Wednesday 30 April 2014

Poo Taboo…Constipation

In order to assess nutritional health, I often ask patients about their bowel movements and inevitably, they are a little embarrassed to talk about it.  Everyone poops.  No big deal.  At least not to a dietitian, it’s not a big deal because after all, “what goes in, must come out.” 

With the limited vegetables and fruits we consume and increased intake of refined and processed foods, constipation is not an uncommon occurrence in our modern society. That’s why food manufacturers are always touting “high fibre” and “with added fibre” products. But the constipation picture is not just as simple as “more fibre equals better poop.”  Good poop (also called “stool”) are not just about regularity or frequency, it’s also about texture.  Here’s a quick explanation of what makes good poop. 

*If you have Inflammatory Bowel Disease or other health conditions that affect your gut and therefore your stool, then you’ll need to speak with your dietitian or your family doctor in a one-on-one appointment.
If you don’t already have one, click these links to find a dietitian and family doctor



What is “regularity”?


Regularity or frequency can vary for different people.  Some people may have bowel movements three times a day and some people have them three times a week.  Anything in between this range is “normal” – generally speaking, according to Dr. Anish Sheth and Josh Richman – authors of “What’s Your Poo Telling You”. 

What about textures?


Stool texture is on spectrum.  Constipation is at one end of the spectrum and diarrhea is at the other.   
Constipation is when stool is hard, or pebbly – like rabbit droppings/deer droppings.  Diarrhea is when the stool is watery, or “fluffy.”  It’s not formed.

Look at the Bristol Stool Scale below for reference.  Ideal poop is #4 on the scale.


How to make good poop?


In order to prevent or relieve constipation, remember the analogy of “The 3 ‘legged’ stool”: fibre, fluids, and physical activity.


Fibre:

Men should consume at least 38g of fibre per day while women should consume 28g. Check out this Alberta Health Services handout on fibre content called “Fibre Facts” on sources of fibre and how can you get more fibre in your diet. 

Fluids:

Most adults need about 2.5L-3L of fluid per day.  The fluids can come from water, coffee, tea, soups, and milk.  Other fluids such as soft drinks and juices are not encouraged because of the high calorie content of these drinks. 

Physical Activity:

The Canadian Physical Activity Guidelines recommends a minimum of 150 minutes of moderate physical activity per week for adults for overall good health.  Even if you just start moving more than you usually would, such as going for an extra walk around the block, this could help to improve your bowel health.  

If you need help becoming more active, please talk to your PCN family physician or PCN healthcare professional about the Prescription to Get Active program.  

So if you’re finding your poo is not similar to a #4 on the Bristol Stool Scale, perhaps the “3 legged stool” that makes up your #2 need a bit more support to achieve balance – balanced nutrition and lifestyle for a #1 healthier you. :)

Sally Ho is a Registered Dietitian at the Leduc Beaumont Devon Primary Care Network.

Monday 28 April 2014

LA Medical is online!

LBD PCN member clinic, LA Medical, is now online! Their website includes bios of their physicians, information on services they offer and they even have a blog! If you are a patient at LA Medical, you can now book appointments online. They are also accepting new and walk-in patients and can offer next or same day appointments.

LA Medical



LA Medical has also joined Twitter. Give them a follow!

Tuesday 15 April 2014

Get Out Get Active - group walk!



~~~~ PLEASE JOIN US! ~~~~

LBD PCN Exercise Specialist, Corinne Cutler, will lead our first Get Out Get Active group walk on Wednesday, April 16th at Alexandra Park in Leduc. 

Please meet by the pool at 12:10 and join us for a walk around the park. We understand there is construction going on by Civic Centre and near the pool, we will avoid those areas. 

All GOGA participants are welcome to join us!

Not a GOGA participant yet? It's not to late to sign up! www.getoutgetactivepcn.com





Tuesday 8 April 2014

Meal Planning 101, or, Why I no longer hate planning dinner.

Ninety-two weeks ago, one of our LBD PCN Registered Dietitians changed my life for the better. I am the Communications Coordinator at the Leduc Beaumont Devon Primary Care Network where Andrea, the aforementioned Dietitian works. She had been teaching our Weight Wise classes for a few years and had listened to me complain about how much I hated planning dinner every night. Finally, she had enough of my complaining and for that, I am so grateful!

Sound a bit dramatic? Maybe, but planning meals and going to the grocery store everyday was grinding on my last nerve. Without fail, my day was always the same. Get up, get the kids off to school, and go to work. Realize at about 3:45 that I had not even thought about supper or taken anything out of the freezer. Does my son or husband have hockey that night? Do I have a class at the gym? Is my oldest going to the ski hill? Did I have to get take-out or run to the grocery store? It was the same routine every day and it was grating on me. I seriously hated it!

One day, Andrea was prepping for the Weight Wise #6 class – Meal Planning and Shopping Tips, when she decided today was the day. She came into my office and simply said, “Come with me.” I had no idea what she was up to but I went with her and because of that, my life has changed.

In the class, we learned how to create a weekly meal plan and building off the meal plan, we could create a grocery list. We learned tips how to plan meals where we could cook enough of the protein (beef, chicken, etc) one night so that it was enough for two meals, thus, eliminating the need to cook meat again the next day. We also learned about which vegetables had a shorter lifespan than others and used this knowledge when creating the meal plan. Very helpful information, it reduces the problem of getting to the end of the week and finding out the tomatoes have gone bad and having to run to the grocery store just for that one ingredient.

I went home that night and created this weekly meal plan template in Excel (feel free to right click and save it to your own computer for use.) I do not include breakfast on my meal plan because my husband and I do not eat breakfast at home, but we ensure the weekly grocery list always has breakfast options for our kids. Lunch is included because we both like to take leftovers to work for lunch and this plan will give you a quick visual to see if there will be leftovers or if we will have to take something else, like a sandwich. The “Prep for tomorrow” column is for notes like “Take chicken out of the freezer”. Reminders like this eliminate the issue of getting home from work at 5:00 pm, only to find out that I forgot to take the chicken out the night before and having to head to the grocery store.

Sunday is meal planning and grocery shopping day. It just works best for my family but you are free to do it whenever works for you. I picked Sunday because by then, I have my kid’s schedules for the week ahead and can plan that right into the week. One of our boys is in hockey which means anywhere from 2-4 ice slots in a typical week. Those nights used to mean take out or fast food meals, but since learning how to meal plan and planning for those kinds of nights, we rarely have to resort to take out anymore and only have it if we plan it in. Sometimes take out just works best, like if we have to be at a hockey game at 6pm on a Wednesday in a town an hour away - that is just fine. Take out food has its place, but using it as an excuse not to cook on a busy night doesn't have to become the norm (which is was in our house.)

How to meal plan:

1. The first thing I do is write our family’s scheduled events right on the plan.


2. Next, I ask each kid and my husband to pick 1-2 meals that they would like to have that week. On the back of the meal plan page, I write the meals they have selected. Don’t worry if they can’t all be accommodated that week, there is always next week to plan for!

3. Now, look at the week ahead and add the meals on nights they would work best. For example, we have nothing happening Sunday night but my younger son has hockey practice at 6:35 Monday. We don’t get home from work until 5:00 or 5:30 so this leaves me little time to prepare a meal from scratch. I cook enough protein for both meals, eliminating the need to cook meat again the next night. Big time saver!



4. Now, I write down all the ingredients I need for each of the meals.


5. Then, I go to the pantry and fridge and see which of those ingredients I already have.


6. If I already have the ingredients, it gets cross off the list.



7. Voila! There is my grocery list for the week! By doing this, I have now ended the guessing game at the grocery store, “Do we have avocados at home?” and ending up with extra food that might end up spoiling before you get around to eating it.

Bonuses of meal planning:

1. By creating a meal plan, I have eliminated the stress at the end of my day of not knowing what to cook. I know what we are going to cook ahead of time; no guess work is necessary. I now feel relief and as if I have been liberated!

2. By creating a meal plan, I have eliminated the need to stop at the grocery store every day on my way home from work. That easily frees up 20-30 per day, at my busiest time of day when I am usually tired from work and just want to get home.

3. By creating a precise grocery list, I have eliminated accidentally doubling up on items we already have at home. It also stops me from impulse buying items. If it’s not on the list, I don’t buy it. This has saved huge amounts of money off my grocery bill.

Lessons learned and how to make meal planning even easier:

1. While I am 95% of the time pretty strict with my meal plan, life happens. Sometimes at  3:00 pm we will get a text from the hockey coach that an extra ice slot opened up and we are now expected to be at the rink in 3 hours. We need to be flexible.

2. A friend once asked me, “what if you get to that night and all of a sudden you don’t feel like the meal you've planned?” Honestly, in the 92 weeks since I've been meal planning, I've never had that happen. I’m so grateful that I don’t have to think about it everyday, the last thing I want to do is throw a wrench in the plan! Just stick with it as best you can.

3. Let everyone have a say in the meals. If each person in the house gets to pick a meal, it gets everyone involved in the meal selection which is a positive way for your children to build healthy lifestyle habits.  It also takes the stress off me of having to decide 7 suppers a week.

4. Make extras. I double up when making spaghetti sauce and put the extras in individual meal sized containers for quick suppers another time.

5. Cook proteins in larger batches for multiple meals. For example, look at the list of meal choices for the week ahead. I see my younger son picked tacos and my older son picked spaghetti. Perfect! If we make tacos on Sunday night, I will just double the amount of hamburger, cook it all as the same time and separate out the amount I need for spaghetti before adding the taco seasoning. Now on Monday night when I am pressed for time, I don’t have to worry about cooking hamburger for spaghetti sauce. Continue planning like this through the rest of the week.

6. Meals don’t have to be elaborate to be planned ahead. Yes, I do plan for soup and sandwich nights!

7. Sometimes even thinking of meals is tedious. Save your meal plans so that you can quickly look back on them for ideas. 92 weeks of meal planning is a lot of sheets of paper! I don’t save them all but have save most as they show the variety of meals we make depending on what is going on that week. I got in the habit of numbering the sheets so I could see how many weeks we’d been doing this. It’s a great reminder that Meal Planning is very do-able and it also makes me feel good to have kept with it for so long. After a few weeks, it will become part of your weekly routine.

8. Keep your meal plan in plain view, like on the coffee table or on the kitchen counter so that you see it daily. That way, you won’t forget to take the chicken out of the freezer and find yourself having to run to the grocery store that day.

9. There a tonnes of free apps for smartphones that can assist with your meal planning, specifically with your grocery list. They are great for those who don't like working off a paper list or, like me, have a tendency to forget the list at home. As soon as complete my grocery list, I then enter all the items into an app so it is with me at all time. I also sometimes take a picture of my completed meal plan so I can take a glance anytime if I forget what's for dinner tonight.



Weekly Meal Plan Templatehttp://lbdpcn.com/Health/Documents/Meal%20Plan.pdf

Special thanks to Andrea Shackel, LBD PCN Registered Dietitian, for showing me the way!


VIEWER COMMENTS:

I love this clear, simple approach to meal planning. I have never done meal planning before! I have found since doing this, with my family's input, we are eating much more healthy. There is also less impulse shopping. Even if I shop while hungry, I'm not straying from the list.
~ Kristine. M, 

Register for our next meal planning class here: http://lbdpcn.com/Pages/Events.aspx