What I’ve learned as a Meal on Wheels Intern

By: Blair Kott, USU Dietetic Intern

My name is Blair Kott, and I am currently completing my dietetic internship through Utah State University’s Distance Dietetic Internship Program. The rotations I have completed thus far have included food service management and school nutrition education in the Alamo Heights School District, long term care at Morningside Manor, and community nutrition at Meals on Wheels. I have three more rotations to complete before I sit for the Registered Dietitian Exam. Each rotation has provided me with a vast amount of knowledge and experiences I will never forget.

My time at Meals on Wheels was such an incredible experience. I was fortunate to be able to have Rhaizza Velasquez Garcia, RD, LD as my preceptor for my rotation. Together, we worked on menu planning, as well as inspections at the three Grace Place locations in San Antonio. During these inspections, I was able to apply the knowledge I have gained not only from my undergraduate didactic program, but my food service management rotation as well.

During my time at Meals on Wheels, I created nutrition education worksheets, wrote several blogs, worked with Vince and Mary in the kitchen, delivered meals with a driver, and visited clients with a case worker. My time spent in each of these departments within the Meals on Wheels organization was crucial in developing an understanding of how Meals on Wheels works as a whole. The work that the registered dietitian does, the preparing of meals, delivering of meals, and visiting clients are all crucial elements to making Meals on Wheels the incredible organization it is.

MOWAA Doorbell IMG_9026

I thoroughly enjoyed my time at Meals on Wheels and am so thankful to have been able to spend time at this wonderful organization. I was just in awe at the incredible work that the employees at Meals on Wheels do for others on a daily basis. Meals on Wheels is truly making a difference in so many people’s lives, and I am so thankful I got to take part in that. Thank you to Meals on Wheels and to everyone who made my experience so wonderful!

If you want to learn more about becoming a Dietetic Intern email our Registered Dietitian Rhaizza.

7 Nutrients for a Healthy Aging Body

By: Blair Lauren Kott, USU Dietetic Intern

Throughout life, it is important to consume a variety of nutrients to keep our bodies as healthy as possible. But, as we get older, certain nutrients are more important to consume than others. This is because as we age, our body gets tired and slows down, causing certain processes in our bodies to slow down as well. In order to slow the processes, it is important to consume these key nutrients:

  • Calcium and Vitamin D
  • Vitamin B12
  • Fiber
  • Potassium
  • Polyunsaturated and Monounsaturated Fats

Calcium and vitamin D help to maintain bone health as we age. They are important to consume to keep our bones strong and to prevent fractures. There are a variety of foods that contain calcium, including vitamin D-fortified milk, yogurt, fortified cereals and fruit juices, broccoli, spinach, kale, and canned fish.

greens.png

Vitamin B12 is important in the formation of red blood cells and proper function of thebrain, spine, and nerves. Vitamin B12 can be found in fortified cereal, lean meat, eggs, and some fish and seafood.

eggs

 

Fiber helps with digestion and helps to prevent constipation. It also aids in the prevention of heart disease. Sources of fiber include whole grains, nuts and seeds, and fruits and vegetables.nuts

Potassium aids in lowering the risk of high blood pressure. Potassium can be found in many fruits and vegetables, as well as low-fat and fat-free yogurt.

bananas

Polyunsaturated fats and monounsaturated fats help to reduce the risk of heart disease. Examples of these types of fats include, olives, nuts, and seeds, as well as olive oil and coconut oil. Make sure to choose unsaturated fats over trans or saturated fats.

oil

By increasing the intake of these 7 nutrients, you can maintain your health as you grow older. Remember to consume a variety of foods and nutrients and eat foods that make you happy and healthy!

References:
http://www.eatright.org/resource/health/wellness/healthy-aging/special-nutrient-needs-of-older-adults
https://www.ars.usda.gov/plains-area/gfnd/gfhnrc/docs/news-2013/dark-green-leafy-vegetables/
https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
https://medlineplus.gov/dietaryfiber.html
https://www.choosemyplate.gov/saturated-unsaturated-and-trans-fats

Staying Hydrated In The Heat

By Rhaizza Velasquez-Garcia, RD, LD
Registered Dietitian for Meals on Wheels of San Antonio

Every year in May, Meals on Wheels San Antonio sends an information sheet to our clients about fluid needs during the summer and hot weather. The warmest months of the year in San Antonio are from May to August, with average temperatures of 95 degree Fahrenheit. During those months, it is especially important to stay hydrated. Even mild dehydration can cause a decrease in physical and cognitive performance. It affects concentration, alertness, and short term memory, and it can also cause confusion, dizziness, and headaches.  While it is important for everyone to stay hydrated, it is even more so for the elderly as the negative effects of dehydration are more intense in this population.  Furthermore, studies show older people drink less water, have low water reserves, their kidneys do not conserve fluid as effectively, and have altered responses to heat and cold stress.  For all of these reasons, it is important for our seniors to learn to drink regularly, even if they do not feel thirsty.

The following are the most common symptoms of dehydration: little or no urine, or urine that is darker than usual, dry mouth, sleepiness or fatigue, extreme thirst, headache, confusion, dizziness or lightheaded feeling, and no tears when crying. If you are experiencing any of these symptoms, the best way to reduce your symptoms is by drinking water.

The average adult needs about 1.5 to 2 liters of water each day (52-68 ounces).  A great way to get that is simply by drinking water, but there are plenty of healthy fruits and vegetables that can help us meet our daily need.  We can also get water by drinking other beverages such as juice or milk, but many of them also add calories.  Sugar sweetened beverages such as soda, highly sweetened coffee and iced teas, and other such drinks should be kept to a minimum.

Some tips for staying hydrated:

Hydration Tips

Water Content of Fruits and Vegetables

Drinking water is the best way to stay hydrated.  If you do not drink often, give yourself a little reminder to do so.  Remember to add more vegetables and fruit to your diet to supplement any lack of liquid in your diet.  So, enjoy the summer heat but stay cool while doing so with these tips!

Food Safety Essentials

Provided by Kristen Keith, Meals on Wheels Dietetic Intern
The University of Texas at San Antonio

Food Safety

Every second of every day we are in contact with bacteria. From the surface of your skin to the dishes in your cabinet, these microscopic pathogens, or germs, can be found on anything at any time. 96% of these microorganisms do not cause harm (they are benign), and only 4% cause illness1.

Prevention is key. Through food safety, we can strategically avoid or kill certain bacteria that have been identified as unsafe. The meals being served and delivered from Meals on Wheels are prepared by knowledgeable staff members trained in food safety procedures, but once it reaches your home, we cannot safeguard it from harmful pathogens.

Think of your mouth as a door, your body as the house, and the harmful bacteria are the invaders. Don’t let anyone in but your friends and family! (Aka, the good bacteria).

I have included tips pertaining to the three areas most associated with foodborne illness. These are personal hygiene, cross-contamination, and the time and temperature of the food1.

Personal Hygiene:

Maintaining good hygiene practices prevent the spread of bacteria from our bodies, clothes, hair, and jewelry. Through the practices outlined below, your food can be safer to eat.
Hand Washing

  • Wash your hands with hot soapy water for a minimum of 20 seconds1. (singing the “Happy Birthday” song will usually be sufficient)
  • Follow hand-washing procedure before preparing food, after using the restroom, between tasks, after touching raw meat or eggs, and after touching doorknobs, countertops, or other surfaces that are in consistent use1.
  • Refrain from touching your face and hair1. (If needed, wash your hands afterward)
  • Pull back hair to minimize contamination
  • Avoid wearing jewelry that may contaminate or get lost in your food1

Cross-Contamination:

This type of contamination refers to the unnecessary mixing and transfer of bacteria from food to food. This component of food safety is a great tool for minimizing this spread of microorganisms.
Cutting Board

  • Separate fresh produce from meats, poultry, and eggs when preparing
  • Using color-coded cutting boards helps to eliminate the transfer of bacteria from each food to the other
  • Thoroughly wash utensils with hot soapy water before using them on another food product

Time and Temperature Control:

Controlling the temperature of food is a critical component of keeping our food safe. We can minimize the bacterial growth on our meals and food products by maintaining the correct temperature2. Meals from Meals on Wheels need to be consumed upon delivery or frozen immediately. When food enters unsafe temperatures, the bacteria have a chance to rapidly multiple; we can prevent their success by keeping our food in safe temperatures.
thermometer

  • Be aware of the temperature danger zone as 41 degrees Fahrenheit to 135 degrees Farheheit2. This is when the bacteria on your food multiple the fastest.
  • If not immediately eating your meal from Meals on Wheels, freeze immediately to deter bacterial growth
  • Reheat meals until thoroughly heated through (minimum of 165 degrees Fahrenheit)3
  • Discard any meals or food items that are spoiled, past the expiration date, or meals have been left out of the freezer or refrigerator for 2 hours
References:
  1. Brown, A. (2014).Understanding food: principles and preparation. Nelson Education.
  2. Payne-Palacio, J., Theis, M., & Payne-Palacio, J. (2012).Foodservice management. Pearson Prentice Hall,.
  3. Heating and Storing Your Food. Retrived from: http://mealsonwheelssolano.org/meal-programs/menu/heating-and-storing-your-food/
Photo Credit:
  1. Hand Washing 101: http://health.howstuffworks.com/skin-care/cleansing/basics/hand-washing.htm
  2. Tag: avoid cross contamination for meat: https://infotravel.com/avoid-cross-contamination-for-meat/
  3. https://www.amazon.com/Taylor-Precision-Products-Classic-Thermometer/dp/B00004XSC4

“Synbiotics” are Good for You

Provided by Angela Franks, Dietetic Intern, University of Texas San Antonio

What comes to mind when you think of bacteria? Get rid of them! Right? We have many weapons: bleach, antimicrobial cleaning products, and anti-microbial personal products, etc.  But, many people are not aware of the fact that there are good bacteria as well as bad bacteria. In fact, the good bacteria can help to fight the bad bacteria! The good bacteria are now in the research spotlight and there are many health benefits that are being discovered. In fact, they are making us healthier! The good bacteria are now known as probiotics. Bad bacteria are commonly called pathogens. Currently, research is showing that probiotics may improve:

  • cholesterol levels
  • immune system
  • blood pressure
  • diabetes
  • obesity
  • coronary heart disease
  • diarrhea caused by antibiotics
  • digestion
  • oral health
  • parasite infections
  • some respiratory and urinary tract infections
  • anxiety, stress and depression
  • detoxification

These little critters can also make vitamins and antioxidants for us! They build “homes” for themselves in our colon and when they are nice and cozy, they produce compounds that are beneficial for our health. Among them are Biotin (a B vitamin), Vitamin K, and certain healthy fats.

Are you already eating foods that have probiotics? Common foods include: sauerkraut, kimchi, yogurt, kefir, sour cream, buttermilk, cottage cheese, cheese, vinegar, miso, and tempeh. Be sure to read the label for the words “live cultures,” however, because not all of these foods are made with the living cultures. You can also take probiotics in supplement form.

Do you eat food? Of course you do! It turns out that good bacteria need food too in order to survive and thrive. Since probiotics live in our colon, they need to eat food that we are not able to digest. It turns out that there is a component of food that we are not able to digest – FIBER! Some foods have special fibers that probiotics like best – inulin and FOS (fructooligosaccharides). Some of these foods include: tomatoes, artichokes, onions, garlic, leeks, jicama, asparagus, berries, bananas, ground flax seeds, and legumes. Some food manufacturers are fortifying breakfast cereals and other foods with prebiotics.

Consuming probiotics with prebiotics is known as “synbiotics”. You can make your own synbiotic meal and the little microbial friends living in your colon will enjoy it as much as you!

Spicy Synbiotic Stir Fry stir fry photo

Servings: 4
Time: About 30 minutes

Stir Fry Ingredients:
1 pound chicken breasts, cut to ¼ inch thickness
1 cup chopped Bok Choy
½ cup chopped asparagus
½ cup shredded jicama
½ cup diced tomatoes stir fry nutrition
½ cup thinly sliced red onions
½ cup sliced red peppers
2 minced cloves of garlic
1 tbs minced ginger
1 tbs olive oil
1 tbs rice vinegar
1 tsp sesame oil
2 tsp low sodium soy sauce
Optional to add spice: 1-2 tsp crushed chili flakes

Sauce Ingredients:
4 oz fat free plain yogurt (or fat free sour cream) with live cultures
1 tsp chili garlic sauce or siracha (2 tsp if you like the spice!)
1 tsp low sodium soy sauce

Directions:

  1. Place olive oil in a sauce pan over medium heat.
  2. Add diced chicken, onions and garlic and sauté, until chicken is lightly golden brown.
  3. Add asparagus, jicama, tomatoes, red peppers, and soy sauce and cook until asparagus is slightly tender.
  4. Add bok choy and sesame oil and cook for 2-3 minutes until bok choy stems are slightly tender.
  5. Place yogurt (or sour cream), chili sauce, and soy sauce in a bowl and stir.
  6. Drizzle sauce over your stir-fry when serving.

12 Wellness Rules To Live By

March is National Nutrition Month, and while we at Meals on Wheels San Antonio are busy taking care of our seniors, we want to make sure you are taking care of yourself too!

Below are 12 Total Body Wellness Rules to Live by from EatRight.org. And if 12 seems like a lot (it is!), just pick one or two and see what you can incorporate over the next few months to improve your overall wellness!

march-2017-blog-header

1. Set one realistic health and wellness goal today (but don’t promise yourself too much)! 2. Color your health happy by planning at least one meatless day into your week (think colorful vegetables).
3. Pamper your brain and fuel it well with carbohydrates like fruit, vegetables and whole grains plus beneficial fats from nuts, seeds, fish and avocado.
4. Keep your pantry, fridge and freezer free of foods with a lot of added sugar, solid fat and salt.
5. Add healthful foods into your day, such as whole grains, fruits, vegetables, fat-free or low-fat dairy products, and lean proteins.
6. Stay hydrated by drinking water instead of sugary drinks. Keep a reusable water bottle with you to always have water on hand.
7. Make physical activity a regular part of the day. Choose activities that you enjoy and can do regularly.
8. Factor in dietary fiber with vegetables, fruits, whole grains, nuts, seeds and beans, peas and lentils.
9. Sit less today – stand while working with a standing desk, pace during conference calls and walk at lunchtime.
10. Slow down your eating by taking at least 20 minutes to eat breakfast, lunch and dinner (it takes 20 minutes to feel fullness).
11. Forge ahead – don’t let a bump in the road of your healthy lifestyle get you down. Keep your goals top of mind and move forward.
12. Make time for restful sleep. Aim for 7 to 9 hours every night.

My Time at Meals on Wheels San Antonio

Provided by Kristen Keith, Dietetic Intern
University of Texas at San Antonio

My name is Kristen Keith and I am a student in the Coordinated Program in Dietetics at the University of Texas at San Antonio. Over the course of this program I have had countless opportunities to learn, grow, and better myself as an individual and as a curious student. My time here at Meals on Wheels, San Antonio has made Fall 2016 one of the most impactful experiences of my dietetic career, and my life in its entirety.

I remember learning that Meals on Wheels San Antonio would be my site; I was over-the-moon excited to work with an organization that has such a lasting impact on the older adult community. Any chance that I can get, I make my presentations and projects on my grandfather, Carl Keith. The older adult population is near and dear to my heart, so the opportunity to impact their nutrition was incredibly exciting. Knowing that they would be my target population for the semester genuinely gave me so much fulfillment, purpose, and the determination and motivation to do my best work.

My activities this semester were diverse and eye-opening. Rhaizza Velasquez, my preceptor and the Registered Dietitian for Meals on Wheels, helped me understand the intricacies of large-scale menu planning. There are special diets, food preferences, and ease of preparation factors to keep in mind when crafting the perfect healthy menu for approximately 3,600 clients. Rhaizza makes it look easy! She has taught me that you can make a delicious and healthy meal for any person on any diet. We would search and search for the perfect recipe to add to the menu for the month. Once we would find a recipe, the modification process could begin. We would start to modify the recipe in order for it to be healthy for renal, gluten free, diabetic/heart healthy, bland, and other clients’ dietary needs.

Not only did I get a front row seat to observing the menu process, but I also experienced a taste of the other operations at Meals on Wheels. I traveled to clients’ houses with a case worker, observed the special diet preparation with Chef Mary, delivered meals with Monica, presented to companionship services training attendees, observed food service meetings with the manager Vince, wrote a holiday themed blog, conducted a community needs assessment project, implemented supplement changes, and observed the cooking process bright and early at 4:00am. Every single person I came into contact with at Meals on Wheels impacted my learning in numerous ways and angles. Not only did I learn more about community nutrition, but I gained more knowledge about the impact of community services on our population.

I look forward to applying the semester’s lessons to my future coursework and time in the professional workforce. Learning from all of the wonderful and dedicated Meals on Wheels employees has been, and will always be, an integral part of my success as a dietetic student.

10 Ways To Eat Healthy On A Budget

eating-healthy-on-a-budget-header

Eating healthy on a budget could be difficult especially after the Holidays. The following are some tips to make it possible.

  1. Buy fresh produce when it is in season and freeze it
    Eating fresh produce is great, but buying fresh produce off-season could be super expensive. Only buy what is currently on season.
  2. Look for sales and plan meals accordingly
    If your local store provides a saving-card make sure you sign up for it and check the weekly circular to see what’s on sale.
  3. Try less expensive cuts of meat and enjoy different cooking methods
    For example, baking your chicken or pork.
  4. Eat more whole grains and legumes
    Legumes are healthy and inexpensive. They will fill you up with fiber and protein.
  5. Plan your meals ahead
    It is easy and convenient to always have something ready in your refrigerator and it helps to minimize waste.
  6. Broaden your horizons
    Try different cuisines. Indian and Mexican cuisines rely on inexpensive ingredients. Mediterranean cuisine relies more on vegetables.
  7. Keep an organized fridge and pantry
    This could help you to avoid waste. Make sure the newest products are always on the back. If you freeze your meals make sure you periodically go through your freezer and eat what you have in there.
  8. Re-purpose leftovers
    Instead of eating the same meal from yesterday try to create new recipes using your leftovers. Look for recipes online.
  9. Go to the farmers market at the end of the day
    In some areas you might find great deals if you go to the farmers market an hour before they closed.
  10. Shop in different supermarkets
    Compare prices and look for the best deal.

High Fiber Foods!

As you get ready to stock your fridge for the New Year once you run out of holiday leftovers, think about getting some of these goodies packed with fiber to help you feel full and satisfied to tackle your 2017 to-do list…

foods-high-in-fiber