, sweetness and taste. Commercial production of clementines began in Spain in 1925. Today there are 161,000 acres dedicated to the cultivation of clementines.” (From producepete.com)
Here are some other recipes, some easy (within the “pizza rule” and others that take a little more effort – good for cooking on a day off.
Chicken Paillards with Clementine Salsa – Paillard just means a flattened out chicken breast – you can use this salsa on plain chicken breasts or fish if you prefer. You can use clementine gremolata (another kind of salsa) on chicken or fish, too.