Our Thoughts On: Intermittent Fasting + Diets

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Intermittent fasting. You’ve likely heard of it or know someone who has tried it. Intermittent fasting is less focused on what you can and cannot eat and more so focused on when you eat. In a nutshell, intermittent fasting is the process of cycling through periods of fasting and “non-fasting” throughout the day aka voluntary abstinence from food or drink.

Example: Meals are eaten from 8am-3pm, with fasting during the remaining hours of the day. This is one method. Another is 5:2. The 5:2 diet calls for limiting your caloric intake to 500 calories two nonconsecutive days per week while eating a healthy diet in the normal caloric range (2,000 for women; 2,500 for men) the rest of the week.

We are going to get into the science and all of that good stuff BUT FIRST- lets conquer the “diet” culture issue.

It’s controversial- but it doesn’t have to be. Finding a diet that works means that it becomes easy for you and becomes your lifestyle. We are not all wired the same way which means not every type of “diet” will work for everyone. Intuitive eating works for us; however, we have seen patients that do well on ketogenic, intermittent fasting, weight watchers, etc. if you are following a diet correctly. If it works for you, if you find it easy, and you are able to create a lifestyle from it then go for it. A diet should be sustainable and make you feel healthy. It should not feel as if you are deprived. You should not be drifting away at work and obsessing about the foods you cannot eat. If this is you, you are on the wrong “diet” [and we don’t mean just being excited about your next meal- because who isn’t- no, we mean obsession].

But if your “diet” of choice is sustainable and keeps you from chronic disease/obesity- go for it. We give the word “diet” more power than it needs to have and to be honest we aren’t sure why. Diet: the kinds of food that a person habitually eats; therefore, technically, we are all following our own, personal “diet”. To try and put everyone in the same box, to try and say what works for one will work for all- isn’t the case, in our opinion.

With any lifestyle choice [including diet] moderation is key.

Example: with the ketogenic diet- make sure your sodium intake isn’t in excess. Be sure to watch your fat/cholesterol intake. With intermittent fasting- don’t be extreme, be moderate. Don’t fast for days [exceptions sometimes include religious purposes]. Fast because it fits in with your life and your schedule. Whatever makes your body feel good, is what is right for you.

In all honesty, Patrick and I have both seen people that have had wonderful outcomes with ketogenic, intermittent fasting etc. diets. We know of physicians and dietitians themselves on these diets. We know equally as many people who have gained weight from the diets and had a terrible experience. The difference between the people that do well and those who don’t is moderation. You shouldn’t be malnourished, obsessing, or wanting to binge on a gallon of ice cream whenever you get the chance. It should feel sustainable and simple. That’s what a realistic lifestyle change comes down to.

I love what a nutrition professor from Harvard University said,

“But intermittent fasting may have a beneficial effect on diet psychology for some people”, says Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women’s Hospital. “One of my patients felt strongly that he didn’t want to be bothered with tracking calories and filling out food records. Instead, he opted for a 5:2 fasting approach, which has worked well for him”. The main goal is to develop a healthy eating pattern that is sustainable, McManus says.

Before we get into details on intermittent fasting, right off the bat, unless working very closely with your physician, we would not recommend this lifestyle for diabetics [as meals and snacks with insulin schedule is crucial], pregnant women, or people with other medical illnesses. This information is not intended nor implied to be a substitute for medical advice, so please consult your healthcare provider if you have any questions or concerns.

Now back to details on intermittent fasting.


As with every diet, benefits are exaggerated and risks of taking the diet to an “extreme” are downplayed. That’s why knowing the science behind diets is important.

science behind intermittent fasting

“The idea is that during the fasting period, cells are under a mild stress and they respond to the stress adaptively by enhancing their ability to cope with stress and, maybe, to resist disease. Researchers compare this to vigorous exercise, which stresses, muscles and the cardiovascular system. As long as you give your body time to recover, it will grow stronger. There is considerable similarity between how cells respond to the stress of exercise and how cells respond to intermittent fasting.” – Mark Mattson, senior investigator for the National Institute on Aging, part of the US National Institutes of Health. Mark Mattson is also a professor of neuroscience in the Johns Hopkins School of Medicine.

findings from the studies

  • Participants who adhered to the diet lost 8% of their initial body weight over 8 weeks. They also saw a decrease in markers of oxidative stress and inflammation, and improvement of asthma-related symptoms and several quality-of-life indicators.
  • Intermittent restriction (fasting from 10-16hrs/day) was as effective as continuous restriction (5:2 method) for improving weight loss, insulin sensitivity and other health biomarkers.
  • Mattson researched the protective benefits of fasting to neurons. If you don’t eat for 10–16 hours, your body will go to its fat stores for energy, and fatty acids called ketones will be released into the bloodstream. This has been shown to protect memory and learning functionality as well as slow disease processes in the brain.
  • Even a single fasting interval (e.g., overnight) can reduce basal concentrations of metabolic biomarkers associated with chronic disease such as insulin and glucose.
  • IF [intermittent fasting] has been linked to warding off neurodegenerative diseases like Alzheimer’s and Parkinson’s
  • IF has been inked to improving memory and mood.
  • Per a study done at UF, intermittent fasting caused a slight increase to SIRT 3, a well-known gene that promotes longevity and is involved in protective cell responses.
  • The same UF study also showed intermittent fasting decreased insulin levels in the participants, which means the diet could have an anti-diabetic effect as well.

our take from this

We are going to be honest with you – it comes down to calorie intake. Whether it is ketogenic, intermittent fasting, weight watchers, low sugar, Mediterranean, etc- the above benefits are happening, to overweight and obese people, because they are losing fat. Getting rid of excess body fat will improve a person’s metabolic profile and lower cardiovascular risk but there’s no strong evidence that fasting adds health benefits beyond any other weight-loss strategy. If you are already a healthy weight- you already have those benefits mentioned above.

This is why it comes down to you. It depends on what works for you and what is sustainable. It depends on what motivates you. The second your “diet” becomes an unhealthy cycle of restriction and obsession, you lose every single health benefit. Happiness is moderation. Practice discipline without obsession. Do not let your diet define you. Focus on health and nourishing your body. Find your motivation to eat healthy whether that is to avoid chronic disease, feel better about yourself, or to just live your best damn life.

Our best diet recommendation: Increase your fruit + vegetable consumption to 10+ cups a day. Everything else is up to what works for you and what keeps you mentally and physically happy and healthy.


http://www.johnshopkinshealthreview.com/issues/spring-summer-2016/articles/are-there-any-proven-benefits-to-fasting

http://easacademy.org/trainer-resources/article/intermittent-fasting

https://news.harvard.edu/gazette/story/2017/11/intermittent-fasting-may-be-center-of-increasing-lifespan/

http://news.ufl.edu/archive/2015/02/feast-and-famine-diet-could-extend-life-study-shows.html

Eggplant [or Zucchini] Lasagna

Ok guys. This is a Romano Family delicacy and it. is. so. good. Every birthday I am always asking for 1 of 2 things [+ my mom typically makes both]. It’s always either this recipe or the stuffed artichoke recipe. For my vegan friends, we just made this on Sunday without cheese and it tastes EQUALLY delicious. So you know to do with the recipe- kick out the cheese + you’re good to go. Plant based, delicious meal comin right up. 

Two options for this recipe. The traditional family recipe calls for  pan frying the eggplant; however, you can also bake! When I make this recipe at home we bake + it tastes the exact same!

From the Dietitian: Eggplants are an excellent source of fiber, folate, potassium and manganese, as well as vitamins C, K, and B6, phosphorus, copper, thiamin, niacin, and magnesium! For these reasons eggplants are beneficial for healthy skin + bones.

From the Doctor: Why I love eggplant- besides the great taste? It’s great for heart health. One study found eggplants reduced inflammation and improved ventricular function. This is because they are loaded with cardioprotective compounds known as phytonutrients. Also, eggplants lower LDL “bad” cholesterol levels, which in turn, aids in avoiding any plaque build-up [which eventually could lead to blocked arteries].

Eggplants are also an awesome veggie for diabetics due to the low carbohydrate, high fiber content.

photo: savory simple

ingredients

  • 1 or 2 eggplant [you can sub 4 or 5 zucchini- we have made it both ways and you can’t go wrong either way]
  • 3 eggs beaten [for vegan friends, 1 C almond milk]
  • All purpose flour [feel free to use whole wheat, oat, sprouted flour, coconut- this is just to coat the zucchini/eggplant]
  • Seasoned Breadcrumbs
  • Sea Salt
  • Olive Oil
  • 1lb Fresh Mozzarella [grated or sliced thin]
  • Grated Locatelli [Parmesan] cheese
  • Marinara Sauce [click link for recipe]

recipe

  1. Preheat oven to 425
  2. Make marinara sauce recipe above first [or your own red sauce recipe or jar of sauce per preference]
  3. Cut off ends and peel eggplant or zucchini
  4. Cut lengthwise [hot dog style] into slices of about 1/4 in thick
  5. For eggplant, to remove any bitter taste, sprinkle with sea salt and place in a colander. Set aside for a 1-2 hours for best results; then, remove slices, rinse and pat dry [skip this step if you have a time constraint OR if you are using zucchini]
  6. Lightly flour each slice of eggplant or zucchini
  7. Then dip in beaten egg [or almond milk] making sure each slice is thoroughly covered with egg [or milk].
  8. You can either pan fry OR bake.
  9. For Pan Frying: Place about 1/4 C Olive Oil  in a large pan, fry each slice, turning over so that both sides are lightly browned; then, remove from pan and place on paper towel to soak up excess oil. For Baking: After dipping eggplant in both flour + egg. Place as many eggplant as you can fit on a baking pan and bake for 5-8 min [you should be able to easily place your fork through eggplant]
  10. In a large roasting pan- cover bottom of pan with a layer of red sauce. Place slices of eggplant or zucchini in a single layer, side by side to cover sauce; then, top the slices with mozarella and sprinkle with grated cheese. Begin again with sauce and repeat layers until all slices have been used.
  11. Top with sauce and grated cheese.
  12. Cover pan with aluminum foil and bake at 425 for 20-25 minutes.
  13. Top with red pepper to taste.

Hope you enjoy one of our favorite meals of all time. It is so worth the bit of work that goes into it. We promise! Once you do it once, you will find it easy the second time around. Also, making red sauce in large batches and freezing – saves lots of time and helps avoid the “oh no, I’m out of time- have to grab a jar of sauce” situation!

photo: savory simple

Feel free to message us with any questions!

-The Neilan Family-

Baked Hazelnut Falafel

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photo: sails + spices

Hi everyone!! Apologies for going MIA for a few weeks- we were in Kiwi Nation aka New Zealand for two weeks! It was absolutely wonderful- from the people, to the landscape, to the food. Patrick gets about 4 weeks off a year from work [in two week increments] and we always try to take full advantage because the rest of the year is quite chaotic [in the best of ways]! But now it’s back to home cooking [I have to say, we totally missed it- even though the food was probably the best I’ve had in all our travels]. So here is one of my favorite recipes. Super simple if you have a food processor- basically does all the work for you. Falafels are a great source of protein and fiber and a great addition to spaghetti squash, pasta, pita, salad- you name it. The only problem is, typically store or restaurant purchased is fried [not all the time BUT a lot of the time], which kind of defeats the purpose! You can get it just as crispy + delish in either the oven or if you have an air fryer that is a great option too!

Tip: For some extra protein/fiber swap out the hazelnuts for 1 Cup full cooked green lentils! Another super delish falafel recipe!!

The recipe below, although modified, is from sails + spices!

ingredients 

  • 1.5 cups dried chickpeas [if using canned, add 1/4 C flour as mixture will come out too liquidy without]
  • ½ small onion, diced
  • 2 cloves crushed garlic
  • 1 red chili, finely diced
  • 1 tbsp coriander powder
  • 1 tbsp cumin powder
  • 1 cup cilantro (coriandar) with stems, chopped
  • ½ cup parsley leaves, chopped
  • ½ cup hazelnuts
  • 1 tsp of baking soda

recipe 

  1. Preheat oven to 375 degrees.
  2. Line a baking sheet or spray with olive oil
  3. If using dried chickpeas: Put the chickpeas in a large bowl and cover with water by 3 or 4 inches—the beans will triple in volume as they soak. Soak for 12 to 24 hours, checking once or twice to see if you need to add more water to keep the beans submerged. (If the soaking time is inconvenient for you, just leave them in the water until they’re ready). Once ready, you should be able to break them apart between your fingers.
  4. Place all ingredients in a food processor + mix. We don’t puree ours because we prefer it a little clumpier; however, mix to your preference. It should look minced.
  5. Roll the mixture into balls, about 1½ inches each, then flatten them into thick patties. Put the falafel on the prepared pan and brush the tops with the remaining 2 tablespoons oil. Bake until golden all over, 10 to 15 minutes on each side.
Hazelnut-falafels-6
photo: sails + spices

We hope you enjoy!

-The Neilan Family-

Mexican Spaghetti Squash Casserole

Mexican food is my absolute favorite. Definitely up there with sushi + Italian. My husband and I crave it almost on an every-other-week basis. So I knew I had to find a healthy alternative. I love burritos; however, I wasn’t about to indulge that often. At the same time- I wanted to satisfy our craving. Cue the spaghetti squash mexican casserole! Honestly this recipe was totally random. Didn’t see it on Pinterest, didn’t see a recipe- we just happened to have the ingredients around the house. Since then, we’ve probably made it about 20 times already. I just love it so much. But even more than I love it- my husband loves it. Every time I ask what he wants for dinner- this. is. always. the. response. When I’m tired of it- he never is! It’s a great family meal because it lasts awhile too. I make it for my husband often if I’m going away for the weekend because you throw it all together and boom it’s done and lasts! Also- I’m not a big rice fan- I actually prefer the taste of spaghetti squash. If you don’t like spaghetti squash- well before I even go there- try this recipe ONCE with the spaghetti squash and if you’re not a fan, you can always swap it out for some brown rice, quinoa or whatever sounds yum to you. We have a pretty good feeling you’ll like it though!

Of note, the beauty of this recipe is that you can really modify to your own preference! Meatless Monday? Leave out the ground turkey. Vegan? Leave out the cheese + swap the meat for beans. Don’t like corn? Leave it out!

One more thing- you will notice I don’t add salt and that is because the taco seasoning has enough for the whole recipe. No need to add. 

ingredients

  • 2 Large Spaghetti Squash
  • 1 Small Yellow Onion – diced [use half if a large onion]
  • 1/2 Avocado
  • 2 Tbsp sour cream
  • 1 Can Vegetarian Re-fried Beans
  • 1 C Corn [canned, fresh or frozen- we use frozen]
  • 2 Bell Peppers – diced
  • 1 Can Black Beans OR 1lb Ground Turkey Meat
  • 1/2 C Shredded Cheese [we use whatever we have- typically cheddar but have also used mozzarella]
  • 1 Packet of Taco Seasoning Mix [we use McCormick Organics]
  • 2 Jalapeño Peppers [optional] – sliced
  • Fresh Cilantro [optional]
  • Hot sauce [optional]

recipe

  1. Preheat oven to 450.
  2. Prep Spaghetti Squash: If my husband is home, he is able to cut the spaghetti squash in half. If he is not home, I will poke holes in the spaghetti squash with a fork (about 5 times) and throw in the microwave for 5-10 minutes (depends on size of squash). At this point, I am able to cut the squash in half. Then remove seeds (sometimes we save these and bake as a snack), drizzle with olive oil and pepper and throw in the oven for 35 minutes on 450. If you have trouble, check out: https://www.thekitchn.com/how-to-cook-spaghetti-squash-in-the-oven-178036.
  3. While your spaghetti squash is baking- whip up the ground turkey meat (if using- if not, skip to step 5).
  4. Brown ground turkey in medium sized pan and follow instructions on taco seasoning packet.
  5. In a large skillet (separate from turkey meat) saute bell peppers, onion and corn with about a 1 Tbsp of olive oil and pepper for about 10-15 min on medium just to soften them up
  6.  Once spaghetti squash is done baking, reduce heat to 375.
  7.  Scrape spaghetti squash out with fork, creating stringy/spaghetti like squash!
  8. Place spaghetti squash in a 9 x 9 baking dish. Spread evenly.
  9. Layer re-friend beans on top (doesn’t have to be spread perfectly even. as it warms in the oven, it will spread)
  10. Then add either ground turkey meat or black beans on top (whichever you are using)
  11. Lastly, add corn/bell pepper/onion mixture
  12. Sprinkle cheese on top + add sliced jalapeño peppers on top
  13. Place casserole in oven for 20-25 minutes at 375

topping

  1. Mash/Mix 2 Tbsp of Reduced Fat Sour Cream with 1/2 Avocado for topping.
  2. Your done! We recommend a dab of hot sauce + fresh cilantro to top!
  3. If you like salsa, throw some on top! When in Rome (or Mexico bahaha)
mexican-spaghetti-squash-casserole-OPTM
photo: pickled plum

-The Neilan Family-

Brain Health [From a Dietitian Who Works in the Neuro ICU]

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Alright!! Brain health. So important. It falls to the back of people’s minds sometimes because cardiac health is usually at the forefront and weight loss and yadda yadda yadda. Truthfully, they are all intertwined. What’s good for your brain, is great for your heart too and weight management AND your body as a whole- so that’s an awesome plus! Nutritional cognitive neuroscience is an emerging area of research and the goal is to basically understand nutrition’s impact on cognition and brain health across the life span. If we could see our brain (like we can see our skin, our hair, etc) you would see that it ages too! So if we’re going to take care of our skin and buy all kinds of lotions so on and so forth- we should definitely care about the healthy aging of our brains too! Alzheimer’s, dementia, memory loss – we all want to avoid these disease states. The research is clear: What you eat has a big impact on your brain.  The right foods [and combinations of foods] can enhance memory, build new brain cells + even help ward off disease. 

It is a critical time in our little world to discuss brain health. Why? Researchers say one new case of dementia is detected every four seconds globally. They estimate that by the year 2050, more than 115 million people will have dementia worldwide. We blame it on poor diet, isolation, and technology but you all keep reading and draw your own conclusions!

Of note, I know some of my dietitians were hoping for a clinical outlook on brain health and that will definitely happen too BUT will be saved for a different post!

First off, for my folks who prefer tables over reading- this is an AWESOME guide from PubMed on important food/nutrition for brain health [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805706/table/T1/]. For my people who love reading, read on!

the brain + nutrition

The brain is highly susceptible to oxidative damage because of its high metabolic load and its abundance of oxidizable material. This is why anti-oxidants and an anti-inflammation lifestyle are so important for brain health.

  • Berries: Have been shown to have strong antioxidant capacity. This is because polyphenols increase hippocampal plasticity by maintaining metabolic homeostasis. Futhermore, providing protection against oxidative damage and benefiting learning and memory performance.
  • Alpha lipoic acid [spinach, kale, broccoli and potatoes]. This is a coenzyme that is important for maintaining energy homeostasis in mitochondria. Alpha lipoic acid has been shown to improve memory deficits in animal models of Alzheimer’s disease and reduce cognitive decay.
  • Vitamin E. Vitamin E has also been shown to aid in cognitive performance, as decreasing serum levels of vitamin E were associated with poor memory performance in older individuals. Vitamin E is found in vegetable oils, nuts, green leafy vegetables and fortified cereals, and has been shown to extend lifespan and improve mitochondrial function and neurological performance. This is likely because Vitamin E protects synaptic membranes from oxidation.
  • Curcumin [active component of turmeric]. This has been shown to reduce memory deficits in  Alzheimer’s disease and brain trauma. Given the high consumption of curcumin in India, it is possible that it might contribute to the low prevalence of Alzheimer’s disease in that country Curcumin is a strong antioxidant that seems to protect the brain from lipid oxidation and nitric-oxide-based radicals.
  • Olive oil + Green tea: Helps fight inflammation. And while inflammation is the body’s natural response to injury, uncontrolled inflammation over time can damage the brain. “By intervening with these anti-inflammatory foods before neurons die, and you may be able to restore normal brain function,” says Paula C. Bickford, professor of neurosurgery and brain repair at the University of South Florida. You know what most people over 100 all have in common? They drink green tea. Yes. I kid you not. I personally adore matcha- but you pick what’s right for you!
  • Beets, tomatoes + avocados: These foods ensure that your brain receives the blood it needs to stay sharp. Studies suggest increased blood flow to the brain promotes neuron growth in the hippocampus, the area of the brain associated with learning and memory.
  • Nuts (especially walnuts) + pomegranates. These foods fight off amyloid plaques. While amyloid is required for brain cells to communicate, when it accumulates several thousand times beyond normal levels, it forms plaques. These plaques kill neurons while creating inflammation, which kills even more neurons.
  • Fish, blueberries, grapes, + dark chocolate. These foods increase the level of brain-derived neurotrophic factor (BDNF), a protein that supports the growth of new neurons. Scientists have compared it to “miracle grow” for the brain. “Stimulating the release of BDNF not only reverses the effects of aging, but also triggers the brain to make more neurons.”
  • Ginger. Bioactive compounds found in ginger increase activity of acetylcholine, a neurotransmitter that plays an important role in learning and memory.There is evidence that ginger can protect against age-related decline in brain function.
  • Onions + Garlic. Onions are rich in the antioxidant quercetin, which has been shown to protect against ischemic brain damage (a type of stroke) and may improve impaired memory. Garlic has been shown to enhance memory in a multitude of studies.
  • Dates. Studies have shown that increased consumption of dates has beneficial effects in lowering the risk, delaying the onset or slowing down the progression of Alzheimer’s disease. A diet rich in date palm (aka dates) was shown to improve memory, learning and reduce beta amyloid.
Tip: our favorite good for the brain smoothie? Blend 1 C almond milk, 1/2 combo of pecans and walnuts, 1 tsp cinnamon [or to taste- I like a lot!], 3 Medjool Dates, and ice to taste [I do about 1/3 C]. I make this drink at least 4 times a week because we looooove it!

exercise + the brain

  • Exercise changes the brain in ways that protect memory and thinking skills.
  • In a study done at the University of British Columbia, researchers found that regular aerobic exercise, the kind that gets your heart and your sweat glands pumping, appears to boost the size of the hippocampus, the brain area involved in verbal memory and learning. Resistance training, balance and muscle toning exercises did not have the same results.
  • Indirectly, exercise improves mood and sleep, and reduces stress and anxiety. Problems in these areas frequently cause or contribute to cognitive impairment.
  • “Even more exciting is the finding that engaging in a program of regular exercise of moderate intensity over six months or a year is associated with an increase in the volume of selected brain regions,” says Dr. Scott McGinnis, a neurologist at Brigham and Women’s Hospital and an instructor in neurology at Harvard Medical School. This is major!

sleep + the brain

  • Sleep is important to a number of brain functions, including how nerve cells (neurons) communicate with each other.
  • Recent findings suggest that sleep plays a housekeeping role that removes toxins in your brain that build up while you are awake.
  • Lack of sleep increases risk of Alzheimer’s disease. Why? Studies have shown that slow wave sleep disruption increases cerebrospinal fluid amyloid-B levels; therefore, many scientists believe chronic poor sleep during middle age may increase the risk of Alzheimer’s later in life.

social engagement + the brain

  • The “use it or lose it” theory of healthy aging suggests that the mental workout associated with social engagement could help to maintain your mind and memory. Because conversation is a particularly challenging activity, it engages multiple mental skills, including attention, listening, reasoning, language, and memory. “It involves mental gymnastics,” one researcher says. “And you also have to stay abreast of topics, like the news, weather, sports, or politics.”
  • How connected you are to other people can be as important to healthy aging as not smoking or maintaining a good weight.
  • Social engagement may also help to preserve your memory.
  • Dr. Suzanne E. Salamon from Harvard medical center says, “Talking and interacting with people takes energy and makes you work harder, which stimulates your brain.”

cognitive exercise + the brain

  • Healthy practices: Innovation, brain rest, sequential tasking, prioritizing
  • Unhealthy practices: Tied to technology, multitasking (in an unorganized fashion), information overload, “cruising on autopilot”
  • Practice challenging your brain- do not rely on technology to remind you of daily tasks. As awesome and great and innovative as technology is – we have to remember to use our brains to (use it or lose it).

Some ideas of how to challenge your brain (these are kinda silly- but I loved it and it gives you an idea of how to challenge your mind in simple ways)

  • brush your teeth with your non-dominant hand
  • shower with your eyes closed (but be safe!)
  • switch around morning activities
  • turn things upside down (literally). Ex: calendar, photo, clock – doesn’t have to be permanently
  • switch seats at the table- I know we all have a favorite spot BUT switch it up. Variety is the spice of life!
  • smell new things every once in awhile and become familiar. Ex: I purchased ylang ylang essential oil- this is something I have never smelled before but after using it for a week- my brain now recognizes it
  • Open the window in the car (see and smell new things) or spend more time outside
  • Play with coins and try to figure out by touch alone which type of coin you’re holding (at a stop light for example)
  • While at the grocery store, look at new foods you’re not used to picking up- read the label. This way you are getting away from auto-pilot (just picking up what you’re used to)
  • Challenge yourself to small talk- this one is the hardest for me!!! I like real, lengthy conversations where you delve into the juicy stuff (which is good too) but sometimes small take can almost be MORE challenging because you’re thinking of relate-able topics with someone new
  • Eat unfamiliar foods

Hope you enjoyed this read. As a dietitian who works in the Neuro ICU, I LOVE this topic. Feel free to email me with any thoughts/ideas!

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references

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805706/
  2. https://www.ncbi.nlm.nih.gov/books/NBK92775/
  3. https://www.aarp.org/health/brain-health/info-2015/brain-diet.html
  4. https://www.health.harvard.edu/blog/regular-exercise-changes-brain-improve-memory-thinking-skills-201404097110
  5. https://alzheimersnewstoday.com/2017/07/17/alzheimers-risk-may-be-worsened-by-chronic-sleep-deprivation-study-sugggests/
  6. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Understanding-Sleep
  7. https://www.health.harvard.edu/staying-healthy/social-engagement-and-healthy-aging
  8. https://www.rd.com/health/wellness/brain-exercise/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4484046/

My Journey to the Neuro ICU + Its Impact

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I know we have done a lot of recipe posts recently but whenever I take it back to nutrition, I’m in my happiest place. Plus I wanted to give you some background info about me before my next post about nutrition + the brain. Neuro health is near and dear to my heart because- these are the patients I see!! I have the Neuro ICU and then I also have the Neuro stepdown unit (where they go when they leave the ICU). I also have the psych lockdown unit- but that’s a story for another day. Just for some background info…I started my career in dietetics in a 1200 bed hospital in Orlando almost four years ago. There, I started on general floors and after about 4 months-ish I moved to the VTICU and cardiac floors. I looooooooved these patients. The VTICU (vascular thoracic ICU- is where patients go after vascular or thoracic surgeries- CABGs etc.) is special because it’s also where I met my husband. At the time he was a med student doing an ICU rotation. I love the ICU setting for so many reasons. Typically, for nutrition, our interventions are clear cut in the ICU. This is because whether the Neuro ICU or VTICU, the patients are, a lot of the time, intubated (need ventilator support to breathe) and a lot of the times on enteral nutrition (aka tube feeding). Therefore, in the ICU it’s more math than diet education. We take into account- labs, disease state, height/weight history, medications, and nutritional needs when deciding what form of nutrition intervention these patients need. I know a lot of people hear dietitian and they think we are throwing around diet plans like little fairies- not the case. It just depends which unit you’re on. So moving on- I left the hospital in Orlando and we moved to northern Florida for my husband’s residency. I started on general floors again, moved to Oncology/BMT unit and then finally moved back to the ICU – but this time, Neuro! My heart has always been in the ICU. As a dietitian, sometimes you have to wait until certain units become available. So the Neuro ICU was the first ICU available and actually – I wasn’t that excited about it. Fast forward and it is by far my favorite patient population. 

The Neuro ICU, and the hospital we’re currently at in general, has had a major impact on honestly even my daily life- both positive and negative. The negative- I’m finally now spinning as a positive though! It took me awhile but I was able to pinpoint why the current hospital I’m at was giving me SO much more anxiety than the previous hospital I worked at. I loved my first job but I did my job, went home and didn’t really think much of it. The patients I have now, have had SUCH an impact. I finally realized it came down to the type of patients I was now seeing. The hospital I currently work for is a Level One Trauma and we also have a Burn ICU. While my first hospital was gigantic – it did not have trauma. Everything but! I see a lot of patients with traumatic brain injuries from the worst of the worst kinds of accidents. It has in turn, increased my anxiety outside of the hospital. Driving, flying…you name it. I’ve had a pretty challenging time separating patients from personal life. But I’ve been working hard to spin it into something positive. I feel so thankful for my health and my family’s health every. single. day. There is something about seeing an innocent 20 year old, in the hospital for a TBI from a car accident, and they’re mind just isn’t there anymore. Seeing how this impacts their parents and their families… I mean it’s very, very heartbreaking. Not to say that patients in the hospital with other disease states don’t hit home too but for some reason or another Neuro has left a tad more of a mark.

Every morning I come to work- my office is on the same floor as the Neuro ICU- and I see these families that literally sleep there for weeks and don’t go home. We have showers in the waiting room and a lot of them will bring pillows, their kids, blankets, sleeping bags and just stay there…waiting on their family or friend to get better and sometimes they don’t/sometimes they do. There isn’t a morning though that seeing that doesn’t effect me. In the best of ways.

Patrick and I always say we wish we could give people just a glimpse into what disease and trauma looks like- people would change their lives immediately. Health is important – THE most important thing. Losing it, is not fun- to put it lightly. It’s agonizing. A lot of these families and patients (if not all) wish they had the opportunity, that most of you reading this blog have- to change your life for the healthier and be thankful for every day. We are all taught to worry about other things- our hair, our cars, our homes- really none of that is important in comparison to your health.

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Ok I went deep with you all and now we can get on to Neuro Health!!! But I had to share my experience in Critical Care + the Hospital setting. If it motivates even one person- totally worth it!

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-The Neilan Family-

Secret Romano Marinara [red sauce]

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Photo: Francesco Tonelli for The New York Times

I am 100% Italian as far back as we know. Maiden name- Romano. My dad’s side- Sicilian and my mom’s from Northern Italy. My mom knows. how. to cook. and my dad – is the pickiest Italian man on the planet (but knows good food!). You can trust this sauce is delish, authentic + honestly, quite simple. We make it in large batches and throw it in the freezer, this way every time we cook we don’t have to make a fresh batch. It would be a sin in our house to use sauce from a jar- I think my parents would disown me entirely so I’ve learned freezing in batches DEFINITELY helps. There are variations of this sauce- she has a meat sauce, fish sauce, vodka sauce- it goes on and on but for today- lets start with the basic marinara sauce. 

ingredients 

  • 3-4 Tbsp of olive oil [enough to coat bottom of the pot]
  • 3-4 Cloves fresh galic, chopped
  • 1-2 Tbsp of sugar [we typically use 1.5 Tbsp sugar but you can sub 2 tsp Truvia]
  • 1 20oz can of Progresso whole tomatoes w/ basil [you can also use fresh tomatoes if you’re really feeling adventurous- we mostly use Progresso]
  • 1 Tsp dried or fresh basil

recipe

  1. Pour tomatoes into blender and blend just for a few seconds, until finely chopped
  2. In a medium sized saucepan, saute garlic and oil. Do not let garlic brown.
  3. Pour in blended tomatoes and add remaining ingredients.
  4. Salt and Pepper to taste
  5. Bring to boil, then reduce heat and simmer for about 20-30 min

That’s it! Kinda silly that people are terrified of making homemade sauce when you see how easy it is! I think the biggest mistake is too many ingredients. Over seasoning is a real thing folks + sometimes simple is best.

-The Romano + Neilan Family-