How to Travel with IBS

Original Image by fdecomite via Flickr

This article is based on an original post that first appeared on the Trim Traveler Blog entitled Have No Fear: Traveling Abroad with Irritable Bowel Syndrome. 

By: Nikki Nies

While last minute trips can be fun, there always needs to be some type of planning involved. At minimum, this should include source of transportation. Bus? Driving? Catching the next flight out of the airport? Yes, this level of spontaneity may sound overwhelming for some that like to plan every detail. In reality, once kids are involved, there are other considerations that are factors in traveling, such as counting for a variety of entertainment and the number of diapers needed. In addition, for those with irritable bowel syndrome (IBS), an intestinal disorder that can cause stomach pains, gas, diarrhea or constipation, it can make multi city traveling more nerve wrecking than appealing.

As a chronic condition, management of IBS is long term and can cause hurdles in traveling. I fondly remember I was in Thailand and one of people on the trip couldn’t leave the bathroom because of intestinal issues. When he wasn’t having diarrhea, he was too scared to leave the hotel in fear of a limited availability and quick access to bathrooms. It is a shame he traveled from the U.S. to Thailand to spend his time in a bathroom. For those of you that have been diagnosed with IBS, by implementing certain planning into your travel plans, you can enjoy your travels, pain free!

Some suggested travel inquiries:

• Plan a trip that is calm or relaxing, as it may be less difficult to maneuver
• Plan enough to know there are enough safe places to use the restroom
• Pack and always keep own toilet paper with you. While most travelers should pack extra clothes in carry on, this can be particularly useful for those with IBS too.
• Keep in reach fiber supplements, medications, bottled water and snacks (i.e. nuts or yogurt). Also, having doctor’s contact information and medical diagnosis listed can help with access to care.
• Allow enough time to get places to avoid rushing and/or giving yourself enough time to assess a situation (i.e. limiting the amount of time between connecting flights can be stressful enough, give yourself at least 2 hours in between scheduled flights to get to your destination).
• Don’t be afraid to ask questions. You might want to ask, “Is there an early check in for hotel?” or “Does the hotel room come with a refrigerator?”
• Investigate what measures you have to easily access bathrooms. Find out if you will need special coins and if you will have to buy toilet paper for access.
• When booking flights, opt for the aisle seat for easier access to on flight bathroom.
• If traveling in a foreign country learn phrases, such as “Where’s the bathroom”, “I can’t eat….” or “Can you make…[dish]…without?” A pocket dictionary or Google translate app can help with language translations too.
• Be up front with traveling companions. Depending on your comfortability, let tour guides, friends and family know need for easy access to bathrooms. People are often more understanding than we give credit.
• Traveling doesn’t always have the same schedule as one’s daily schedule, but try to consume the same serving and number of meals you’re used to.
• If you’re up to trying new foods, experiment in small amounts.

A lot of these tips provide you asking lots of questions, but in the long run it will provide a more stress free trip. Having a few of the above-mentioned essentials can ease travel plans, but resist the temptation of overplanning! By leaving room for spontaneity, you can truly enjoy your travel! Happy travels!

Sources: http://www.everydayhealth.com/ibs/ibs-and-traveling.aspx

http://www.webmd.com/ibs/features/tips-traveling-with-ibs

http://www.aboutibs.org/site/living-with-ibs/travel

http://ibs.about.com/od/livingwithibs/tp/Travel-Tips-for-IBS.htm

http://mylifewithibs.com/travelling-with-ibs/

10 Ways to a Healthier YOU!

By: Nikki Nies

Being honest with ourselves’ goals and future lifestyle changes is the best thing to do moving forward.  While one might have the best intentions of losing weight, as we all know, learning how to walk is essential and part of the foundation of learning how to run.  With that said, with the New Year upon us, there’s no better time to jumpstart healthier changes.  BUT, while there are ten suggestions to a healthier lifestyle, you know, deep down, what changes will stick and what changes are not realistic to implement.

You don’t have to implement all ten changes, as that may be too overwhelming and backfire in the long run, but incorporating one or two ideas that best fit into your daily routine can provide insurmountable intrinsic and extrinsic benefits.

1. Drink more water! Aim for 16 oz. of water with each meal and snack

2. Plan at least one more meal per week in advance.  Meal ideas :

Breakfast:

• 1 cup egg whites, 1/2 cup old fashioned rolled oats, 1 cup blueberries, 1 tablespoon raw honey
• Flatbread sandwich with 3/4 cup egg whites, lean meat, cheddar cheese, spinach, onions and black olives
• 2 scrambled eggs, 1/4 cup cheddar cheese and Canadian bacon on an English muffin

Lunch/Dinner: 

• Chicken and flank steak, 1/2 cup white rice and 2 cups steamed vegetables
• 4 oz. extra lean ground turkey, 1/2 cup sweet potatoes, 4 cups spinach with olive oil and vinegar dressing
• 4 oz. salmon, 2 cups broccoli with 2 tablespoons of organic unsalted butter
• 2 oz. turkey breast, 1 oz. raw, unsalted nuts, sliced cucumber
• 6 oz. oven roasted chicken breast 1, 1 cup vegetables and 2/3 cup brown rice
• 1/2 cup brown rice, 4 oz. tilapia and 1 cup steamed green beans
• 1/2 cup chickpeas, 1/4 cup fat free cheddar cheese and 2 tablespoons olive oil

Snack:

• Banana and peanut butter smoothie
• 1/2 cup cottage cheese with 1 tablespoon natural nut butter or 1 cup of blueberries
• 1 cup oatmeal and protein shake
• Fresh pineapple and yogurt
• Handful of almonds and an apple
• Carrots and hummus
• Peanut butter and jelly sandwich
• Brown rice cake with almond butter and string cheese

3. Make meat proteins a side dish, not main entree of meals

4. Follow the 80/20 rule-with healthy options 80% o the time, but still having the occasional indulgence

5. Instead of concentrating on the number of calories consumed, focus more on the variety of colors and foods you’re eating from the increased intake of fruits and vegetables

6. Gradually cut down on calories where you are willing to make lifestyle changes you can live with

7. Be patient and realistic–remember that small changes do make a difference and that it’s more important to FEEL better!

8. Sharing is caring! Share your latest achievements via social media! Post on Facebook the latest meal you made, take a picture and upload to Instagram of the view at the top of a mountain you’ve hiked and/or follow motivational and inspirational quotes on Twitter

9. Use the outdoors as your gym will decrease excuses of working out.  While it’s winter, indoor swimming, hiking, rock climbing and biking are great year round exercises!

10. Find a partner, a support system and/or accountability buddy to encourage, confide and motivate you to make healthier choices.

If you need more information, please search and contact a Registered Dietitian near you! Keep us posted on your lifestyle changes! What healthier lifestyle additions are you adding to your day to day life? Good luck!

Photo Credit: Care2 and Green Bean Delivery 

Snack’s Bad Reputation

Original Image by jeffreyw via Flickr

By: Nikki Nies

It’s become more common and socially acceptable to deviate from the mainstream three meals of debates.  There are even debates on whether one should eat five “snacks” throughout the day instead of over sized portions of the common three meals.  While the debaters figure it out for us, I’m going to zero in on snacking today.  You know there’s a concept of “bad” snacking, right? I hope I’m not introducing a foreign concept today.

This blog post came about as I was at school the other day, passing the vending machine. For those that don’t know, I carry food with me everywhere I go. I’m not talking about a carrot, but full on meals. I like to defend my load of food as being prepared and boy has those meals helped me get through my current dietetic internship and master’s program. I digress. Walking past the vending machine, I asked myself, what if God forbid I forgot to back food with me and had to resort to vending machine food? I went through the vending machine options and I really couldn’t find any foods that I saw “worth” the cost. The healthiest snack might have been pretzels, yet how long would that sustain me? Not very long!

With that said. if you’re still with me, I don’t recommend or endorse vending machines.  Those prcocessed treats may have to be used in the dire need of emergencies, but not for day to day energy needs! Please don’t resort to those types of foods as many are filled with empty calories, full of sugar, sodium and fat! Who needs that?!

Original Image by Zdenko Zivkovic via Flickr

Bad snacking can become a vicious cycle of overeating oversized portions, with many Americans easily eating 600 calories from snacks alone.  As you know, too much unhealthy foods can lead to inflammation, oxidative stress, elevated triglyceride and cholesterol levels, which can directly impact one’s weight and development of heart disease.

Continuous eating also can contribute to the development of dental caries.  With increased exposure to food, the enamel has more opportunities to produce damaging acids. One should be espeically careful with sticky foods or those that leave particles behind (i.e. dried fruit, granola and/or crackers). If you’re not sure about the foods you’re eating, when in doubt, use the travel toothbrush you have handy!

Be honest, do those processed leave you feeling ready to tackle the next task?  I doubt it! Snacks on the go are a great way to incorporate more fruits and vegetables into your day! Yes, keeping healthier snacks on hand does require some planning, but investing in your health is a facet of our lives we should all aspire to do.

Sources: http://healthyeating.sfgate.com/bad-effects-snacking-3832.html

http://www.webmd.com/food-recipes/features/best-and-worst-snacks

http://www.today.com/health/why-snacking-night-bad-you-1C8505702

http://www.everydayhealth.com/diet-nutrition/meal-planning/healthy-snacking-benefits.aspx

http://www.eufic.org/article/en/expid/review-eating-between-meals-health/

Copycat Snacks

By: Nicole Arcilla

A new school year has begun and students are well on their way into the first semester. No doubt parents all over the country were looking up ideas for quick lunches and snacks to pack for their kids. [Quick—how many recipes do you think were pinned on Pinterest before the first day of school??] For some parents, it’s a struggle to think up creative lunch and snack ideas to send off with their kids. Many parents will rely on the school to provide meals and snacks. But not to worry – there’s always plenty of options kids can choose from at school! Plus with all the school food regulations there’s got to be plenty of healthy choices too, right?….RIGHT?! Maybe not.

Before we get into the issue at hand, let’s add in a little more context:

In 2010, President Obama signed into law the Healthy Hunger-Free Kids Act. This act aims to improve child nutrition and provide funding for free school lunch programs. In addition to these goals, the act also required that the USDA establish national nutrition standards for food sold and served in schools.  In 2013 the USDA proposed new food rules. After reviewing public comments and much revision of the rules, the USDA published “Smart Snacks in School.” The rules required any school participating in the National School Lunch Program to comply to the new guidelines by July 1st, 2014.

So what exactly does the Smart Snacks in School rules do? These rules set strict guidelines for competitive foods – specifically foods that are sold in vending machines or in à la carte lunch lines, and even fundraisers and student school stores. Essentially, in order for a food product to be sold at school, it must be able to check off every single requirement of the Smart Snacks in School rules — including not exceeding the set limits on calories, fats, sugar, and sodium. Depending on the product, other rules may apply, but for now we’ll look at these basic rules.

Naturally, food companies weren’t going to give up and simply pull their products out of the school market. Instead they went back to the drawing board and reformulated their recipes. These new items have successfully checked off every single box on that Smart Snacks checklist (but barely). Snacks like Doritos, Goldfish, Cheetos, and others are now lower in fat, sodium, calories, etc…at least that’s how they are inside of schools. Now, this is where the problem starts: the packaging of these approved food products look incredibly identical to the original packaging that you see sold in stores. From the eyes of a child, there is zero difference between the Smart Snacks and the original snacks sold in stores. Cara Wilking, J.D., a senior staff attorney with the Public Health Advocacy Institute, states that this is exactly what food companies are trying to achieve – to use near identical packaging in order to “co-market traditional junk food to children in school”.

Earlier this year Wilking released a brief on these school approved snacks, now called “Copycat Snacks”.  In her brief Wilking explains that having similar packaging may allow the child to believe that traditional snacks sold in stores are just as healthy as the ones sold in their schools. Who can blame them? At first glance the packaging of these snacks are too similar to notice any difference. Moreover, most of these Smart Snacks aren’t even sold in local grocery stores — so children and their parents wouldn’t exactly know to look for those “Smart Snacks” packaging and logo. See for yourself and look through the pictures Wilking provides in her brief. Be honest – would you have noticed the difference?

Wilking and several other attorneys are well on their way to resolve this issue by working with other organizations such as the Center for Science in the Public Interest. According to the Center for Disease Control and Prevention, childhood obesity has increased drastically in the last three decades. By 2012, more than one-third of children were classified as obese. Today, the numbers are reaching a sort of plateau, but that doesn’t change the fact that so many children are at risk for even more health complications as adults or even experiencing them now. Considering these facts and numbers, it’s important that continued action is taken to help improve the food environment of the children, particularly the ones in school. Schools are, after all, the one place that children spend majority of their days in. Luckily, the Smart Snacks in School rules are actually an ongoing process and the USDA will continue to make improvement before finalizing the rules – so there’s plenty of opportunity to improve this current situation with the Copycat Snacks.

How would you handle the situation with these Copycat Snacks? What message do you have for the food companies?

Photo Credit: Smart Snacks in School 

“Hangry”-It’s Here & It Doesn’t Have To Be!

By:  Nikki Nies

We’ve all heard jokes about it, but studies are showing the term “hangry” is a very real, legitimate adjective. Think about the last conflict you may have had with your SO, friend, roommate and/or colleague.  And when was the last time you had eaten prior to the argument?  Not willing to admit you’re wrong? Blame it on being hangry! 

All jokes aside, a recent study led by Bushman et al., 2014, used voo doo dolls and glucometers.  The study found that those with lower glucose levels were more likely to stab the voo doo dolls with more pins.

When glucose levels are lower than normal, it can cause a higher intensity of anger and/or rage. Reduced blood sugar can lead lower self control, which is an integral part of maintaining good relationships.

How to limit your hangriness? Keeping small snacks on hand (i.e. granola bar, almonds) can help keep your relationships afloat without the unnecessary conflicts due to lack of food! Limiting your angry when your hungry is obviously the opposite of the overshadowed end of the spectrum, overeating.

Sources: http://abcnews.go.com/blogs/health/2014/04/14/why-your-spouse-may-be-hangry-for-a-fight/

Bushman, B. J., DeWall, C. N., Pond, R. S., & Hanus, M. D. (2014) Low glucose relates to greater aggression in married couples. PNAS.

http://www.theguardian.com/science/shortcuts/2014/apr/15/hangry-stupid-made-up-word-angry-hungry

http://www.psychologytoday.com/blog/meet-catch-and-keep/201404/pack-snack-simple-trick-reduce-romantic-fighting

http://www.foxnews.com/health/2014/04/15/5-steps-to-avoid-getting-hangry/

http://www.keepcalmandposters.com/poster/keep-calm-and-dont-get-hangry

https://www.yahoo.com/food/hangry-is-a-real-thing-82802959390.html

Michael Pollan’s Food Shopping Rules

National School Lunch Program (NSLP)

By: Nikki Nies 

The National School Lunch Program (NSLP) is another USDA, federally assistance food program, striving to provide nutritious meals to children during the school day.  As of 2012, like the School Breakfast Program, the NSLP operates in over 100,000 public, private and non-profit schools nationwide, which feed over 31 million children a day.  To say that the NSLP is needed in schools would be an understatement.  Thankfully, since the introduction of NSLP, Congress has expanded the program to include the reimbursement of snacks for children during extracurricular activities and/or enrichment programs.

Schools that opt to participate in the program are provided cash subsidies and USDA foods for each meal served. To continue to qualify for the program, schools must comply with federal meal nutrition requirements and must offer free or reduced lunches to students. While the specific foods and how they are prepared can be decided by the facility itself, the nutrition requirements include:

• Offer fruits and vegetables as two separate meal components;
• Offer fruit daily at breakfast and lunch;
• Offer vegetables daily at lunch, including specific vegetable subgroups  weekly (dark green, orange, legumes,  and other as defined in the 2010 Dietary  Guidelines) and a limited quantity of starchy vegetables throughout the week;
• Offer whole grains: half of the grains would be whole grain-rich upon implementation of the rule and all grains would be whole-grain rich two years post implementation;
•  Offer fluid milk that is fat-free (unflavored and flavored) and low-fat (unflavored only);
• Offer meals that meet specific calorie ranges for each age/grade group;
• Reduce the sodium content of meals gradually over a 10-year period through two intermediate sodium targets at two and four years post implementation;
• Prepare meals using food products or ingredients that contain zero grams of trans fat per serving;
•  Require students to select a fruit or a vegetable as part of the reimbursable meal

Children from families’ with incomes that meet or are below the 130% poverty level are eligible for free meals. Those from families that are between 130-185% of poverty level are eligible for a reduced price lunch, and are not allowed to be charged more than 40 cents. Children from families over the 185% poverty line will pay full price.

After reading these guidelines, it may sound like the USDA is setting schools up for success, but since schools have the autonomy to choose how foods are prepared and the numerous complaints about how “bad” the food is, I’m sad to see that the NSLP meals aren’t where they could be.  Additionally, there is a discrepancy since all schools have to do is “offer” these healthier foods.  Observations have found that many of the fruits are thrown in the trash after lunch! For anyone has ever gotten school lunch, how are the meals? What’s your take on the school’s ability to meet the above nutrition guidelines? How can the NSLP be improved?

Photo Credit: RubyUHart

Sources: http://www.ers.usda.gov/topics/food-nutrition-assistance/child-nutrition-programs/national-school-lunch-program.aspx#.UxFhJmRdWRA

http://frac.org/federal-foodnutrition-programs/national-school-lunch-program/

http://www.gpo.gov/fdsys/pkg/FR-2012-01-26/pdf/2012-1010.pdf

http://www.fns.usda.gov/nslp/national-school-lunch-program-nslp

http://www.fns.usda.gov/sites/default/files/NSLPFactSheet.pdf