Hit the Reset Button Part 3: Healthy Eating in 2019

Three PA Experts Suggest Ways to Tackle Post-Holiday Eating

January 11, 2019

By PAs Karli Burridge, Ellen Mandel and Corri Wolf

PAs Burridge, Mandel, and Wolf

These three PAs have experience and expertise at counseling patients on healthy eating. So, what do they advise other busy PAs about hitting the reset button after the holidays?

Part 1: How to get back on track, thoughts on trendy diets and effective programs.
Part 2: The truth about added sugar, substitutes for high fat and high calorie foods, and how much water you should be drinking.

What does a day of balanced eating look like for a busy PA?
Karli
– It all depends on individual preferences and metabolic profile, so what works for one person may not be what’s best for someone else. This is what my typical day might look like:

Breakfast: Coffee with cream. Often, that’s all I need, and I don’t get hungry until later. If I do eat breakfast, it’s usually two eggs with a piece of bacon or ham, with a sprinkle of cheese. Or, if I don’t have time to make my eggs, I may have a QuestTM bar or a protein shake.

Lunch: When I’m at work I usually go to the provider lounge at the hospital and choose based on what’s available. I always get a protein, which may be chicken, fish, or any other kind of meat, and I’ll pair that with whatever non-starchy veggies they have, which may be broccoli, cauliflower, green beans, zucchini, or a salad. If I’m eating at home or bringing lunch, it’s usually a big bed of salad with a protein like chicken or tuna salad and my own dressing. I like to top my salads with pumpkin seeds for a little crunch, and avocado if I have some around the house. I usually finish off my lunch with a square of 80 percent dark chocolate.

Dinner: I try my best to cook at home most days of the week, and limit eating at a restaurant to once or twice a week. At home, I try to keep things simple and meal prep to under 30 minutes. Like lunch, I usually pair a protein with non-starchy veggies and some healthy fats.

Ellen– Balance means different things to different people. I rarely eat breakfast and never have (just ask my mother). Give me a strong cup or two of coffee in the morning and I’m good until 11 a.m. At this point I eat a light brunch/lunch. I’m a big dairy lover, so yogurt, cottage cheese, nut butter on rice cakes, and maybe a banana. By 2 to 3 p.m., I’m hungry again and may eat a granola bar or other heathy snack.  I eat a larger dinner and try really hard not to eat after 8 p.m. Although still being researched, I believe that a longer no-food in the gut time allows my system to reboot. My background in endocrine medicine drives this thinking as a food-free period reduces insulin levels and also reinforces what hunger feels like. Take care with this approach if you experience hypoglycemia or have diabetes. Eating when hungry, and less on the clock, is one of my goals, which is not always feasible every day.

Corri– Balanced eating for a busy PA is like that of any other busy person. We are fortunate that most of us do not have “desk” jobs and can get a decent portion of our daily steps in while working, but that often means not having much time to sit and eat a meal. Balanced eating means you are consuming a variety of healthy foods in the correct portions. With some planning ahead, this can still be achieved when on the go. Consume a variety of vegetables from all subgroups (dark green, red and orange, legumes, starchy), whole fruits, whole grains, proteins (seafood, lean meats and poultry, eggs, legumes nuts, seeds, soy products), low fat dairy or fortified soy products, and healthy oils. Consume less than 10 percent of your calories from saturated fat and added sugars and don’t forget to watch your sodium intake; consume less than 2,300 mg per day. There are lots of choices and while all meals may not be perfectly balanced, aim for a colorful plate and a balanced day. Consider each healthy meal you consume a personal win.

When should you eat before you work out?
Ellen– It depends on the workout. Generally eating about one to two hours before a workout allows for more blood flow to the muscles and less to the gut. If feeling hungry prior to exercise, a snack with higher carbohydrates such as fresh or dried fruit is good, along with a small handful of nuts, provides quick energy with longer term sustainability. This is a basic answer for moderate exercise of 30 to 45 minutes duration. I often carry a snack in my jacket when I am taking a longer walk to be on the safe side.

Karli– That depends on the individual. I would usually recommend waiting two hours after a large meal to exercise, but if it’s a smaller meal or a snack, you can work out whenever it feels comfortable for you. If you’re not hungry before your work out, then don’t eat before (again, there are certain exceptions, ex: individuals on insulin, etc.). It also depends on what types of fuel your body typically uses during exercise, and how long and how strenuous your workout is. For someone who is fat adapted (meaning their body uses fat as a primary fuel source), they may not need to eat before a workout since their body is able to tap into their own body fat to get the energy it needs. If someone primarily uses glucose, and they find themselves getting tired or hungry during work outs, or running out of energy, they may want to have a small snack one hour or 30 minutes before exercise, such as a half apple with peanut butter, a cup of Greek yogurt with berries, or some nuts.

Corri– A large meal should be eaten three to four hours before exercising and a small meal should be eaten one to three hours before exercising. Eating too close to exercising doesn’t allow time for digestion and can result in heartburn, nausea, and even vomiting. If hitting the gym and feeling hungry, have a snack no less than 30 minutes prior to your workout. The goal is to have digested your food but still have energy on board to fuel your workout.

What kinds of snacks do you carry in your lab coat during the day?
Corri– I am a big fan of 100-calorie packs. They are portion controlled, easy to grab, and curb my craving for something savory or sweet. A more economical and often healthier alternative is creating your own by using resealable snack size bags. Just about anything can be turned into a 100-calorie snack. Simply check your favorite food’s nutritional label and note the serving size and calories per serving. Do some simple math to determine how much of the food equals roughly 100 calories. My favorites are a medium-sized apple, 19 salt free almonds, 2 to 3 cups popcorn and two mini Reese’sTM peanut butter cups.

Karli– I try not to snack unless I am truly hungry. A lot of times, we eat because we are bored, stressed, or looking for a distraction. Sometimes taking a few deep breaths or getting out of the office for a quick brisk walk at lunch time can help with this. However, for when I am truly hungry, or I end up having to work through lunch, I usually keep almonds or macadamia nuts, some dark chocolate (80 percent), or a QuestTM bar in my work bag. I recommend getting enough protein and healthy fats during meals, and avoiding processed carbohydrates, to prevent blood sugar swings and hunger between meals.

Ellen- My go-to snacks are usually a cheese stick, Kind BarTM or a Fun Size SnickersTM Bar. Are you wondering if I really meant a Snicker’s bar? Am I out of my dietitian’s mind? Let’s assess based on my goals. I want some protein and fat for satiety, and maybe some quick energy from sugars.

One Polly-O mozzarella cheese stick (28 gram size) contains 80 kcal, 6 grams fat, 7 grams of protein, 0 grams carbohydrate and the bonus of calcium. Yes – it contains lactose.

One Fun Size Snicker’s Bar (17 gram size) has 80 kcal, 3.5 grams fat, 11 grams carbohydrate and 1 gram protein, and 0 calcium.

One Kind Bar (40 gram size), Dark Chocolate, Nuts and Sea Salt has 200 kcal, 15 grams fat, 16 grams carbohydrate, 6 grams protein and some calcium.

Applying the idea of variety, I can combine a cheese stick with a Snicker’s Bar as compared to a Kind Bar and have fewer kilocalories (80+80 = 160 compared to 200),  fewer carbohydrates (0+11=11 compared to 16), less fat (6+3.5 = 9.5 compared to 15,) and more protein (7+1=8 compared to 6), than one Kind bar. And, I get to have two different snacks, which psychologically is more pleasing. Knowing food labels can be enlightening in more ways than one.

Read More

Hit the Reset Button Part 1: How to get back on track, thoughts on trendy diets and effective programs.
Hit the Reset Button Part 2: The truth about added sugar, substitutes for high fat and high calorie foods, and how much water you should be drinking.

More Resources

Primary Care Obesity Management Certificate Program

Obesity Awareness Education Under Review

Two PAs Discuss Importance of Obesity Education to Patient Care

PAs in Obesity Medicine special interest group

Authors: Karlijn (Karli) Burridge [email protected], formerly with Baylor Scott & White Weight Loss Center, recently moved to Chicago, IL where she is looking for a new opportunity. Ellen D. Mandel, DMH, MPA, MS, PA-C, RDN, CDE, is Clinical Professor, Pace University, Physician Assistant Studies-Lenox Hill Hospital – NYC, [email protected]. Corri Wolf, PA-C, MS, RD, is Associate Professor, Academic Coordinator & Assistant Chair, Department of PA Studies, New York Institute of Technology, [email protected].