Dr. Julie Brennan - Registered Dietitian

Transcript

Voice Over:
Welcome to a special edition of prescribed listening from the University of Toledo Medical Center. For the next few weeks, we'll be featuring UTMC providers, sharing advice on how to start off 2022 right.

Voice Over:
This week, Dr. Julie Brennan, a board certified psychologist and registered dietician. Dr. Brennan shares tips on a healthy, balanced diet and staying on track throughout the year.

Julie Brennan:
Thanks for having me. I am a psychologist and dietician. I have been at the university of Toledo now for 15 years. And so I work with individuals both in terms of behavioral health as well nutrition, and often together.

Julie Brennan:
Yeah. So as we start off the new year, a great activity to begin with is reflection. And so it's just an honest and compassionate look back at the past year, just acknowledging with gratitude and blessings of the past year, the struggles and the lessons learned, and have you grown.

Julie Brennan:
So numerous studies have shown that people who have daily gratitude and count their blessings consciously, really tend to be happier. They have lower stress levels and are less likely to experience mood issues. So to begin with that reflection of just being able to see what's really important in your life, how satisfied are you with the different areas of health. So both physical health, emotional health, spiritual health.

Julie Brennan:
So one activity I often will have people do is on a one to ten scale on those three pieces of health is how important are each piece. And then also, how well or how satisfied are you. And so that gives an individual a self-assessment of what's going well and how to keep certain positive behaviors, no matter how small they can be, but also to be able to take that honest look at how to make changes in their world.

Julie Brennan:
So, this reflection can lead us to reflecting an area of health, for instance, maybe diet, of how they can improve. And what you would start with is maybe a smart goal. Everybody knows specific, measurable, attainable, realistic, and timely. And then from there, to be able to create a really well-defined plan. And so from that plan, being able to maybe even know, have an app or some other accountability partner to be able to measure that specific goal.

Julie Brennan:
And then over time, you might also want to recognize how you could create a new habit with that goal that is paired with an already existing habit. So we think of that as a scientific word of stacking behavior, and it helps us stay true to the behavior, helps us continue with that behavior.

Julie Brennan:
So for example, in the morning when you are brewing your coffee or your tea, you might take a few breaths and be able to pair mindful breathing, or deep breathing. Another activity could be when you go to the grocery store, usually you put your groceries away and then you go do something else, and maybe pairing right then and there to cut up fruits and vegetables for the rest of the week, so you have those right available for you.

Julie Brennan:
Lastly, I would say, when we look back at our year and look forward to our next year, we need to create a routine of reflection. So not only just at the end of the year or the beginning of the year, but rather how could we get in a routine of reflecting and living an intentional life, maybe even on a daily basis. And we could use that stacking tool of being able to say, maybe on the way home from work, or perhaps on a Sunday when we do some other activity, or at the end of the month, that we just really go back and reflect on how we're doing with our health and our goals.

Julie Brennan:
It's so confusing because so many magazines are saying opposite things of other magazines. And what do we know, what do we actually know in nutrition? And so there's so many fad diets and restrictions, and we really want to watch out for those. So anything that is focused on these short term outcomes and telling you things that you think how is that going to happen, is probably not going to be a good solution or a healthy solution from a long term strategy.

Julie Brennan:
Sometimes those maybe fad diets or restrictive diets will provide some weight loss in a short term, but it's very clear in the evidence that the best way to be able to be healthy is live a balanced diet in a way that you can be consistently eating the same way and stay consistent over time. I think it's really important to recognize that any of those fads diets are going to lack major nutrients and it can cause us to even contribute to further health problems. And we certainly do not want that.

Julie Brennan:
It's always a good idea to have big changes in your diet to be discussed with a healthcare provider, particularly if you have a chronic disease such as cardiovascular disease, diabetes, kidney disease, thyroid issues. For these health conditions, there may be some times that your nutritional needs really may be different than those that are otherwise healthy. And certainly you do not want to exacerbate any existing condition you might have.

Julie Brennan:
So for example, a doctor may help you with a diet that your blood sugar is kept in mind so it doesn't get too low or too high, or make recommendations for medication-friendly food. Another example would be for somebody who has kidney disease, you would want to stay away from high protein diets, or diabetics making large shifts in carbohydrates and so on. We need to recognize that there are some basics that are really important, but we also have to individualize that for each particular person, their preferences, their cultural values, all of that.

Julie Brennan:
So a good guideline would be looking back at dietary guidelines 2020, 2025, or you could use also MyPlate. It reminds us that, being balanced, meeting all the food groups with nutrient dense foods and beverages, staying within calories and limiting over-consumption of things like sodium, fat, alcohol that can lead to disease and poor health outcomes.

Julie Brennan:
So these dietary guidelines say make every bite count. And so it really focuses on really what are the core elements, and that is lots of fruits and vegetables. So getting those vegetables of all different colors, getting fruits, and hopefully more whole fruits, rather than fruit juices. Grains, making sure at least half of those are whole. Including either dairy or soy beverages. And thinking about protein, and one thing that is certainly something when we don't think about protein a lot is recognizing that we can get protein from plant-based sources, and recognizing meatless and choosing meatless options, or plant-based sources more often can be beneficial, things like peas, lentils, beans, nuts, seeds, soy products, all of that.

Julie Brennan:
It can include also healthy oils, like vegetable oils and seafood, nuts. And then the dietary guidelines give us a couple different things that we want to really limit. And that is added sugar, limiting that to 10% of calories per day. For those that are over two, limiting saturated fat to 10%, limiting sodium to 2300 milligrams, and then certainly limiting alcohol. And that is two drinks for a man or a male, and one drink for a woman.

Julie Brennan:
So the dietary guidelines are really about not is this is a good food or a bad food, but rather a pattern of eating. And we think of our plate, we want to think of half of it should be at least fruits and vegetables, and a quarter of it should be some type of protein. And then the other half again, would be grains. And that would be, again, half of those being whole, at least. Some experts prefer something over another, but we have to really recognize that everybody's an individual and they have personal preferences, and we can eat in lots of different ways to be balanced. It's a pattern of the way we eat. And certainly recognizing, again, like I said, plant-based foods have a really important role in prevention of chronic disease and promoting health.

Julie Brennan:
So just like when, if we think of our lives in general, we tend to be much more successful when we plan. So even in terms of a meeting, in terms of teaching a class, in terms of having a party, we need to plan. And so food is no different. And so having a meal plan and meal prep can be very advantageous. And it has been associated with healthier diets. It's been associated with people being able to maintain their weight in a healthy range. So it's important.

Julie Brennan:
How do we do it? So maybe we want to start small. And we may want to start with maybe one meal a day that perhaps sometimes goes off the rails. And we think, oh geez, we are really hungry. And when we're hungry, and really hungry, we crave high salt, high fat, high sugar food, and that's where we go to those fast food places or get something out of our pantry that is maybe not something we'd normally eat.

Julie Brennan:
And so being able to start with maybe that one meal and being able to recognize what do I like to eat for that particular meal, and creating a grocery list. And then being able to be realistic of when would you be able to have time to prepare for that? And is there a where you could do some meal prepping for that as well? But the more well-defined the plan is obviously, and recognizing what barriers might be, is going to be a higher probability of chance to succeed.

Julie Brennan:
We all need convenience. We love convenience in this society, so we have to be able to help, be able to create that within our environment. So there is something called stimulus control. If I had M&Ms sitting right here and there, I didn't even like M&Ms, but the jar would probably be empty by the end of the day, just because they're there and I'm a little hungry. So we have to keep healthy foods around us. So that's a big awareness piece of being able to say what foods, when I go to the grocery store, that can I keep around me that are convenience that I can grab for, that are going to support my health goals.

Julie Brennan:
And so being able to figure out a time in the week, a lot of my patients will say Sunday night or Sunday during the day, create an hour or two hours to just cut things up or prep for the week. And that can be really successful. But obviously every individual is different, but you just have to say, isn't it important enough to put this time in and how do I do it? Where do I put these things? And then when you go to the grocery store, being able to say, ah, I'm not going to keep that in my house because if I keep it in my house, it'll be gone in one day. And I don't want that, that doesn't support my goals. And that's not to say that food should be off limits. We want moderation. But we also know that some foods probably are food that we only want in our house once in a while though. So I think it's really important how we respond cognitively and what we say to ourselves.

Julie Brennan:
So first, if we can prevent that, so if people want to set New Year's resolutions, it's not this all or nothing thinking of, oh, I'm going to lose 50 pounds, oh, I'm going to make these big goals of exercising 60 minutes every day, if that is not something that is in their normal routine at this point. So it's about starting small, first of all, and not recognizing. We can all have these really lofty goals for a few weeks and do well with them, but then it gets annoying and then it gets irritating and then we start to fall off. And then typically what we do as humans, have an all or nothing thinking. And so it's like never going to work. Oh, I'll never be able to be healthy. I'll never be able to work out or lose weight or whatever the goal is. And so being able to take a step back from that and say, okay, let's see it as it is. And maybe this goal was a little bit too big. And so how can I break it down and what would be the first step and what went wrong, and problem solve.

Julie Brennan:
The way we treat ourselves with that is sometimes we have shame, and shame is about ourselves and seeing ourselves as a failure. Not I made a mistake, oh, this part was a failure, but rather I am a failure. And so shame doesn't have any benefit in that way. And so we need to take a step back and say, yep, okay, yep, I made a mistake. I need to have compassion. What would I be saying to a friend right now? Okay. All right. And then how do I get back on track? Because today matters, this moment matters. And what's more realistic for myself to move forward?

Julie Brennan:
And so I think it's mostly about that. There's many people who feel that being self-critical is a motivator, and it can be short term, but it's very clear evidence-based that being self-critical of one's self is not a great motivator and will not support good behavior change over time. And that goes back to number one, what we talked about of creating a regular routine of reflection, just having that in a pattern, a routine in your daily life or weekly life or whatever method you want to have so that you're constantly being able... Or not constantly, but regularly being able to check in with yourself and say, am I living the best life? Am I living a valued life? Am I living the life I want to live?

Julie Brennan:
I would just like to lastly think about the importance of kindness. And so we talked about self-compassion and being kind to ourselves, and now we also have to think of the health benefits of being kind to others. And so this world has gone through a lot, we've all gone through a lot, and so it's also really great for your health. We know kindness increases self-esteem, it increases mood, empathy, compassion. It can decrease blood pressure, it can decrease the stress hormone. And so my challenge for everyone is to do a random act of kindness today.

Voice Over:
That's all for this episode of prescribed listening from the University of Toledo Medical Center. Join us next week for another episode.