RD Q&A (vol. 37)

lilybeachframed

Shame on me. It has been nearly 5 months since my last Q&A. For those new to this series…readers ask questions and I give my RD opinion! Here we go!

Anonymous: I have a career question for you. I work as a clinical dietitian in a regional hospital, and while I LOVE it and the people I work with, I wish that we could be more progressive. In your hospital, you are able to make new and unique recipes for the cafeteria, and people really enjoy it! Here, “new” foods are though of as “weird”. Sadly, even by the dietitians. And the fryer is used daily. I have the opportunity to move to a smaller hospital where I would have more control and authority to make the changes I think hospitals need, but as always, change is scary. What is or was the most difficult part of making your hospital “the best restaurant in town”? What is the most challenging part of your job, BESIDES managing people? 😉

Prevention RD: Hi! Firstly, I love your question. I think circumstances have taken me out of my comfort zone a lot in my young career. As we have moved to follow job opportunities for Mr. Prevention, I have been able to work in so many areas of dietetics. Running a kitchen was probably not something I saw myself doing, but I love it! The hardest part is just taking risks and accepting that some risks will be successes and others will be failures…and, that’s okay. I’ve had to learn to trust my staff, especially my cook, and to push people outside their comfort zones with food. One of the most successful tricks we’ve implemented is letting customers and employees taste food items before buying. Any time we offer something new or “weird”, we encourage people to try it! I also think we’ve been successful in implementing changes in the hospital cafeteria because we offer new items often, but retain lots of the favorites (i.e. Burger Bar, Philly Cheesesteak Fries, etc). People don’t mind change when they ease into it. As I’ve come to find out, the cafeteria was on a 4-week cycle menu and people have simply come to appreciate the variety. Other than managing people (which, yes, is extremely challenging at times!), I think small hospitals are challenging because you may wear many hats. In a given day I will see in-patients, out-patients, attend meetings, recipe develop, manage one of my 2 departments (nutrition and diabetes) in any number of capacities, and probably attend several meetings. The health inspector can walk in at any minute, and we always have to be ready for an audit. While balancing clinical, non-clinical, people, and management can be challenging, no two days are alike and I am neverrrrrrr bored at work, that’s for sure! I wish you luck in making your decision – it’s tough!

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Calvin: What does sugar free really mean? Doesn’t everything have sugar in it?

Prevention RD: What a great question! One of the things I find myself saying often is, “Sugar-free does not mean carb-free!” – a very common misconception, especially for diabetics. In truth, I don’t look at sugar very often on food labels because nearly every food contains sugar. By law, “sugar-free” means less than 0.5 grams of sugar per serving. Carbohydrate, on the other hand, represents sugar, complex carbohydrate, and fiber. Focusing on sugar can also deter people from eating foods that are actually quite healthy, such as fruit (fructose) and dairy (lactose). Another point is sugar alcohols which will show up on ingredient lists often listed as sorbitol, xylitol and/or mannitol. While sugar alcohols are not sugar, they have similar tastes and properties with less calories, but are not carbohydrate-free. Some of the products I may compare sugar on include cereal and yogurt – for some reason, those 2 foods tend to vary a lot in actual sugar content and may be worth comparing. Otherwise, I urge people to focus more on fiber than sugar. I hope that helps!

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Barb: What is the best/most nutritionally sound option for a sweetener?

Prevention RD: Hi Barb! I get this question a lot! I think I have every sweetener there is on hand – granulated sugar, powdered sugar, brown sugar, honey, maple syrup, agave, turbinado, sucanat…you name it! I think they all have their purposes and in the end, they’re all very similar from a broad nutritional view (i.e. calories and carbohydrate/sugar with few vitamins and minerals), so I tend to choose based on taste (for me, I love honey best). The least “processed” sweeteners would be sucanat or honey, which also have lower glycemic indexes (though I don’t give too much consideration to this). Recently, I’ve started to use more and more sucanat (an abbreviation for sugar-cane-natural) which is simply dehydrated sugar cane juice and is the least processed granular sugar that can be used 1:1 to substitute sugar. I used lots of sucanat in the gluten-free cookbook I’m finishing up and I love the stuff! I hope that helps!

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Chloe: My grandfather is very skinny, almost underweight, any advice for people trying to put on weight?

Prevention RD: Hi Chloe – thanks for your question! It is ironic with so much of America trying to lose weight that some individuals struggle to gain weight. In such cases, it’s important to focus on wholesome, high calorie foods such as nuts, oils, avocado, seeds, dried fruits and whole fat products, such as condiments and dairy. Many people find that eating 5-6 meals/day is helpful, as well as drinking (calorie-containing) beverages between meals to avoid early satiety. Individuals can choose milk and juices rather than water, tea, coffee, and other zero-calorie and low-calorie beverages. Encourage foods that are well-liked and enjoyable. I hope that helps 🙂

Have a question you would love answered? Send it to me at [email protected] dot com or post below as a comment! Thanks for your questions, as always!

Be well,

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4 Comments

  1. October 9, 2013 / 9:08 am

    I love these Q&A posts (and that picture of Lilly on the beach). My husband actually needs to put on weight, so the last question really hit home for me. Having someone in the house who could stand to gain more than a few pounds can be difficult when I’m trying to lose weight. It’s frustrating sometimes!

  2. October 9, 2013 / 11:38 am

    I don’t find any difference in my blood sugar vs. what type of sweetener it is, whether its sugar, brown sugar, honey, etc. – to my body, they are all the same!

  3. Libby
    October 10, 2013 / 8:21 pm

    Hey =)
    I love these Q & A posts! Thank you so much for taking the time to do them! I can’t believe how much you pack into your role at work! That is so intense! I could not do the food services and managment stuff and so admire people who are good in those areas! You rock!

    One question I have is around different intake requirements. I know the amount of calories and macro-nutrients that people need differs, but is this the same for the micro-nutrients? I am pretty small (152cms) so would my requirements for things like calcuim, iron ect be less than someone who was bigger? And also I know that for some of the nutrients men and woman have different requirements. When you see the % of your RDI’s listed on the packages of foods, does that refer to men or womens needs? Or is it an average of the two?

    Thanks so much for your help!

    Love your blog! =)

    Libby

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