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Future Generations Learn Healthy Eating Through Teaching Kitchens

In the San Antonio, Texas area (69% Latino) families, health care leaders like Dr. Mark Gilger, and philanthropy groups like the Goldsbury Foundation are exploring what healthy and culturally fun Latino meals look like with the Children’s Hospital of San Antonio’s new Culinary Health Education for Families (CHEF) program. Aiming to be a new culinary health model for families needing help in preventing diet-related disease such as childhood diabetes, hypertension,and obesity, the goal of the program is to provide San Antonio residents with tools, resources, and education to lead healthier lives and encourage healthy weights for children.

Robert Wood Johnson Foundation Salud Success Story
http://www.communitycommons.org/wp-content/uploads/2016/05/CHEFSA.pdf

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Picky Eaters: How Taste Impacts Healthy Eating

excerpt from an article by Julie La Barba, MD, FAAP
read full article at Rivard Report

We all have our favorite foods and other foods that we dislike, but why? How does the taste of foods impact our eating habits and, in turn, our health?

Dr. Julie La Barba, a pediatrician at the Children’s Hospital of San Antonio and medical director for the new program Culinary Health Education for Families (CHEF), explored the connections between taste and food at the Children’s Hospital on Friday, Feb. 26, during a presentation to pediatricians, medical students, and the greater San Antonio health care community to demonstrate how taste impacts food preferences.

More than 14% of San Antonio’s population has diabetes – which is double the national 7% average, according to the American Diabetes Association. Eating healthier foods, having access to healthier foods and being aware of the medical health risks associated with consuming unhealthy foods is vital to the growing city.

To help guide the future of pediatric medicine within San Antonio, La Barba has committed to building a healthier food environment for children, and helping families, pediatricians and the community see how food, nutrition, and health can work together.

La Barba, along with CHEF’s Program Director Chef Maria Palma, presented how nature vs. nurture can impact a child’s preference for healthy or unhealthy foods.

Using educational videos and taste tests, La Barba and the local chef helped practitioners learn about taste and how it applies to medicine and healthcare.

“Taste preferences have cumulative effects on our overall health,” she said. “As a pediatrician, you are in a pole position to effect the ways family feed their children. They are looking to you for information.”

She went on to explain the medical science of how different foods can impact emotion and moods, and then had participants watch a film on neurogastronomy, showing how smell and sight tell the brain about taste and flavor…

read full article at Rivard Report

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Tips for Healthy Dining Out

Eating away from home has become a daily part of our American lifestyle.  According to the National Restaurant Association, Americans are eating out 5.8 times per week. Turn your awareness into action using mindful strategies and the abundant amount of nutrition information available to you.

As you may know, eating out exposes you to some nutritional challenges; larger portions, distraction to mindfulness, larger amounts of calories, dietary fat and dietary sodium, less fiber, and more processing of natural foods are just a few.

Mindful strategies are an important key to your success:

  • Plan Ahead by reviewing the menu ahead of time
  • Watch for the 3 B’s: bread, butter, and beverage. These can easily add up to over 600 calories before you even begin your meal.
  • Look for healthy cooking techniques: plank roasted, grilled, seared, stir fry, en papillote, nut crusted, grain medley, and poached with white wine, herbs, or broth.
  • Build a smarter salad: dark greens, nuts, seeds, beans, legumes, small amounts of flavorful cheese, dry fruits, plant oils, vinegars
  • Feast on vegetables: colorful seasonal varieties
  • Go for the Grain: choose whole grain options such as quinoa, all rices, farro, whole wheat, amaranth, and oats
  • Visualize the components of your healthy plate: 75% plant based fruits, vegetables, and grains with 25% lean protein or approximately 4-5 ounces. Keep in mind that a plate would be approximately 9-10 inches in diameter. Add more color on your plate for a wide variety of protective nutrients. Consider plant sources of protein such as nuts, seeds, soy, beans, and legumes.

Planning is a key element to your success.

The FDA has issued the long awaited final rule on nutrition labeling of standard menu items in restaurants and similar food establishments. Effective December 2, 2016 you will be able to make informed and healthful dietary choices when dining out. Nutrition information will be placed on menu boards next to menu choices or directly on the menu. It will include a statement for context about daily calories and the nutrient summary per serving.

Here are some tips to keep in mind while dining out:

  • Be mindful when dining out
  • Visualize your healthy plate
  • Inquire about ingredients and preparations of different menu items
  • Feast on colorful vegetables and whole grains
  • Plant to share an entrée or dessert
  • Take advantage of the abundant resources for nutrition information available to you
  • Eating out can be a healthy indulgence, Enjoy.
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Six Tips to De-Stress and Slim Down

Think back to the last time you felt pressure from your work, family, or friends — did you have the urge to reach for a candy bar? If the answer is yes, you’re not alone. Stress is one of the major causes of eating poorly and eating excessively, so it’s no surprise that stress can lead to extra pounds around your waist. And it’s a red flag for risk factors associated with inflammation, heart disease, and diabetes. Finding ways to manage your stress is essential to healthy weight loss. Follow these 6 tips to recognize and manage your stress:

  1. Choose Healthy Fats – Since the brain is approximately 60 percent fat, the type of fats in your diet can make a difference in brain function. Research shows that omega-3 fatty acids can act as an antidepressant because they boost serotonin production. Serotonin improves communication between brain cells and can help prevent or fight depression. Salmon, walnuts, and flaxseed are rich sources of omega-3 fatty acids. Olives, olive oil, avocados, nuts, and canola oil are also packed with healthy monounsaturated fats. Limit your intake of saturated fat from animal fats and tropical oils, and eliminate trans-fatty acids, found in the partially hydrogenated oils used in processed foods.
  2. Stop “Dieting” – Diets that completely eliminate carbs and dietary fats actually increase stress, anxiety, insomnia, and depression — not to mention set you up for failure. The correct approach to healthy eating is to choose a diet you can live with, one composed of healthy fats, lots of fruits and vegetables, and a daily intake of whole grains. The only way to feel full and satisfied is to provide your body with all the nutrients it needs.
  3. Get Some Sleep – Stressful situations can often lead to a lack of sleep — which can be especially dangerous for a dieter. Lack of sleep throws off the body’s chemistry and can increase cravings for carbohydrates, sweets, and fats. Plus, sleeping less than 5 hours a night not only produces inflammatory compounds linked to heart disease but also hinders your weight-loss efforts. Two hormones, cortisol and ghrelin, are the main culprits — sleep deprivation can cause an increase in ghrelin, the hormone responsible for stimulating appetite, and a decrease in cortisol, the hormone that signals the brain that you are full. The result is an inability to control your appetite—a situation that can lead to a diet disaster. So get some rest!
  4. Vary Your Exercise – Varying the type exercise you do — alternating from a high-intensity workout to one of a more meditative style, like yoga — can be restorative, relaxing, and essential for boosting your immune function and general outlook on life. It’s important to switch up an exercise routine to stave off boredom and keep challenging your body. Exercise also improves brain chemistry, increasing the level of feel-good endorphins, dopamine, and serotonin. So the next time you feel overwhelmed by stress, take a break and get active. You’ll notice the difference!
  5. Breathe – Breathing slowly, deeply, and deliberately is a very simple and easy way to cope with everyday stress and exhausting schedules. Take a few moments to stop and breathe when stress rears its head. You’ll be able to relax your muscles and focus your mind, readying yourself for whatever obstacles lie ahead.

Recognize the Symptoms of Stress:There are two kinds of stress: acute (intense but short lived) and chronic, or ongoing. It’s the chronic type of stress that causes health problems. We commonly suppress feelings of exhaustion, stress, and anxiety to the point that we can’t even recognize the symptoms anymore. This is when we get into trouble with weight gain and more serious health conditions. Pay attention to stress symptoms — for example, an increase in blood pressure, insomnia, body aches, feelings of anxiety or depression, or a general feeling of being overwhelmed.

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Saying Goodbye to Food Hangovers

By Connie Guttersen, RD, PhD
Foundation Nutrition Advisor and Consultant, CHEF

Many of us eat the foods we love as a reward and then we feel terrible, which doesn’t make much sense. And yet, we do it all the time. Why is it we overeat foods loaded with sugar, fat, and salt and then groan in physical discomfort, swearing never to do it again… only to repeat the same process days, even hours, later?

One explanation is that the immediate good feelings you get from foods containing sugar, fat, and salt are far more powerful in influencing your behavior than the misery you feel later. Foods such as chips, ice cream, pizza, and French fries provide immediate stimulation to the pleasure center in your brain. The punishment—when you wake up feeling tired and bloated and dealing with digestive distress—is delayed just enough that you no longer connect it to the food, the association between food and your physical discomfort having weakened over time.

The same behavior pattern happens with other addictive substances such as drugs and alcohol. That’s because all these substances light up the reward center in our brains, triggering the release of serotonin, endorphins, and dopamine and creating a temporary pleasure high. It doesn’t last, though, and despite the repercussions, you still want to go back for more. It’s a vicious cycle! The only way to break the junk food addiction is to remove fast foods and other processed foods from your diet. While you might feel deprived initially, the long-term rewards will be so much greater than the temporary pleasure you’ve given up— you will experience freedom from cravings, increased weight loss, and more energy, and you never have to experience a food hangover ever again.

Tips to Avoid a Food Hangover:

  • Decrease your stress levels with a healthy and balanced lifestyle that includes regular exercise, smart time management, and relaxation. Stress can trigger cravings for foods that are high in fat, sugar, and salt. Relying on these types of foods for positive emotions sets you up for a roller coaster of extreme moods and cravings.
  • Sleep at least 7.5 hours each night to keep hunger hormones from triggering cravings. Insufficient sleep or poor quality of sleep can cause a hormone imbalance, making you feel hungry or crave sugary fatty foods.
  • Cut out sugary, simple carbs like cookies, pastries, and sweetened drinks to help keep optimal blood sugar levels.
  • Minimize fatty foods, especially those that are from processed snack foods and chips.
  • Avoid calorie-crashing diets. Rapid weight loss promised by very low calorie diets can lead to hunger and cravings.
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Memorable and Healthy Breakfast Meals

Breakfast continues to be the most important meal of the day. Studies have shown that eating a nutritionally complete breakfast, rich in nutrients, vitamins, and minerals can better help you maintain a healthy weight, increase strength and endurance, benefit your concentration and performance, and is associated with healthier meal choices and patterns through out the day.   Eating breakfast is especially important for children and teen. Children who eat breakfast perform better in the classroom and on the playground, with better concentration, problem solving skills, and eye-hand coordination.

Many studies in both children and adults have shown that breakfast eaters tend to weight less than breakfast skippers. The National Weight Control Registry provides positive results for 80% of the people in the registry who regularly ate breakfast containing protein and whole grains. The studies suggest that eating breakfast reduces hunger throughout the day, and help people make better choices at other meals. A closer look at the medical research also finds a role for breakfast and heart disease. Men who regularly skipped breakfast had a 27% higher risk of a higher attack and death from coronary heart disease than those who did eat breakfast ( Circulation, 2013). Missing breakfast was also found to have 20% less weight loss and higher insulin resistance than individuals who ate most of their calories earlier in the day ( International Journal of Obesity, 2013)

Look for protein choices to contain at least 5 grams of protein per serving. Below are examples of high protein choices.

Low fat cottage cheese, 1/2 cup
Reduced-fat cheese, 1 ounce
Stonyfield Farms Organic Low-Fat, Fruit flavored
Egg substitute, 1/4 cup
Soy milk, low-fat, 1 cup
Soy-based sausage, 2 ounces
Tofu, extra firm lite, 2 ounces
Canadian bacon, 2 ounces
Extra lean ham, 2 ounces
Turkey bacon, 2 strips
Light turkey sausage, 2 ounces
Nut butter, natural, 1 tablespoon
Light cream cheese, 1 ounce
Lox (smoked salmon), 1 ounce

Sweetened cereals are part of a 160 million dollar marketing strategy aimed at children. Studies have found that children who ate highly sweetened cereals ate twice as much as those who ate low sugar cereals. These cereals have 85% more sugar, 65% less fiber, 60% more sodium than cereals targeted to adults. An easy way to calculate the amount of teaspoons of sugar per serving is to divide the grams of sugar per serving by 4.

Look for breakfast whole grains to contain at least 5 grams of fiber per serving. Breakfast is the perfect time to start the day with at least one or two servings of whole grains. Gluten free, protein rich quinoa flakes is a delicious hot cereal idea, steel cut oats, bran, buckwheat, and other multi grain cereals blends are all delicious ideas.

Quick and Easy Healthful Breakfast Ideas

1) Whole grain waffle or pancake with 1 – 2 tablespoons of nut butter. Sprinkle 1 teaspoon of sesame seeds, or sliced fresh fruit.

2) A slice of toasted whole grain bread toped with 2-3 tablespoons of low fat ricotta, sliced tomatoes, drizzled with extra virgin olive oil, and sprinkle of fresh herbs and black pepper.

3) Steel cut oats with fresh fruit compote, flax seeds, and sweet spices of cinnamon, clove, and cardamom

4) Whole Wheat Pita Pocket with one ounce of Canadian bacon and a one ounce slice of cheese

5) Two slices French toast made with whole-grain bread and one egg (use a higher omega-3 type if possible) blended with 1/4 cup fat-free half-and-half or low-fat milk, 1/8 teaspoon vanilla, and a pinch of cinnamon. (278 calories, 42 grams carbohydrate, 5 grams fiber, 14 grams protein, 6.5 grams fat, 1.5 grams saturated fat, 215 mg cholesterol, 480 mg sodium.)

6) A Breakfast burrito made with 1 whole-wheat tortilla (weighing about 50 grams), 1/2 cup egg substitute scrambled with 1/2 cup assorted cooked vegetables, and 1 ounce of reduced-fat cheese. (304 calories, 32 grams carbohydrate, 6 grams fiber, 25 grams protein, 7 grams fat, 2.5 grams saturated fat, 15 mg cholesterol, 669 mg sodium.)

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CHEF: Teaching Pediatricians About Taste

The taste of food impacts our eating habits and, in turn, our health from a very young age, even from the womb.

On Friday, February 26th, Dr. Julie La Barba, a pediatrician at the Children’s Hospital of San Antonio and Medical Director of Culinary Health Education for Families (CHEF), presented to and discussed with pediatricians, medical students, and other healthcare professionals in San Antonio how taste and food preferences are formed and how these preferences can impact a child’s diet.

Dr. La Barba is committed to building a healthier culture and showing how food and medicine can work together. The new CHEF program, under Christus Santa Rosa Health Care, targets practitioners and teaches them the importance of healthy eating and how taste applies to medicine and healthcare through in local Chefs, educational videos, and taste testing.

San Antonio, (63.2% Latino), has a diabetic population of over 14 percent, which is double the national average (7%), according to the American Diabetes Association. Because taste preferences influence diet and diet impacts health, it is important for pediatricians to understand this connection.

“Taste preferences have cumulative effects on our overall health,” said Dr. La Barba, “As a pediatrician, you are in a pole position to effect the ways family feed their children, they are looking to you for information.”

Follow Dr. La Barba’s suggestions to help kids incorporate healthier eating preferences below.

Do:

  • Increase availability and palatability (offer healthy foods often and in different ways)
  • Model the desired behavior (eat what you want them to eat)
  • Incorporate different flavors to healthier foods (e.g. broccoli cooked with sesame oil to combat bitter taste)
  • Give positive reinforcement

Don’t:

  • Offer contingencies, rewards, bribes or threats (e.g. “If you eat this, I will give you that”)
  • Feel at fault or try to control everything they eat
  • Use guilt or anger to make them eat healthier (e.g. “No one ate all these vegetables!”)

SA! Salud America – by Lisa
http://www.communitycommons.org/groups/salud-america/changes/108598/

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A Simple Pantry: Mexican Caesar Salad Recipe

Back in January, I was able to attend the Culinary Medicine Boot Camp through the Goldsbury Foundation, and The Children’s Hospital of San Antonio, which took place at the Culinary Institute of America San Antonio. To say it was an amazing experience is an understatement. I learned a lot about cooking, and especially prepping, to help bring more whole foods into our daily routine, as well as expand our palates by changing a few simple ingredients in normal, everyday San Antonio cuisine. Take, for instance, this Mexican Caesar Salad Recipe.

It’s kind of the bees knees of easy and delicious. If you love classic a Caesar salad recipe, then I promise you are going to straight up ADORE this fun new version.

Blogger – A Simple Pantry Easy Gourmet
http://asimplepantry.com/mexican-caesar-salad-recipe/

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Raising Healthy Eaters

Five tips for rearing kids who prefer broccoli to Twinkies

Lofty January resolutions largely forgotten, parents see February’s busy schedules and convenience triumphs over healthy eating. Dr. Julie La Barba, director of the Children’s Hospital of San Antonio’s new Culinary Health Education for Families (CHEF) program, says it doesn’t have to be that way. CHEF Program Director Maria Palma, Registered Dietitian Celina Parás and La Barba sat down with us to share some easy (but often not followed) steps for raising kids who will eat their vegetables, which La Barba, a mother of four, says can help prevent a whole host of diseases later on.

Chop Veggies Before You Need Them
Parás and Palma say a healthy diet begins with a prepared kitchen. With nutritious options waiting in the fridge and pantry, meals come together in minutes. Keep low-sodium canned beans on hand for an easy addition to salads, stockpile frozen fruit for smoothies and take the time to cut fruits and veggies after you shop so they’ll be just as easy to use in snacks and meals as pre-packaged foods that are higher in sugars and fat. “Being prepared and having a game plan for the kitchen can help save time,” says Palma. “By washing and chopping or slicing a few key items you are set up to throw something together in a pinch.”

Make Lunch Before Bedtime
Leaving lunch packing until morning is a recipe for disaster. Spend a few minutes before bed putting together a meal your child will look forward to—that way you’ll have time to pack something healthy and you’ll have time for breakfast in the morning. “(It) lessens that Grand Central Station effect we seem to experience in our home each morning,” says La Barba.

Start Small
Sometimes switching to a healthier diet is as simple as choosing wheat over white. “Try making a couple of small attainable changes at a time and stick to them for at least three months to allow yourself to get used to them,” says Parás. Eating whole wheat rather than white bread is a start. You can also flavor dishes with fresh herbs instead of extra salt.

Add Healthy Twists to Old Favorites
Have picky eaters? Serve what they like but with a healthy twist. Quesadillas can go from filler food to healthy meal with a few key changes. “Try choosing corn or whole wheat tortillas; add low-fat cheese and fruits and vegetables of your choice,” says Parás. Try broccoli, tomatoes, spinach or even fruits like apples.

Shop Along Store Edges
Grocery shop at the outer edges of the store first, where the produce department, butcher and other sections with fresh foods are usually located. Your cart will be filled with fresh foods before you can even consider other options. “Eat a variety of colored plant-based foods that are in their most natural form,” says Palma.

San Antonio Magazine – By Lauren Moriarty
http://www.sanantoniomag.com/February-2016/Raising-Healthy-Eaters/

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Health-related Culinary Education: A Summary of Representative Emerging Programs for Health Professionals and Patients

ABSTRACT
Background:
Beneficial correlations are suggested between food preparation and home food preparation of healthy choices. Therefore, there is an emergence of culinary medicine (CM) programs directed at both patients and medical professionals which deliver education emphasizing skills such as shopping, food storage, and meal preparation.

Objective:
The goal of this article is to provide a description of emerging CM programs and to imagine how this field can mature.

Methods:
During April 2015, 10 CM programs were identified by surveying CM and lifestyle medicine leaders. Program directors completed a narrative describing their program’s structure, curricula, educational design, modes of delivery, funding, and cost. Interviews were conducted in an effort to optimize data collection.

Results:
All 10 culinary programs deliver medical education curricula educating 2654 health professionals per year. Educational goals vary within the domains of (1) provider’s self-behavior, (2) nutritional knowledge and (3) prescribing nutrition. Six programs deliver patients’ curricula, educating 4225 individuals per year. These programs’ content varies and focuses on either specific diets or various culinary behaviors. All the programs’ directors are health professionals who are also either credentialed chefs or have a strong culinary background. Nine of these programs offer culinary training in either a hands-on or visual demonstration within a teaching kitchen setting, while one delivers remote culinary tele-education. Seven programs track outcomes using various questionnaires and biometric data.

Conclusions:
There is currently no consensus about learning objectives, curricular domains, staffing, and facility requirements associated with CM, and there has been little research to explore its impact. A shared strategy is needed to collectively overcome these challenges.

Volume 5, Number 1 • January 2016 • www.gahmj.com
GLOBAL ADVANCES IN HEALTH AND MEDICINE
http://www.gahmj.com/doi/pdf/10.7453/gahmj.2015.128

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Culinary program to benefit San Antonio children

An innovative program aimed at reducing childhood obesity and improving access to healthy foods for patients and the community at large is being launched in San Antonio by Baylor’s newest affiliate, the Children’s Hospital of San Antonio.

The culinary health and education program will provide a comprehensive approach to childhood health and nutrition and will incorporate many elements in the community, including:

  • Hospital teaching kitchen – Designed by The Culinary Institute of America, it will offer nutrition and hands-on cooking courses created by the institute in conjunction with clinical experts at the hospital, with the support of Aramark, the hospital’s food services provider. Courses will be offered to patients and open to the general public.
  • Teaching and healing gardens – 2.4 acres for patients and families to play, pray and learn through interactive experiences as well as about the foundations of a healthy diet.
  • “Prescriptions for Produce,” a program in partnership with H-E-B in which physicians at the hospital can write prescriptions for produce to be redeemed at local H-E-B stores.

Baylor College of Medicine magazine – by BCM Office of Communications
https://bcmfamily.bcm.edu/2014/08/01/culinary-program-to-benefit-san-antonio-children/

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Planting seeds for healthier S.A.

These days, Dr. Julie La Barba is busy planting seeds.

Seeds in a garden? No doubt. Spring is here, and this pediatrician was practically born with green thumbs. But the seeds we’re talking about are visionary ones.

Seeds that one day may sprout in the most surprising and amazing ways down at the Children’s Hospital of San Antonio and across this community. Seeds for a healing garden and a teaching kitchen at the hospital where children and their families can learn about healthy foods. Seeds for research. Seeds for a healthier San Antonio, where the scales are perpetually tipped between overweight and obese.

“We are not going to talk about weight loss or calories or Jenny Craig or any of that because we are really focusing on real food, breaking bread with your family,” La Barba told me. “Really being mindful of your choices and the balance in your life. What you eat. How you move.”

This was downtown at Christus Santa Rosa’s children’s hospital, where La Barba works as the medical director for the hospital’s groundbreaking CHEF program. As in Culinary Health Education for Families, thanks to funding via the Goldsbury Foundation.

Express News – by Josh Brodesky
http://www.mysanantonio.com/opinion/columnists/josh_brodesky/article/Planting-seeds-for-healthier-S-A-6204780.php