For years I have been ranting about the food choices in hospital cafeterias.  In addition to schools, which are getting so much attention for unhealthy lunches, hospitals should be the other place in our society that promotes healthy food choices.  We all know that healthy eating is important for recovering patients and their families.  Also, the hospital work force needs the benefits of healthful meals. So why do so many offer goopy pies and heavy sauces as easy purchasing choices, placing them front and center in the display cases?

Since this is the beginning of Heart Month, I think it’s important to check in on what’s happening.

Last week I got excited about a short synopsis, reporting the results of a food coding system that was tested at Massachusetts General Hospital in Boston.  The full study will be published in the American Journal of Public Health in March.

I didn’t want to wait for publication, so I called Dr. Ann Needham Thorndike, chief researcher, and was delighted to find her willing to explain their process.

Dr. Thorndike said that while there are many food labeling systems, her question was, “How do we know which ones motivate people to change their habits?” The study used the universally recognized and understood color coding system – red, yellow and green –indicating the least healthy to most healthy foods – stop, caution, go for it.

The USDA Guidelines were used to rate the foods by color.  Foods were divided into 4 groups: entrees, other items, condiments and beverages.  With an emphasis on weight control, calories and saturated fats were used to determine what color a food was designated. This concept could easily be expanded to include sodium, fiber, etc.

The first phase lasted 90 days and the results were significant, especially with beverages.  Sales for red-labeled drinks fell 16.5% while green-labeled beverages sales rose 9.6%.  Sales of all red items fell 9.2% and green item sales were up 4.5%.

In phase 2, green foods were placed at eye level.  Again, the results show a decrease in red beverages and foods and an increase in green ones.

Positive change = Positive results

“Overall sales did not go down.  The cafeterias are doing better than ever.  People really responded to this positive change, especially employees, who eat in the hospital cafeteria on a regular basis.  As a result, the phase 2 arrangement was left in place,” said Dr. Throndike.

Dr. Thorndike reported another by-product of the research.  “Cafeteria staff reworked some of their offerings, like tuna fish.  Turns out that their recipe had too much fat in it, so the fat was reduced to be healthier.”

Finally, here is a solution to healthier eating in hospitals.  The system is elegant in its simplicity and approach and successful in implementation.

Take action

On the hospital front

Please forward this post to people in your hospital who may be able to make these changes. For too long we’ve heard that hospital cafeterias couldn’t possibly change to healthier items without sales dropping.  At last here is data that shows positive change reaping positive results.  We’ll all benefit from having healthier options that are clear choices.

If you would like me to forward the study, just let me know.  Contact me at Susan@wellfedheart.com.

At home

So, what could this mean for our homes?  If we’re trying to teach our families about healthy eating, we could incorporate a less onerous program in our own kitchens.

Look at what you have in your pantry, refrigerator and freezer for daily consumption.  What’s at eye level?  The healthier foods should be up front and in grabbing range, such as nuts in the cupboard, fruit on the counter, and cut-up veggies in the refrigerator.  Put the cookies and other “goodies” out of sight down below or up high.  You could also use color coded tops or labels for children.

I’m signing off to go check out my kitchen. Thanks so much, and have a heart-healthy day!

Remember, if I can do it, you can, too!

Susan Levy
Publisher, Well-Fed Heart

The Well-Fed Heart -

There’s no one way to keep a food journal. Our research indicates that most journals fall into one of 3 types. Which one is right for you?

Simple food journal

Studies show people are often unaware of all that they are eating. It may seem hard to believe that people don’t even know they are eating, but in a multitasking world, where eating happens while in the midst of doing any number of other activities (especially while working or driving) it’s easy to forget. People also don’t realize how much they eat, filling a bowl with cereal not knowing it’s enough for 2, or more, servings. So the most basic journal is one for getting an accurate picture of what you are eating. This can be as simple as carrying a notebook and jotting down everything you eat each day. (Using the memo pad on your smart phone works, too.)

The only goal is being faithful about writing down every single bite, including drinks and snacks. The intent is to find out how aware you are of what you are eating.

More data, more insights

Take the simple food journal a step farther, and it becomes possible to find patterns and start making sense of your eating habits. Just noting the time when you eat, for instance, might turn up a habit of unhealthy snacking on certain days but not others. If your goal is to cut calories, figuring out what is going on for you when a snack attack hits will likely turn up better solutions for you.  Noting your mood, or how hungry you are when you eat, can help you identify non-hunger related triggers, too.  (think evening TV)

Once you’ve figured out your patterns, and identified some changes you want to make, continue journaling to create a record of your changing habits.  At this point you could try making entries to your journal before you eat, instead of after. An added benefit of journaling is how the short pause of writing gives you the opportunity to be more mindful of what you are about to eat.

The complete journal

Of course, eating is only part of the road to better health. Exercise is the other half. The same study that noted journaling helps dieters loose weight, also showed that physical activity is a necessary factor. So track your daily exertion, whether it’s your pedometer reading or minutes in exercise class.

Other data that you may find helpful to record are:

• Daily weight
• Glasses of water each day
• Servings of food categories or nutrients, such as protein, carbohydrates, fat, fiber, colors, whole grains, etc.
• Daily calorie intake or output (obviously this is helpful to know, but since it usually requires checking another source to figure out your daily intake, we find it can be a barrier to keeping up your journal.)

Get started!

Download our food journal and try it out for a week. Since we think uncovering your eating habits is a good place to start, we’ve included those as factors. Plus, there’s space for you to add any additional information you want to track.

⇒ Well-Fed Heart Food Journal

Click the above link to download and print out the worksheet. This file is in PDF format. Most people will already have software on their computer to display and print the worksheet. However, in case of difficulty, you may need to download a free PDF reader for your computer.

The Well-Fed Heart -

First, a shout-out to our Well-Fed Heart friend, Terese Scollard, RD., from the Providence Health System in Portland, Oregon.  Terese named Wellfedheart.com as a helpful tool for people who want healthy recipes. The rest of the sites mentioned in her article are actually “apps”.

Simultaneously with Terese’s article, I have been conducting my own research about sites and apps for losing weight and staying healthy.  Like Well-Fed Heart, there are many sites on the web that were developed with mobile technology in mind, so purchasing an app isn’t necessary.  (Thanks to our developers!)

Each of us has to decide what’s the main goal and if a site fits our needs.  Some people need community, so explore any number of sites like SparkPeople and LiveStrong.  Then there are hi-tech gizmos like FitBit and BodyBugg.  You wear them and then upload results to the web.  This grabs a slice of folks, but for how long? What I find difficult is that so many sites want an ongoing fee, when in fact, I just want a heads up on what changes I need to make for my optimal wellness.

I looked at taxpayer sites, like the National Heart Lung and Blood Institute, the Centers for Disease Control, and ChooseMyPlate.  Each had interesting information, some cool and easy tools, such as the body mass index (bmi) tool on the NHLBI site. However, when it comes to weight loss tools online, calculating what I ate or my exercise, I stumbled.  All the tools seem too complicated or time consuming or simply incomplete.  My bottom line – it didn’t seem worth the effort and frustration.

All of this research dove-tails with the best diets rankings from US World News and Report.  I’m happy to report that both the Mediterranean Diet and the DASH Diet, which we’ve written about for years and base our recipes upon, made the top tier.

No matter what plan you choose to follow, here are two ideas to use for controlling weight. These don’t have to cost money and take no time at all.

Keep a food journal

Write down absolutely everything you eat and drink.  Whether it takes a few days, weeks, or months, at some point, we all get a better understanding of our actual food habits.  (See our guide: Food Journaling 101.) Calories in and energy out.  Speaking of energy, list your exercise as well.

I find that the best low-tech way to know exactly what our portions are is to get a food scale and measure everything.  Read the label on the package.  Is your portion size the same as the package?  Just how much is 2 ounces of whole wheat pasta?  Shocking for some.

Weigh yourself

Do it every morning, or at the same time every day.  Nothing keeps us on track better than this simple task.  Remember, sometimes the way our clothes fit can fool us, but the scale doesn’t lie. (Well, maybe, if I stand a certain way, I can help those pounds disappear…)

Achieving optimal health is obviously more complicated than these two steps, but it’s a good way to start.

Remember, if I can do it, you can, too.

Susan Levy
Publisher, Well-Fed Heart

The Well-Fed Heart -

I interrupted my blog this week when I saw and read Paula Deen’s admission to Al Roker on the Today Show that she has Type II Diabetes and has for three years.

This public display came just at the onset of Deen’s campaign for Novo Nordisk, the supplier of her diabetes medication.  Deen says she kept her diagnosis under wraps until she could figure out how this would affect her life (and biz).

Here’s the Sarah Palin twin…figure out how to make money for yourself in your new circumstances.  Leave your public in a bind.  It’s so American.  Don’t you just love it?  Both share huge audiences of true believers. Just as Palin has cashed in on every opportunity to espouse whatever her party line is (whether or not it’s truly best for American families), so Deen says that she and her minions cook like they do, because they are the hard-working Americans putting meals on the table day in and day out – not eating out in fine restaurants like Anthony Bourdain.

Deen has been crowing about butter and processed ingredients and deep fryers as late as April of this year on Today, knowing full well that she herself had diabetes.  Hell, why “walk the walk”, when you can just “talk the talk” and have the cash register ka-ching!

Now, she’ll make millions without admitting that her lifestyle choices got her in this position. And, voila!  She’s a heroine.  No conscience.  In it for herself…and her son gets a new show, to boot – Not My Mama’s Meals, or some such jazz. And don’t even get me started on Novo Nordisk, the company that espouses to care more about Diabetes than any other company.  They are the “sugar daddy” paying Deen millions and presenting her as the promise of their brand.

What makes Deen so laughable and arguably brilliant is that she makes no apologies for her full-blown processed food choices that affects millions.  No, honey, that’s just entertainment.  People have to decide for themselves…”I’m not your doctor,” she told Oprah.

Okay, but now Ms. Deen has a chance to turn it all around, become a poster child, not for medication, but rather for lifestyle change. Obesity and diabetes are national epidemics and while Deen isn’t the cause, she could become part of the solution that creates lasting change.

Let’s consider Oprah

Remember over a decade ago when Oprah’s show used to have all kinds of crazy subjects (ala Jerry Springer)?  She had a huge following, but the negative content left her empty and gave nothing of value to her audiencne.  Oprah had an epiphany about a more positive approach.

As a result, she revamped her show from the top down, firing her executive producer and charted a new course.  The results are her legacy.  Oprah’s popularity soared with her new message.  She lead the charge for changing our lives from the inside out.  It worked.  Yes, she also made millions, not by hood-winking her audience, but by embracing change that would affect positive change in people’s lives.

I believe that’s called wisdom.

Speaking of wisdom

Chinese New Year is coming January 23rd (the year 4709).  It’s my year, so to speak, Year of the Dragon, which happens every 12 years (1928, 1940, 1952, 1964, 1976, 1988, 2000, 2012).  There are different Dragons, too.

I plan on getting together with family and friends to dine from our Asian heart-healthy dishes.  The choices here are so wonderful, that I’m going to ask each guest to cook one of the recipes and share, creating a “smorgasbord” (an Asian word, right?) of tastes and flavors.

We’ll celebrate the New Year and in the process learn how simply delicious heart-healthy Asian cooking can be.

Remember, if I can do it, you can, too!

Susan Levy
Publisher, Well-Fed Heart

The Well-Fed Heart -

Learning to snowshoe with (the adorable) Ranger Eric

We’re 12 days into the New Year. Did you make a New Year’s Resolution? Are you still keeping it?

The number one resolution is to lose weight and get in shape. However, according to one survey, by now 75% of people have already given up on the idea. Does strength of willpower have anything to do with our success? Or, as some have suggested, does reliance on our willpower alone set us up for failure?

Lack of willpower?

We start a strict diet, going cold turkey, and are really good for a few days before starting to back slide. Then, we’re back to old habits, our willpower failing us.

We start a walking program, hoping that using a pedometer will catapult our mileage. How long before our willpower caves, the walking becomes intermittent, and the little gizmo sits on a shelf forever?

These examples are not about lack of willpower, but rather, about not understanding the nature of change. “Readiness to Change” is a model of behavior change which recognizes that the process we go through in deciding to change is a continuum. No short cuts allowed.

5 Stages of Change

1. Pre-contemplative. Change is not even on our radar. In fact, we may even be in denial about the need for action.
2. Contemplative. We’re thinking about losing weight or starting an exercise class, taking our medication regularly, or cooking dinner three times weekly. This “thinking about” stage can last a long time.
3. Preparation. We’re making plans for small behavior adjustments, like not buying soda and ice cream as a weight loss technique.
4. Action. We’re working the plan, whatever it may be.
5. Maintenance. We’ve reached the new behavior goal and are maintaining it.

Change is a process. “Readiness to Change” recognizes that at any of the 5 stages, we can slip up and find ourselves at the beginning of any of the previous stages; but that doesn’t mean we’ve failed. We are simply experiencing the process of change, which rarely happens in a straight line.

So, my question is this, “Do we succeed because of willpower, or because we’ve done the work at each stage to create the mindful decision for change?”

Mindful resolutions

I like New Year’s Resolutions, but I keep them broad, like trying one new physical activity a year. Last year was river rafting. My niece and her friends helped me succeed in reaching the goal. I kicked off this New Year with a new activity. I’m posing above with Ranger Eric of the US Forest Service last Sunday. I was part of a guided snow shoe trip for beginners in the Olympic National Forest.

In terms of “Readiness to Change”, the success of this trip suggests that I had the support to make my plan happen, and that my ego was happy because my legs weren’t sore in the aftermath. Thus, I’ll sign up for longer hikes. I paid some money to get professionals (my local parks and rec) to help me succeed, and I feel good about it. Plus, it was a shared experience with friends participating, too.

When we seek support from peers and/or professionals, whether free or paid, we become more committed to a positive outcome.

So, as you think about the resolution you want to make (and keep) this year, ask yourself – how ready are you to change? What’s the biggest barrier to your change and what are you willing to do about it?

Remember, if I can do it, so can you! Happy New Year to us!

Susan Levy
Publisher, Well-Fed Heart

The Well-Fed Heart -

The studies are in! It is possible for you to reduce your risk of cardiovascular disease, as well as diabetes, stroke, cancer, and other diseases.

It’s time to forget about rigid menus and rapid weight loss, because they aren’t sustainable.  Instead, think about the original meaning of the word “diet,” a way of life. The way to make lasting changes in your health is by making a lasting change in your lifestyle. Remember, even small changes equal big rewards.

How many of these changes have you already made?  Choose just one to begin your new year.

• Make sure half your plate at each meal is fruits and vegetables. Go for variety of color for the most nutrition.
• Go for healthy fats. Choose olive and canola oils.
• Get your Omega 3s. Eat fish twice a week.
• Reduce or eliminate processed foods. Read the label for hidden salt, sugar, and fat in any food that comes in a box, can, bag, or carton.
• Eat breakfast every day. Skipping it makes you sluggish and more likely to use a sweet treat to compensate.
• Try new herbs and spices. It’s all about big flavor.
• Keep a food journal. Taking just 5 minutes a day to record what you eat is one of the best motivators to help you lose weight.

Want some help putting together heart-healthy eating plans and tracking your progress? There is no reason to spend money on advertised eating plans that promise quick success and require special foods. Instead there are many popular plans, which are absolutely free, and are supported by research consistent with the U.S. Dietary Guidelines. Here are 2 of our favorites.

• The Mediterranean Plan is a delicious and holistic way to be heart-healthy. www.oldwayspt.org
• MyPyramid helps you create a personalized nutrition plan with foods and amounts that are right for your age, gender, and activity level. www.mypyramid.gov

Here’s to your heart-healthy new year. Starting now.

The Well-Fed Heart -

After the holidays everyone wants to eat lighter. Also, winter is the perfect time for cooking up a big pot of soup. But eating the same soup over and over can be boring.

So, consider hosting a soup swap.

Here’s how it can work: Get some friends together, and have each sign up to make his/her favorite soup or stew. Each person brings a designated number of one quart containers filled with frozen soup.

Then, it’s swap time! For a small number of guests, each person can cook just enough so everyone gets a sample of each. For a larger group, you may want to go with a lottery system.

A soup swap saves you time and money by stocking your freezer with easy dinners, and it’s a fun way to try something new too.

What soup do you like best for sharing with friends and family?

Susan Levy
Publisher, Well-Fed Heart

The Well-Fed Heart -

It’s easier to improve your heart health if you can chart your progress. That’s what this chart is all about. Print it out and take it with you the next time you see your doctor. It lets you compare your numbers over time, as well as to those published by the National, Heart, Lung, and Blood Institute.

Since these numbers are based on the general population, consider them guidelines only. Ask your physician for tests and goals that are tailored for your situation.

If your numbers need some improvement, try some TLC or Therapeutic Lifestyle Changes. These include better nutrition, more physical activity, and weight control. Then get tested again in 6 months to see if you’ve progressed.

⇒ Vital Digits for Heart Health Worksheet

Click the above link to download and print out the worksheet. This file is in PDF format. Most people will already have software on their computer to display and print the worksheet. However, in case of difficulty, you may need to download a free PDF reader for your computer.

The Well-Fed Heart -

What's in your door?

All Recipes.com released their latest Measuring Cup survey about consumer preferences.  The results which caught my eye were those that revealed the contents of our refrigerator doors.

Since catsup made its debut in 1876, it has enjoyed favorite condiment status in American kitchens.   A rousing 93% of refrigerator doors keep this sweet tomato basic.  But today, 91% of refrigerators now also include salsa, as well as the perennial favorite, mayonnaise.

A diverse list

In fact, what strikes me about the list below is just how ethnic and diverse the list is.  It’s reflective of our society and how world-oriented our food is becoming.  Practically every ethnicity is represented on this list –a long way from the days of catsup, mustard, mayo, and steak sauce.  It makes me proud to be a home cook today and prouder still of the adventures that we’re taking in our kitchens.  We may not be able to afford to travel to Asia, but we can go there nightly at the dinner table.

After reviewing this list, I went to my own refrigerator and asked, “What’s in my door?”  The condiments that I have that did not make the list below are lemon and lime juices, capers, green pepper corns, anchovies, chili paste, and relish. Also, there appears to be a striking omission of Indian chutneys, which could take up an entire compartment in many refrigerators. Then again, this is a self-reported list. Given that Indian cuisine is on many trend lists for 2012, that will mean more recipe postings, and perhaps chutney makes the list next year.  After all, isn’t that how hoisin sauce made it into my refrigerator door?

That’s it for me.  What about you?  Please read, research, and comment below.

Most Popular Condiments

The Well-Fed Heart -

One of the top issues that many people have with learning to cook fish is that the entire food category is simply beyond their experience in the kitchen.  The only fish that many of us grew up with was fish sticks, which isn’t exactly a good precursor for gaining a greater comfort level with fish.

The other day my friend Debbie stopped by with our holiday gift. A gifted chef on board the yacht Alaskan Song, she’s known for her seafood dishes.  When Debbie presented us with our gift, she announced,

“This is the best seafood cookbook I’ve seen in years.”

I was intrigued.  Our present, Good Fish: Sustainable Seafood Recipes from the Pacific Coast by Becky Selengut, turns out to be a great read and a great recipe book, too.  “You already cook with a lot of these ingredients,” Debbie explained.  “Now, Becky shows you how to do it in new ways that aren’t complicated at all.”

Mac and I started reading, flipping through different sections and found that the book is exactly as our friend explained.  Whether you’re a beginner with fish or wanting to cook more heart-healthy fish dinners in the New Year, this author has something for everyone, no matter your locale — East Coast, West Coast or no coast.

Fish made easy for everyone

Each section explains about the raising of that particular species, and its sustainability or gives substitutes, as appropriate.  She tells you which questions to ask before buying, the best season to eat different fish, and tips for getting your money’s worth, as well as how to keep your purchase fresh until using it.

In this spirit, Becky is not a snob. For instance, she writes as delightfully about fresh sardines as she does the canned variety — a gal after my own palette.

We’ve made two recipes so far, and we modified them slightly for our heart health, and the taste was sublime.  For old trout fans like us, it was a sheer wonder to find a new and even faster way to prepare this fantastic fish.

We plan many more dinners using this book.  Here’s a shout out for Becky and all of us who will open her book this holiday season!

Thanks Debbie for mine!

What was your favorite healthy cookbook this year?

The Well-Fed Heart -