Keeping PACE – Food for Thought

Keeping PACE – Food for Thought

March was National Nutrition Month. This annual campaign was created 50 years ago by the Academy of Nutrition and Dietetics. This was a perfect opportunity to connect with Kelsi Bruno, a Registered Dietitian at Senior Care Partners PACE. The conversation and suggestions below are opinion and information intended for a general audience. You should consult with your doctor before making any significant changes regarding your specific nutrition and eating habits.


Ryan: Is there one, or maybe two, nutrition tips that apply to almost everyone? Is there something that we could all do better when it comes to nutrition?

Kelsi: For general healthful nutrition education, we like to refer to MyPlate. It is a guideline on how to balance your meals to get enough carbs, protein, and fruits and vegetables in a day. The recommendation uses a standard 9” plate. Fill one half of your plate with a variety of fruits and non-starchy vegetables. Try to get as colorful as possible! One quarter of the plate is filled with a protein source. This can be animal or plant sources of protein. The last quarter is filled with your starches – pasta, bread, rice, or starchy vegetables. Also, it is important to emphasize proper hydration! I think we focus so much on food sometimes we forget that drinking enough water is essential as well. Perhaps the most important thing to remember when it comes to nutrition is to keep it simple. As a society, we tend to over complicate things.


Ryan: Can you solve the age-old debate for us? What is the most important meal of the day?

Kelsi: As Registered Dietitians, we believe that all meals are important! But if you are talking specifically breakfast, there are some very good selling points about why consuming breakfast daily is beneficial for your health and may be considered the most important meal. We wouldn’t try to drive a car with no gas, so we need to think about our bodies in the same way. Fueling your body in the morning gives it the energy it needs to function, especially your brain. The morning is also when your body is most sensitive to insulin and when it uses blood sugar most effectively. It is a great time to eat fiber-filled carbs to help lower cholesterol and promote heart health. Although, we like to focus on food intake as a whole throughout the day rather than specific meals, so if breakfast is not your thing early in the morning, listen to your hunger cues. The importance of breakfast varies from person to person and skipping it is not the end all, be all of chance to fuel your body during the day.


Ryan: Some people do the traditional three meals a day – breakfast, lunch, and supper. Others do more small meals or snacks throughout the day. Is one method better than the other?

Kelsi: Everyone has individualized nutrition needs, and what works for one person, may not work for someone else and vice versa. Again, we look at nutrient intake as a whole and the number of meals required to reach their nutrition goals in a day can be modified as needed. As nutrition experts, we spend a lot of time working with individuals who have specific medical needs that prevent them from eating the traditional 3 meals a day. In many cases we actually recommend small, frequent meals. There are other times when we focus on 3 larger meals plus snacks because it supports those specific medical needs. Neither is better than the other and both can absolutely meet a person’s required nutrition needs.


Ryan: What would you say to the person who says, “I don’t like ‘healthy’ foods. They don’t taste as good.”?

Kelsi: I think that the term “healthy food” has, unfortunately, been correlated with bland, dry, tasteless food for a long time. When in fact, nutrient dense foods, as we like to call them, can be enjoyed and very flavorful. A lot of times, the education on how to make these “healthy foods” taste good is lacking so the perception of them is negative. This is one of the things that RD’s can help with. Exploring each person’s likes and dislikes and working with them on an individual basis to create dishes or find recipes that include nutrient dense foods, but that are also enjoyable for this person to eat. This isn’t saying someone is magically going to love all vegetables, I even have those I avoid, just that it is possible to meet your health goals without having to sacrifice the food you love to eat!


Ryan: Two factors that I struggle with when it comes to healthier eating habits are cost and convenience. Hitting the McDonald’s drive thru when I’m in a hurry, is much quicker than other options and, probably, cheaper. It seems like healthier options cost more than less healthy choices. I also find myself thinking that the healthier option is going to take more time and/or work to get prepared. How do you address those struggles?

Kelsi: This is a huge struggle in many peoples’ lives, especially today with the cost of food continuing to increase. I think the first step in alleviating some of that struggle is to stop demonizing canned and frozen foods. The idea exists with some that the only way to eat healthy is to eat all fresh produce and to “stick to the outside aisles of the store” when shopping. While these foods are a great option, they tend to be more expensive and are not feasible for many people. There are more affordable options, such as canned and frozen foods, that are still good options to fuel your body. An RD can provide education on how to choose these items, read nutrition labels to choose lower sodium and lower sugar options, and provide creative ways to create meals with these items. As far as convenience, pre-planning is key. Is it important to you to create space during your week to prepare meals/snacks ahead of time? How much time do you have to support the goal of eating more homemade meals? Fast food is often the more convenient choice, especially if you know there is nothing already prepared at home. Meal planning and prepping for the week really is an effective way to eat more meals at home if that is your goal.


Ryan: It feels like every few weeks a new diet is being pitched – Keto, Paleo, no carbs, gluten free, high fat, low fat, all bacon, all liquids, Atkins. We had Jared doing the Subway meal plan and now there is a guy trying the McDonald’s diet. How do I know what is right for me?

Kelsi: Meet with a Registered Dietitian! With TV and social media influencing our food choices at an all-time high, we all know how difficult it is to sift through all the information and figure out what is best for our own individual needs. It is truly overwhelming, even for someone who is a nutrition professional, to keep up with the latest food trends. I can’t imagine how the general public feels. A lot of times, many of these “FAD diets” you mentioned can actually cause more harm than good because there is no one sitting down with you and explaining the science behind how they work, what they can or can’t do for your body, how to correctly follow the diet, and no one helping you deciding which one is most appropriate for your specific health needs and health goals. The food you put into your body doesn’t have to be as complicated as some of these diets are recommending, and speaking with a nutrition professional can help get you on the right track of where you want to be.


Ryan: This may seem like a rhetorical question, but I’m going to ask it anyway. Is there more to healthy living than just what we eat?

Kelsi: I love this question. Food is the basis of all life. If you think about Maslow’s Hierarchy of needs, physiological needs – food, air, water, sleep – are at the bottom of the pyramid. They are holding everything up. If we don’t eat, and we don’t eat well, there will be no other parts of our life that will thrive. But food is not all that we need to meet our health needs. As we move up the pyramid, our physical health is important, our mental health is important, our emotional health, our social interactions, doing the things we love daily and feeling a sense of purpose are all very important. One of the best parts about my job is getting to be the person to help people choose the foods to eat that will let them fully thrive in all these other aspects of health. This can include helping someone include 5 servings of fruits and vegetables in their day to help keep their immune system pumping, to helping someone eat enough protein to support their love of going on hikes every day. I could help someone choose foods to avoid gluten because of an allergy, or even validate someone in their choice to eat ice cream for dinner because they were having a bad day and their mental health needed it. Health will always be multifactorial, and it is important that we all figure out what that looks like in our lives.


Ryan: We’ve addressed some of the “what to eat” questions. Is there a right or wrong time to eat?

Kelsi: Ideally, the goal is to eat something within 2 hours of waking up, but that isn’t always the case for everyone. If someone is just not a breakfast eater, we recommend eating as soon as you feel hungry. There is also the debate of not eating food too close to bedtime, but that can’t always be accommodated. Due to different life circumstances, such as weird job hours and family obligations, some people’s only time to eat is right before bed, and we ALWAYS recommend eating over not eating just because it is close to bedtime. Again, listening to hunger cues. I think the problem is a lot of people tend to choose less nutrient dense foods when they are snacking right before bed, so it is important to be mindful of our food choices at this time. As far as the “in between” hours, there is no right or wrong time to fuel your body as long as you are eating when you feel hungry.


Ryan: Another area that readers may struggle with, I know I do, is portion size. Do you have any tips on getting a better understanding how much we should be eating of certain foods?

Kelsi: It is common in the U.S. to consume portions much larger than what is recommended as a serving size. Many people are shocked when they find out what most food recommendations are for a serving size. This causes what is called portion distortion for many people. As a society we have become accustomed to “filling our plates” when we eat as a better value when is reality, many people are overeating. Ways to help with portion control is to read labels to identify appropriate serving sizes and eat from a plate or bowl rather than the package. It is also helpful to use tools to stick to portion sizes such as measuring cups and spoons. Using smaller dinnerware to make the portion seem larger and leave you feeling more satisfied. Lastly, skip the upgrade. When dining out, the upgrade may seem like a good deal, but it can often cause you to overeat with the urge to finish your plate and leave you feeling stuffed.


I was apprehensive about having this conversation because I knew that some of the answers were going to be convicting. I have some work to do. I appreciate Kelsi taking time to share with us and for providing practical suggestions that we can incorporate into our daily lives. In my option, heathier eating shouldn’t be viewed so as much as restricting us as it is helping us to do more, live more, be more. We can do this!


Author(s): Ryan Miller, Senior Care Partners P.A.C.E with Kelsi Bruno, Senior Care Partners P.A.C.E.


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