Eatin’ Like In Sweden

Today the nutrition community is all in a frenzy over the release of the highly anticipated (and overdue) Dietary Guidelines for Americans, 2015. [I like that they tried to hide their tardiness by calling this 8th edition the “Dietary Guidelines for Americans 2015-2020.” Maybe they were hoping to buy themselves another year or two?] While the nutrition community and pundits will debate the effectiveness or science base or applicability of the updated Guidelines, I’ve decided for the time being to defect to Sweden – dietarily, anyway.

Don’t get me wrong, I have a deep respect for the Dietary Guidelines process and how it will be applied in nutrition policy. And I will pore over the 2015 revision in due time and make my own conclusions about those. But I can’t help but think that we could do a much better service to health professionals and the general public with simple guidelines. Like this one-minute summary of the Swedish Dietary Guidelines:

Key messages from the Swedish dietary guidelines

Here’s why I like it:

  • The messages are clear. Have more of this, less of that, and make better choices like these.
  • The messages are positive. There’s no language like “never” or “don’t” as in “don’t eat sweets.” Because let’s face it, we all like to treat ourselves every so often (just not too often).
  • The messages imply that all foods are in relation to one another…and that’s how we eat. We tend to get stuck on the notion of an “ideal” diet. But the fact is, we’re all human and we all have different ways we approach food – and likely different ways we metabolize food. The best approach I think is to consider individual food items in relation to one another.
  • This takes a mindful approach to food, which is key to healthy eating. Making food decisions, a person could take this tool and think to themselves: could I add more broccoli to this meal? Should I have a glass of wine with dinner tonight given I had two glasses last night? That’s being mindful and thoughtful about what you eat when you’re eating. Even the healthiest eater could likely stand to eat more vegetables and less salt. Show me someone – anyone – who is counting up all their sodium values from Nutrition Facts labels to ensure they’re staying within their 2,300 mg daily limit. Right…I thought so.

I applaud the 2015 Dietary Guidelines Advisory Committee on its science-based review of the latest evidence and for compiling its tome of a recommendation to the U.S. Department of Health and Human Services and the U.S. Department of Agriculture. And I appreciate the time and effort taken by our government officials to take those recommendations into consideration as they set nutrition policy. But next time, can’t we just keep it simple, like the Swedes? Tack.


Photo credit, cover photo: by Carlos Porto. Published on 13 June 2010
Stock photo – Image ID: 10017690

New feature: the Dietitian Dine Around

Today I’m launching a weekly blog series: the Dietitian Dine-Around. Each week I will feature a review of a food find at area restaurants and cafes. And although I’m a sucker for locally-owned businesses, for the most part  I’ll be reviewing items found at popular chains, so that non-DC-area-based readers can enjoy the “fruits” of my labor as much as the local folks.

Photo credit: Panera Bread

The first installment of Dietitian Dine-Around features a healthy food find from Panera Bread. This morning I found myself with about 20 minutes to spare while I waited for a local grocery store to open. In the same shopping plaza was a Panera Bread, so I decided to have a quick breakfast and some coffee.

A typical on-the-go healthy and satisfying breakfast for me is a bagel and peanut butter, but I was delighted to see a few egg and cheese sandwich options. I chose the Breakfast Power Sandwich – a complete 340-calorie meal of a grilled egg with cheese and ham sandwiched between a slice of whole grain bread. Eggs in the morning tend to satisfy me longer than most other breakfasts, so I was excited to try this healthy-seeming sandwich.

When my Panera Pager went off, I picked up my sandwich at the counter. I’ll be honest, what was awaiting me was a little disappointing. The sandwich looked bland and lonely on its large, bright yellow plate. The fork and knife provided were unnecessary, as the sandwich itself was just a slice of bread cut in half with the egg/ham/cheese layered between. I’m certainly not complaining about the portion – the sandwich was certainly filling and provided plenty of calories and nutrients – but eating is a multisensory experience, involving not just our taste buds, but also our noses and eyes, even our sense of touch (mouthfeel) and ears. No wonder healthy food sometimes gets labeled as boring…this sandwich certainly looked it.

Undeterred, I found a place to sit and picked up my breakfast, ready for the first bite. As I did, water dripped out and made a small puddle on my plate. How an egg, ham and cheese sandwich could be watery is beyond me, but sure enough I had a soggy sandwich.

Not only was it wet, but the sandwich was really salty. I guess I shouldn’t be too surprised, since both ham and cheese tend to be salty, but this combo seemed especially so. Sure enough when I looked up the nutrition info online when I got home, this 340-calorie meal wasn’t quite the bargain I thought: at 820 mg sodium, I was getting about 1/3 of my daily limit (current guidelines recommend no more than 2,300 mg sodium per day for the average healthy adult; that number drops to 1,500 mg for certain populations and those at higher risk for hypertension and heart disease).

Another closer look at the nutrition info found that my little sandwich had 15 grams of fat, 7 of which were saturated fat. Not terrible, but also a little high considering that 40% of the calories in the sandwich came from fat (most nutrition professionals recommend getting no more than 30% of calories from fat).

All told, six hours later I realize I didn’t need my usual mid-morning snack and am now finally ready for lunch. Still, here are some improvements I suggest to Panera:

  • Hold the salt! Not sure why additional salt is needed. Keeping it off will save 40 mg sodium.
  • Use lower-sodium ham and/or cheese.
  • Add some veggies for extra nutrients. The Mediterranean Egg White sandwich has spinach and tomatoes – those would be great additions to this “Power” sandwich as well.

Have you hugged your RD today?

Today’s a special day, haven’t you heard? No?

Not only is March 14 “Pi” day (the number pi is approximately 3.14), but this year it is also national Registered Dietitians Day, or RD Day for short.

OK, so maybe we haven’t gotten the attention of Hallmark or Google yet, so there are no greeting cards or fun search-engine graffiti to increase awareness of this notable day, but RDs all across the country are wishing each other a happy RD Day…and I hope others take note of today, too.

The fact is, it’d be hard to find a single person who hasn’t been affected by the work of a registered dietitian. I mean, have you ever…

  • eaten a school lunch? (especially lately? You should see some of the great things schools are doing for lunch and breakfast.) An RD likely prepared that menu, sourced the ingredients and ran nutritional information to ensure the meal met certain criteria for calories and nutrients.
  • read a book, article or brochure on healthy eating? It might’ve been written by an RD, who spent the time reviewing complex research and putting the information in clear language to make it easier for people to understand…and better yet, to follow.
  • bought food from a grocery store? Many supermarkets have RDs on staff to help guide healthy eating programs at the corporate level, and help consumers make smart choices at the store level. And many food manufacturers have RDs doing product research, marketing and communications, among other functions.
  • tried a delicious, healthy dish at a restaurant or from a cookbook? Culinary RDs know all about recipe development using healthful ingredients, and understanding that enjoying food is as much about the experience of eating as it is about the flavor.
  • heard about MyPlate (or its predecessor, the food pyramid)? This icon for healthy eating is based on the Dietary Guidelines for Americans, which is updated every five years after a thorough evidence-based review of the research by leading food and nutrition researchers, many of whom are registered dietitians.

Yes, we have “diet” in our titles, but dietitians are more than that. Sure, we help people who want to “go on a diet,” but many of us think of “diet” in the more general terms – as an eating plan to help people live healthfully. You may find us in hospitals, clinics, schools or restaurants; online, on TV, in the bookstore, in the paper or in a magazine; working for a company, for a health club, at a university or in the public sector. We’re not the food police, but we do love food. And we’re here to help people live healthier, longer and better.

Ode to Oatmeal

Do you have the January blues? You know what I mean – the holidays have come and gone, with the next major holiday not until Memorial Day in May (unless you’re one of the lucky ones who gets Presidents’ Day off); the weather is dreary and cold; your New Year’s resolution of eating healthier is starting to get boring…time for some inspiration and comfort to get you through the winter blues.

One thing January has going for it is that it’s National Oatmeal Month. Now, oatmeal isn’t much to look at – it IS pretty blah on its own – but it’s a nutritional powerhouse that’s just begging to be dressed up with other nutritious ingredients.

Near where I used to live in Colorado, there is an annual Oatmeal Festival. The event kicks off with a 5K race and ends with a health fair, cooking contest and perhaps the world’s largest oatmeal topping bar. At this breakfast you can top your oatmeal with the usual fruit and nuts, but among the offerings as well are M&Ms, peanut butter, gummy bears and jelly beans. Perhaps not the healthiest way to prepare this breakfast dish but, hey – those folks just ran 3 miles! And besides, anything that gets people to try a healthy dish they might not otherwise is considered a win in my book.


There are many reasons to love oatmeal:

  • It’s a whole grain – According to the Dietary Guidelines for Americans (2010), at least half of the grain products we eat should be whole grains. The reason is that whole grains have more fiber than refined grains since the bran and germ remain intact. Refined grains keep just the starchy part – the endosperm, and the bran layer and germ are removed.
  • It’s a good source of fiber – Nearly all Americans aren’t eating enough fiber every day. For most adults, that’s 25-38 grams daily. One half-cup of oatmeal provides 4 grams of fiber. Add some berries or nuts, and you can easily get one-quarter to one-third of your daily fiber goals just at breakfast!
  • It helps lower cholesterol – the fiber in oatmeal, beta-glucan, is a heart-healthy soluble fiber that essentially attracts cholesterol like a magnet and helps flush it out of the body.
  • It’s inexpensive – One 18-oz. can of Quaker Old-Fashioned oatmeal, which makes 13 half-cup servings, sells for $2.95 at my nearby grocery store. That’s 23 cents per serving! For comparison, an 18-oz. box of Cheerios, which contains 18 servings is $4.85, or 27 cents per serving.  
  • It may be a galactogogue – OK, so I don’t have the science to back this claim up, but there’s an old wives’ tale that eating oatmeal may help increase milk supply for breastfeeding women. For something as healthy as oatmeal, it certainly can’t hurt for a nursing mother to try.

Back in my pre-kids days when I ran marathons, a packet of oatmeal (plus coffee and an orange) was my standardbreakfast before long runs and races. The packets and oatmeal-to-go dishes were perfect for out-of-state races – I’d just heat some water in the hotel room coffeepot, mix and go. That, and when I travel is perhaps the only time I can tolerate the pre-packaged oatmeal. I find it’s a little too sweet for me, and I prefer the texture of old-fashioned oats (instant oats are chopped smaller to make them cook faster).

I guess I can be a little picky about my oatmeal, since I almost never order it at restaurants and would rather make it myself. I like using milk – but not too much or it won’t cook as well. Also nuts – but they must be coarsely chopped as slivered won’t give the same result. And must have berries mixed in – bananas, raisins and other toppings just aren’t as good. I use frozen berries throughout the winter and fresh berries when they’re in season. The result is a filling meal loaded with about one-third of my daily fiber and calcium needs, and is loaded with iron, a mineral that most pregnant women and women of childbearing age need. (Helpful hint: iron is better absorbed when you pair it with vitamin C, which the berries provide!)

Here’s my recipe:

Elana’s Oatmeal – Perfected!


  • 1/2 cup old-fashioned oats, dry
  • 2/3 cup milk (fat-free or 1%)
  • 1/3 cup water
  • 1/2 cup frozen berries*, unthawed
  • 1/2 ounce almonds, coarsely chopped
  • 1 tsp Brown Sugar Blend Splenda
  • Ground cinnamon, to taste


  1. Mix the dry oats with the milk and water in a microwave-safe bowl. Heat for 2-3 minutes on high in the microwave. Careful that the oatmeal doesn’t bubble over.
  2. Remove the bowl and stir in the frozen berries, almonds, brown sugar and cinnamon. Heat for 1 minute more on high.
  3. Let sit for 1 minute to cool and thicken. Enjoy!

*If you’re using fresh berries, add after the oatmeal is done cooking.

Serves 1

Nutrition per serving: 355 calories, 11g fat, 1g saturated fat, 121g sodium, 51g carbohydrate, 8g fiber, 14g protein, 27% daily value for calcium, 16% daily value for iron.

How do you like your oatmeal?

MyThoughts about MyPlate

Today, Agriculture Secretary Tom Vilsack, along with First Lady Michelle Obama and Surgeon General Regina Benjamin, unveiled the new icon replacing the food pyramid, which first debuted in 1992. These icons are designed to translate the complex Dietary Guidelines into a simple, “how-to” guide for following a healthier diet. The most recent pyramid, unveiled in 2005 as MyPyramid, was widely panned by health professionals as too complex and not user-friendly.

The new icon is called MyPlate, and is a simplified version of the recommendations laid out in the Dietary Guidelines. I applaud the USDA and Obama administration for choosing a straightforward design which applies more directly to the act of eating. But I am concerned that the icon has been oversimplified. That said, here are “MyThoughts” about MyPlate:

Likes –

  • The name: ChooseMyPlate. “Choose” implies empowerment, and that the responsibility for eating healthfully (and making behavior changes) ultimately resides with the individual.  “My” is a carryover from MyPyramid, which were actually 12 individualized pyramids based on age, sex and activity level. The “my” is a nod toward one’s individual dietary needs:  while the elements of every person’s plate would be the same, a toddler’s plate would look different from an adult male’s plate.
  • It can apply both to a single meal as well as an overall diet, and just by a quick glance you get the main message of: make half of what you eat fruits and vegetables – slightly more veggies than fruits. I also like how exact measurements have been left off the icon…that the different food groups are really more or less relative to one another.
  • The “Milk” group is back to being categorized as “Dairy,” which is a little more accurate about the foods you’d find in the group, such as yogurt and cheese. Calcium-fortified soymilk is also in this group, and while technically not a dairy product it is often a dairy substitute.
  • The plate design makes it easier to visualize what to put on your plate at a meal. Many RDs, myself included, use a plate technique with clients to educate about portion and food groups. HOWEVER, many people are still eating meals on the go – in the car, in a carry-out bag or in some other convenient form – such as a sandwich. Using a plate approach still requires some imagination for translating the actual food one is eating into these categories.
  • While there was a lot of discussion about physical activity no longer represented on the icon, I’m OK with that. This is meant to be a representation of how people should eat – other behaviors such as physical activity and practicing food safety principles can be a separate conversation.

Dislikes –

  • Dairy appears to be an afterthought, and not a main component in one’s diet. Also, its shape is different from the others, making it difficult to envision how much dairy relative to other food groups a person should eat.
  • “Protein” is ambiguous to the average American. Why they chose to do away with the more descriptive “Meat and Beans” group is beyond me. Protein is a macronutrient, whereas fruits, vegetables, grains and dairy are all foods. I’m glad they didn’t rename the grains group “Carbohydrates”!
  • Fats have been excluded. Will this icon send an inadvertent message that fats don’t belong in our diets? The fat-free craze of the 1980s was a diet disaster and should not be repeated. People are still learning that certain fats do deserve a place in our diets, such as oils, seeds and nuts.
  • Non-plateable foods such as soups, cereals and mixed dishes will be hard to translate into the new plate model. Consumers will need to “deconstruct” their foods to see how it fits into their daily needs.
  • The plate represents an ideal – as it should – but it excludes other foods people eat, including items addressed in the dietary guidelines such as foods with added sugar and alcohol. Granted, MyPyramid also didn’t address these foods in the icon, either. While such foods/drinks should be limited and need not be a part of a person’s everyday diet, we cannot simply ignore these foods and pretend they don’t exist, particularly if we’re going with an icon we hope people will apply to their everyday dinner plates.

In general, I think the new icon is a good starting point to help consumers think about what they eat in a single eating occasion and as a whole. But it should not exist in isolation. Registered dietitians still need to translate what the icon means and apply it to individuals to help them meet their healthy eating goals.

If you’re interested in starting a healthy eating plan, let’s make an appointment! I work with individuals and families on adopting healthier lifestyles, weight loss and general wellness. Check out my website at or contact me for more information.

Pizza day!

It’s Sunday, which in my house means pizza day. “What?” you might be thinking? Isn’t pizza loaded with fat, calories and everything yummy but bad for us? It sure could be, but not always.

According to the 2010 Dietary Guidelines for Americans, pizza is in the top 5 sources of calories consumed by Americans ages 2 and older. The most popular pizza topping is pepperoni, which as far as I’m concerned is a nutrient-poor choice.

Yet look at any pizza menu and you’ll see a bunch of different toppings – some healthier than others. And if you make it yourself, the possibilities really are endless.

I started making pizza for myself when I was living on my own for the first time and honestly did not know how to cook vegetables. I was living on a tight budget, so I didn’t want to spend too much time experimenting and throwing away expensive fresh produce. So I figured – how wrong could things go if I just put veggies on a pizza? I even made my own whole-wheat dough (thanks to a long-since-lost Cooking Light recipe), but later found that Trader Joe’s has delicious, inexpensive doughs in whole wheat, plain and herb varieties, saving me a lot of time and effort.

Try making a pizza at home, top it with sauce (I use regular pasta sauce), your favorite veggies, and 2% cheese for a well-rounded, healthy meal. Some of my favorite pizzas:

  • Veggie meatball, made with green peppers, onions, mushrooms, sliced olives and crumbled turkey meatballs, topped with 2% Italian blend cheese
  • Cajun chicken, made with southwestern seasoning and topped with green and red peppers, onions and 2% Italian blend cheese
  • Pizza rustica – sun-dried tomatoes, broccoli, red onions and sliced garlic, topped with goat cheese
  • Mushroom medley – go beyond boring button…top with cremini, shiitake, enoki and oyster mushrooms. Goes well with almost any kind of cheese, or none at all!
  • Thai pizza – more calorie-dense but sooooo tasty! And my most requested dish. I make my own peanut sauce (another Cooking Light cookbook recipe) to use as the base, then top with shredded carrots, sliced red bell peppers, bean sprouts, green onions and 2% mozzarella cheese. After removing it from the oven, top with fresh torn cilantro. For a heartier pizza with more protein, add cooked chicken or shrimp.