NIFS Healthy Living Blog

Halloween is a day full of fun, costumes, treats, friends, and family! With all the food and candy, is it even possible to be “healthy” and still enjoy the festivities? The answer is YES. Take a look at these SPOOK-tacular tips to keep you and your family in good health.

Find a Balance

Halloween comes around once a year. It’s a time to feed your social and mental health, which may require easing up on the physical health guidelines for a moment. Remember, any decision you make for your physical health that comes at the expense of your social and mental health may not be all that great after all.

Let’s be honest, Halloween is FUN. The candy is FUN. Trick-or-treating is FUN. All this feeds our mental and social health. Plus, think about it: daily nutritional choices consistently over time have the greater impact on your health than nutrition choices on one holiday.

What does this “balance” look like? Keep reading.

Use portion control and omit the “off-limits” mentality.

All foods in moderation can fit into a healthy regimen. Instead of making candy off-limits, work it into your established routine. Still have breakfast, lunch, and dinner. Make those meals nutritious, including fruits, veggies, whole grains, and lean proteins. At each meal, offer one serving of Halloween candy to everyone. Instead of the full-size pieces, make them like the “fun-size” or “snack-size.” This allows everyone to enjoy a sweet, while filling up on the nutritious foods that are important for physical health.

Make festive, healthy options.

On the day that you all go trick-or-treating, really get into the spirit! Make nutritious meals that are Halloween themed. Some examples include:

• Green-goop smoothie with Halloween straws: Include low-fat Greek yogurt, spinach, chia seeds, pineapple, and low-fat milk of choice. Try this recipe.
• Monster teeth: Slice a green apple. Smear peanut butter on one side of a slice (bottom lip of the mouth). Stick yogurt-covered raisins in the peanut butter. Smear a little more peanut butter on another apple slice and place on top of the raisins for the top lip.
• Boo-nana pops: Cut bananas in half and place a stick in the end as a handle. At the tip of the banana, add two chocolate chips as eyes. Serve frozen, cold, or at room temperature.
• Devil spiders: Make deviled eggs. On the top, put an olive in the center for the spider’s body. Then put slices of olives around the outer edge of the egg for the legs.
• Cute pumpkins: Peel Cuties/clementines/mandarins. Slice celery into small sticks. Place a celery stick at the top of each mandarin for the pumpkin stem.
• Yo-yo graveyard: Scoop nonfat Greek yogurt into cups. Crumble some chocolate cookies on top (just a thin layer to cover the top) for the dirt. Write “Boo” on graham crackers for tombstones. Place one tombstone in each yogurt cup.
• Spider sandwich: Make a sandwich of choice. Cut the sandwich into a circle. Place chocolate chips as the eyes (use peanut butter to help them stick). Use pretzels as the legs, sticking them into the bread or middle of the sandwich, with the tips sticking out.
• Ghost cheese sticks: Get individually wrapped mozzarella cheese sticks. Take a sharpie and make black dots for the eyes and a block dot for an open mouth. These make perfect snacks while you are out and about trick-or-treating.

This ensures everyone is filling up on nutritious options high in fiber and protein, which leaves less room for tons of candy. Now, do not mistake this for “NO ROOM” for candy. There is still room, but not as much. You are just making sure everyone is properly nourished and still having fun in the process.

When you get home that night, enjoy a few pieces of candy with the kiddos, then put it in a non-accessible place. You are in control of when and how much the kids get. You are also in control of when and how much you get as well. Refer to what I said about portion control to plan your approach here. Remain consistent so that you and the kids both have a clear understanding of when candy will be served. For example, one individual piece will be served with each meal. It gives both you and the kids something to look forward to and does not make candy off-limits, but instead teaches proper portion control and provides a positive relationship with all foods. In the long run, this reduces binging or obsessing over any one food.

Stay active.

One of the best things you can do is to get everyone moving and active. Be sure to get in a workout on the big day, even if it is a quick 20-minute HIIT session at home, or try this spooky workout. Get the kiddos moving with you! Walk from house to house instead of driving during trick-or-treating. Go on a walk in your costumes if you are not trick-or-treating this year. Or just go on a walk in your regular clothes and enjoy all the house decorations. You can also play games:

• Monster Tag: The tagger is a monster and anyone they tag becomes the monster.
• Monster vs. Ghost Freeze Tag: If the monster tags you, you become frozen until one of your ghost teammates unfreezes you. The goal is for the monster to freeze all the ghosts!

ENJOY HALLOWEEN!

Have fun with your family. Soak in the moments. Laugh a lot. Feed your mental and social health, knowing it will benefit your physical health in the long run and that choices you make consistently over time matter the most. Stay safe.

As always, reach out to your NIFS Registered Dietitian if you need some holiday nutrition support.

This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Let’s be real: a health journey is not always linear and not always easy. Sometimes it can be overwhelming and mucky. What do you do? Where do you start? What if you backslid and need to get back on track? There is so much to health, right? If you try to fix it all at once, you might become overwhelmed and at a greater risk of failure.

Small Actions That Will Have a Big Impact on Your Health

Start with the things that seem small but make the most impact on your health.In this blog I identify five areas that will give you the biggest results for your efforts. Spoiler alert: none require silly supplements, tummy wraps, or popular diets such as Keto or Paleo.

Get 7–8 hours of sleep each night.

Sleep is our body's cheat code for restoration, rebuilding, and recovery from all of the sources of stress. You can eat all the nutritious foods in the world and exercise for hours, but if you are not sleeping, hormone imbalance starts working against you and halts your physical goals.

Fun Fact: A study at UC San Francisco found that those who sleep less than 5 hours are 4.5 times more likely to develop the common cold compared to those who sleep 7 hours. So hit the hay and keep infection at bay! Your body will thank you later.

Manage stress and mental health.

We all have stress. It’s important to manage the stress instead of using negative coping mechanisms, such as overeating, sleeping all day, isolating ourselves, and falling into the “I can’t change this” trap.

YOU CAN CHANGE THIS. You can get through this, and you can manage the stress in your life. Coping has its place in the health cycle, but ultimately, we want to shift into the “stress management” part of the cycle sooner rather than later. Coping is when we put up with the stress, live with it, and accept that it’s just the way it is (nothing can “lessen” the stress). Managing stress is when we try to lessen the stress by adjusting our thoughts and actions; we find a way to make it better. Examples include music, therapy, exercise, time management, making lists, saying “no,” nature, yoga, meditation, stepping away from toxic relationships, and doing a hobby.

Start dialing in on your nutrition.

What we eat fuels our physical, mental, emotional, and social health. Because of this, nutrition can get a bit complicated sometimes. So, start with small but significant changes and build from there. My suggestion is to start by practicing the 80/20 rule and having a consistent meal pattern.

So what does 80/20 mean? We all know it’s important to eat nutritious, whole foods. But what about those foods we love that aren't necessarily the best for our physical health but are good for our mental and social health (such as sweets, chips, pizza, eating out with friends, holiday food, etc.)? It’s unrealistic to cut these foods and events out of our lives—let’s be real, we have all tried this and failed. It's time to find a balance, one that will still keep you on track for hitting your health and fitness goals.

Here are the #dEATS: 80% of your food intake should be from nutritious, whole foods such as fruits, vegetables, lean proteins, legumes, whole grains, and high-quality dairy (if you’re not lactose intolerant). The other 20% of intake (calorie intake) should be from the foods you love and can't live without, but maybe aren't the greatest for your physical health. Use this 20% when going out with friends once a week, enjoying a sweet treat every other day, or grabbing a small bag of chips to compliment your chicken sandwich.

If you have a calorie goal, track these calories and make them part of your regimen to meet your daily caloric goal. If you do not have a calorie goal, practice portion control. Regardless, be sure to have a consistent meal pattern (3 meals and 2 snacks daily). Remember, there is more to health than just our physical bodies. The two other realms of health are mental and social. Food plays a big role in all three realms that make up health. Therefore, you must have a food plan that meets the needs of all three.

Increase your daily steps or non-exercise activity.

Get up and moving. I know it’s hard to do this, especially for those with desk jobs. But take a 10–15-minute break to walk in place, stretch, and do some deskercise. If you can get out and take a walk with some coworkers during the day or your family at night, do that! This gets your body moving and your metabolism going. You may be surprised at what some extra movement does for your mental and physical health.

Exercise 150–300 minutes per week.

Aside from trying to move throughout your day, plan to exercise 150–300 minutes each week. This exercise should be moderate to high-intensity. Be sure to consult a personal trainer if you are unsure what is best for you. Find something you enjoy and start there.

Incorporate Changes to Your Routine and Then Build on It

These are some starting points. Pick a few and get started. Do not overcomplicate this. No, you do not need a fad diet. No, you do not need a ton of supplements. No, you do not need to overcomplicate the timing of meals or workouts. These BIG FIVE are some of the most important things you can do to improve your health. What you need is to find a routine with all five of these points and build consistency over time. Once these become a part of your everyday life, you can dig deeper into other things, such as supplements, meal timing, and specific exercise movements.

As always, NIFS professionals are here to help! Reach out if you need help implementing any of these big 5 health improvements.

This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Did you know that cardiovascular disease is one of the leading causes of death? According to the CDC, heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States. One person dies every 36 seconds in the United States from cardiovascular disease. About 655,000 Americans die from heart disease each year—that's 1 in every 4 deaths.

It’s because of this fact that the American Heart Association (AHA) has poured millions into heart research and producing guidelines to help people not only manage heart conditions but prevent them, too. One initiative by the AHA that has been around is the Life’s Simple 7 for heart health. Life's Simple 7 is defined by the American Heart Association as the 7 risk factors that people can improve through lifestyle changes to help achieve ideal cardiovascular health. Let’s take a look!

Life’s Simple 7

1. Manage blood pressure. High blood pressure can put strain on your heart, arteries, and kidneys, leading to heart disease and stroke. Both exercise and nutrition can help here. Nutritionally speaking, be sure to watch your sodium (salt) intake, keeping your intake at 1,500–2,300mg per day. Also, eat plenty of fruits and veggies to get fiber!
2. Control cholesterol. When cholesterol levels are high, plaque buildup causes clogged arteries. This also leads to stroke and heart disease. For healthy cholesterol levels, it is important to manage total fat intake and eat a balanced diet. Fat intake should make up about 20–35% of total calories. Of those fats, be sure that the bulk come from unsaturated sources, such as olive oil, avocado, nuts, and seeds. 
3. Reduce blood sugar. Everything we eat turns into sugar (aka glucose), but glucose is most readily available in the carbohydrates we eat. Our bodies use this glucose for energy. Now, carbohydrates and glucose are important! However, just like everything else, we want to find a balance. Chronically high levels of blood glucose can be damaging to the heart, eyes, nerves, and kidneys. If you struggle with high blood sugar, be sure to consult your Registered Dietitian, Primary Care Provider, and Endocrinologist. The team can come up with a care plan to manage your blood sugar.
4. Get active. Living an active life comes with far more benefits than just heart health! But for heart health, it is recommended to exercise 150–300 minutes per week at a moderate intensity level. Outside of that time, be sure to stay active by going on walks, doing yard work, taking “standing breaks” from sitting down, and stretching.
5. Eat better. A balanced and nutritious diet is always a game changer. The things we put into our bodies matter. When you eat a nutritious diet, you are giving your body one of the best weapons to combat cardiovascular disease. This goes both ways, though; when we eat junk a majority of the time, we are opening the gates to a plethora of chronic diseases.
6. Maintain a healthy weight. To be honest, I wish this said “maintain a healthy body composition.” Current research shows that body composition (fat mass and lean body mass) is far more indicative of risk for chronic disease than total body weight. Maintaining healthy body fat levels and adequate lean muscle mass reduces the burden on your heart, lungs, blood vessels, and skeleton.
7. Stop smoking. Cigarette smoking is one of the leading risk factors for cardiovascular disease. If you do smoke, consider sitting down with your healthcare team and coming up with a plan to quit. Like everything, this is absolutely your choice, but do be aware that smoking drastically increases your chances of heart disease.

Take It One Step at a Time

Now, if you are anything like me, you may be thinking “that is not ‘simple.’” Trust me, I agree. That is my only critique of these guidelines. It is not that simple. These things take work and time; I do not want to downplay that. My suggestion is to pick one at a time and work on it. Then, once you have that down, move on to another. Keep repeating this until you feel like all your bases are covered and heart-healthy lifestyle habits are in place.

NIFS Can Help

As always, NIFS professionals are here to help! We have certified personal trainers to assist in getting active (step 4); a Clinical Registered Dietitian who can assist with eating better (step 5) and blood sugar, blood pressure, and cholesterol control (steps 1–3); a weight-loss program for step 6; and health coaches to help with navigating lifestyle steps to stop smoking. All of these can, in turn, lead to healthier cholesterol, blood sugar, and blood pressure levels (steps 1–3). Please reach out if you need anything! We are here to help keep you and your heart healthy. 

This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Think about some top goals you have. Maybe your top goal is to lose weight. Your weight-loss journey is what I call the “Big Picture”—your target on losing weight and starting a healthier lifestyle. Sometimes the big picture can be daunting. Many might perceive this goal as too big, or virtually unattainable. But IT IS ATTAINABLE! It just takes focus and hard work.

The best way to accomplish your big-picture goal is to first make the goal SMART (more on that shortly). Then, create smaller, short-term goals that you can check off along the way. These are sometimes called action steps. Action steps will allow you to create small habits that will help you not only REACH your goal, but also ultimately maintain your success.

GET SMART

SMART is an acronym:

• Specific: Clearly identify the goal. Be concise.
• Measurable: Attach a measure to the goal such as inches or blood-work measurements (%, mg/dL, etc), minutes, or percentage).
• Attainable: Ensure that the goals are realistic and manageable. Really think deeply about this. Be honest about yourself and your lifestyle.
• Relevant: Make sure the goal is important to you.
• Time-bound: Define the timeframe during which you are aiming to achieve the goal.

Here are some SMART goal examples:

• I will decrease my mile time from 8:30 to 8 minutes over the next 4 weeks.
• I will drink 100 oz of water each day for the next 4 weeks.
• I will decrease my HgA1c by 1% in 3 months.

Create Your Action Steps

Now that you have determined the BIG GOAL, it is time to create action steps that will help you reach that goal. Think of these as mini SMART goals.

1. List 3-5 action steps (or habits) that pertain to your overall goal.
2. Explain how they will help you reach the big goal.
3. Decide how you are going to track your success with each action step you take.

Here are some examples of action steps:

Let’s use the SMART goal example from above. I will decrease my mile time from 8:30 to 8 minutes over the next 4 weeks. Here are some action steps that may help someone reach that goal:

• Run 5 days per week for 15–30 minutes over the course of 4 weeks.
• Run 4, 1-mile repeats 1 time per week until I retest my mile time in 4 weeks.
• Hire a running coach immediately to assist me in programming a customized running plan.

Questions to Ask Yourself Later

Once you’ve achieved an action step, ask yourself these questions:

• How did you do?
• How did it make you feel?
• Was it easy to do, or were you pretty challenged to stay on track?
• Does it still pertain to your overall goal?
• What worked and what didn’t?
• What needs to change?

The answers to these questions will help you determine whether you are staying focused on your goal, whether you are ready to take on or create another SMART goal, or if you need a little more time to concentrate on the one you are trying to turn into a habit.

Once you feel that you have accomplished your goal, work on another. Make changes and adjustments as needed throughout your journey. And even though these steps seem small, they ultimately lead to a large reward.

Check out this blog for an even closer look at the goal-setting process and why it's important!

This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Cranberries and cranberry-derived products are commonly used as a remedy for urinary tract infections, especially among women. Cranberries contain proanthocyanidins (PACs), specifically A type (PAC-A). It is argued that this component of cranberries fights and prevents UTIs, just as an antibiotic would. However, there is much controversy on this topic.

Clinical Trials and Studies on Cranberry for UTIs

Freire Gde C. completed a large review of 24 studies totaling 4,473 participants. In the research, there was minimal evidence suggesting that cranberry products prevented UTIs. Within those studies, cranberry juice decreased the number of UTIs in women who had recurring UTIs; however, the studies that showed a significant efficacy were small trials. When studies grew in size, the difference between the placebo groups and the cranberry groups shrank.

Furthermore, a Stapleton AE et al study completed a randomized control trial of 176 participants, of whom 120 were taking cranberry juice and 56 were given the placebo over the course of 168 days. The adherence to instruction was similar between both groups (91.8% and 90.3%). However, cranberry juice did not significantly reduce UTIs.

The Maki KC et al study argues that cranberry juice intake does indeed lower the number of UTI episodes in women with a UTI history. In their RCT, 185 women were given 240-mL cranberry juice each day for 24 weeks, while 188 women were given the placebo. The cranberry group had 39 UTIs, while the placebo group had 67 UTIs. This makes the differences significant, meaning cranberry juice did indeed work.

So, why do some trials show significance while others do not? Occhipinti A et al¹ suggests this is due to the lack of authentication of cranberry products used (some are not really cranberry-derived). Thus, the products used do not contain PACs-A, which are what scientists claim fight the UTI. In their study, they authenticated and measured the PCAs-A in the cranberry product given. They gave one group a cranberry product with 36 mg PACs-A two times daily and another group with the same number of participants a product with no PACs (placebo). After 7 days, a significant difference in colony forming unit/mL counts (via urine cultures) was found between the placebo and the PACs-A group. The PACs-A group had significantly fewer colonies. The argument here is that for cranberry products to work, the cranberry product must be carefully authenticated to ensure that it indeed contains PACs-A, which is a component typically lost in processing.

The argument here is that for cranberry products to work, the cranberry product must be carefully authenticated to ensure that it indeed contains PACs-A, which is a component typically lost in processing.

Drug Interactions, Additive Effects and Side Effects

Lexicomp, a drug database used by medical professionals, still advises people to monitor cranberry intake while taking warfarin; however, there is little research to suggest the two adversely interact. Since cranberry juice is acidic, it is important to avoid drinking it within 2 hours of taking erythromycin, a common antibiotic, because it will decrease metabolism of the drug.

Common side effects of cranberry are nausea, vomiting, tightness in the chest, itching, cough, swelling of the face or lips, seizures, GI upset, and loose stools.

The Clinical Bottom Line

There is little evidence that suggests cranberry products decrease UTIs, mainly because the PACs-A have been lost in the processing. Although people are welcome to use cranberry-derived products, I would warn about the GI upset that can occur with excessive use, the cost of cranberry tablets, lack of authentication of the products, and added sugar content in the juices. Because of the lack of evidence, I would not advise individuals to spend their money on cranberry tablets. I would also argue that the risks associated with added sugars in the juices outweigh the small chance of preventing a UTI. If you insist on using cranberry for UTIs, be sure that it contains the bioactive PACs-A.

Further Research Is Needed

Much of the research done to prove cranberry juices and products prevent UTIs fails to address the authentication of the products used, and whether they even contain the bioactive PACs-A. I think further research should include authentication of the products used. If they do that, they may see that cranberry can indeed reduce and treat UTIs.

This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Healthcare providers and scientists are all working diligently to find ways to prevent, treat, and cure COVID-19. Many of us are eager for answers and probably getting tired of not knowing what to believe. One of the hot topics floating around is about Vitamin D’s role in preventing COVID-19. Can Vitamin D really protect us against COVID-19 or at least lessen the effects? Let’s take a look.

The Role of Vitamin D

Vitamin D serves many purposes in the body, the most commonly known purpose being assisting calcium absorption and bone mineralization for good bone health. It is less well known that Vitamin D plays an essential role in immunologic function—keeping your immune system strong. Vitamin D inhibits both B cell and T cell (lymphocyte) proliferation/rapid increase, affects T cell maturation, and facilitates the induction of T regulatory cells. It also helps regulate monocytes production of inflammatory markers and inhibits dendritic cell (DC) differentiation and maturation. All of this leads to a decreased production of inflammatory markers and an increase in anti-inflammatory markers. In short, it has an anti-inflammatory role.

Vitamin D and COVID

Now that you understand the role of Vitamin D in immune support, let’s look at the link between that and COVID-19. When healthcare providers check your Vitamin D levels, they request a lab called 25-hydroxyvitamin d. This is the circulating Vitamin D in your body. Ideally, we want to see that number be at least 30 ng/dL. In theory, having enough circulating Vitamin D should reduce complications by preventing the “cytokine storm” that providers are seeing in response to COVID-19 infection. The cytokine storm is when the level of inflammatory proteins rapidly rises to dangerously high levels. It is what leads to complications such as ARDS, myocarditis, and acute renal and heart failure, especially in those elderly patients with previous cardiovascular comorbidity. Researchers have started requesting this lab from patients with COVID-19.

Study Shows Decreased Risk for Adverse Affects

One cross-sectional study of 235 individuals showed that patients with at least 30 ng/dL had a significantly decreased risk for adverse effects, such as hypoxia (low oxygen levels), death of individuals over 40, and unconsciousness. Serum C-reactive protein (an inflammatory marker) was lower and lymphocyte percentage was higher in Vitamin D–sufficient COVID-19 patients. In the study, 67.2% of the 235 COVID patients had Vitamin D levels less than 30 ng/dL. The study saw no significant difference in hospitalization duration, ICU admissions, Acute Respiratory Distress Syndrome (ARDS), and intubation between insufficient and adequate Vitamin D levels.

Similarly, a study showed Vitamin D levels were significantly lower in COVID patients with severe symptoms than those with mild symptoms or no COVID at all. Of the symptomatic patients, 54 were admitted to the ICU due to ARDS—all of whom had lower Vitamin D levels than the patients not needing the ICU. Sadly, 19 patients died, and again they found that these patients had lower Vitamin D levels than the ones who survived.

Another Study Finds Lower Levels of Vitamin D in Hospitalized Patients

A study of 216 COVID-19 patients and 197 population-based controls saw significantly lower levels of Vitamin D in the patients hospitalized due to COVID-19 than the controls (of similar age and sex), which lines up with the previous studies. On the contrary, they did not find a relationship between severity of infection and Vitamin D levels like the other studies found.

Study Finds People with Vitamin D Deficiency More Likely to Test Positive

Another study of 489 patients found that those with Vitamin D deficiency (<20 ng/dL) were 1.77 times more likely to test positive for COVID-19 than those with sufficient Vitamin D levels. The study above by Hernandez et al supports this finding, showing that 82.2% of COVID-19 cases were deficient in Vitamin D compared to the population-based controls, where only 47.2% were deficient (which is significant).

Correlation Is Not Causation

Something to note: These studies are observational studies. Thus, we cannot determine a cause-and-effect relationship between vitamin D deficiency and COVID-19 infection outcomes. Correlation is not synonymous with causation. So, while these results are important and useful, we must be careful to not go as far as saying, “Vitamin D can protect me from COVID-19 or lessen the impact if I get sick with COVID-19.”

Further research is being conducted since we do have strong observational support that suggests low Vitamin D levels may favor respiratory dysfunction and even death in those with COVID-19. Several Randomized Control Trials are in process. Many are trialing high-dose Vitamin D in those with COVID-19, such as the registered study by University Hospital in Angers (France). One has already concluded, but it was small with only 50 hospitalized patients being given a high dose of Vitamin D (calcifediol) and 26 not given a high dose of Vitamin D. Only 1 of the 50 high-dosed patients needed ICU treatment, whereas 13 of the 26 not given Vitamin D needed ICU treatment. 

Vitamin D Recommendations

Let me be real clear: You do not need to start taking a megadose of Vitamin D! Doing so can actually lead to toxic effects because it is a fat-soluble vitamin. The goal is to prevent deficiency to help keep your immune system strong.

I do suggest reflecting on your Vitamin D intake and exposure. Do you get out in the sun 10–30 minutes several times weekly? Sun exposure is less common in the winter, which hints at why more people are Vitamin D deficient in the winter months. When the sun’s UV rays hit our skin, Vitamin D3 (cholecalciferol) synthesis can occur. Do you eat Vitamin D–rich sources? If not, start to add some foods that are rich in Vitamin D. This will help you reach the RDA of 600 IU for young adults under 70 years old and 800 IU for adults older than 70 years old.

Here are some Vitamin D–rich foods:

• Trout, rainbow, cooked (3 oz = 648 IU)
• Pink salmon, cooked (3 oz = 444 IU)
• Halibut, Atlantic or Pacific, cooked (3 oz = 196 IU)
• Portobello mushrooms (1/2 cup = 316 IU)
• Canned tuna (3 oz = 228 IU)
• Milk, whole, 1%, 2%, and nonfat (1 cup = 115–128 IU)
• Yogurt, various types and flavors (8 oz = 80–120 IU)
• Soy milk (1 cup = 116 IU)
• Orange juice, fortified (1 cup = 100 IU)
• Eggs (1 large = 44 IU)

If getting your RDA by eating these foods is not realistic for you, I would suggest a Vitamin D3 (cholecalciferol) supplement to help increase your intake. A Registered Dietitian can help you adapt your nutrition regimen to meet Vitamin D requirements.

Finally, speak with your healthcare provider. They can always request that your 25-hydroxyvitamin d (circulating Vitamin D in your body) lab be checked. If you’re found to be deficient, you may require larger doses for treatment.

The Bottom Line

We do have strong observational support that suggests low Vitamin D levels may favor respiratory dysfunction and even death in those with COVID-19. However, we simply do not have enough strong data to conclude that Vitamin D sufficiency can treat or prevent COVID-19 infection until Randomized Control Trials are complete.

In the meantime, the best thing to do is continue to stay healthy (or improve your health) and keep your immune systems strong, which includes eating enough Vitamin D or having adequate Vitamin D exposure.

As always, please reach out to a NIFS Registered Dietitian for any nutrition support you need.

This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

• “I am going to eat a salad because I’m on a diet.”
• “I am going to eat a salad to clean my pipes.”
• “I am going to eat a salad because that’s the only way I know how to eat my veggies.”
• “I am going to eat a salad because I hear that’s how I can be healthy.”

Come on. We've all heard this before—from friends, from coworkers, and possibly from our own mouths. I swear, salads are easily the most famous “diet food.” Why is that? Do we really have to eat salads to lose weight, clean out our “pipes,” or be healthy? In this blog I break down each of these claims and then talk about ways to improve your veggie game!

“I am going to eat a salad because I’m on a diet.”

This is usually said when someone is trying to lose weight or be “super healthy.” First, to lose weight, it is widely understood that we must burn more calories than we eat. Thus, we try to minimize our calories to lose the weight. Second, people think that if they eliminate all “processed foods,” they will automatically become healthy. The idea behind salads is that they’re “healthy,” “low-calorie,” and blah blah blah.

Guess what? Salads can quickly turn into a high-calorie snack or meal and become full of unhealthy saturated fats and sodium. For example, let’s look at the Southwest Avocado Chicken Salad from Wendy’s. Sounds healthy, right? They even market this salad as healthy. A full salad has 530 calories with 34 grams of fat, only 15 grams of carbs, 43 grams of protein, and 1060mg of sodium. First off, that’s not a big salad for all those calories—which will make maintaining a caloric deficit (for weight loss) difficult. Finding foods that can be eaten in large volumes for lower calories tends to help satiety during weight loss attempts. Also, 34 grams of fat is a lot for one meal. The RDA for a full day is 44–77 grams for someone eating 2,000 calories. Now look at the sodium: 1060 mg of sodium is close to half of the RDA for sodium. Yikes. Hey, at least the salad has protein. They got that part right.

In addition, health is not just about physical well-being. Salads, if built correctly, can most certainly offer physical benefits. But health includes mental and social well-being too. Think for a moment. Does the salad taste good? Am I satisfied? Can I keep this up forever? Am I happy with this? If the answer is “no,” consider a different approach. Any change you make should be one that is sustainable for life. In the midst of making these changes, you must evaluate your physical, mental, and social health at all times. How can you improve one part of well-being without sacrificing another? Finding that balance is the key to SUSTAINABLE, healthful lifestyle changes, which ultimately leads to lifelong results.

“I am going to eat a salad to clean my pipes.”

Fiber does wonderful things. There are two types of fiber: soluble and insoluble. Soluble fiber is found in oats, beans, peas, berries, apples, plums, and sweet potatoes—all of which can be found in salads. This type of fiber helps absorb water, which adds bulk to stools. There is also insoluble fiber, which helps to get things moving in the GI system, thus helping to relieve constipation. Insoluble fiber is typically found in whole grains, the skins of fruit, skins of beans, seeds, spinach, carrots, cucumbers, lettuce, celery, zucchini, and tomatoes. These foods are even more common in salads, which gives you a hint as to why having a bowel movement after eating salad is not uncommon.

Fruits and vegetables, particularly lettuce, have high water content. It’s no secret that water assists in the digestion process. In this case, fiber works best when it absorbs water. This makes your stool soft and bulky.

“I am going to eat a salad because that’s the only way I know how to eat my veggies.”

This is valid. Vegetables can be super boring. Finding new ways to enjoy veggies can be a challenge. However, there are ways to eat veggies without having to eat a salad. Raw veggies with dip, grilled, steamed, and roasted are all ways to have veggies. Do not skimp on the spices and seasonings, such as garlic powder, onion powder, cumin, Italian seasoning, and ginger. I promise that makes the veggies taste 100,000 times better.

“I am going to eat a salad because I hear that’s how I can be healthy.”

Read above. I think you got the point.

Bottom line: You do not need a salad to be healthy, lose weight, or clean your pipes. If you like salads, eat them! But be careful of the added fats that tend to sneak into salads. If you do not like salads, find another way to eat your vegetables. Roasted, steamed, raw, and grilled are all yummy ways to eat veggies. Check out my recipe page for more ways to cook veggies. Remember, it’s important to like and enjoy the foods you eat.

This blog was written by Sabrina Goshen, Registered Dietitian. To learn more about the NIFS bloggers, click here.

The holidays are HERE! We all know what happens around the holidays. I see two extremes in my practice as a Registered Dietitian:

• The vicious cycle of dieting all year to lose the “holiday weight” or to get bloodwork back to normal after all the holiday meals. People accomplish their goals just in time for the holidays to start again—and gain back the weight and drive our doctors nuts with outrageous bloodwork again.
• The person who is terrified to “lose all their progress,” brings their own “healthy” meal to the gathering, and completely avoids the yummy meal—even at the cost of social, mental, and emotional health. Let’s be honest: that behavior distances people socially, and not having Grandma’s famous pie is just sad. 

Honestly, both are unhealthy approaches and they are, frankly, unnecessary. Let me be real clear: what we do consistently over time is what has the greatest impact on our health, not what we do on one day, two days, or a couple holidays. We can break these cycles! You don’t have to gain weight or ruin your bloodwork over the holidays. You also do not have to bring your own “healthy” meal, avoid Grandma’s cooking, and face a socially awkward and sad situation.

There is a way to enjoy the holiday food with family and friends all while pursuing your health goals. Here are the action steps.

Be Active

Get up and moving. This can be as simple as taking a walk with family, going on a morning stroll before the gathering, walking the dog, or playing a game that has you up and moving (such as Wii, tag, Twister, or Simon says). You can also get in a quick 20–30-minute workout before all the festivities start that day, or wake up early to get in a full lifting session. Don’t overthink this; a short 20–30-minute workout with high intensity is very effective! (Here are some workouts you can do when traveling.)

Follow Your Eating Routine

Forget the “don’t eat anything to save calories for all the food tonight” method. That leads to a very hungry person, which makes overeating at the gathering much easier. Go about your morning as you normally would. Eat breakfast (if you eat breakfast). Have your typical snack and lunch. Fill up on fiber-rich sources, such as fruit and veggies, along with lean proteins. All these options will help fill you up and nourish your body. You will walk into the gathering satisfied and ready to eat your Grandma’s holiday meal.

Hydrate 

Be sure to stay hydrated with plenty of non-caloric fluids (mainly water) the days before, the day of, and the days after holiday gatherings. Liquids take up room in your stomach, meaning staying hydrated contributes to proper regulation of hunger/satiety cues. Again, this helps reduce overeating. Additionally, holiday foods tend to be high in sodium. You will want plenty of water to offset the negative effects that a high sodium intake has on your hydration status. Trust me, you will feel much better if you stay hydrated.

Eat the Holiday Meal

For heaven’s sake, do not bring your own meal, measuring cups, or scales to the gathering! Eat the holiday meal. Fill up your first plate with all your favorites—the ones that grandma and momma only cook once or twice a year. Be mindful of portion sizes. Then, if you want, go back for a second plate. For that plate, pick two or three more things that you want some more of. Take a portion of each and enjoy it.

Enjoy the Meal

Sit down with each plate. Take a nice deep breath. Start eating. Chew each bite thoroughly. Slow down your eating. Be present at each bite, soaking in all the yummy goodness of that home cooking. Don’t be afraid to pause between bites and converse with family around the table. This not only helps you enjoy family around you and to be present in that moment, but it also gives your body time to send you satiety cues. When we eat super-fast, we do not allow our body enough time to signal “I AM FULL.” Be present and listen to what your body is telling you.

Have a Conversation

During the meal, talk with your family and friends, even if you are the one having to initiate conversation. DO IT! Think about one of the true reasons for the season. Hint: it is not food and gifts. Sure, food is a huge part of it. But we gather to be with family and friends to celebrate our blessings, our year, and our religion, and to give thanks. Conversing really embraces what holidays are all about and shifts your focus to more than just the heap of food in front of you.

Eat Dessert

Find your favorite deserts and eat a serving. I promise, eating dessert will not derail your health goals. I’d argue this action will actually help your health goals because Grandma’s famous pie sure does positively contribute to mental and emotional health.

Get Right Back to Your Typical Regimen the Next Day

Wake up the next day and get back to your typical routine. Exercise as you normally would. Eat your normal meals and snacks. Honor your physical health with nutritious options. Sleep. Do this on the days you are not at a holiday gathering. Back to the idea of consistency, there are more non-holiday days than there are holiday days and gatherings. Be on your game and remain consistent during those weeks and days, knowing that another gathering full of food and fun is right around the corner. Repeat steps 1–7 during the next gathering.

HAPPY HOLIDAYS!

This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Pumpkin season is officially here, and I am SO excited! Call me “basic”—you would not be wrong. Starbucks has launched their pumpkin drinks. Food bloggers, including myself, are basically turning their kitchens into giant pumpkins. It is a whole thing.

Here is my hiccup with pumpkin season and all the yummy beverages: THEY ARE FULL OF SUGAR AND CALORIES. Basically, we drink this little serving that takes up a huge portion of our daily calories yet contributes very little to improving our satiety. When you combine no fiber, little protein, and minimal volume you get “hangry” feelings and a higher risk of overeating later in the day. This makes weight-loss attempts and health goals harder to accomplish.

Now, don’t get me wrong—I am one who believes all foods and beverages can fit into a healthy nutrition regimen, even the high-sugar drink from time to time. However, I also believe in finding alternatives that are lower in sugar and calories when possible. Don't worry, these “alternatives” I speak of MUST taste yummy or else I would just stick with having the “real deal” in moderation.

Here are 8 DELICIOUS Starbucks Pumpkin Spice drink orders that won’t take up the bulk of your calorie budget and are low in sugars.

Hot Options

Pumpkin Spice “Latte”

Order: Grande blonde coffee with 1 pump pumpkin sauce, 2 pumps sugar-free vanilla, 2 shots espresso, and 1 cup steamed almond milk (or about half-full of steamed skim milk)

Nutrition Facts: 95 calories, 14g carbs (9g sugar), 4g fat, 3g protein

Pumpkin Spice Americano

Order: Grande blonde caffe Americano with 1 pump pumpkin sauce, 2 pumps sugar-free vanilla, and light splash of half & half. Ask to put in a venti cup to allow room for the add-ins.

Nutrition Facts: 75 calories, 12g carbs (7g sugar), 2g protein, 3g fat, 255mg caffeine

Pumpkin Chai Tea “Latte”

Order: 1 venti brewed chai tea. Add steamed skim milk, 4 Splendas, and 1 pump pumpkin sauce

Nutrition Facts: 65 calories, 12g carbs (12g sugar), 4g protein, 0g fat

Pumpkin Spice Coffee

Order: Grande blonde coffee with 1 pump pumpkin sauce, 2 pumps sugar-free vanilla, and light splash of half & half. You can add Splenda for a little sweeter taste with no additional calories.

Nutrition Facts: 65 calories, 9g carbs (7g sugar), 2g protein, 3g fat

Cold Options

Iced Pumpkin Spice Latte

Order: Grande iced coffee with no classic syrup. Add 1 pump pumpkin sauce, 2 pumps sugar-free vanilla, 2 shots espresso, and 1 cup steamed almond milk (or about ½ full of steamed skim milk)

Nutrition Facts: 95 calories, 14g carbs (9g sugar), 4g fat, 3g protein

Iced Pumpkin Cinnamon Coffee

Order: Grande iced coffee with no classic syrup. Add 1 pump pumpkin sauce, 2 pumps sugar-free vanilla, and a light splash of half & half.

Nutrition Facts: 65 calories, 9g carbs (7g sugar), 2g protein, 3g fat

Pumpkin Cold Brew with Cinnamon Almondmilk Foam

Order: Grande Cold Brew with Cinnamon Almondmilk foam. Add 1 pump pumpkin sauce and 1 pump sugar-free cinnamon dolce syrup.

Nutrition Facts: 65 calories, 14g carbs (12g sugar), 1g protein, 1g fat

Pumpkin Cold Brew with Dark Cocoa Almondmilk foam

Order: Grande Cold Brew with Dark Cocoa Almondmilk foam. Add 1 pump pumpkin sauce and 1 pump sugar-free vanilla syrup.

Nutrition Facts: 65 calories, 13g carbs (10g sugar), 1g protein, 2g fat

Extra Hacks

Want more pumpkin? You can certainly add another pump of the pumpkin sauce. One pump of the pumpkin sauce is an additional 25 calories, 6g carbs (6g sugar), 0g fat, and 0g protein.

Want more sweetness? You can add a packet or two of Splenda for a noncaloric sweetener. No, this will not cause cancer. Research does not support that claim. So, if you want Splenda to help sweeten your beverage, add it.

Want more cream? Have them add a creamy milk, such as oat milk or almond milk. Both are fairly low calorie. Skim milk is great and offers more protein, but it is not as creamy.

Those are my tricks. And if you’re still hungry for pumpkin and that other fall treat, apples, check out these recipes. I hope you enjoy these drinks and ultimately have a great PUMPKIN SEASON while still reaching your health goals! Enjoy!

This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Coenzyme Q10, also known as ubiquinone, is a commonly used supplement by those with cardiovascular risks and disease, and especially those using statins. CoQ10 acts as a carrier in our cells to assist in oxygen utilization.  It also assists enzymes in the mitochondria. This allows the production of energy in a cycle referred to as the Krebs Cycle, and hints at why the mitochondria are the “powerhouse of the cell.” Some believe that those with heart failure have a buildup of reactive oxygen species (ROS), which can lead to adverse effects. Furthermore, they suggest CoQ10 antioxidant properties can combat the buildup of ROS. Additionally, CoQ10 is thought to balance calcium-dependent ion channels within the heart, which is critical for heart function. As far as supplementation with statins goes, people are led to believe that supplementing CoQ10 is essential because statins block the pathway that leads to CoQ10 production.

Researchers looked into these claims. Some found many studies that showed CoQ10 had no clear effect on how much blood the heart was able to pump (left heart ejection fraction), and other studies were inconclusive with poor research design. On the other hand, a Large study (a meta-analysis of clinical trials) revealed that those who supplemented CoQ10 had lower risk of death and increased exercise capacity, but no correlation between CoQ10 and how much blood the heart was able to pump. Lastly, another study observed those with heart failure receiving medical therapy. In addition to medical therapy, some of the participants received a placebo and some received Coenzyme Q10. Although the concentration of CoQ10 in the blood serum increased dramatically, those patients saw no greater effect in ejection fraction, peak oxygen consumption, and exercise duration. 

Drug Interactions and Additive Effects

CoQ10 has been known to interact with Vitamin K Antagonists, such as warfarin, a commonly prescribed drug in cardiovascular disease cases. Some cases have shown that CoQ10 blocks the anti–blood clotting (aka anticoagulant) effect of Vitamin K Antagonists, especially warfarin, which can lead to fatal blood clotting (according to Lexi-Drugs Online). On the other hand, some studies have shown that CoQ10 has done the complete opposite to Vitamin K Antagonists and actually enhanced the anti-blood-clotting effect, which leads to excessive bleeding.

Side Effects

Some side effects reported include severe gastrointestinal (GI) bleeding, allergic reactions, headaches, vomiting, urine discoloration, and abdominal pain.

Further Research

Much of the research that shows a positive outcome when supplementing CoQ10 had small trial groups (not enough people). The number of participants in the trials, known as sample size, is too small for the evidence to be conclusive. Moving forward, is it possible to get a bigger sample size that can give conclusive results? As of now, many are torn on this topic.

The Clinical Bottom Line

There is not enough evidence to support the use of CoQ10 for treating heart failure or even lessening the risk of muscle weakness (myopathy) in those taking statins. Until more research emerges, I would suggest those with cardiovascular disease not take CoQ10, especially if they are taking a Vitamin K Antagonist. If you are torn about taking CoQ10, consider speaking with your Primary Care Provider and Registered Dietitian to see if it's right for you.

This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.