Dr. Christina Tarantola, PharmD, CHC

For the busy person, the words 'meal prep' may be the last thing you want to hear. You may have so many responsibilities that cooking makes you cringe. However, many of the clients I help find that when they plan out their meals, they stay on track with their nutrition goals and minimize stress. They feel more in control of what they are eating since they know what ingredients they used and they are more organized. 

Meal preparation, or more simply, 'meal prep,' doesn’t have to be an elaborate, miserable task. Everyone has different food preferences, food allergies or intolerance, and a variable schedule, so it is important you find a routine that works for you. By following the 3-step meal prep (I didn’t plan on it to rhyme), you will be on your way to staying on track and making healthy meals for you and your family.

If you are new to the meal prep concept, remember it doesn't have to be 'perfect' the first time through. Timing out your meal prep schedule may take some trial and error to find what works best. You may choose to dedicate a whole day to this or spread it out. If you are planning your weekly dinner meals in advance, it may be in your best interest to just get it done and out of the way on one day. If you have enough time and prefer to plan out your lunch and snacks while you’re at work, you may prefer to take some time to do this every morning.

By following the 3-Step Meal Prep plan below, you will be on your way to healthy, simple cooking in no time. Here it is: 

Select one day of the week that is going to be your 'prep' day.

For example, Sunday or another day of the week with available time

 On that day, you can think of meals that you’d like to make for that week, do the grocery shopping and do the cooking. You can also choose to do those three things—planning, shopping and cooking&mdash;on separate days. Try to choose meals that are simple and healthy and require minimal prep and cook time. The goal is to cook and store pre-portioned food that you can throw together and reheat quickly.

Take a calendar and write down the meals you will be preparing for the week. This depends on which meals you plan on making ahead, as mentioned before—just dinner, just snacks, all meals, etc. If a week’s worth of planning seems too overwhelming for you at first, start with 3-4 days first, and slowly build up to a week.

Write down the list of ingredients you will need for each meal, and how much you plan on cooking. It is also a good idea to use recipes that can be prepared in advance and won’t spoil too quickly. For example, overnight oats are a great breakfast recipe that can sit in your fridge for a few days or hard-boiling eggs that you can take on the go.

Not only are these methods a good way to help visualize your plan, but it also helps you stick to it and not be tempted by unhealthy takeout food when you are in a hurry!

Side note: If you are so busy that you can’t shop, you can often order your groceries online and have curb-side pick up. Doing a quick online search of your go-to grocery store can help you find out if they offer curb-side pickup. Online-only stores also deliver groceries. 

After the planning and shopping comes the actual 'prep' part of meal prep. Getting good-quality containers is a good investment. BPA-free Tupperware, glass, and even the pre-portioned 'lunchboxes' with different sized compartments will make storing and transporting food easier.

If you have prepackaged items (e.g. bags of salad greens, precut/pre-peeled produce, containers of berries, etc.): Store these as you normally would. These are easy enough to grab on-the-go, or to throw salads together quickly without already assembling a salad and having the lettuce go bad. 

If you have foods that require cooking (meat, fish, or other proteins, or anything you plan on baking or roasting, such as potatoes): Season these first and start cooking. Using the oven is a great way to prep, because you don’t have to keep an eye on it as much as you would if you were cooking on the stove.

If you have foods that require a little more prep (peeling carrots/dicing onions/steaming vegetables): Prepare this while your other food is cooking. This way, you are managing your time effectively.

Another option is to make one larger batch of your favorite sauces or salad dressings and refrigerate them, rather than make several smaller batches. If you like your vegetables freshly cooked, then you can portion them out for each meal and put them in containers ready to be steamed or cooked. If you know you will be making a meal that requires a lot of chopping, you can do this in advance as well. You can also wash all fruit and portion the nuts that you will be using as snacks, so that you can easily take them on-the-go. 

While the point of meal prep is to make life easier for you during the week, this doesn’t mean you have to pre-cook all of your food. For example, you can marinate some chicken breasts, place them in the freezer, and defrost when you’re ready to use them.

When it comes to cooking carbohydrates, such as quinoa, brown rice, and whole grain or bean pasta, these are easiest to cook ahead of time and refrigerate as well.

A helpful tip that minimizes time spent on cooking is using a Crockpot. You can make a Crockpot recipe, like chili, and freeze it for later use. Either the night before or the morning of, you can place all your ingredients into the Crockpot, leave it on for the day, and come home to a delicious meal. This is useful for anything that requires slow-cooking such as soups, stews, oatmeals, and even desserts.

Many healthy recipes can be found online. You can tailor your search by category, such as meat (poultry, fish, beef), or by calorie, fat, protein, carbohydrate amount.

Preparing your meals in advance will save you so much time stressing and worrying about what you will feed your family. Not only will you have peace of mind, but your family will be eating much healthier.

Articles

For the busy person, the words 'meal prep' may be the last thing you want to hear. With this 3-Step Meal Prep, you can save time and minimize stress of cooking.

The 3-Step Method for Successful Meal Prep

It was previously thought that certain conditions or diseases were simply 'genetic.' If someone had high blood pressure or had some illness, they attributed it to 'getting older' or they simply inherited it, like an old family sweater passed down through the gene pool. “I have high blood pressure just like my mom,” someone might say.

However, is it true that our DNA equals our destiny? Or can we modify our odds of disease?

The study of epigenetics looks at how our environment or lifestyle influences our genes. Lifestyle factors such as nutrition, physical environment, sleep, exercise, and stress levels can eventually cause gene modifications that will turn certain genes on or off over time.

 has shown that more than 90 percent of our longevity is determined by the choices we make—not our genetics. People can have a genetic predisposition for certain diseases, but the gene or set of genes may not be expressed if it is not triggered by these epigenetic factors.

In that study, researchers found that factors such as smoking, exposure to sunshine, depression and low socioeconomic status are known to contribute to aging. Being married, high social status, lack of depression and a low body mass index (BMI) are factors that positively impact aging.

Other research from The Okinawa Centenarian Study

 showed that there is no reason why the majority of us can’t live at least 100 healthy years. Okinawa is one of the largest islands off the coast of Japan, and that study confirmed the concept of epigenetics; it is the interaction between our genes and our environment that determines our health.

When Dr. Suzuki, the Principal Investigator of the Okinawa study, first started his research in 1975, he found an unusual number of centenarians to be in extraordinarily healthy shape. They were lean, youthful-looking, energetic, and had low rates of heart disease and cancer. The Okinawans have among the lowest mortality rates in the world from a multitude of chronic diseases of aging.

The question becomes, how can we positively influence our environment?

Looking at how our behaviors correlate to telomere length is one way. Telomeres are the caps at the end of each strand of DNA that protect our chromosomes, like the plastic tips at the end of shoelaces.

 Without telomeres, DNA strands become damaged and our cells can't do their job.

Several studies have linked chronic stress to shorter telomeres.

It’s no secret that stress ages us and now you understand why! Constant stress shortens our telomeres. Practicing meditation and yoga has been proven to lengthen telomeres.

Foods high in vitamins are believed to protect cells and their telomeres from oxidative damage. Blueberries, goji berries, dark chocolate, cilantro, and artichokes are some examples of high antioxidant foods. These foods are measured by their ORAC (Oxygen Radical Absorbance Capacity) score. In essence, these foods are tested in a lab to quantify 'total antioxidant capacity.' The higher the ORAC score, the more effective that food is in its total antioxidant capacity.

Ultimately, knowing that you have an influence on your genes is empowering. You have control over your health and can take small action steps to improve the quality of your life and reduce your risk for long-term disease. Consuming more antioxidant rich foods, reducing stress and good old fashioned exercise is your fountain of youth!

Herskind, AM et al. The heritability of human longevity: a population-based study of 2872 Danish twin pairs born 1870-1900. 

https://www.ncbi.nlm.nih.gov/pubmed/8786073

https://www.tasciences.com/what-is-a-telomere/

Lu, Stacy. How chronic stress is harming our DNA. October 2014, Vol 45, No. 9. 

http://www.apa.org/monitor/2014/10/chronic-stress.aspx

Effect of comprehensive lifestyle changes on telomerase activity and telomere length in men with biopsy-proven low-risk prostate cancer: 5-year follow-up of a descriptive pilot study. 

. September 17, 2013 http://dx.doi.org/10.1016/ S1470-2045(13)70366-8

Is it true that our DNA equals our destiny? Or can we positively impact our risk of disease?

Epigenetics: Does Our DNA Equal Our Destiny?

I hear this quite often in my nutrition consulting practice. There are so many perceptions about food that circulate in our social media newsfeed, our peer groups, church, work, and so on. One day you hear that coffee is beneficial and has protective effects on reducing your risk of cancer, and then next day it is bad for your health.

As you walk down the grocery aisle, you may think, 'Oh this food is healthy. I read that article a month ago that said gluten-free bread is better than regular bread.' Without realizing it, you’ve put an unhealthy food in your grocery cart.

I spend a good deal of time helping clients clear up misconceptions and myths about nutrition. Societal beliefs teach us that 'I can't eat after 7 pm' or "carbs are bad," and these are some of the main beliefs that prevent people from having a healthy relationship with food. Utilizing science-based nutrition and focusing on being flexible with eating is the way to permanent behavior change. 

I promote the idea of 'Everything in moderation' and use the 80/20 rule. Eighty percent of the food I consume comes form a whole food source, and is nutrient dense. Things like kale, apples, oats, and so on; food that grows in the ground or comes from a natural source. Twenty percent can be 'fun foods' like Greek yogurt pops (Yasso is my favorite brand), a protein bar or whole grain waffles. You may be thinking, 'Aren’t those fun foods healthy?' But, any food that is processed should be limited as it has a lower nutrient value. 

When you are aware of what healthy food looks like, you’ll be able to tell what your 'fun foods' are and enjoy those sparingly. 

Here are 5 'healthy' foods that sabotage your nutrition efforts:

Most brands have excess sugar, and fat, and are made using vegetable oil, butter, and sugar. Turn over any nicely packaged bag of granola and you will see that 1 cup packs 400 calories or more, and up to 30 grams of sugar. We all know we can’t stop at the recommended serving size of ¼ cup! Be cautious about portion size, and be sure to measure it out if you decide to indulge in granola. 

Often you will see sugar, high-fructose corn syrup and preservatives in low-fat dressings. Bolthouse Farms is one I use and recommend for clients, as it is made from yogurt. It does not have artificial flavors or preservatives and still tastes like dressing should. If you want to make your own dressing, use olive oil, balsamic vinegar, or a squeeze of lemon with fresh herbs to flavor your salad. 

Or at least the ones laden with extra fat, carbohydrate, calories, and sugar. In addition to all of those factors, many bars have sugar alcohols, which have been linked to causing gastrointestinal symptoms. Select bars that have natural ingredients that you can pronounce like RxBar, which has the basic formula of egg whites, almonds, cashews and dates.

Flavored products, like oatmeal or yogurt. 

One packet of Quaker Maple and Brown Sugar Oatmeal has 12 grams of sugar in it. Added sugar and preservatives make these flavored products unhealthy. Instead, try purchasing the plain version and adding healthier toppings like berries, chia seeds or coconut flakes.

Naked Mighty Mango Smoothie may sound healthy, but it packs 57 grams of sugar for a 15.2 oz bottle. Turn the drink over to see what the first ingredient listed is and you will know what the product is predominantly made from. For example, many smoothies that are green may seem healthy, but the first ingredient is orange juice.

Bottom line: Don’t be fooled by advertising, health claims, commercials, or nice packaging. Turn the box, bag or bottle over and be sure to read the nutrition label. You will be glad you did!

These are some of the top foods that may seem 'healthy, but can sabotage your nutrition efforts.

5 'Healthy' Foods that Can Sabotage Your Nutrition Efforts

Ask anyone if they are busy and I’ll bet most, if not all of them, say 'yes.' Get up, make coffee, feed the kids, and out the door may be your routine. However, if you are skipping meals, you may be setting yourself up for failure. Feeding your body with good food is key for sustained energy levels, improved productivity and blood sugar regulation. Without good nutrition, our bodies fall prey to illness, fatigue and low energy.

As pharmacists, it is imperative that we eat properly to maintain good cognition and deliver the best care for our patients. You may be thinking, 'I don’t have time to make healthy food' or 'I’ll just grab something in the pharmacy.' Without proper planning, it’s easy to just grab chips or soda from the food aisle in the pharmacy. While that packaged food may taste good temporarily, you will find you hit a wall about an hour after consuming it. You may even be hungry again. No one likes a hangry pharmacist!

Why suffer with blood sugar swings when you can create small changes that make a big difference? Here are 7 key tips to eat healthy no matter how busy you are:

 Who hasn’t heard the phrase, 'Breakfast is the most important meal of the day.' Well, mom was right; there is some science behind it. Skipping breakfast may increase your risk of obesity or make it harder to 

 reports that if you eat breakfast you are less likely to overeat throughout the rest of the day. Skipping breakfast may also trigger bad eating habits throughout the day, as cravings ensue and quick-fix fast foods are often sought out. The side effects of not eating breakfast negatively impact weight, hormonal health, memory, cognition and mood.

 Instead of rushing out the door and having to buy lunch and graze on unhealthy snacks at work, plan ahead. If you don’t have time in the morning, plan some time on the weekend to prepare snacks and meals for your work week. For things like pretzels, trail mix, or nuts, use small bags. For lunch or dinner you can buy BPA-free containers on Amazon or get them at Target.  

 To stay full and boost your metabolism, plan out snacks with protein. Purchase simple, yet healthy snacks like 100 calorie almonds, protein bars or light string cheese.

 completed by University of Birmingham in the United Kingdom and published by the 

 concluded that being distracted or not paying attention to a meal tended to make people eat more at that meal and that paying attention to a meal was linked to eating less later on. One trick I use is to put my fork down between each bite. This helps to slow down my pace of eating and savor my food.

 Often the brain registers dehydration as hunger. If you feel hungry, have an 8 ounce glass of water and wait 5 to 10 minutes. If you are still hungry, have a snack or meal depending on your meal schedule. Staying hydrated helps your energy levels and helps transport nutrients to your body.

 Many of my clients have lunch meetings or take their clients to lunch. You may have a pharmacy job where you do the same. Most restaurants have a menu that designates healthier options. There are ample ways to cut calories and stay healthy while eating out. If you are ordering out at the pharmacy you can follow these tips. Choose grilled or baked options instead of fried to reduce grease and amount of fat. Ask for dressings and sauces to be placed on the side. Be mindful of fat-laden salad toppings like cheese, croutons, nuts and bacon. Ask for those ingredients to be taken off. All of these methods will keep you on track and getting back to the office without feeling sluggish or needing a nap.

 Eating convenience package foods all day will have you feeling tired and sluggish. They also have minimal nutrients. Consume whole foods like fruit, nuts, legumes or cut up vegetables as much as possible. Since whole foods are natural, they contain the highest levels of vitamins, minerals and fiber. They also have healthy natural compounds called phytochemicals, some of which are antioxidants that can prevent cell damage and boost the immune system. Eating whole foods doesn’t have to be boring. Some examples of dishes that can be made with whole foods include peach cobbler, pear salad, mango salad, cream of broccoli soup, bean burritos, bean and avocado quesadillas, sweet potato veggie lasagna, veggie pot pie, stir-fry vegetables and rice, among others.

Implementing one change at a time can set you on a path to success. Remember that your diet does not have to be perfect. There is room for structure and flexibility as you nourish your body for optimal performance and energy.

Some Myths about Nutrition & Physical Activity. National Institute of Diabetes and Digestive and Kidney Diseases. 

www.win.niddk.nih.gov/publications/myths.htm/

Lewine, Howard M.D. Distracted eating may add to weight gain. 

www.health.harvard.edu/blog/distracted-eating-may-add-to-weight-gain-201303296037

. Published March 29, 2013. Accessed March 5, 2018.

Are you a busy professional? Think eating healthy is difficult? It doesn't have to be!

7 Ways to Eat Healthy No Matter How Busy You Are

Gluten-free diets have become popular in the last few years, even for those are are not gluten intolerant. Whether your patient truly has a gluten intolerance or celiac disease or they are simply cutting it out, there are many ways to easily substitute popular food items containing wheat and other gluten-containing grains. Helping patients find healthy and safe alternatives is key to supporting them to live a healthy lifestyle and decrease gastrointestinal symptoms, fatigue and inflammation associated with celiac disease. 

About 1 to 2 percent of the population has celiac disease

, which is an autoimmune form of gluten-intolerance. Those who have celiac disease cannot consume gluten or any food that has been cross-contaminated with gluten. About 6 percent of the population falls into the gluten intolerant category. 

Gluten is a protein found in wheat, rye and barley. For those who are intolerant or have celiac disease, consuming gluten can cause inflammation in the gut leading to gas, bloating and diarrhea. You may hear patients ask about gluten, as wheat or rye may also be present in some oral medications. Most drug products contain 'no gluten' or 'virtually no gluten' and the starch flour used is potato or corn starch. The FDA released a document

 for manufacturers to provide recommendations on how certain oral drug products should be labeled regarding gluten, a matter of interest to individuals with celiac disease. 

The FDA website states that, "Based on information available to the Agency, we are aware of no oral drug products currently marketed in the United States that contain wheat gluten or wheat flour intentionally added as an inactive ingredient. We would expect any such product, if it existed, to include wheat gluten or wheat flour in the list of ingredients in its labeling."

Gluten is found in many bread products, such as cereals, and pasta, as well as salad dressings, condiments and deli meats. Knowing which foods to avoid is paramount for reducing symptoms and improving quality of life.

What should patients look for on food labels? Items will not necessarily say ‘gluten’ on the label. Look for anything that says wheat, rye, barley, malt, yeast or oats (unless gluten-free). Also look for the gluten-free label on the package. Since gluten-containing grains contain nutrients, make sure that your patient is speaking with a nutritionist, doctor or healthcare professional about creating a well-rounded diet.

How can one incorporate gluten-free grains?

Add quinoa to soups or sprinkle over salads.

Cook gluten-free grains for a breakfast cereal. Add fruit, nuts or cinnamon for some extra flavor and nutrients.

Amaranth flour can be added to gravy or used to boost nutritional quality of baked goods.

Teff can be used to make veggie burgers by combining cooked teff with beans or tofu, garlic, herbs and onions.

Use gluten-free oatmeal to make muffins or cupcakes.

There are plenty of ways to live a gluten-free lifestyle without compromising on taste or missing out on your favorite foods. Being aware of what to look for on nutrition labels as well as what to avoid will help your patients decrease symptoms and enjoy eating!

What is gluten? Celiac Foundation. https://celiac.org/live-gluten-free/glutenfreediet/what-is-gluten/. Accessed February 27, 2018.

Gluten in Drug Products and Associated Labeling Recommendations. U.S. Food and Drug Administration. www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM588216.pdf. Accessed February 27, 2018. 

Medications and Gluten. U.S. Food and Drug Administration. www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/ucm410373.htm. Accessed February 27, 2018.

Helping patients find healthy and safe alternatives is key to supporting them with living a healthy lifestyle and decreasing gastrointestinal symptoms, fatigue and inflammation associated with celiac disease.

A Patient Guide to Gluten-free Living

When you are making chocolate chip cookies, you need the right ingredients. Chocolate chips, butter, sugar, vanilla etc. If you do not include one of the ingredients or put hot sauce in instead, your chocolate chip cookies won’t come out as planned. I guarantee you won't enjoy those cookies.

I liken this recipe idea to the Transtheoretical Model of Change. We all know what we are supposed to do, but we don’t always do it. Sometimes, we start baking, we forget to add ingredients, and we don’t always get the final product we want.  

There is an equation in motivational interviewing that describes the ingredients needed for change:  Knowledge x Motivation x Confidence = Change Resistance

what the right choices are, but examining behaviors we engage in and the motivation we have. There are many ingredients that can foster change such as knowledge, vision, plan, resources, taking ownership, developing new coping skills and confidence. Other behaviors such as resistance, fear, denial, low motivation and comfort can keep people from changing.

Everyone is at a different stage of behavior change. Creating permanent change requires a shift in mindset and a willingness to try a new method.

Pre-contemplation phase: This stage is where the person has no intention to change and is reluctant to admit they have a problem. They may rationalize why the behavior is okay to continue. 

Contemplation phase: In this stage the person is willing to consider change and acknowledge that they have a problem. However they are still on the fence about starting treatment.

Preparation phase: The decision is made to stop the behavior. Commitment and determination to change requires a realistic plan and support. People will usually take action in the next month. A motivating belief usually propels people to enter into the next phase.

Action phase: Individuals at this stage will enter treatment or seek counseling. They seek an external support network to keep them accountable and cheer them on.

Maintenance phase: This phase takes 3-6 months. The threat of old patterns becomes null or insignificant and confidence increases.

Why is behavior change so important? Lifestyle related disease states are ever increasing. Metabolic syndrome affects 40% of people older than 60

 and combines at least 3 of the following issues: high blood sugar, high triglycerides, high blood pressure, abdominal obesity or low HDL ("good") cholesterol. This puts patients at higher risk for cardiovascular events.

What are risks of developing metabolic syndrome?

Waist circumference over 35" for women and 40" for men

HDL level less than 50 for women, less than 40 for men

Fasting blood sugar of 100mg/dL or higher 

Losing just 3-5% of body weight can lower a person’s risk for metabolic syndrome. Many of my clients have comorbidities such as asthma, hyperlipidemia, hypertension, diabetes, IBS and more, due to their weight. One of my primary goals is to help them create positive behavior change to reduce their risk of chronic disease, morbidity and mortality.

Patients need support when they are embarking on a new journey with their health. If we can meet them where they are in the stages of change, we will create better rapport and results. Change is not always easy. According to CDC statistics, 70.7% of Americans older than 20 are overweight. Without a sustainable plan, support, and the skills to deal with setbacks that come with every day life, it can be difficult to succeed. The majority of individuals who embark on a change or goal pursuit revert back to old behaviors within the first few months. Moods happen, motivation declines, life happens, and when setbacks occur, getting back up proves to be difficult. 

Pharmacists are uniquely positioned to help patients adapt healthy behaviors. There is an increasing need for pharmacists and health coaches to partner with other healthcare professionals, such as doctors, nurse practitioners, and physician assistants, for this purpose. If someone is identified as 'pre-diabetic,' many times there will be a minimal conversation that involves little direction on an action plan. A healthcare professional may say, 'Just lose weight. Eat less and move more.' The ambitious patient may take action and Google a diet plan or hire a nutrition coach. However, other patients do not know what action to take and thus experience disease progression and worsening blood markers.

We must discover why we overeat to then create permanent change. Otherwise, we can get in a cycle of constantly yo-yo dieting, or regaining and losing.

What increases the likelihood of permanent change? 

Discovering inner motivation to pull you to your goals rather than push you

Understanding and applying the knowledge and skillset

Increased self awareness to understand why we do what we do

Coaching allows collaboration between client and coach to help foster growth and transformation. As a coach, I help my clients increase self awareness, create new habits, which leads to improved self confidence and a skillset of success to enable them to be healthy for a lifetime.

1. Metabolic Syndrome. Mayo Clinic. www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916. Accessed February 23, 218.

Identifying the right ingredients for change can help patients reduce their disease risk, improve health and empower them to adapt positive behaviors.