Review: Nutrium Client Management Software

Hi everyone! I know, I know. It has been WAY too long. The best excuse that I have is that I’m still full-time at the hospital managing the nutrition department, working on my doctorate (Integrative Healthcare; tell you about that another day), and building my functional nutrition consulting business….all while trying to maintain a household and happy marriage! It’s exhausting, really, and my blogging falls by the wayside. I’m pledging to get back to this regularly, though. I promise!

Anyway, a lot of what I do in my consulting business involves conducting nutrition analyses and writing meal plans. It can be a pretty time-consuming process, especially with my relatively old-school methods of typing meal plans into Word document tables. I was recently given an opportunity to try a software called Nutrium, which is designed especially for dietitians who do this type of thing. It would be ideal for those in private practice, or clinical dietitians who work 1-on-1 doing Medical Nutrition Therapy. I will disclose right off the bat that I was offered a 6-month free subscription to the service for writing this review, but anyone who knows me knows I’m incapable of anything other than honesty. Having said that, and without further ado, here is my honest review.

User-Friendliness

I would consider myself moderately computer savvy, but by no means an expert. Making an account was easy, and there is a tutorial that is offered immediately upon signing in for the first time. I found this very useful and it eliminated pretty much any doubt I had about being able to operate the program. Everything is organized into neat little tabs so information about each patient is easily accessible. You can also upload your business logo, if you have one.

Comprehensive Analysis

A profile can be created for each of your clients/patients, which can be saved for later reference, with sections for both new assessment and follow-up. An example of the patient home screen is below (don’t worry, it’s a fake patient — no HIPAA violations here!). Basic information about them is entered and displayed here, such as their nutrition goals, sleep habits, and food diaries.

nutrium pt info

After the client profile is done, you can begin entering measurements. This includes both anthropometrics and lab work, and these are trackable over time. It’s very comprehensive — so much so that it includes things I don’t even measure! The data makes nice, neat trend lines after two measurements are entered. (I love graphs! So visually appealing, no?) The dietitian can then move on to meal planning, analysis of the meal plan, and so on.

Meal Planning

In the meal planning process, macros can be pre-set. While adding foods to the meal plan, a macros pie chart is displayed next to the plan and updates in real time, so the RD can ensure he or she is staying within the defined macronutrient ranges. This is possibly my favorite feature. Macros are the new “thing,” you know, and I often have clients request specific percentages. This saves me a LOT of math! (I like math, but not that much!) The foods database is pretty comprehensive, too, which is not always the case with this type of software. Because this program isn’t United States-based, some things are in grams that I wouldn’t necessarily measure as such, so my only real complaint here is I wish there were drop-down boxes that offered US measurements such as ounces, cups, etc for easier conversion. Having said that, one can do these conversions online pretty easily with a Google search, but of course convenience is key!

macro graphsRecipes can also be imported here, and templates can be created as a time-saving tool for later. Once the meal plan is written, the RD can analyze it for adequacy. Again, lots of lovely pie charts appear, which even break down fats and carbs into their individual distribution, which is useful for ensuring — for example — that the patient is getting plenty of MUFAs and PUFAs and minimal trans/saturated fats. It’s brilliant, really! Physical activity recommendations are also done here.

nutrium macros

Patient/Client Use

You can then share all of this with your client electronically, which is awesome for those of who do virtual appointments. Meal plans are easily emailed or printed. Follow-up appointments can be entered and tracked, and you can send them reminders. Oh! Did I mention there’s a mobile app they can get? It’s true, and is available for both Android and iPhone formats. They can use this to track their macros, enter their daily intake, and update the RD on their progress. This keeps an open line of communication which is SO important in the dietitian-client relationship. Here’s a snapshot of some of the mobile features:

mobile app

The Verdict

All in all, this is a fantastic software and I fully intend to make good use of that free 6-month subscription. I would even pay for it after that runs out. I truly foresee it streamlining my patient assessment and meal-planning processes, and I think any other RD working 1-on-1 one with clients would find it beneficial as well.

Thanks for reading. New recipes and more coming soon!

 

Solving the soy debate: the latest research

I recently wrote this article as part of a freelance assignment. The publisher decided not to use it, so I will share it with you instead!

For many years, soy has been a controversial topic. Conflicting research over the last decade has left consumers confused and wary. This, along with the abundance of information (and misinformation) on the Internet, has led many consumers to avoid soy completely out of fear of developing cancer or consuming GMOs (Genetically Modified Organisms). This article will examine the latest research and provide updated recommendations for soy consumption.

Characteristics of Soy

Soy products are found in many forms in the United States food market, most commonly tofu, tempeh, soy milk, and edamame. There is also an abundance of processed soy products, such as vegetarian forms of chicken nuggets, burgers, and hot dogs. Soy is a rich source of many dietary nutrients, including protein, fiber, vitamin K, and B vitamins.

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edamametofu

Soy and Cancer Prevention

Many studies have shown the protective effects of soy against cancer. It should be noted that in many Asian countries, where soy consumption is high, overall cancer rates are much lower than in the United States. One cohort study in Japan showed that consumption of isoflavones was associated with a reduced breast cancer risk (Journal of National Cancer Research, 2003). Genistein, an isoflavone in soy, is thought to prevent cancer cell growth by binding estrogen to decrease the development of hormonal cancers, particularly that of the breast. This contradicts older studies that showed a link to increased cancer, however these studies were conducted on mice. The author of one such study, Dr. Mark Messina, later discovered that rodents metabolize isoflavones at a much higher rate than humans, and therefore the effects were only seen in very high doses. In fact, even the rodent studies did not consistently produce these results (American Journal of Clinical Nutrition, 2011). Studies have been difficult to conduct in the United States, because soy intake is relatively low among American women (Today’s Dietitian, 2013). Therefore, it is challenging to determine the exact reason(s) that Asian women have lower cancer rates.

One proposed theory to explain the disparity between US and Asian cancer rates is the amount of meat in the diet. Typically, the Japanese diet contains almost no saturated fat due to relatively low meat consumption. Countries with higher animal fat intake have higher breast cancer rates. Even in modern Japan, where a Western diet is more commonly consumed than in past decades due to the rise of international fast food chains, breast cancer rates are rising among the younger generations. Meat and other foods high in saturated fat are known to increase estrogen production. However, saturated fat is not thought to be the direct cause, as many studies have shown positive relationships between meat intake and breast cancer even when fat intake is controlled (Physicians Committee for Responsible Medicine, 2016).

Soy and Cancer Survivors

One common perception is that women who have survived breast cancer should avoid soy products. The thought process behind this is that because soy foods promote estrogen production, that the estrogen can promote the growth of breast cancer cells. Current research, however, contradicts this belief. The largest study to date, a pooled analysis of studies consisting of over 10,000 breast cancer patients, showed that consuming as little as 10 mg of isoflavones was linked to a 25% decrease in recurrence. This was true in both American and Asian women. Isoflavones have also not been shown to have any harmful interaction with hormone treatments like tamoxifen, and in fact may even be protective of women taking these treatments. However, more research is needed in this area to make conclusive recommendations (Today’s Dietitian, 2013).

Areas of Controversy

Soy has been purported to reduce the risk of heart disease by lowering LDL cholesterol. These findings are controversial as it is unclear whether it is a direct result of eating soy or simply due to replacing animal proteins with soy protein. In addition, benefit was only shown by consuming at least 50 grams of soy protein daily, the equivalent of eight cups of soymilk. Consuming soy in these quantities is likely to be difficult to achieve for most individuals (The Nutrition Source, 2014).

Another area of current research is the impact of soy consumption on memory. One study of Hawaiian women of Japanese heritage showed that excessive soy intake was possibly related to a decline in cognitive function, but this finding has not been confirmed by other long-term studies (The Nutrition Sources, 2014).

Finally, there is ongoing debate regarding the effects of consuming GMOs. Unfortunately, soy is one of the most common GMO crops grown in the United States. The long-term effects of eating GMO foods are not yet known, as not enough time has elapsed since their adoption into the United States food supply. It is currently the consensus of the USDA and FDA that GMO crops have no adverse health effects, but one must consider the well-known relationships that exist between the government and agricultural giant Monsanto, the largest producer of GMO seed in this country (Robin, 2008). There is no current law requiring labeling of GMO foods, however many companies are doing this voluntarily. Many manufacturers of soy products, such as Silk, are proudly labeling their products as non GMO.

Whole vs Processed Soy

One issue that many individuals have with soy is that fact that it is often highly processed in the United States. Great effort has been made by manufacturers to lure meat-eating consumers by creating products that have a similar taste and texture to meat. As with the processing of all other foods, the chemical composition and nutritional content is changed, and arguably, so are the health effects. Isoflavone content and antioxidant potential can be lost through various steps in processing such as bleaching, isolating, and deodorizing (South Dakota State University, 2008). There is sweeping evidence that consuming a diet high in processed foods, particularly processed meat, can lead to adverse health effects.

Current Recommendations

Soy should be chosen in its whole, unprocessed form, such as edamame, and it is generally recommended that a whole-foods diet be adhered to as much as possible (Today’s Dietitian, 2013). When purchasing soy foods, look for the non GMO label on the package. The Dietary Guidelines for Americans currently recommends 1-3 servings daily of soy foods to get the benefits of the isoflavones (USDA, 2015).

Snacks you can feel good about

Happy New Year everyone!

One of my resolutions is to be more active on this blog. I have been gaining more followers and I don’t want to lose them out of boredom. Sooooo, you can definitely expect to see more from me this year! Hurray!

To start it off, we’re going to talk about snacks, because who doesn’t love snacks? Many of my clients feel that snacking is a bad thing. They feel guilty and hang their heads in shame when they admit to me they’ve been munching between meals. What do I tell them? Snacking is a good thing! It helps keep you satisfied when it’s not time for a meal, and can actually help keep you from overeating when you do have a meal. HOWEVER — WHAT you snack on very much matters. I’m always being asked for suggestions, so to help you make smart choices, I’ve compiled a list of snacks that you can enjoy without feeling guilty.

General rules – For most people, snacks should be under 200 calories and should contain at least two food groups — one of which should be a protein or healthy fat. If you eat only carbs, the satisfaction won’t last long and you’ll be hungry again in no time. Some great combinations:

  • Apple with 1 Tbsp peanut butter
  • Baby carrots with 1/4 cup hummus
  • Trail mix: 2 Tbsp dried fruit, 2 Tbsp raw almonds, 1 tsp dark chocolate chips
  • 6 oz Greek yogurt with 1/2 cup sliced fruit and 1 Tbsp hemp seeds
  • Small banana with 1 Tbsp almond butter spread on it
  • 1 slice whole grain toast with 1/4 avocado smashed on top
  • Homemade smoothie, such as the one below: 1 cup almond milk, 1 cup desired fruit, 1 cup baby spinach

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Now, for specific products:

Bars – you must be careful with these. Look for bars without HFCS (high fructose corn syrup), soy protein isolate, or ingredients you can’t pronounce. They often have over 200 calories and are loaded with sugar, so I don’t generally recommend a bar unless it’s meant as a post-workout refuel and meets the criteria above. Protein bars from GNC or other “nutrition” stores are usually poor quality. The brands I like:

  • Larabar (particularly Alt as they have 10 g of plant protein)
  • Kind (including Healthy Grains)
  • Kashi GoLean roll
  • Raw Revolution
  • Chia Warriorraw revolution

Really, you should make your own. There are tons of recipes out there. I love to make the energy balls from Rich Roll’s The Plantpower Way book:

  • 8 Medjool dates, pitted (soak in water for 30 minutes before making the recipe)
  • 1/4 cup cacao nibs
  • 2 Tbsp cocoa powder
  • 4 Tbsp hemp seeds (Walmart carries them)
  • 1/4 cup walnuts

Grind walnuts in the food processor until mealy. Add in the nibs, cocoa powder, and half of the hemp seeds.  Add dates one at a time and blend until everything is a paste consistency. Turn off the food processor, remove the blade, and roll into balls. Roll the balls in the rest of the hemp seeds. The way I make them I usually get about 16 balls out of it, and 3 of them would equal about 180 calories.

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The energy balls I made last week.

Salty – when I say salty, I simply mean they taste salty. Everything listed here is still considered low sodium, although many of them don’t taste that way! Some Jean-approved products:

  • Skinny Pop — all varieties
  • Lesser Evil popcorn (try the wasabi — yum!)
  • Air-popped popcorn (not microwave…the bags have cancer-causing chemicals, yuck!)  — Can you tell I like popcorn??
  • Most brands of kettle corn
  • Newman’s Own protein pretzels (hard to find, Vitacost has them)
  • Snapea Crisps
  • The Good Bean crispy crunchy chickpeas
  • World Peas (see my review in the previous post)
  • True North Nut Clusters (bonus: also sweet!)

Sweet – now let me be clear on something: this should NOT be your first choice and should NOT replace healthier snacks. Sugar does not keep you full and you will likely end up craving more if you’re not careful. Treat these as desserts or emergency supplies (you know, like if you’re having the worst day ever or PMS). I personally allow myself a couple of pieces of dark chocolate every day after lunch, but wouldn’t eat it in place of my morning snack. It’s all in the balance! Some 200 calorie ideas:

  • Five Ghirardelli dark chocolate squares
  • 2 Tbsp dark chocolate-covered nuts
  • 1/2 cup ice cream (preferably non-dairy versions like cashew or almond)
  • 9 Hershey’s kisses
  • 2 fun-size candy bars

coco-ice-chocolate-pb

 

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Happy snacking!

Eat Healthy on a Budget? Yes, We Can!

First of all, I have to apologize for my absence. I have missed all of you! I just saw that my last post was over a month ago, which mortifies me. I hope you are all still out there, having EAGERLY anticipated my next post, and so I’ve made it a good one for you (I hope!!!) 🙂

I want to talk about eating healthy on a budget. I could safely say that it’s the most common nutrition-related obstacle identified by my clients. They say things like, “I can’t afford to eat healthy” or “Produce is just so expensive!” There seems to be a great deal of misconception in regards to what you can really get for your money. I decided, as both a dietitian and consumer, to help my fellow consumers save money without sacrificing their nutrition. I even did some incognito prowling of the grocery store aisles to show you some product comparisons. Read on, for my top tips on savvy shopping!

1) Think outside the box. It’s a fairly well-kept secret that discount stores can have some really great finds. There is a chain here in Virginia called Big Lots, which calls itself a closeout store. They sell overstocks, discontinued products, off-brand items, etc at a deep discount; they have everything from furniture to cleaning products to Christmas trees. The Big Lots in my town just so happens to be a treasure trove of organic and natural products. For example, they have an entire section of Bob’s Red Mill products, many of which are hard to find in this small town (think coconut flour and organic rolled oats). Not only is the selection huge, but they are something close to 40% off of retail. I have also found Kashi products, organic dried fruit, and these amazing imported Italian cookies I’ve never seen in the US. Check out this haul from my most recent Big Lots trip:

Major

Major score! I paid $4 for the PB2, which retails closer to $5 in most stores.

I also recommend scouring places like TJ Maxx, Marshall’s, and Ross, where I’ve found goodies like organic popcorn, gluten-free cookies, jarred roasted red peppers, and trail mix for, again, significantly below retail. It’s true! (And hey, you might even find a cute scarf or a designer dress while you’re at it!)

2) Do a little comparison shopping. Don’t write off the store brand — many big-chain grocers are even making their own organic and/or natural brands. Food Lion has their own brand, as does Farm Fresh, Kroger, Whole Foods, Trader Joe’s, and likely others that I don’t have around here! A money-saving example:

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The ingredients were identical — I checked! Yet the price difference was a whole dollar.

While comparing name brand with store brand is a good way to go, you can also compare different sizes of the same product to see which is a better deal. Sometimes, you’ll find that buying the larger or multi-pack container is more economical. It takes a little math to determine the cost per pound or per ounce, but it’s worth it! Some stores, like Food Lion (where I did my research today) lists that cost right on the price tag so the math is done for you (no headache for you, hurray!) Today, for example, I was buying Greek yogurt for my son’s lunch.

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Note the price of the individual yogurt. The 4-pack of the same brand, flavor, and size was $3.89, making the price 97 cents per yogurt. While an 18-cent savings may not seem like much, think about how that would add up in a $200 shopping trip!

3) Look for sale items. Food Lion has a small “natural foods” section, and while a lot of the items are overpriced, I keep finding deals all over the place! Several items were marked as closeout, and some were on sale with the store’s loyalty card. See for yourself:

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This was the find of the day!! I love these single-serving almond milks for a snack at work or post-workout.

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They had my favorite crackers on sale; next to them you can see some of the closeout items as well.

4) When it comes to fresh produce, I cannot emphasize this enough — BUY IN SEASON!!! I have compared prices on foods that I know grow here (apples, for example) during their respective on- and off-seasons, and the difference is not insignificant. That being said, if it’s in season, you should be able to buy it from a local grower. Look at farmers’ markets, roadside stands, even random pickup trucks in parking lots (an enormous quantity of watermelons are sold this way around here!!!). Other fruits are always cheap, like bananas. Make sure they have the Rainforest Alliance sticker, though, for responsible consumerism! If you can’t get in season and/or feel the food item costs too much, head to the freezer section. Frozen fruits & vegetables are a great alternative — they retain the fresh taste and nutrient content of fresh without the high price tag. A word to the wise: avoid canned vegetables if possible — they are often high in sodium and the nutrient content is subpar at best. Ever put a fresh green bean next to a canned one? Yeah. No comparison. I rest my case on that one.

5) Last but not least — this part may seem obvious, but it’s absolutely worth it to clip coupons. I get coupons in the mail, troll for them online, (try http://www.coupons.com, http://www.valupak.com, and manufacturer’s websites) and look through the weekly store ads. Find out what day is “double coupon” day at whatever store(s) you frequent. Also, almost all large grocery chains have a loyalty membership card, which is always free, and the payoff is often huge! My husband makes fun of me, but I have all of the local stores’ cards on my keyring, and I am not ashamed! You can often visit the store’s website for additional coupons, as well. Many of them can even be used more than once, so the savings continue until the coupon expires. I know, couponing (is that a word?) can be time-consuming, but in my humble opinion, it’s a small price to pay (pun intended!) for the money you will save.  You don’t have to be one of those Extreme Couponers from reality TV who end up with an 80-cent grocery bill (how is that even possible?), but every little bit of savings helps!

Adding up my coupons and MVP store card, I saved $12.68.

I know it’s hard to read, but adding up my coupons and MVP store card, I saved $12.68 on my $98 grocery bill. Not too shabby, eh??

Thanks for hanging in there. This is what happens when I don’t blog for a while — I get wordy! Next entry will be full of beautiful pictures, because I’m going to feature my favorite meal —- BREAKFAST!!!! I’ve been taking pictures of my morning concoctions for weeks now, so be prepared…..and I promise to get it to you sooner rather than later.

As always, have a healthy and happy week!

The chocolate lover’s dilemma

chocolate

As a dietitian, I am under significant pressure to set the perfect example for how one’s diet should be. If I am spotted eating chips, or — God forbid — some cake, people say, “You’re a dietitian, you’re not supposed to eat that!” What people forget is that I am, in fact, human, and have the same cravings as everyone else. Granted, I follow a vegan diet 90% of the time and probably eat things people would consider strange (kale chips, anyone??), but I like a good cupcake every once in a while, too. Chocolate is a particular vice. My day is not complete without it. Do I feel okay about this? Absolutely!

Case in point: Myself and the other two dietitians I work with all decided to give up chocolate for Lent (also known as 40 days of suffering). At the end of Lent (Easter Sunday), we all found ourselves with some major cravings. We began to indulge said cravings, eating chocolate chips right out of the bag and concocting desserts that even a stoner would envy. Then came the guilt-stricken dialogue that we dubbed “Confessions of Crazy Dietitians.” (Watch out, this could become a regular blog theme!) “What is wrong with us???” we lamented after one particular episode, “it’s like crack!” Which got me thinking. There are a lot of bad habits one could have, and if chocolate is the worst vice you have, then I’d say you’re doing okay.

The bottom line: Go with the dark chocolate — less fat, more antioxidants, and the rich flavor is more satisfying. Antioxidants fight cancer and promote heart health, so this is a perfect excuse to indulge. The dietitian approves!