Checking sale papers and using up what foods you already have are the first steps to saving at the grocery store. You can also clip coupons to use and buy in the larger packages to then make your own smaller sized food portions. You’ll find that the fresh produce is usually cheaper when it is in season. If you need something that is not in season, try the frozen or canned.

Limit your purchases of expensive items like soda, chips, cereal, cookies, crackers. These are not healthy for your body or your wallet! Try to make most of your shopping around the perimeter of the store where you find fresh produce, meats, fish, and dairy. Buying produce in the least processed form is usually the least expensive (ex. a head of lettuce vs. bagged lettuce).

In order to make your economical choices healthier, make sure you are reading labels. Look for whole wheat/whole grains for higher fiber, lower salt and lower fat items. A low fat food has less than 3 grams of fat per 100 calories. Choose no sugar added or unsweetened. Remember, “low-fat,” “light,” and “sugar free” does not always mean low calorie or healthy. Also, don’t be fooled by popular terms like: organic, natural, “energy” etc. This does not guarantee a healthy food item.

We also discussed some inexpensive protein foods. The top 5 were:

1. Cottage cheese (80 cents per serving) 11 grams protein

1. Canned tuna (44 cents per serving) 11 grams protein

1. Canned beans (39 cents per serving) 7 grams protein + 7 grams fiber

1. High protein pasta (Barilla Plus) (34 cents per serving) 10 grams protein

1. Eggs (22 cents per egg) 7 grams protein

Please email me at mjfarley@lexhealth.org for any questions.

Hope you can join us at support group next month, Tuesday June 5, at 6 pm in the Lexington Medical Park 1 Auditorium!

Maybe you are one of those people who has stopped taking their vitamins. Perhaps you forgot for a few days while out of town and got out of the habit. Maybe you ran out of the expensive ones that you ordered online and never got around to buying any others. Whatever the reason, none of them are good excuses for not taking your vitamins.

Multivitamin and mineral supplementation is essential after bariatric surgery. With some surgeries, your body physically can’t absorb vitamins as well so you have to take higher doses, just to absorb enough. With all surgeries, the amount of food you are eating will never be able to supply all of the vitamins and minerals that you need.

There are many different signs and symptoms of deficiencies, but most are not noticeable until you are severely deficient. Symptoms include: hair loss, fatigue, leg swelling, bone pain, brittle nails, vision changes, poor wound healing, easy bruising, numbness and tingling in the hands and feet. Deficiencies can also make it more difficult to lose and maintain weight loss long term.

Do you remember the recommendations for vitamins after your surgery?

Gastric Bypass Surgery:

-        Chewable Complete Multivitamin/Mineral Supplement (2 per day)

-        Iron 18 mg/day (if not included in multivitamin)

-        B-Complex Vitamin

-        Women should also take 1200 mg Calcium Citrate and 800 IU Vitamin D3

Sleeve Gastrectomy Surgery:

-        Chewable Complete Multivitamin/Mineral Supplement

-        Iron 18 mg/day (if not included in multivitamin)

-        B-Complex Vitamin

-        Women should also take 1200 mg Calcium Citrate and 800 IU Vitamin D3

Adjustable Gastric Banding Surgery:

-        Chewable Complete Multivitamin/Mineral Supplement (2 per day)

-        Women should also take 1200 mg Calcium Citrate and 800 IU Vitamin D3

For more information on vitamins http://scobesity.squarespace.com/nutritional-counseling/ or contact your dietitian if you have questions at 803-791-2828. Or you can email me at mjfarley@lexhealth.org .

The qualifying process, funds transfers, and repayment are all handled directly with Advance Care. Our financial counselor, Marva Hazel, can provide you with a brochure filled with information on how to contact Advance Care and their hours of operation.  Their user friendly website can be accessed at www.advancecarecard.com.

Advance Care offers interest free financing, instant approvals, generous credit limits and no prepayment penalty.

We are truly excited to be able to provide this financing option to patients who have plan exclusions, limited coverage or no insurance coverage to help them achieve a better quality of life through Weight Loss Surgery. Please contact Marva Hazel for financial information to assist you with your application at 803-791-2828.

Baked “Spring” Rolls

1 12-oz pkg broccoli slaw

1 clove garlic, minced

1 1/2 tsp ginger

1 lb cooked chicken, finely shredded or chopped

4 tsp cornstarch

1 tbsp water

3 tbsp light soy sauce

1 tsp vegetable oil

1 pinch cayenne pepper

20 egg roll wrappers

Directions

1. Coat a large skillet with nonstick cooking spray; add the first three ingredients. Cook and stir over medium heat until vegetables are crisp-tender, about 3 minutes. Add chicken; heat through.

2. In a small bowl, combine cornstarch, water, soy sauce, oil, and cayenne until smooth; stir into chicken mixture. Bring to a boil. Cook and stir for 2 minutes; remove from the heat.

3. Spoon 2 tbsp of chicken mixture on the bottom third of one egg roll wrapper; fold sides toward center and roll tightly. Place seam side down on a baking sheet coated with nonstick cooking spray. Repeat with remaining wrappers and filling.

4. Spray tops of egg rolls with nonstick cooking spray. Bake at 425 degrees F for 10-15 minutes or until lightly browned. May be individually frozen, then reheated to serve.

 Nutrition Info:

1 roll = 96 calories, 1 g fat, 16 g carbs, 7 g protein

Questions or comments? Contact me at mjfarley@lexhealth.org

            We often see spouses of our patients losing weight as the patient loses weight. Maybe the spouse makes healthier choices so as not to tempt the patient or maybe the patient makes healthier decisions overall for the family. Either way, this can be beneficial for the entire family.  Many people find new ways to do physical activity and this becomes a fun family outing that brings them together.

The healthy lifestyles choices that one person makes can influence many individuals. If you are trying to eat healthier and bring a healthy option to a potluck, you may be surprised at the number of people who would prefer to have that than some of the traditional, diet-busting choices. So many people in America are trying to lose weight that it is more often the norm to be “on a diet” than not.

            After bariatric surgery there are guidelines and recommendations to help you be successful which may seem “diet-like,” but the ultimate goal is to internalize these changes to make a lifetime commitment to being healthier. Making this commitment is difficult if you do not have any support. If you are the one preparing the food for the family and you make one meal for yourself and a different one for your spouse or children, how long can that really go on? Having the commitment for a healthier lifestyle from your family is essential to lifetime success. 

            Support can come from anywhere. Having friends or coworkers who are living healthy can make you more likely to live healthy as well. Our program offers a monthly support group where you can meet other patients and learn and share with them.  So surround yourself with positive, healthy people and you can become more healthy and positive. Share your success!

Questions or comments? Contact me at mjfarley@lexhealth.org.

This is the month of love.  Usually that means chocolate and heart candy.

If you set some goals in the beginning of the year to become healthier, don’t let all of the sweet treats derail you.  Instead, focus on incorporating some new foods in your diet that will show your body some love!

1. Oatmeal.  Choose the plain old fashioned or rolled oats and add your own flavorings or fruit.  Oatmeal is packed with fiber (soluble and insoluble) and is a source of thiamine (vitamin B1). This is a whole grain that can keep you feeling fuller longer.
2. Salmon.  Salmon is a type of fish that is rich in omega-3 fatty acids, which are important for heart health and brain function.  An added benefit is that salmon is also a source of vitamin D, an important nutrient for bone health.  Some studies have shown that vitamin D may protect against diseases such as hypertension and cancer.
3. Strawberries.  Not only are strawberries delicious, but they are also packed with Vitamin C.  Vitamin C helps to promote immunity and aids in iron absorption.  Add fresh strawberries to a salad or make a smoothie with frozen ones.
4. Beans.  If you want to get protein, fiber and carbohydrate all wrapped up in one food, eat beans!  They are not as high in protein as lean meat, but they do provide some added protein to the diet.  Also, the high fiber content of beans can not only help prevent diseases such as cardiovascular disease and diabetes, but can also help you lose weight due to the fullness you experience.
5. Spinach.  Nutritionally, you get a lot of bang for your buck with spinach.  Packed with folate, iron, vitamin K and beta-carotene, spinach can be eaten raw or cooked.  If you love the taste of spinach, make a spinach salad with other raw vegetables and a lean meat.
6. Eggs.  Eggs are a wonderful inexpensive form of protein with only around 70 calories per egg!  And not only do you get protein, but you also get some Vitamin A and D, some B complex vitamins and phosphorous.  Adding an egg to your daily breakfast can make you feel more satisfied throughout the day.

Feel free to contact me with any questions/comments! 

Christen Ferster, RD, LD (ctferster@lexhealth.org)

How many times have you heard that? This is quoted to everyone by their parents, doctors, teachers and many others. Sometimes people skip breakfast thinking they will save calories, but in fact, the opposite is usually true. If you save 300 calories by skipping breakfast, you are likely to consume an extra 400 calories at lunch. People who have lost weight and kept it off were studied—they always ate breakfast.

Breakfast has many benefits, including:

• Healthier metabolism
• Decrease in snacking throughout the day
• Good source of energy, so that you do not need that extra sugar/caffeine pick me up later in the day
• Starting the day with a healthy breakfast leads to better choices throughout the entire day

If it’s true, then why do so many people skip breakfast? Skipping breakfast is like starting on a road trip without any gas. You won’t be very successful or get very far. Not eating breakfast is correlated with difficulty concentrating, problems with metabolism, and higher weight.

Why do people skip breakfast?

-         Don’t feel like eating breakfast – this is pretty common, especially if you eat a larger dinner, eat dinner late (after 7 or 8 pm) or have higher calorie snacks in the evening

-         No time for breakfast – in our fast paced world, many people skip eating to take care of other responsibilities

-         Don’t like breakfast food – some people hate eggs, dislike yogurt, and are disgusted by oatmeal

What’s the solution?
First, to feel hungry in the morning (and to try and regulate metabolism) it’s important not to eat too much too late the night before. Try to have your evening meal before 7 and don’t overdo it. And definitely avoid snacking after dinner – this almost always leads to weight gain. Also, if you have time to exercise in the morning, before breakfast, you can work up an appetite!

Second, find a few good quick recipes/meals that you enjoy for breakfast and keep those items on hand. Most breakfast recipes are pretty quick, so getting up just a few minutes earlier to prepare something or making it the night before can make this a realistic change.

Lastly, there is no rule that says you have to eat “breakfast food.” Our guidelines are that breakfast should be a good source of protein and fiber.

To help make breakfast a little easier, here are some quick and nutritious ideas:

• Make a low fat granola-berry parfait: Layer 1/2 cup nonfat vanilla Greek yogurt with 2 tbsp low fat Quaker granola and 3 tbsp berries
• Scramble an egg with reduced fat cheese and wrap it in a tortilla with salsa for a quick breakfast burrito.
• Fry an egg using nonfat cooking spray top with a slice of Canadian bacon and put on ½ of an English muffin
• Blend up a breakfast smoothie with a scoop of protein powder, a little nonfat yogurt and some frozen berries. Add ice to get desired consistency.

Here's to a good morning!

Marlena Farley, RD, LD

mjfarley@lexhealth.org for any questions/comments

Here are a few things to keep in mind as you are evaluating your lifestyle and determining where you want to be:

1. Make goals that are attainable.  Oftentimes, we make extreme goals that we “hope” we can reach.  Though it’s great to challenge yourself, you will be more successful if you set something that is within reach. 
2. Set “mini-goals” that will help you reach your bigger goals.  In other words, if your goal is to run a half-marathon by the end of 2012, schedule a 5K and a 10K before doing the half-marathon. 
3. Write down specific objectives on how you can meet these goals.  The only way to reach a goal is to have a plan on how to get there.  Think of it like going on a road trip.  If there’s a certain destination you need to reach, you need to map out your trip before you leave.  Or, better yet, take a GPS with you!  We, at SC Obesity Surgery Center, can be your “GPS” and help you along the way.
4. Be in it for the long haul.  We want to help you reach your goals and stay there for life.  It takes the right attitude to be successful: patience and a steady determination.
5. Evaluate your progress and reward yourself when you reach your mini-goals.  Every week, evaluate whether you are getting closer to your goal.  If not, don’t beat yourself up.  Take that opportunity to come up with a plan for how you can work toward your goal the next week.  If you do reach a mini-goal, reward yourself with a non-food reward (trip to the spa, new pair of shoes, etc.).

Lifestyle changes are what produce lasting results when it comes to health and weight loss. 

Happy, Healthy New Year!

Christen Ferster, RD, LD 

(Email me at ctferster@lexhealth.org if you have any questions or comments!)