• 530.541.3420 | 2170 South Avenue, S. Lake Tahoe, CA

General Information/Questions

Barton Nutrition Services
2170 South Ave.
South Lake Tahoe, CA 96150

Phone:  530.543.5824
Fax:  530.543.5821

Email us at lnorton@bartonhealth.org

Please select the Nutrition Tip Topic you would like to look at or simply scroll down to view all topics.

An Apple a Day

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By Jamie Deem, MS, RD, CDE

We’ve all heard the old saying “an apple a day keeps the doctor away”….while this advice shouldn’t be taken literally, apples offer dozens of health benefits and happen to be at peak flavor and freshness in autumn. 

Apples offer a myriad of nutrients and are an especially good source of fiber. The fiber and antioxidants found in apples have been shown to reduce the risk of developing certain types of cancer, including colon and breast cancer.  Regular apple consumption has also been associated with lower risk of obesity, high blood pressure and type 2 diabetes (March 2007 American Journal of Clinical Nutrition). 

Apples are nearly the perfect snack as well.  Portable and inexpensive, a medium apple provides only 80 calories and 3 grams of fiber, making it a satisfying between-meal treat.

Fresh apples will have shiny skin and firm flesh.  Apples will retain their optimal freshness at a temperature of 32 degrees F.  Apple growers are constantly developing new varieties.  For something different, look for Pink Lady, Cameo, Honeycrisp,  or Pippin apples this fall.

Fall Harvest Salad with Blue Cheese dressing
This salad is full of disease-fighting vitamins and minerals available in spinach, apples, and cranberries as well as the healthy fats found in avocado and pecans.  Add a grilled chicken breast to each salad serving to make it a meal. 

16 ounce bag of baby spinach, washed and drained
1 large unpeeled sweet-tart apple, such as Pink Lady or Honeycrisp, washed, cored and thinly sliced
1 Haas avocado, peeled and sliced
½ of a medium red onion, thinly sliced
1/3 cup dried cranberries
¼ cup toasted pecan pieces

1/3 cup blue Cheese, crumbled
2 Tbsp white vinegar
1 Tbsp Dijon mustard
1/3 cup orange juice
8 ounces Fat Free plain yogurt

Combine salad ingredients in a large bowl.  In a separate bowl, whisk together vinegar, Dijon mustard, orange juice and yogurt.  Gently fold blue cheese crumbles into dressing mix.  Serves 4.

Nutrition Facts per serving: ¼ salad with 2 Tbsp dressing.  Calories:  250;  Fat: 16 grams, Protein: 4 grams; Carbohydrate: 32 grams; Fiber:  6 grams

Eating on a Budget

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By Lynn Norton, MS, RD 
Outpatient Dietitian

The start of a new year should be filled with motivation for positive changes… but for many, 2009 brings difficult financial times that are adding negative pressures to day-to-day life. My goal is to help those struggling with basic finances to make a resolution to reduce food costs without making significant nutritional sacrifices. Taking time to plan food purchases, may actually make your routine diet healthier!

Fruits and Vegetables. How many times do we hear they are good for us, but think they are too expensive to buy? The American Dietetic Association’s spokesperson, Katherine Tallmadge, reminds us otherwise. “The reality is, fresh produce gives you some of the best bang for your buck. In fact, in June 2008, the U.S. Department of Agriculture’s Economic Research Service studied the prices of produce throughout the country. They concluded a person needing 2,000 calories per day could meet the dietary recommendations for fruit and vegetables for under $2.50 per day,” Tallmadge says. At the grocery store, less healthful foods such as bakery goods, snack foods and sodas can be more expensive than a healthier alternative. Tallmadge notes that while a 10-ounce bag of potato chips costs about $2.59 and may seem like a cheap source of calories, consumers could buy four pounds (16 servings) of fiber and vitamin C-rich fresh red potatoes or three pounds (12 servings) of vitamin,- mineral- and beta-carotene-rich carrots for the same price.”

Shop “In Season.” Seasonal fruits and vegetables are far less expensive than those that come from the opposite hemisphere (and keep the planet a little greener at the same time!)

Cheaper Cuts of Meat. They are often healthier for us, too. Higher priced beef tends to be more highly marbled in fat—that what makes it juicier and more tender. Choose cuts labeled, “Choice” or “Select” for a leaner product, along with a leaner price. Don’t forget reducing your portion-size can also stretch your dollar.

Change Cooking or Serving Methods. Leaner meats may need to be pounded first to make them more tender. Crock pot cooking with additional low fat liquid added is another option. Cutting meats in thin slices, against the grain, produces a less chewy product. Leaner meats are more likely to toughen up with over- or rapid cooking, so take a little extra care when using less familiar types of meat.

Plant Proteins. Dried beans and peas (“legumes”) are very economical protein sources that are also high in fiber and iron and free of cholesterol and fat. Have meatless meals with legumes as the entrée or side. Why not try a soothing lentil or split pea soup during these cold Tahoe evenings for a change?

Less Processing. The more “convenient” the food is to prepare and eat, the higher the price tag. Start with more basic ingredients like a whole chicken, instead of buying sliced cold cuts or deboned portions. Make your own “microwavable meals” from leftovers to capture both time savings along with money savings.

Bulk Shopping. Buy large. Split large volume purchases with a friend or neighbor. Ever price a 1lb bag of rice with a 10 or 25 lb bag?

Comparison Shop. A must. Check your local grocers for weekly sales and coupons. Plan meals around these sale items. Generic brand cereals, breads, canned goods, and other staples are almost always cheaper than name brands.

Eat Out Less. Reassess the frequency you grab a meal or beverage out. How much did that cost you or the family compared to a healthy meal at home? Make sure you pack your lunch or thermos of coffee instead of being tempted to eat and drink on the run. How much have you paid for bottled water, soda, or a cappuccino lately? If there is a special occasion at hand, why not go out for lunch instead of dinner. Often meals will be a quarter or half the price.

Like anything else we wish to succeed at, shopping and eating “on a budget” takes time and planning. Sticking to a shopping list and reducing compulsive buying may be a significant behavior change for many. Head to the library, a friend or the internet to find recipes that fit the ingredients you wish to use. Be patient and set yourself up to succeed. The time you invest will pay you back in financial as potentially health savings.

Resources: The American Dietetic Association: www.eatright.org

For information on Federal “Nutrition Assistance Programs”: www.fnic.nal.usda.gov/

A Safe and Healthful Tailgate

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Reprinted by permission of the American Dietetic Association.

Fall weekends are usually filled with food, festivities and fun – not to mention football. Whether you are having your tailgate party at home or at the field, here are some tips for a safe and healthful tailgate.

  • Have a small snack before going to a tailgate party. Going to a party hungry often results in overeating.
  • Stick to a strategy for eating. Don’t let your eating be dictated by the pace of the game.
  • Use a plate for even the smallest snack. You’ll eat less.
  • Moderate your alcohol intake. Alcohol causes blood sugar to drop, which leads to hunger.

Hosts, serve your fellow fans fresh vegetables with low-fat dip, fruit kabobs, popcorn, pretzels with mustard dip, baked tortilla chips and salsa, whole-grain breads and a variety of lean meats for sandwiches.
You’ll score points with your guests and help guarantee your tailgate get-together will be a hit right up until the final whistle.
If you plan to set up camp at the game, load up the cooler, pack the picnic basket and get ready for an afternoon of food, drink and football.
For healthy appetizers at your tailgate, bring tortilla roll-ups made with flour tortillas that are filled with leafy greens, salsa, refried beans and low-fat cheese. Try hummus with pita chips or veggies with yogurt dip.
For the main meal, pack lean meat or tuna sandwiches on whole-grain bread or three-bean chili. Add lots of vegetable pieces to your chili and serve it with crusty, whole-grain bread. For a sweet ending just before kickoff, bring fruit and angel food cake.
And if you plan to fire up the grill at your pre-game gathering, keep in mind that fun and successful grilling all come down to proper food safety.

  • Start your meal off right by thawing meats properly in a refrigerator set below 40° F or in a microwave on the “defrost” setting.
  • Use a meat thermometer to ensure that food is thoroughly cooked to ensure both taste and safety. Hamburgers should reach an internal temperature of 160° F; chicken breasts, 170° F.
  • Bust barbecue bacteria by marinating meat in the refrigerator, never on the counter or outside by the grill.
  • Keep clean by washing cutting boards and utensils in hot, soapy water between uses. Or use color-coded sets to keep raw meats and ready-to-eat foods separate. And always, always wash your hands!
  • Remember the “two-hour rule” and make sure perishable foods do not sit out of refrigeration for more than two hours (one hour in temperatures of 90° F or higher).

For more tips on a healthful and safe tailgating visit www.homefoodsafety.org.

Getting Your Children to Eat Healthier

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Jennifer Trew, RD

Getting children to accept and eat a healthy diet, as any parent knows, can be a challenge. Fortunately, there are many ways parents can encourage healthy habits. It is important to have well balanced diet for good health and disease prevention. The younger children are, when introduced to healthy eating habits, the more likely they will follow these healthy habits into adulthood. So it is important for children to develop healthy food habits at a young age. 

Parents often find that their babies and toddlers will readily eat fruit because of the sweetness. But when it comes to eating veggies, some children will spit them out or make strange faces because veggies tend to be bitter. The key to acceptance when offering veggies to babies is to introduce veggies before introducing fruit. Additionally, before deciding that your child doesn’t like a particular vegetable, offer it 10-15 times. 

Tips for getting your children to eat veggies as they continue to grow:

  1. Offer veggies at lunch and dinner on a regular basis
  2. Be a good example by eating a variety of veggies
  3. Offer dips along with veggies
  4. Offer low sodium canned beans (pinto beans, kidney beans, black beans, etc) as a side dish or part of a salad
  5. Experiment with both cooked and raw veggies. Cooked vegetables are stronger in flavor than raw vegetables. Since children’s taste buds are more sensitive, raw vegetables may be more acceptable.
  6. When children are hungry, and dinner isn’t ready provide an assortment of raw veggies  to snack on
  7. Hide veggies in foods by using veggie purees as part of tomato sauce, soups, mix in meatloaf, and in casseroles
  8. Give children a choice of two different vegetables, and have them pick one
  9. Allow children to help choose produce when grocery shopping
  10. Allow children to help in the kitchen when you are preparing a meal. Participation stimulates interest.


Some children will be stubborn at meal time because this is an easy area to control. So the more control you allow at mealtime, the more likely they are to eat what is served.

  1. Allow children to choose the utensils, plates, etc. Have younger children get items from the pantry or utensils out of the drawers.  Young children can also help pour, measure, stir and spread.  As they get older they can also get items out of the refrigerator and get pots, pans etc.  The more they help the better!
  2. Allow children to choose one part of the meal (starch side or veggie side) that will be served
  3. If you plan your meals for the week, allow children to choose recipes or make at least one meal/week more kid-friendly

Since children have small tummies, snacks are needed to round out a healthy diet. Snacks also provide an opportunity to introduce new foods and reinforce good habits.
Snack ideas:

  1. Yogurt
  2. Fresh fruit (have a bowl with washed fruit visible on the counter)
  3. Fresh veggies with dip
  4. Low fat cheese sticks
  5. Whole grain crackers and natural peanut butter
  6. Dried fruit (raisins, apricots, cherries)
  7. Nuts
  8. Trail mix
  9. Smoothies (I use fresh or frozen fruit, baby oatmeal cereal, yogurt, milk or juice; I also have thrown in cooked veggies with the fruit--they will never know!)

Don’t forget to let kids have fun with food. Make a contest (for those with more than one child) for who will have the strongest heart--who eats the most broccoli; who will have the biggest muscles--who eats the most chicken; etc. Talking with your children about how nutritious food affects the body can stimulate interest and motivation to eat healthy, especially as children get older.

If you need more ideas, there are many child-friendly cookbooks available. The Sneaky Chef and Deceptively Delicious are two that I use to help me incorporate vegetable purees into meals. Remember, the more ownership children have in a meal, the more likely they will eat it! 

Check out these websites for kid-friendly nutrition info and games:

The Smell of Spring Means Fresh Produce

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Source: Used with Permission from the American Dietetic Association

The end of March and the beginning of April are a welcome turn of the calendar. As the ground thaws and the soil warms, visions of cantaloupe, strawberries and peapods dance in our heads. April showers not only bring May flowers, they also bring us more choices in the produce aisle.
The Dietary Guidelines for Americans recommend we eat between 2 cups of fruit and 2½ cups of vegetables every day (for a 2,000 calorie diet). They’re almost all low in fat and calories, full of fiber and a key ingredient in a healthful eating plan. Research continues to show the role fruits and vegetables play in disease prevention, such as cancer, heart disease and diabetes.
Get ready to fill your plate with all the fruits and vegetables spring and summer seasons have to offer: berries, grapes, fresh greens and tender onions; blushing beets, mouth-watering melons, fabulous fennel and incomparable tomatoes.

  • Puree berries for a thick, sweet sauce on grilled or broiled fish or poultry, pancakes or waffles.
  • Grill or sauté spring onions and serve them on sandwiches, salads or in pasta dishes. The phytonutrients that make onions so flavorful and so healthful may also help to lower LDL — (bad) cholesterol.
  • Dip vegetables in fresh salsa made with lycopene-loaded tomatoes. Add mangoes and honeydew melon. Both contain zeaxanthin, which helps keeps your eyes healthy.
  • Add folate-rich beets to your green salad.
  • Grill fennel and serve it as a side dish. You’ll benefit from the potassium, calcium and phosphorus fennel brings to the table.

Treat yourself to heaping helpings of all the produce that is in season. Enjoying the great taste of good food doesn’t get any easier and it doesn’t get any better than spring and summer.

For more information on the health benefits of fruits.

Start Reducing Your Cancer Risk Today

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Start Reducing Your Cancer Risk Today
By: Lynn Norton, MS, RD
Outpatient Dietitian, Barton Memorial Hospital

The American Institute for Cancer Research (AICR) issued its second Expert Report last month, and with it, ten diet and lifestyle recommendations to help reduce your risk of cancer. Below I’ve listed these ten goals. Some, I believe, may surprise you!! Did you think your weight, intakes of alcohol or sodium might increase your risk of cancer?

Let me elaborate on some of AICR’s key points:

  1. Be as lean as possible without becoming underweight. Body fat produces proteins and the hormone, estrogen, which encourages inflammation and cell multiplication. These cells could be precursors to cancer cells. Extra fat around the abdomen appears to be particularly harmful. It is strongly linked to colon cancer and probably to cancers of the pancreas and the uterus, and breast cancer in older women.

  2. Be physically active for at least 30 minutes every day. Besides helping us to maintain a healthy weight, exercise may also keep our immune and digestive systems healthy. The more calories we burn, the more food we can eat-- allowing us to take in more anti-oxidants (cancer-protective nutrients) if we make the right choices.

  3. Avoid sugary drinks (and high calorie snack foods). They often contribute to weight gain. Water is your healthiest choice!

  4. Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans. Research shows that vegetables and fruits probably protect against numerous cancers, including mouth, pharynx, larynx, esophagus, stomach, lung, pancreas and prostate. There are many reasons why fruits and vegetables keep the body healthy and strengthen our immune system. They are natural sources antioxidants and phytochemicals which help to protect cells from damage that can lead to cancer. Fruits, vegetables and whole grains contain plant fiber—believed to move waste and carcinogens (cancer-causing substances) more quickly through the gut thereby reducing cancer risk.

  5. Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats. There is research to indicate eating more than 18 ounces of red meat per week raises one’s cancer risk. Carcinogens may also be formed when meats are processed with added preservatives, curing, smoking or salting. These appear to raise one’s risk no matter what size the portion.

  6. If consumed at all, limit alcoholic drinks to 2 for men and 1 for women a day. During the past decade, stronger evidence shows that alcohol of any type increases the risk of several cancers. These include mouth, throat, breast and colorectal cancers in men, and colorectal and liver cancers in women. Alcohol is particularly harmful if you also smoke.

  7. Limit consumption of salty foods and foods processed with salt (sodium). Believe it or not, a high sodium diet may increase your risk of stomach cancer. No more than 2400 mg of sodium daily is recommended.

  8. Don't use supplements to protect against cancer. A healthy diet is your best nutrient source.

  9. It is best for mothers to breastfeed exclusively for up to 6 months and then add other liquids and foods. Breastfed babies tend to grow up to be leaner adults. Also, breastfeeding reduces certain hormone levels in the mother, thus reducing her risk of developing breast cancer.

  10. After treatment, cancer survivors should follow the recommendations for cancer prevention. To the best of our current knowledge, healthy weight, eating and lifestyle may help prevent cancer recurrence.

You may have noticed that AICR’s recommendations will also reduce your risk of heart disease and diabetes. You are right! Even more reason to commit to healthy changes and choices today. (To access AICR’s full report log onto: www.dietandcancerreport.org/ or log onto their homepage at: www.aicr.org.)

Top 10 Nutrition Facts

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Top 10 Nutrition Facts
By: American Dietetic Association

During National Nutrition Month®, the American Dietetic Association urges consumers to look beyond the myths of nutrition and focus on the facts. Remember, the theme for 2008 is Nutrition: It’s a Matter of Fact.


  1. Eating right doesn't have to be complicated. Use Mypyramid.gov to develop a personalized plan for lifelong health.

  2. The best nutrition advice is based on science. Before adopting any changes to your diet, be sure the information is based in scientific fact.

  3. Get your food and nutrition facts from the expert: a registered dietitian. RDs are uniquely qualified to translate the science of nutrition into reliable advice you can use every day.

  4. Balancing physical activity and a healthful diet is your best recipe for managing weight and promoting overall health and fitness.

  5. Think nutrient-rich rather than "good" or "bad" foods. The majority of your food choices should be packed with vitamins, minerals, fiber and other nutrients — and lower in calories.

  6. Look at the big picture: No single food or meal makes or breaks a healthful diet. Your total diet is the most important focus for healthful eating.

  7. Prepare, handle and store food properly to keep you and your family safe from food-borne illness.

  8. Don’t fall prey to food myths and misinformation that may harm rather than benefit your health.

  9. Read food labels to get nutrition facts that help you make smart food choices quickly and easily.

  10. Find the healthy fats when making food choices. By choosing polyunsaturated or monounsaturated fats, you can keep your saturated fats, trans fats and cholesterol low.

A Family Affair: Healthy food and fitness impact health for a lifetime

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A Family Affair: Healthy food and fitness impact health for a lifetime

By: Laura Dick, PhD, RD, Director of Nutrition Services at Barton Memorial Hospital

With February designated as American Heart Month, we have the opportunity to promote disease prevention and increase awareness of the health benefits of being physically active and consuming a diet low in saturated fat, trans fat and cholesterol. As adults we role model the lifestyle choices children follow. We have tremendous opportunity to not only affect our own health but the current and future health of our children.

Once thought to be a disease associated only with adults, there is now convincing evidence that cardiovascular disease actually begins in childhood. Cardiovascular disease, including stroke is the primary killer of adults in the United States. When poor diet and physical inactivity are dominant lifestyle choices, overtime there is a gradual and continual decline in physical health. What further underscores the problem is the increase in the rate of childhood overweight, obesity, high blood pressure, and type-two diabetes. The good news is that this problem can be fixed.

Setting goals to have an active lifestyle and to eat a nutritious diet is a starting point. Goals have to be followed by action to be successful. One example of an action plan is to limit sedentary activity (watching TV, computer work, video games) to less than 2 hours/day. Schedule one hour in your day to be physically active with your children. Take a nature walk, play your children’s favorite music and make up new dance moves, play hide-n-seek, play with your dog, have your children teach you a new game they learned on the playground, and so forth. Being physical is fun, relieves stress, and brings families together and burn calories all at the same time.

When you engage in physical activity you tone muscles, lose weight and are motivated to eat healthier foods. If your goal is to eat healthier, then one action plan may be to eat five servings of fruit and vegetable every day. Keep fruit on the kitchen counter and vegetables washed and ready to eat on the refrigerator shelf you see the most. Keeping fruits and vegetables visible increases the likelihood of you consuming more. Have your children make up a colorful tracking form to put on the refrigerator and mark down every day how many fruits and vegetables each family member ate. When some one consumes the five servings then plan a fun family outing to celebrate.

The point is to get started in whatever way works best for you and your family. Modeling a healthy lifestyle will positively affect our children. Our actions do speak louder than our words. If you need a jump start then consider Barton University’s Well Within Reach Program. This comprehensive program provides you with body composition analysis, a health risk assessment, nutrition workshops, cardiac health lecture, physical activity sessions, introduction to Emotional Freedom Technique, and much more. If interested contact Nancy Ressler at Barton University at (530) 543-5767.

Healthful Eating, Active Living: One Step at a Time

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Healthful Eating, Active Living: One Step at a Time
(January 2008)

By: © 2008 American Dietetic Association (ADA) Used by Permission.

There is no time like a New Year to invest in your health and the health of your family. For 2008, follow these goal-setting steps to start eating smarter and moving more.

Audit your food choices and lifestyle. Start by keeping track of what you eat or drink, along with how much, when and why. For example, do you snack when you feel stressed or bored? Keep a food diary to determine the eating behaviors you want to change.

Set realistic personal goals. Decide what you want, such as a healthier weight or lower cholesterol. And remember that change doesn’t mean giving up a food you like. However, smaller portions, different ways of cooking or being more physically active give you more “wiggle room” to occasionally enjoy foods with more calories.

Make a plan for change. Divide big goals, such as “I will eat better,” into smaller, more specific goals, such as “I will eat one more piece of fruit each day.” Write down practical steps you can take to achieve your goals. For example:
Goal: Eat more whole-grain foods every day.
Steps: Make sandwiches and toast with whole-grain bread. Switch to brown rice. Eat oatmeal for breakfast. Add whole-wheat pasta or whole barley to vegetable soups.

Re-evaluate your plan every month or two. Monitor how the changes you’re making fit with your goals, and make additional changes as needed.

Be patient. Changes that last take time, commitment and encouragement. Most health goals take a lifelong commitment. Stick with your plan and remember that small steps toward reaching your goal add up over time. If you get off track, pick up where you left off and start again.

Seek help from a qualified health professional. A registered dietitian is your best source of reliable and up-to-date food and nutrition information, with the skills to translate science into practical advice you can use.

Holiday Food Safety

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Holiday Food Safety (December 2007)

December Nutrition Tip:

Holiday Food Safety
By: Amy LaPierre*, Registered Dietitian

The holidays are always a season to celebrate family, friends and most importantly, food!  While preparing delicious meals for the holidays, keep a few of these food safety tips in mind to keep all of your loved ones safe this season.

  1. Always wash your hands with hot soapy water for at least 20 seconds before and after handling food (Sing Happy Birthday twice).
  2. Refrigerate or freeze perishable, prepared and leftover foods within 2 hours of being prepared.  DO NOT leave them sitting out at room temperature
  3. Always thaw food in the refrigerator.  NEVER defrost food at room temperature on the countertop
  4. Cook food to the proper internal temperature and check for doneness with a meat thermometer.  Here are some basic temps: Beef (160 degrees), Chicken or Turkey Ground (165 degrees), Beef, Veal & Lamb (160-170 degrees), Pork (160 degrees), Chicken or Turkey breasts (170 degrees), Chicken or Turkey legs, thighs & wings (180 degrees).  All temperatures are in degrees Fahrenheit.  And remember to place the thermometer in the center of the meat.
  5. Wash cutting boards and knives with hot soapy water after food preparation, especially after cutting raw meat, poultry, or seafood.  Sanitize countertops after all food prep is finished with a diluted bleach solution or store bought cleaner
  6. Never place food on the same plate or cutting board that previously held raw meat, poultry or seafood unless the cutting board has been thoroughly washed
  7. If no thermometer is available to determine the temperature of a food, use visual signs such as: steam rising from foods, clear juices running from meat and poultry, no
    pink.  Pork, veal and poultry are white inside, not pink or red.  Shellfish is opaque and fish flakes easily with a fork.  Egg yolks are firm, not runny with opaque egg whites
  8. Store raw meat, poultry, and seafood tightly wrapped on the bottom shelf of the refrigerator away from foods that will be eaten raw
  9. Always marinate foods in the refrigerator, not on the countertop.  Discard leftover marinades that have been used with raw meat, poultry or seafood
  10. Replace and wash dish towels and sponges often to prevent the spread of harmful bacteria throughout the kitchen.

*Amy LaPierre is a Per Diem Registered Dietitian at Barton Memorial Hospital

National Diabetes Month 2007

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National Diabetes Month 2007

There are 20.8 million children and adults in the United States living with diabetes, yet some people don’t even know they have it. Diabetes exists in three forms: Type 1, or insulin dependent, Type 2, or non-insulin dependent and gestational diabetes.
Diabetes is a condition that affects the way your body uses energy in food. People who have diabetes have trouble controlling their blood sugar levels. Common symptoms of diabetes include fatigue, increased thirst and urination, infections and cuts that don’t heal, blurred vision, hunger and weight loss.
The goal for diabetes management is controlling your blood sugar levels so they stay as near to normal as possible. Your blood sugar levels are like a teeter-totter, they go up and down. Those swings can be dangerous when diet, exercise and medication such as insulin aren’t balanced properly.
No matter what type of diabetes you have, control the “teeter totter” by carefully managing what you eat, how much and when. The game plan for smart eating with diabetes follows this general strategy: Eat about the same amount of food, in the right balance, at about the same time daily; to avoid weight gain, balance your day’s food choices with regular physical activity.
Some other general guidelines about managing diabetes and preventing its symptoms include:

  • Get advice from a registered dietitian, many of whom are certified diabetes educators, for an eating plan that’s right for you.

  • Choose a variety of nutrient-rich foods that supply at least 60 percent of calories from carbohydrates.

  • Check Nutrition Facts on the food labels to know total carbohydrate grams, as well as fat and protein grams in a single serving.

  • Be portion savvy. Use measuring spoons and cups and buy a kitchen scale.

Reprinted by permission American Dietetic Association

Keeping Fit - New Physical Activity Guidelines

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Keeping Fit - New Physical Activity Guidelines

As summers’ long warm days and early sunrise turn to dark chilly mornings, we all feel winter is just around the corner.  Here in the Tahoe basin we know the benefit of fitness, making the most of the plethora of activities inviting us to play outside year round.  Summer days started at dawn and were spent hiking and biking along the basins ascending trail systems, and afternoons spent paddling and swimming in our beautiful lake will soon turn to early mornings of making first chair, and powder untouched for those of us willing to skin through waist deep snow just for the freshest snow atop the chair-less peaks. Mother Nature will challenge each of us with respect to our level of fitness, daring to take it one step farther for that clean line.  To make the climb, be it on foot, bike, or ski, we must maintain our cardiovascular health – especially at such altitude.

The new physical activity guidelines put out by the American College of Sports Medicine (ACSM) in collaboration with the American Heart Association (AHA) have recently been updated.  The new research from ACSM and AHA yields new Physical Activity Recommendations for healthy adults under the age of 65 which include:  Moderately Intense (or to the point of breaking a sweat) Cardio 30 minutes, 5 days a week; or Vigorously Intense Cardio (or to the point where it is nearly impossible to have a conversation) 20 minutes, 3 days a week.  In addition to aerobics, add 8-10 Strength Training Exercises with 8-12 repetitions each, 2 times a week. These strength exercises are important to minimize bone and muscle losses that occur as we age. After performing your activities don’t forget to stretch for 10 minutes to help your muscles and tendons recover more quickly and aid injury prevention. For folks over age 65, or 50-64 with chronic conditions, the same physical activity recommendations apply; with additional recommendations that you add balance exercises (such as Pilates) and have partner or set plan to increase your participation.  Remember these are just the minimum recommendations to maintain fitness.  If you can do more, do!

If you feel strapped for time due to work or family obligations then exercising in short bouts may help on the busy days.  If finding time is a challenge because of family obligations, try to make a “family activity time” take a walk together, play Frisbee, have a snowball fight – just move more.  New research shows that moderate intensity physical activity accumulated throughout the day in three 10-minute increments can be just as effective at improving cardiovascular health as exercising for 30 minutes.  Mixing activities up with a combination of moderate and vigorous-intensity physical activity may also make it easier to fit the recommendations into your schedule.  For example, you could combine 2 days a week walking for 30 minutes with 2 days a week of a fast paced jog for 20 minutes.  Scheduling is everything – set aside time for yourself on specific days, after all…if you don’t take care of number one, who will?  You don’t need a gym membership, or a season pass to maintain fitness; a comfortable pair of shoes or boots and little motivation is all you need, a buddy may help with the motivation part.

Remember the goal of these lifestyle modifications is to maintain or improve your cardiovascular health.  This will give you more strength and energy to enjoy our beautiful surroundings.  As a nutritionist I couldn’t write this article without a line about the importance of frequent snacking to sustain your energy and ensure optimal pleasure and performance during your recreation.  Be sure to pack healthy snacks for the road (or lake, or trail).  Packing quick fruits and veggies like mini-carrots, raisins, cranberries, or apple slices will provide your body with energy and lots of nutrients.  Protein sources – such as nuts and seeds, with your fruits and veggies will help you sustain your energy by providing a balanced intake of carbohydrates, proteins, and fats.  Nut butters (like almond or peanut butter) spread on apples or whole grain crackers is a sure thing.  If you have a cooler you might consider plain yogurt or a low fat cheese and fruit slices.  Hydration is important to your performance and metabolism… so bring plenty of water with you or locate a safe water source along the way as well as at your destination to stay hydrated.  Most of all enjoy yourself knowing you are happy and healthy.

Written by:
Glynis Weaver, MPH, RD
Clinical Dietitian, Barton Memorial Hospital

Celebrate Breastfeeding

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Celebrate Breastfeeding

Lynn Norton, MS, RD
Outpatient Dietitian
Barton Memorial Hospital
(530) 543-5824

Global organizations including the World Health Organization (WHO), the World Alliance for Breastfeeding Action (WABA) and the United Nations Children’s Fund (UNICEF) join each year to celebrate “World Breastfeeding Week” during Aug 1-7.  This year’s theme emphasizes the importance of initiating breastfeeding within the first hour of a newborn’s life.  Breastfeeding is seen as essential in protecting against many preventable illnesses, diseases, and malnutrition which rob more than 10 million children of their lives before their fifth birthday!

Recent rates of breastfeeding in 37 countries have revealed an increase from 34 to 41% of exclusively breastfed infants through the first 6 months of life.  But, still this if far from goal rates of 90%, with the American Academy of Pediatrics recommendations of breastfeeding through the first 12 months of life or more.  Why is this so important?

What are the benefits of breastfeeding
For the baby, the list is long.  Breastfed infants have reduced rates of illnesses including ear and respiratory infections, colds and viruses, staph and strep infections, SIDS (Sudden Infant Death Syndrome), as well as incidence of allergies and diarrhea.  Lifetime risks of obesity, insulin dependent diabetes, some cancers, as well as gastro-intestinal disorders like Crohn’s Disease and ulcerative colitis are reduced.  Development of the jaw, teeth and speech are more normal.  Breastfed infants have even been found to have higher IQ’s than formula-fed infants.

For the mother, breastfeeding actually reduces her risk of developing breast and ovarian cancers later in life.  Breastfeeding also aids returning the uterus to its prepregnancy size, burns calories which aids in postpartum weight loss, and delays the return of menstrual cycles—reducing the likelihood of rebound pregnancies as well as preserves her precious iron stores.  Let’s also not forget the time and financial savings of breastfeeding over artificial feedings.  Breastmilk is also “ready-to-feed” without potential mixing problems or refrigeration requirements.

For employers, because of breastfed infant’s lower rate of illness, mothers will miss fewer days of work.  For the environment, breast is best because no cans, wrappers, or scoops need to be manufactured and disposed of.

What’s the magic in the milk?
What formulas can’t mimic is the living immune properties, antibodies, in mother’s milk—specific to each mother and baby depending on their surroundings and exposures.  Antibodies are naturally present in breastmilk and serve to strengthen the newborn’s immune system to fight infections early on.  Nutritionally, breastmilk is unique in its ease in digesting and absorbing its over 200 components, such as proteins and minerals, thought advantageous to human growth and development.  Even infants with Down’s syndrome, cleft lip or palate, or reflux problems can benefit from breastfeeding.

Breastfeeding and the Law:
Because of the undeniable value of breastmilk, there are laws in place in California that: 1)  Mandate that breastfeeding information be available in all hospital maternity wards.
2) Allow mothers to defer jury duty 1 year or more as long as they are breastfeeding.
3) Insist that employers (in most cases) provide reasonable break time for a working mother to pump or express her milk.
The majority of states in the U.S. have similar regulations.

Giving our children the advantage.
Isn’t giving our children the upper hand in life what we as parents and citizens want as we raise future generations?  Then why not start with breastfeeding!  Education and support is available locally, by internet, and phone.  Here are just some to start with:

La Leche League International Help Line: 1-877-4LALECHE (www.lalecheleague.org)
South Lake Tahoe La Leche League: 530-577-8330 (contact Beth)
California Department of Health Services/WIC:  www.wicworks.ca.gov
Barton Memorial Hospital’s “Family Birthing Center” has 4 certified lactation consultants that provide inpatient counseling for new mothers during their hospital stay.