Fresh Focus

While pregnancy may seem like the perfect time to eat extra portions of dessert and veg out on the couch, it is actually one of the most important times to prioritize your health! There are many contributors to your health, but one very important one is physical activity and exercise. In fact, the American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women participate in 150 minutes of moderate exercise each week. 

Regular physical activity during your pregnancy is incredibly important to support a healthy pregnancy and birthing experience. There are many amazing benefits of physical activity during this transformative time of your life! Some of these benefits include: 

·         Reduction in back pain

·         Improving constipation

·         Decreased risk of gestational diabetes and preeclampsia

·         Decreased chance of needing a c-section, pain relief, or Pitocin

·         Promoting healthy weight gain

·         Improvement in overall general fitness

·         Strengthening your heart and blood vessels

·         Helping you lose the baby weight more quickly after baby is born

Furthermore, benefits for the baby may include:

·         Increased blood volumes

·         Leaner builds

·         Better tolerance to the stress of pregnancy and delivery

·         Improved brain development

Pregnancy is such an exciting time, but it can also be intimidating with all of the changes going on in your body. While simply being active is important, when participating in a pregnancy exercise program, it is equally important to discuss with qualified professionals to determine the best level of activity and to make sure you are able to complete the exercises with proper form.  The goal is for you to feel empowered to take charge of your (and your baby’s!) health and to help you feel the best you can so you are able to enjoy this time.  As always, if you have any questions, contact your local VA dietitian and we will be happy to help you! 

 
Host Bio: Tori Stewart, MS, RD, LDN, CPT is a Registered Dietitian, Certified Personal Trainer, and Group Fitness Instructor. She serves veterans through facilitating a Home Based Cardiac Rehab program. Tori received a Dual-Master’s Degree in Food & Nutrition and Exercise Science from SIU Carbondale and has been at the VA for over two years. She is passionate about helping patients learn how to take control of their health and live a healthy and fulfilling life.

Basic pregnancy nutrition is important to keep you and baby healthy. When you get that positive pregnancy test, your body is already undergoing many changes. Right from the beginning, hormones can cause some unpleasant side effects. The most common being morning sickness. 

Morning sickness can be different for everyone and can happen during any time of day. The most important thing is to make sure you are getting adequate nutrition. Ideally you want to be getting good sources of folic acid, calcium, iron, vitamin B12 and omega 3 fatty acids, but if morning sickness is a problem, getting these nutrients might be the last thing on your mind. Always take a prenatal multivitamin to cover all your basic micronutrition needs. 

If you are unable to keep anything down due to ongoing morning sickness, try these 5 tips:

1. Avoid an empty stomach by having small meals or snacks frequently.
2. Use herbs and spices that combat nausea such as ginger, peppermint, and lemon.
3. Focus on easy to digest foods that you know you are able to stomach.
4. Drink at minimum 64 oz of water or non-sugary beverages daily. 
5. Give yourself some slack. Although you may not be getting well-rounded meals at this point, you will be getting the calories you need to avoid unintentional weight loss.

As you are assessing your food intake, remember that some foods need to be completely avoided during the pregnancy. Meat, poultry, eggs or seafood that are raw or undercooked should not be included in your diet. Avoid any unpasteurized soft cheese. Lastly, if choosing deli meats, make sure you heat them until they are steaming hot. 

Weight can be a tricky topic during pregnancy.  Some women have difficulty gaining weight, others seem to gain too quickly and some have no difficulty at all following the guidelines. Try not to get discouraged if you have gained a little more or a little less than you are supposed to. The important thing is that you are eating balanced meals packed with nutritious foods. Now is NOT the time to start restrictive eating or binge eating to try and match weight gain goals perfectly.  Listen to your body- it knows what to do. 

As you near the end of pregnancy, swelling and fluid retention can be  noticeable in the feet, hands, and face. Tips to help reduce swelling include resting with feet elevated, staying cool during hot weather, drinking plenty of fluids, wearing loose, comfortable clothes, staying active to help circulation and lastly, monitoring your sodium and potassium intake. Excessive or rapid swelling may also be a sign of an underlying issue, especially if paired with high blood pressure. Keep an eye on rapid weight gains you may have and report them to the doctor to rule out any serious conditions like pre-eclampsia. 

As you near birth, remember to continue a balanced diet and staying active. Pregnancy is such an amazing experience and a life changing event. Embrace every moment as it truly is grand!

Host Bio: Loran Morris, MS, RDN, LDN is a Registered Dietitian Nutritionist serving Veterans within in the Marion VA Healthcare System. She received her Bachelor’s Degree in Human Nutrition and Dietetics and Master’s Degree in Food and Nutrition at Southern Illinois University Carbondale. She started her career with the Marion VA Healthcare System as a Dietetic Intern in January 2014 and transitioned into a PACT Dietitian later that year. She is passionate about meeting each Veteran’s healthcare needs through counseling, education, and support.

What happens if you’ve tried and tried and can’t get pregnant? What happens if you’ve done everything “right”, but it’s still not happening? You may be in the 12% of couples who struggle with infertility. Infertility is the failure to achieve pregnancy after 12 months of unprotected sexual intercourse. Infertility can be attributed to the female partner ~30% of the time, the male partner ~30% of the time and both partners ~30% of the time. The other 10% of cases are considered “unknown” or “unexplained” infertility.

Diet is a modifiable risk that can improve or even reverse infertility. Consider these 5 action steps you can take to improve your fertility. 

1. Eat more fiber. Aim for 25-30gm daily. Fiber is found in plant-based foods such as fruits, vegetables and whole grains.

2. Eat the right fats. Pay attention to 3 different categories of fat when it comes to fertility. Eat more unsaturated fat. Limit saturated fats to a few choices per day. Avoid trans fats.

3. Watch what you drink. Limit caffeine. Avoid alcohol and sugary beverages.

4. Stay away from sugar. Check food labels and product ingredient lists to avoid foods that list sugar as the first or second ingredient. Daily recommendation for women is 25gm sugar, and for men is 36gm sugar.

5. Achieve a healthy weight.  Aim for a BMI between 20-30. Make dietary changes and incorporate physical activity to jump start your weight goals. 

If you have a specific infertility diagnosis, consider talking to your provider or a registered dietitian about individual nutrition tips that might be helpful for you. Listen to the podcast to hear more in-depth information regarding nutrition for infertility and personal experiences from VA dietitians who experienced infertility first hand.

Host Bios: Loran Morris, MS, RDN, LDN is a Registered Dietitian Nutritionist serving Veterans within in the Marion VA Health Care System. She received her Bachelor’s Degree in Human Nutrition and Dietetics and Master’s Degree in Food and Nutrition at Southern Illinois University Carbondale. She started her career with the Marion VA Healthcare System as a Dietetic Intern in January 2014 and transitioned into a PACT Dietitian later that year. She is passionate about meeting each Veteran’s healthcare needs through counseling, education, and support.

Gaya Hart, RDN, LDN is a Registered Dietitian Nutritionist serving veterans within in the Marion VA Health Care System. She received her Bachelor’s Degree with an area in Dietetics from Murray State University. She completed her internship through Morehead State University. Gaya has worked for the VA for 5 years. Prior to coming to the VA, Gaya worked in acute care, long term care, at an HIV clinic and home health. She and her husband have a six year old son they adore! She enjoys spending time with family, gardening, swimming, hiking, crafts, and putting Legos together with her son. She has a passion for helping veterans as her husband, father and grandfather all served.

In this season of the series we are covering the entire maternal diet…from what to eat when you are thinking of starting a family to feeding your newborn!  

How exciting to think about becoming a momma! As you are thinking about starting a family and making that decision to try to get pregnant, we want to help you prepare now to allow for a smoother transition to a healthy pregnancy.   There is a ton of information out there and trust me, it can be overwhelming and confusing. 

I want to be the first to tell you that you definitely do NOT have to wait until you have that little bundle of joy to start eating well for YOU.  Now is the time to review your eating habits.  It is both beneficial and easier to overhaul your habits prior to becoming pregnant.   

It is always a good idea to add in nutrient dense meals and snacks for everyone.  In this episode we review 10 Tips that can be followed. Whether you are planning for your first time or if you are an experienced mom wanting to expand your family.

Healthy tips prior to pregnancy

·         Getting off birth control and ensuring essential nutrients 

·         Assess your current weight. 

·         Assess your current meals and snacks

·         Ensure Healthy Hydration

·         Ensure healthy supplementation  

·         Daily Exercise

·         Reduce Stress

·         Get enough Sleep

·         Start healthy eating practices now

·         Take Care of YOU! 

The Marion VA dietitians are here to help you answer your nutrition related questions.   Stay tuned for the rest of this podcast series to gain more valuable to ways be and stay healthy.  

Resources

https://www.move.va.gov/docs/Resources/BMIchart.pdf

https://www.womenshealth.va.gov/WOMENSHEALTH/outreachmaterials/reproductivehealth/pregnancy.asp

https://www.womenshealth.va.gov/WOMENSHEALTH/OutreachMaterials/GeneralHealthandWellness/maternity.asp

Bio:  Beth Blair, RDN, LDN is a Registered Dietitian Nutritionist.  She serves veterans out of the Evansville Healthcare Center within the Marion VA Health Care System. She received her education from Western Kentucky University and completed Dietetic Internship at Indiana University Medical Center.   She has been at the VA for over 8 years.  She enjoys teaching the MOVE! Weight Management Program and helping veterans focus on attainable goals to help jump start their health and wellness journey

The healthy plate method is not a diet but a strategy to focusing on making healthy choices one meal at a time. This concepts can be modified and tailored to your individual needs and that’s where Dietitians can help.  

Here are some actions you can take now to put this method into place. 

1. Veggies for breakfast

Increase your intake of colorful vegetables that are full of vitamins and minerals. The goal is filling ½ your plate of non-starchy vegetables three times a day to be on the right track. 

Try adding pico to your eggs! You can make it yourself or find in the produce section. 

2. Let’s talk noodles

Moving on to one of the most talked about topics I hear on a regular basis is carbohydrates. I would recommend first making the switch from enriched white grains to a whole grain. Then after you cook your pasta consider reducing the size on your plate so you can fit those non-starchy colorful vegetables on half of it. Grilled asparagus are a favorite! 

3. Adding the fat

Salad dressings are a great way add some good fats and breath some life to those leaves. You can experiment with a variety of oils, vinegars, herbs and spices. Here is a basic recipe we love:

o   ¾ cup oil (olive, extra virgin olive, grapeseed, or avocado oil)

o   ¼ cup vinegar (apple cider, balsamic, red or white wine)

o   1 tsp garlic

o   1 tsp oregano

o   1 tsp basil

o   Salt/pepper/onion powder/red pepper as desired

4. Hide the goods

Drinking smoothies is a great way to get that healthy plate in. Think about the plate when you build the blender. I recommend the single serve blender for this because it keeps portion size on target. Add a leafy green, small handful of fruit, and protein source. 

5. Bulk up your protein

Cook your meat in bulk. For example, if you and your spouse decide to grill chicken Sunday. Try cooking chicken for three meals vs just one since you already have the grill out. What if you have a change of plans and don’t eat those extras? No problem, toss those in an air tight bag and freeze for later. 

 
Host Bio:Lindsey Purcell, MS, RD, LDN is a Clinical Nutrition Supervisor and Registered Dietitian. She serves veterans out of the Mt Vernon, IL CBOC within the Marion VA Health Care System. She received her education from SIU in Carbondale and has been at the VA for over nine years. She specializes in helping veterans transition into eating healthier one step at a time. Making simple modifications to current meal favorites and debunking diet culture myths using an intuitive eating approach. 

Protein is considered the building block of life and is found in every cell of our bodies. It has many important functions and benefits. It helps with muscle tissue repair, growth, and maintenance. Protein also prevents muscle loss. It helps keeps your blood sugar balanced, and protein and amino acids are essential for the formation of hormones, enzymes, neurotransmitters, antibodies, transport proteins, nucleic acids (DNA, RNA), and structural proteins (which are found in hair, nails, connective tissue). Protein plays a huge role in weight management.  Protein helps reduce appetite and curb cravings.  Protein also requires the most calories to digest. Furthermore, since protein helps preserve lean body mass, it can help to make sure that weight you lose is mostly fat. 

While protein has clear benefits, there are certain sources of protein that are better for you than others.  Good sources of protein include foods such as meat, dairy products, legumes, grains, nuts, seeds, and some vegetables. Some less healthy sources include foods like processed meats, fried foods, and highly processed protein-enriched foods. 

The amount of protein you need in order to feel your best will depend on several factors- your age, activity level, goals, and underlying health conditions.  Meeting your optimal protein requirement is necessary for good immune function, a healthy metabolism, satiety, weight management, and performance. A good rule of thumb is to get at least ½ your body weight (in pounds) in grams of protein.  A simple way to make sure you are getting an adequate amount of protein in your diet is by making sure you are including a good source of protein, which would be at least 25-30 grams, in each of your meals. When relating this to the healthy plate method of eating- you want to fill ¼ of your plate with quality protein. 

Be sure to listen to the Fresh Focus Podcast episode on protein to learn more!

Host Bio: Tori Stewart, MS, RD, LDN, CPT is a Registered Dietitian and Certified Personal Trainer and Group Fitness Instructor. She serves veterans through facilitating a Home Based Cardiac Rehab program. Tori received a Dual-Master’s Degree in Food & Nutrition and Exercise Science from SIU Carbondale and has been at the VA for over two years. She is passionate about helping patients learn how to take control of their health and live a healthy and fulfilling life.

Fat has had a very strange, political, and controversial history. In order to get down to what’s important, we need to navigate through the confusion. 

Fat is one of our macronutrients (along with protein and carbohydrates), and it is an essential part of our intake. It has many functions within the body, including organ protection, providing fuel, coating nerve cells, making up organs (our brains are roughly 60% fat), making up cells (lipid bilayer), nutrient & phytochemical absorption, skin/hair/nail health, hormone balance, etc. 

As with anything diet related, the first step is to evaluate the source of your food. Are you eating mostly real, whole foods from nature, or processed, refined foods from the grocery store shelf? Good sources of fat are going to come from those whole food options. 

Step one- Continue to eat real, whole foods, and follow a system (such as the healthy plate) to guide you to a balanced intake. 

Step two- Include good sources of fat, such as olives & olive oil, avocados, nuts & seeds, fatty fish, coconut oil, eggs, dairy, minimally-processed meat, and even butter (especially if it’s grass fed and organic). Remember that, although we shouldn’t fear fat from animals, we should still get plenty of our fat from antioxidant-rich plant-based foods. Balance is important. 

Step three- Avoid the following sources of fat: fast food, fried foods, heavily processed meats, processed/packaged foods such as TV dinners and box meals, refined sugars & sweets  (including sugar from fluids), highly processed vegetables oils such as soy, corn, and safflower, as well as Crisco and other hydrogenated oils. 

The sources we choose to get our fat from, as well as the overall quality of our diet & lifestyle, will make a huge difference on whether that fat will be helpful or harmful. Eat well!

Host Bio: Sieger Giroux MS, RD, LDN is a registered dietitian with a dual-master’s degree in exercise science from SIU Carbondale. Sieger also worked as the sports nutritionist for Saluki Athletics during his second year of graduate school. He has been with the VA since 2015, and has helped cover various positions & programs such as MOVE!, RRTP, outpatient, inpatient, Home-Based Cardiac Rehab, etc. He enjoys all aspects of nutrition, but specializes in helping Veterans simplify the process of achieving better health through positive lifestyle changes. 

Whole grains and starchy vegetables are great sources of antioxidants, vitamins and minerals.  But what they are best known for is their carbohydrate and fiber.  The healthy plate method of meal planning recommends that you limit 1/4 of your plate to grains or starchy vegetables.  This is to make sure you leave room for those non-starchy vegetables that should make up half of your plate.  Examples of starchy vegetables include potatoes, corn, peas, winter squash, pumpkin, yams and sweet potatoes. 

The healthy plate method also recommends that at least half of your grains should be whole grains.  Whole grain refers the complete intact grain with none of the nutrients or fiber removed.   

There are two types of fiber that occur naturally in foods.  Both types of fiber are important for overall good health, making it important to choose a variety of fiber-rich whole foods.  Familiar examples of whole grains include 100% whole grain bread, 100% whole wheat pasta, brown rice, and oats. 

Some tips for replacing processed grains with whole grains include:

1. Choose foods with as few ingredients and as close to their natural states as possible.  
2. Check the nutrition facts label and ingredient list for the words “whole” or “whole grain.”  
3. The amount of fiber in whole grain foods vary, so choose those with the most. Aim for at least 3 grams of fiber or more per serving.  
4.  For grain-based snacks choose air-popped popcorn, and rye or other 100% whole grain crackers. 
5.  Change up familiar meals by substituting ancient whole grains or seeds in casseroles and grain-based salads, such as pasta salad or rice pilaf.

Tune into our podcast episode on Grains and Starchy Vegetables for more information on how to make your plate a healthier one! 

So often when we think about eating healthier or getting to a healthier weight or lowering blood sugars so much we hear is “cut back on this” or “eat less of that”.  

There is a category of foods we all need to focus on eating MORE of! That category of foods is non-starchy vegetables.  In the healthy plate planning method we are shooting for filling HALF of your plate with non-starchy vegetables.

Non starchy vegetables have much lower carb content than starchy vegetables (think potatoes, corn, beans, etc), have a ton of inflammation and disease fighting vitamins and minerals and fiber, and are very low in calories.  So what are some examples of non-starchy vegetables?? 

·         Broccoli

·         cauliflower

·         green beans

·         peppers

·         spinach 

·         kale

·         asparagus

·         cabbage

·         cucumbers and so many more, click the link below for a full detailed list

The dietary guidelines for Americans recommends we get 2.5 cups of vegetables per day, but in this situation the more the better!  A serving is considered 1 cup raw vegetables or ½ cup cooked vegetables. 

My top 10 tips and tricks for increasing your intake of non-starchy vegetables are:

1. Stack sandwiches high with veggies.

2. Veggies as an appetizer 

3. Mix cooked veggies into your scrambled eggs/omelets or potatoes 

4. Buy fresh raw veggies for snacking.

5.  Mix cooked chopped veggies into any starch-based side dish.

6. Try veggie-based recipe swaps. 

7. Mix chopped veggies into meats like hamburgers, meatballs, or meatloaf.  

8. Add veggies to your pizza.

9. Experiment with new veggies. 

10. Try roasting veggies! Or any new way to cook vegetables. 

Tune into our podcast episode on Non-Starchy Vegetables for more information on these 10 tips and tricks and more ways to increase your non-starchy vegetable intake to make your plate a healthier one!

Non-starchy vegetable list

15 ways to increase veggie intake hand out from website

How to cook veggies handout from website

Host Bio: Lauren Hocking, RD, CD is Registered Dietitian Nutritionist serving veterans out of the Vincennes, Indiana CBOC within in the Marion VA Healthcare System.  She received her Bachelor’s Degree in Human Nutrition and Dietetics at Southern Illinois University Carbondale and went on to complete her Dietetic Internship at the Memphis VA Medical Center in Memphis, TN.  She has been at the VA over 8 years where she covers PACT clinics at Vincennes in addition to Home Based Primary Care. She assists our nations heroes make strides toward living a healthier life by helping them make lifestyle changes while taking it one step at a time.

As Dietitians with VA, our job is to help take the mystery out of good nutrition habits. We want to make it as simple as possible for you to make the healthy choices you need to reach your nutrition and lifestyle goals. And it’s with that goal in mind that we are going to be taking a deep dive into a personal meal planning tool called the Healthy Plate.

Put very simply, the healthy plate is a visual guide that shows what types of foods, and how much of each type, you should eat at each meal, using the space on a standard 9 inch dinner plate as our guide. You separate each circular plate into 4 equal quadrants, like 4 pieces of a pie (just kidding, I’m not recommending you eat pie). So at each meal, all you really need to do is focus on filling half of your plate, or 2 of those 4 quadrants, with non-starchy vegetables. Then quadrant 3 you will want to fill with grains, beans, or starchy vegetables, and quadrant 4 with minimally processed meats or other proteins. And that’s it. 

For example if you plan to have porkchops for tonight’s meal, that would be your protein source, so you would have a 4-6 oz baked porkchop,  add a ½ baked potato for a starch/carbohydrate section, and add some cooked broccoli or mixed veggies to fill ½ your plate complete the healthy plate model. 

In our MOVE program, at VA we teach our veterans to utilize a 9 inch plate. So that could be your goal for the next meal to use a smaller plate.

We want to review these simple guidelines so you can plan a meal that you can be confident will move you one step closer to your fitness and nutrition goals.

Beth Blair, RDN, LDN is a Registered Dietitian Nutritionist.  She serves veterans out of the Evansville Healthcare Center within the Marion VA Health Care System. She received her education from Western Kentucky University and completed Dietetic Internship at Indiana University Medical Center.   She has been at the VA for over 8 years.  She enjoys teaching the MOVE! Weight Management Program and helping veterans focus on attainable goals to help jump start their health and wellness journey.