RD Q&A (vol. 32)

Allegra: Thank you so much for sharing your story. I’ve recently been through a dramatic weight loss of 30 lbs after going to see a nutritionist and I feel great. Everyone asks what my secret is, and it’s really just eating healthier and exercising! (Which is, of course, what we’ve all heard all along and never actually tried!) My question is about relating to people. When I first changed my diet, I was shocked at how unsupportive my friends were. When looking at a menu at a bar one time, a friend tried to cajole me into splitting an order of nachos with her. When I said that I was just going to order a salad, she rolled her eyes and said “oh come on – just do it,” and tried to tempt me. I told her that I had gone to see a nutritionist so I was now trying to eat healthier and she got annoyed. I understand that she was looking for a “partner in crime” for her poor eating habit, but it made me feel guilty for making her feel bad about her choice. I really dislike people that get preachy about food, and I don’t ever want to be one of those people or have people think that I feel superior about my eating choices. How would you suggest dealing with situations like this? I still want to be able to go out to bars and partake socially in activities, but I don’t want my diet to suffer.

Prevention RD: Ah, what a wonderful question and a huge congrats on your weight loss!! Rest assured, you’re not alone in this — it is a very common problem…so common that research has actually been performed on this very topic. Women, when they are together with other women, eat more. When a man is added to a group, regardless of feelings towards a man (stranger, lover, acquaintance…whatever), women all eat less. Willpower is a very hard thing to instill in other people — you have it or you don’t. The other curious thing about willpower is that it ebbs and flows. This is why weight loss and weight gain tend to fall hand-in-hand. The truth is, your friend is jealous. We all know what the “right” thing is to do when eating out, or at the very least how to make healthier choices. Yet, few people do so. I’m not a psychologist and I certainly won’t pretend to be, but your ability to make a choice that is getting you results stirs up feelings in your friend because she isn’t able or willing to do the same at that point in time. I am with you about not wanting to be preachy about food and choices, and when I don’t make the best choices, I prefer not to have the commentary myself. If your friend is not respectful of your choices, go with the route of “this is what I’m craving” or maybe even tell a white lie of, “I had a late lunch” or “I’m just not that hungry”. You shouldn’t have to justify your menu selection to your company so do what you feel most comfortable with. In the end, you have to do what’s best for you and a true friend would want that for you…hopefully she’s just working through some issues of her own and will come around. :)

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Sharon: What are your thoughts on the Paleo Diet? I have several friends who are on this diet. I ahve several friends on low-carb diets. I am really tired of people blaming wheat/carbs for weight issues. Aren’t whole grains good for you?

Prevention RD: Sharon, what a great question and I know, without a doubt, some other readers have this very same question. I’m fairly “inside the box” when it comes to nutrition, but I know that we have to think “outside the box” when technology has nutrition has changes as much as it has. Wheat has changed a lot through the years — from the growing to the harvesting to the processing, but I still firmly believe that whole grains not only play a vital role in good nutrition, but are also critical to balanced diet. Whole grains supply B-vitamins, folate, and loads of fiber. Perhaps an organic variety would be preferred due to the changes in wheat, but to blame wheat for the obesity epidemic is absurd, in my humble opinion (though I heard recently that Dr. Oz said quite the opposite — *eye roll*). As for the various diets out there, I truly believe that there is more than one way to skin a cat when it comes to good nutrition. That said, the one diet I refuse to even entertain as healthy is a low-carb diet. Simply put, if you are eating the recommended 5-9 servings of fruits and vegetables daily, you are not following a “low carbohydrate” diet (that is assuming 2-3 pieces of fruit and at least 1 starchy vegetable — you’re looking at 70-90 grams of carbohydrate from fruit and vegetable alone). The DRI for adults is 130 grams of carbohydrate daily and so long as that minimum is being met, I’m open to recognizing a lower-carbohydrate diet as healthy. That said, exercise should be a part of a healthy lifestyle, and additional carbohydrates are necessary to support the nutritional demands of exercise. The Paleo Diet wouldn’t be my pick either (here’s another Q&A post on this topic). Cutting out entire food groups always raises red flags. I hope that helps!

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Lena: My mom is regularly taking her blood sugar but can’t seem to figure out what triggers high numbers in the morning. She can have some smarties before bed and have a low blood sugar or she won’t have any snack and it’s high in the morning. Any insight on how your evening eating habits affect tomorrow morning’s blood sugar levels?

Prevention RD: Hi Lena :) Tell mama not to fret — she should be having a snack before bed, ideally, within an hour of bed time. That snack should contain 15-30 grams of carbohydrate with about 1 ounce of protein (I like to recommend toast and peanut butter, cottage cheese and fruit, cheese and crackers, apple and cheese, trail mix, etc.). Diabetes is very confusing and it is frustrating in that it is a “darned if you do (eat too much) and darned if you don’t (eat enough)” situation. Diabetes is a hormonal disease and over night, hormones do funny things. Plus, we all store a lot of sugar (glycogen) in our muscle and liver that can be released during fasts. High morning glucose levels are very common — encourage her to adopt the habit of a snack before bed that includes the above criteria. Almost every time (assuming the treatment regimen is appropriate), this snack resolves those high morning numbers. :)

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Tonya: I’ve got one for my fellow dietitians. This is a patient so I will be fairly vague. Elderly (60+) hospice patient with COPD and 85% of his gut removed. This includes about 30% of his colon — he does not have a colostomy. He has severe nausea and vomiting with meals. He refuses a DNR. A J-tube is what we are thinking with an elemental formula. Thoughts/suggestions?

Prevention RD: Hi Tonya, my dear Oklahoma dietitian friend! I love this question because it perfectly showcases all that RD’s are able to do. I agree with your approach 100%, despite it being invasive and expensive. To walk through the scenario, the patient clearly has will to live and live well, so measures should be taken to preserve his strength and improve his recovery process. Sixty is the new 40, right?Many people don’t realize that nutrition and COPD alone can be reason for concern. Many people who struggle with shortness of breath struggle to eat. A satisfied stomach can decrease lung capacity and smaller, frequent meals can be offered. Furthermore, chewing/swallowing can be difficult while short of breath and so many COPD patients lack appetite as it is. The colon is responsible for fluid removal and is the organ that solidifies stool for removal. Without a colon, malnutrition and diarrhea are common struggles. For this reason, in addition to the fact that the patient lacks any substantial amount of small intestine whose main function is absorption of nutrients, an elemental tube feed formula would alleviate the need for the gut to breakdown food components to derive their nutrients (elemental tube feedings contain readily available glucose, amino acids, and medium chain triglycerides versus polysaccharides, proteins, and fats that require breakdown into their “elements” before being absorbed into the bloodstream). The tube placement in the jejunum versus the stomach (which the patient may or may not have) or duodenum (the first portion of the small intestine) decreases the risk of nausea and vomiting. You could try a standard tube feed before going elemental to rule that out as an option. I only say that because elementals are SO expensive. My hunch is that an elemental will be the end result, however. A high-fiber, lower carbohydrate formula may help reduce diarrhea and CO2 levels. Great question – thank you…can’t wait to hear what others think as I certainly do not specialize in GI!

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TGIF! This week has been crazy busy….I’m ready for some R&R over the holidays! After work, it’s on to holiday baking :)

Be well,

RD Q&A

My house is starting to feel like a home. Mr. Prevention worked all day yesterday and I managed to unpack 60-70% of the boxes on my own. Here’s some shots of the…mayhem.

Before…
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During…

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 Let’s get on with the Q&A…just looking at those pictures is making me exhausted and stressed!

Cheryl: While at the health food store picking up some Satiereal Saffron Extract (Dr. Oz’s suggestion for natural appetite suppressant), I asked the owner if there was anything to supplement thyroid medication.  She suggested cold pressed, extra-virgin, coconut oil, 1 tsp 3x per day.  Told me that it helps with memory, cholesterol, weight loss, and some other things.  My concern is the calories.  She said when it is taken as a supplement, calories aren’t counted because it contains MLTs(?).  Is this true?  The label said 1 tsp is 125 calories.  She has customer’s that take it for energy and other benefits that have also lost weight.

Prevention RD: Hi Ceryl! :) I think she’s referring to medium-chain trigycerides (MCT’s) which is the main type of fat in coconut oil and why it is being touted as a “healthier” oil. While MCT’s are metabolized differently (check out this post for more info on that), the calories very much so still “count”. In fact, in a clinical setting, some patients are given MCT’s for quick energy (calories) and to assist in weight GAIN. Three teaspoons (1 tablespoon) is typically 120 calories. Certainly people can lose weight any number of ways – it all boils down to calories. As for the calories not “counting” – false! :)

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Nicole O.: Please explain the difference between and allergy and an intolerance. I have been having issues with this because I believe an allergy can be detected with a blood test, correct? But, what about an intolerance? Would an allergy have more severe reactions and an intolerance may not? Is an allergy inherited and an intolerance may just upset the system? Help! with the “gluten intolerance” craze sweeping the nation, I need to know. Also, some people with a lactose intolerance can tolerate soft serve or yogurt, but not ice cream…and so on…

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Gina, RD: I’d love to hear your opinion about; What is “too little” calories? And when do you go in “starvation” mode? I have an answer I like to give, but I’d love to hear your thoughts and what you’ve read. So many people seem to think that even if they are overweight they can eat too few calories and then they will burn muscle…I’d love to hear your thoughts.

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Heather of Southern Pink Lemonade: Could you describe the benefits/differences of palm/coconut sugar vs. white granulated sugar?

Prevention RD: Coconut sugar is getting famous for its low(er) glycemic index, meaning the energy (calories) are absorbed more slowly and the body does not see the quick spike in blood sugar that it may from other sugars (this spike can cause anything from fatigue to hunger). While this sounds positive, the glycemic index (GI) is not a very well-respected measurement for nutrition. What I love about coocnut sugar is that it has 1/3 less calories (30 calories/tablespoon vs. cane sugar’s 45 calories) and 7 grams of sugar per tablespoon vs. cane sugar’s 12 grams. In short, it’s lower carbohydrate. That said, recipes may call for more to offer up adequate “sweetness” and the reduced sugar content is then irrelevant. Coconut sugar is VERY expensive and in my very limited experience, does not “act” like sugar in baking. In short, it may offer a nutritional edge, but the cost, availability, and benefit may not make it worth the c0mmotion.

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Chrissy of Stick a Fork in It: What are your thoughts on flax seed, and what is the best form to consume it (whole, ground or oil)?

Prevention RD: I’m glad you asked! Whole flaxseed are NOT digested and therefore, no nutritional benefit is gained. Flaxseeds must be ground or their oil extracted to yield the nutrition. Flaxseed oil is expensive, so I usually opt for the ground seeds, but both are nutrition powerhouses and packed with omega 3 fatty acids. I love to use flaxseed oil in salad dressings and is there anything better than a warm flaxseed muffin with some dried fruit? Yum!

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That’s it for today. As always, please feel free to pass along your questions on the Prevention RD Facebook page, as a comment below, or via email at preventionrd at gmail dot com! Thanks for all the great questions! :-D

I have to run up to the hospital for my TB test and then it’s on to unpacking some  more. The family comes tomorrow…gotta be ready!

Thanks for all the birthday wishes. Love you all to pieces! xo!

Be well,

Whole Wheat Cinnamon-Raisin Swirl Bread + Weekly Menu

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Yesterday morning, I rolled out of bed at 7:15 am.

I turned on the coffee maker, fed the dog, and did my usual morning routine. When I went upstairs to get dressed at 8:30, Mr. Prevention decided at that point that he would get out of bed and run the 5K race with me.

Five minutes later we were out the door, with Lily in tow. Mr. Prevention had no water, coffee, or breakfast. Hopefully, he paused to brush his teeth.

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I’m convinced it was my breakfast that had me run half-way decent yesterday morning. I had the last 2 slices of this stunning Whole Wheat Cinnamon-Raisin Swirl Bread. Toasted, with a smear of Melt. And a latte. And water. Some people PREPARE for racing. Others just decide to run and place 8th overall (let’s note now that I am referencing Mr. Prevention).

We registered, met up with Donna and Layla, and tucked Lily away in the car parked under a shade tree with a peanut butter-stuffed bone.

I must have lost track of time because before I knew it the gun had fired and the clock had started. My MapMyRun app wasn’t recording and Pandora didn’t appreciate the sub-par signal out in the country. I walked the first 20 seconds to figure out my technology and began my run. At which point, I had a wardrobe malfunction. My capris kept falling down (due to being old and lacking elasticity, sadly…not because of weight loss) and I had to keep pulling them up.

cinnamonraisinbread5The race was an out and back and I didn’t glance at my pace until the 1.5 mile mark. At which point I saw I was on track for a sub-30 finish. I saw Mr. Prevention right around this point and he was officially on the “back” leg of the “out and back” course. He looked good and stopped to give me a funny face. I told him to catch up with the 2 grade school-aged boys who were a few strides ahead of him. I told him his legs are longer, he should get’em. ;)

For a mid-March morning, the sun’s heat was brutal on the black asphalt and I wished it was just a few degrees cooler. Around 2.3 miles, I started to struggle and until I rounded the corner for the final 0.1, it was rough going. I honestly wanted to walk, but I knew that I could do it.

I had super power Whole Wheat Cinnamon-Raisin Swirl Bread fueling my legs!

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I sprinted…maybe I should say “sprinted”…the last 0.1 and finished in 30:04 (9:14 min/mile pace) according to the race clock (my app had me clocked faster). Had I not had technological and wardrobe malfunctions, I would’ve finished in my much sought-after 29-minutes. Oh well…

After the race, Mr. Prevention informed me that he finished in “22 something” (SERIOUSLY?!) and 8th overall. We retrieved Lily from the car and joined Donna behind the YMCA for an Irish ale, as any classy group of adults would do when there’s an awards ceremony going on in the front. Funny part was she brought the cooler and beers, but forgot a bottle opener. Rest assured, another racer was questioned about his possession of a bottle opener — attempt #1. Winner!

He retrieved an Irish (he informed us) bottle-opener( that looked more like a shoe horn) from his car and very happily popped the caps off our beers. What a guy!

Bread, run, beer…now that’s one heck of a St. Patty’s Day!

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Whole Wheat Cinnamon-Raisin Swirl Bread slightly adapted from The Kitchn via Tide and Thyme (dot) Com

1 cup raisins 1 cup warm water 1 Tbsp active dry yeast 1 cup nonfat milk 1/4 cup unsalted butter, melted 2 tsp salt 2 1/2 cups  all-purpose flour 3 cups whole wheat pastry flour

1/3 cup granulated sugar 1 1/2 Tbsp cinnamon 1 large egg beaten with 2 tsp warm water

Directions:

Put the raisins in a small bowl and cover them with hot water. Let the raisins plump for at least 10 minutes. Drain and set aside.

Pour a cup of room temperature water into the bowl of a standing mixer or large mixing bowl. Sprinkle the yeast over top. Give it a few minutes, then stir to fully dissolve the yeast into the water.

Stir the milk, melted butter, and salt into the water. Add the flour and stir to form a shaggy dough. Knead in your mixer on low speed with a dough hook or knead by hand for 8-10 minutes to form a smooth, slightly tacky dough. Check the dough halfway through; if it’s very sticky (think: bubble gum), add a little more flour.

Toss the raisins with a few tablespoons of flour to absorb any residual moisture from when they were plumped. With the mixer on low, add them to the bowl and continue kneading until they are evenly distributed. If kneading by hand, knead in the raisins in two batches to distribute throughout.

Return the dough to the bowl and cover. Let the dough rise in a warm place until doubled in bulk, about an hour. Meanwhile, combine the sugar and cinnamon in a small bowl and beat together the egg and water in a second bowl.

Divide the dough into two pieces. Working with one piece at a time, roll the dough out on the counter. It should be slightly less wide than your bread loaf pans and as long as you can make it (about 2 feet).

Brush the entire surface of the dough with egg wash, leaving about two inches clear at the top. Sprinkle generously with half the cinnamon and sugar. Starting at the end closest to you, roll up the dough. When you get to the top, pinch the seam closed. Transfer the loaf to your loaf pan seam-side down. Repeat with the other half of the dough. *Do not toss egg wash.

Let the loaves rise until mounded over the top of the pan and pillowy, 30-40 minutes. Halfway through rising, preheat the oven to 375 F.

Brush the top with some of the remaining egg wash. Bake for 40-45 minutes until golden brown.

Remove the loaves from the pans and allow them to cool completely before slicing. Baked loaves can also be frozen for up to three months.

Yield: 2 loafs (12 slices each).

Nutrition Information (per slice): 150 calories; 2.2 g. fat; 6 mg. cholesterol; 200 mg. sodium; 28.5 g. carbohydrate; 1.8 g. fiber; 1.9 g. protein

Result: If I can make this recipe without any issues, anyone can. Yeast, multiple rises…let me tell you, it’s worth it. These loaves turned out beautiful and when I brought one loaf to work, everyone was so impressed! If there’s ever a time you want to bake for a bake sale…or have some weekend time to bum around the house, I all but insist you give this bread a shot. So, so good and very doable if not rushed for time! :) This bread kept for 10 days…when it gets a little dry, just toast it! LOVED this recipe…definitely a keeper! Enjoy!

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Weekly Menu: March 18th – 22nd

 My grades are submitted for the quarter and I am relinquished of all teaching duties for the next week! I believe this is what students call “Spring Break”, but you can find me at either of my dialysis units!

Be well,

Chocolate Glazed Baked Chocolate Donuts (& a donut pan GIVEAWAY!) + Weekly Menu

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Oh, hi. Yes, I’ve been sleeping in…and attending to very important matters like feeding my donut obsessed self these nearly guilt-free Chocolate Glazed Baked Chocolate Donuts. At 93 calories a piece, there’s no denying they will be the best spent calories of the day.

Week one on the job was great. I really, really love my new position thus far. Everyone is so nice and I feel like I am going to develop my skills as a dietitian. Not only will I be making the recommendations for IV vitamin D (a drug called Zemplar) in an effort to keep my patient’s bones healthy, but I will get to learn about IDPN (IV nutrition for dialysis patients so they are getting nutrition while they run treatment three days a week). This is all very exciting stuff in my little nutrition world. :-D

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And I’m excited, too, about all things going on with this here, the blog (P.S. preventionrd.com will be getting a “face-lift” come February!). January has been a booming month, and I think I can attribute that to the healthy goals people set come the new year. Despite the cold, snowy, I-just-wanna-snuggle-on-the-couch-and-read-a-good-book weather, this time of year is filled with good intentions to eat well and be a healthier, happier you.

chocolateglazeddonuts1I think that’s a great goal any time of year…but there’s something very motivating about having so many people working towards the very same goals, at the very same time.

People, we are so in this together.

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I have “seen” new faces on Facebook (I’m lovin’ it). I’ve had the chance to check out new healthy cooking and living blogs from the comments and emails you’ve sent my way, or tweeted my direction. And more than ever, I feel that those coming to my little corner of the web are actually trying and loving the food that I prepare, photograph, and post about. For me, it doesn’t get any better than that — so, thank you.

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Chocolate Glazed Baked Chocolate Donuts adapted from Milk & Honey and Stephanie Cooks

1 cup whole wheat pastry flour 1/4 cup unsweetened cocoa powder 1/4 cup sugar 1 Tbsp baking powder 1/4 tsp salt 1 egg 1/2 cup almond milk 1 tsp vanilla 1 Tbsp canola oil 3 Tbsp unsweetened applesauce

1/2 cup semisweet chocolate chips 1 tsp canola oil 1 Tbsp corn syrup 1/4 tsp vanilla extract

Directions:

Preheat the oven to 450 degrees and coat a donut pan liberally with cooking spray.

Stir together flour, cocoa powder, sugar, baking powder, and salt in a large bowl. Add the egg, milk, vanilla, oil, and applesauce; stir together for 1 minute.

Fill each cavity in the pan 1/2 of the way full with batter. Bake for 7 to 8 minutes or until the donuts spring back when lightly touched. Cool completely.

Meanwhile, melt the chocolate in a microwave safe bowl. Add the corn syrup and oil and microwave in 20 second increments, stirring in between. Stir in the vanilla. Dunk each donut into the glaze and allow to set. Yield: 14 donuts.

Nutrition Information (per donut): 93 calories; 3.4 g. fat; 15 mg. cholesterol; 157 mg. sodium; 15.2 g. carbohydrate; 1.9 g. fiber; 1.1 g. protein

Result: Oh my yum! I slimmed down this recipes bunches and it was still delicious! The glaze makes it. These come together quickly and are good for several days afterwards. Is there anything better than a chocolate glazed chocolate donut…for under 100 calories a piece? Nah.

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Before I get to the good stuff, here’s a weekly menu…

Weekly Menu: January 21st – 26th

Since I’m in a great mood today and feel far too selfish to post yet another donut recipe while so few of you own a donut pan (seriously, you NEED one)…let’s have a little GIVEAWAY!

Leave a comment on this post letting me know which of the following donut recipes you’d be most likely to try if you won a donut pan! I will draw ONE winner at random tomorrow evening, 10pm EST.

Orange-Glazed Blueberry Doughnuts
“Healthy” Baked Chocolate Chip Donuts
Baked Eggnog Donuts
Pumpkin Spice Donuts with a Chocolate Glaze
Baked Apple Cinnamon Doughnuts

Be well,

Low-Fat Granola Bars with Bananas, Cranberries & Pecans

I was almost scared to try another granola bar recipe. I’ve tried on many occasions (okay, maybe only like…5, but still), and none were a huge success. Most were actually a huge disaster.

They either didn’t stick together into bars, which defeats the whole idea of a granola bar for on-the-go. Or the contained more sugar, honey, maple syrup, or agave that they may as well have been a cookie. Or frankly, they tasted…bad.

These granola bars? They were different.

First, they were bars. And they stayed that way. No crumbling. No scraping them from the bottom of a 9×13.

Second, they’re healthy. Not “healthy”, but really and truly healthy. They are naturally sweetened with banana and unsweetened applesauce. That’s it. No sugar, even natural sweeteners. They come in at 157 calories and nearly 4 grams of fiber a piece. They have healthy fats from the nuts and vitamin and mineral-rich fruit from banana, apple, and cranberries.

Lastly, and most importantly, they taste awesome.

With the new year and all the resolutions, snacking can be a pitfall of people’s diets. Snacks should be filling and nutritious, and moderate in calories. These fit the bill.

These are also great to add to a simple breakfast of yogurt or fruit for something quick and easy. As much as us grown-ups will enjoy these, they won’t last long with kids around, either!

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Low-Fat Granola Bars with Bananas, Cranberries & Pecans from Cookin Canuck

3 1/2 cups old-fashioned oats 3/4 cup pecans, roughly chopped 3 large, ripe bananas 2/3 cup unsweetened applesauce 3/4 cup dried cranberries 3/4 tsp ground cinnamon 1/2 tsp ground nutmeg 2 tbsp ground flax seed (or flax meal) 1/2 tsp salt

Directions:

Preheat oven to 350 F.

Line a 9- by 13-inch baking sheet with parchment paper, with about 1 inch of parchment paper overlapping the sides.

Spread out the oats and chopped pecans on a baking sheet. Place in the oven until they are lightly toasted, stirring occasionally, about 10 minutes.

In a medium bowl, mash the bananas with the back of a fork. Stir in applesauce until combined.

Transfer the oats and pecans to a large bowl and stir in dried cranberries, ground flax seed (flax meal), cinnamon, nutmeg and salt.

Stir the banana mixture into the oat mixture until well combined and starting to clump together. Transfer to the prepared baking dish and press down evenly.

Bake until the bars are golden brown and starting to separate from sides of the pan, about 30 minutes. Let cool on a wire rack for 15 minutes.

Use the parchment paper to lift the bars out of the pan. Let cool to room temperature, then cut into 15 bars. Serve or store in an airtight container. Yield: 15 granola bars.

Nutrition Information (per serving): 157 calories; 5.9 g. fat; 0 mg. cholesterol; 79 mg. sodium; 24.5 g. carbohydrate; 3.8 g. fiber; 3.3 g. protein

Result: Sweet, dense, filling. These are hands down the best granola bars I’ve made. They come together in just a few minutes and keep well in the fridge for up to a week, or in the freezer for up to 3 months. Enjoy!

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I stayed up too late watching the Illinois vs. Ohio State game…*yawn*

Be well,