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Melanie Cole (Host): Nutrition can play a very important role in patient care and recovery. MyPlate was developed by the USDA in 2011 and is an update from the food pyramid to help guide Americans towards healthy eating by using an illustration of a plate. Here to explain more about that, is Jennifer Lyman. She’s a Registered Dietician. Welcome to the show, Jennifer. Give us a little bit of an overview of what MyPlate is and how eating healthy and concentrating on good nutrition can help patients in recovery and before they would have any surgery even.

Jennifer Lyman (Guest): MyPlate is just an easy way of thinking about food on a moment to moment basis. The pyramid was a little bit too big, and a bigger concept than a lot of people could manage, but the MyPlate method is – it splits your plate up into four sections: protein, which that’s meat, and eggs, and then soy-based proteins if you’re a vegetarian. The next section would be grains, so that is rice, and pasta, and cereal, and things like that. The next section is vegetables, and the final section on your plate is fruit. And then it also has a dairy on the side.

So, that’s what the MyPlate diagram looks like, and it’s very helpful. The nice thing about the MyPlate method is that it can work with really any diet. If you need low sodium, consistent carbohydrates, anything really can fit with the MyPlate method, so it’s really convenient in that sense. It’s helpful for patients to have good nutrition after being in the hospital. Any time that were hospitalized, our body has undergone some kind of stress -- whether that’s surgery or having some big event happen in your body that you’re going to need more calories to make sure that you’re healing. Not only that but when we have some kind of big stress like that, typically, our appetites drop because we just don’t feel good. When we don’t feel good, we’re not very hungry.

Optimal nutrition – that’s why we have Dieticians in the hospital, to make sure that people heal and go home and get better. Especially before surgery, if you know that you have something coming up, making sure that your body is in a really good state to heal itself or to fight off any infections that could happen. That’s why the MyPlate method is really easy and very helpful.

Melanie: So, that’s so important. Good points, all. Now, let’s talk about the plate itself – the size of our plate. We’ve heard from dieticians over the years that using a smaller plate instead of the bigger plate – do you think that that matters in how our brain plays this role in making us feel satisfied? When we’re looking at the plate, does the size of the plate matter? And then, speak about the types of foods that are going to go on there as far as when we’re making it for ourselves, making it for our children, and post-hospital, and why each one is so important?

Jennifer: The size of your plate does have a huge impact. If we normally eat with a 10 or 12-inch plate, there’s a huge factor of our brain that makes us feel satisfied. We feel satisfied when our plate is empty, typically. There was a study that had a soup bowl that had a tube in the bottom of it, and they were testing to see how much somebody would eat if their bowl never emptied. They found that people ended up eating almost double what they normally would eat. Even after they would ask the participants, “Do you feel full?” And they would say, “No,” even though they are eating more than double what they normally would eat. That goes to show that our brain plays a huge role in whether or not we feel satisfied. Using a smaller plate can help you to feel more satisfied because you can finish all of your food and look and see -- oh, it’s empty – and you end up eating less because your plate is smaller.

Melanie: So, Jennifer, give us your best advice and tips to start with to help people make those small changes at the beginning to eating healthier.

Jennifer: As we talked about, a really easy, small change, is to reduce the size of your plate, whether that means going from a 12-inch to a 10-inch plate, or 10 to 6, it really doesn’t matter. You’re going to end up eating fewer calories if you use a smaller plate. Secondly, anytime that we can increase fiber, it’s going to help you feel satisfied longer. Ways that we can increase fiber that is really easy would just be going from white bread to whole wheat bread, or white rice to brown rice, or white pasta to whole wheat pasta. Any time that we can incorporate those whole grains is going to make you feel fuller and more satisfied longer, so you won’t’ be hungry and starving between your meals.

Another way that we could make little, easy changes is just to go from higher unhealthy fats like saturated fats, to leaner foods. For example, going from getting the T-bone steak to getting a sirloin, or going from having the pork chop to the pork tenderloin, or thinking about that dairy section going from whole milk too – I mean, you don’t have to bump all the way down to skim. You can take those little steps of going from whole milk, to 2%, to 1%, to skim. However, it ends up working out for you. Those little changes definitely go a long way.

Melanie: And what if people really – if they’ve been in the hospital, and maybe they have heart disease, high blood pressure, and what if sodium becomes a factor, what do you want people to know about reading labels to see what’s in the food that they’re eating so that they can see the amount of sodium or saturated fat or added sugars that are in the food that they’re preparing?

Jennifer: I think a really easy way to think about salt is that salt is a preservative. Any food that comes in a box, or a bag, or a can, is probably going to be high in salt because those foods last a long time. You can absolutely look at the label and find that sodium section and see exactly how much sodium is in there. But like I said, if food is going to last a while, it’s probably high in sodium, so instead, go for fresh foods, so sticking to – and this is a rule of thumb. It’s not a hard and fast rule, but a good tip is to stick to the outside perimeter of the grocery store because things like the fruits and vegetables, the dairy, the lean meats – all those you’ve got to cook and eat within about a week, otherwise they’re going to go bad. You know that those are going to be low in salt.

And for saturated fats, like you were saying, you can always check the label. The label is going to break down – it will give you the total fat, but it will also break down where that fat is coming from, whether it’s saturated, unsaturated, polyunsaturated, et cetera. Choosing the lowest saturated fats and trying to avoid trans saturated fats as much as possible is really helpful, especially for someone who has heart disease.

Melanie: Now, what about making family meals? Because we keep hearing how important that is, and if somebody has been in the hospital, maybe convenience is what they’re looking for, but planning ahead can really help a family to eat healthier and to eat together. What tips do you have for planning ahead and meal prep that can help somebody, especially if they have a loved one in the hospital?

Jennifer: I know that with kids it can be really hard because kids tend to be picky. I know, you know, we’ve all been there too. If we can incorporate our family into our meal prepping as much as possible, it’s going to help them want to eat it. If you have your kid help you with something easy -- I mean obviously, it has to be something age appropriate. If they’re little, maybe just have them mixing up the salad, versus when they’re, maybe they can cut up some vegetables. But having them help – when we make something, we have a lot of pride in it – they’re going to like it more if you get them involved.

Another easy way – there are several apps that you can download. One that I really love is called the Meal Lime, M-E-A-L L-I-M-E app. You can select on there if you have allergies, or sensitivities, it will filter out all of these meals for you, and you can select however many meals you’d like to make that week. It will give you the recipes and the ingredients that will make every single one of those meals. It’s really easy. That way you know exactly what you’re trying to buy whenever you go to the grocery store, and that way you don’t waste time or money wandering around there. That one has been super easy, and then again, you can incorporate your family by having them pick the meals that they would like to eat that week.

Melanie: That’s such a great tip, and how can we add more vegetables to our day? It’s easy enough to add fruits, but people don’t always know, Jennifer, what to do with vegetables. They walk around; they say, “I don’t know what to do with kale or kohlrabi, or Brussel sprouts,” or, “I never liked Brussels sprouts.” These things are so good, so what do you tell people when they say, “How do I get more vegetables into my day,” because that’s where the antioxidants really are hiding?

Jennifer: Something that’s really helpful with vegetables is to cook them a different way. You mentioned, for example, you don’t like Brussel sprouts. Well, maybe your mom just boiled them, and you don’t like the mushy texture that they have. Instead, try roasting them. When you roast vegetables, it lets out a sweeter flavor, and it’s also a different texture – it’s going to be crunchy. It’s something completely different than what you maybe were used to.

Also, try your vegetables – if it’s something that you know you didn’t really like in the past, or didn’t like as a kid, try it on a day that you’re feeling really good – you’re feeling happy about life – when you just had a good day. Do that several times, and chances are, you’re going to end up liking that vegetable. Trying vegetables and cooking them in different ways, we can sneak them into almost anything that we make. For example, if you’re making breakfast and you have an omelet, you can throw in tons of veggies into that.

I know that salads are an easy way to get vegetables, but I know that can get kind of boring eating a salad every day for lunch. Maybe instead, try making a soup that has vegetables in it, making a sandwich that has lettuce and tomatoes, anything really. Any way that you like vegetables that you can incorporate them, that’s going to help increase the fiber that I was talking about earlier, and it will make you feel satisfied longer so that you’re not hungry between your meals. That’s when we end up making the poor choices, running by the vending machine between our meal times.

Melanie: So important. Wrap it up for us, Jennifer, with your best advice about healthy eating and MyPlate and why it’s so important for patients in the hospital to concentrate on their nutrition both before and after their hospital stay so that they can recover faster.

Jennifer: Well, when you’re in the hospital, your main goal is to eat. We want to make sure that you’re getting enough nutrition, even if you don’t feel good. If you don’t feel hungry, do your best to make good choices and to eat even when you don’t feel like it. In general, when you go home, when you’re feeling better – or before you come into the hospital if it’s a planned surgery – focus on lean meats, fruits and veggies, and whole grains. That’s going to be the best way to ensure that you have really good nutrition going into the hospitalization. That way, you can get out of here sooner, and feel better, and recover faster.

Melanie: Certainly, all true. Thank you so much, Jennifer, for being with us, today. You’re listening to TVH Health Chat with Temecula Valley Hospital. For more information, please visit TemeculaValleyHospital.com, that’s TemeculaValleyHospital.com. Physicians are independent practitioners who are not employees or agents of Temecula Valley Hospital. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much, for listening.