Gestational Diabetes: What Should I do ?

“You have Gestational Diabetes.”  If you hear that statement when you are pregnant, don’t be frightened. Even though it’s not a desirable diagnosis we would like to hear while we are growing a baby, but there’s ways you can do to keep it under control without needing to take insulin.

Diabetes (high blood sugars) that is diagnosed during your pregnancy is called “Gestational Diabetes Mellitus (GDM)”.  According to American Diabetes Association, the prevalence of GDM is as high as 9.2%.  Pregnancy naturally increases your insulin resistance due to the growth hormone releases from the placenta, therefore all expectant mothers are at risk for developing GDM and we all have to go through the gruesome glucose tolerance test around 26-28 weeks of our pregnancy to ensure we don’t develop it.

Gestational diabetes is not to be taken lightly. Uncontrolled blood sugar level will negatively affect your growing baby in vitro and also putting your newborn baby at risk for very low blood sugar at birth, increases their risk for obesity and developing Type 2 diabetes in adulthood.

So, what can you do? Best way to keep your blood sugar in check is to watch the amount of carbohydrate intake daily.  Therefore, knowing what kind of foods contains carbohydrate is the first step.

Carbohydrate Containing Foods:

  • Grains, Rice, Cereals, Pasta, Breads, Crackers, Tortillas, Anything made with flour
  • Starchy Vegetables: Potatoes, Yams, Corn, Peas, Squash (Winter, Pumpkin, Kabocha)
  • Dried beans, Legumes, Lentils
  • Fruits, Dried Fruits, Fruit Juices
  • Milk and Yogurt
  • Carbonated drink, desserts.

Basic Dietary Modification: 

Be mindful of Breakfast

When you have GDM, morning blood sugar is the hardest to predict and control due to the highest concentration of pregnancy hormone during the morning. Therefore, it is recommended to only have 2 carbohydrate choices or 30g of carbohydrate foods during breakfast time and eat a higher protein meal to keep hunger at bay.  In addition, it is advised to avoid fruits and fruit juices in the morning as the simple fruit sugars are easily digested, which in turn raises the blood sugar too quickly.

Eat 3 meals and 2 snacks

One way to keeping blood sugar stable is to avoid the peaks and fall. Having a smaller but frequent meal to provide the body steady supply of glucose to be utilized and distributed to your growing baby. Make sure you include about 15-20 g of complex carbohydrate at snack time.

Pair your carbohydrate with protein

Eating carbohydrate with a protein food will help stabilize your blood glucose level.  The body needs time to digest the food mixture, therefore avoiding the highs and lows when compared to just eating a heavy carbohydrate meal alone.

Eat Complex Carbohydrate

Even though carbohydrate appears to be the bad guy here, but our body still need carbohydrate to function on a daily basis.  So, how can we achieve a balance? Eat complex carbohydrate foods (whole grains, brown rice, legumes, beans, vegetables (both starchy and non-starchy).Try to keep your carbohydrate amount at lunch and dinner in between 60-75 g per meal.

Space you Milk/Milk alternative consumption

Milk/Milk alternative is a healthy beverage and good source of calcium and vitamin D. However, it is a liquid carbohydrate just as similar to juice; it gets absorb very quickly and can raise the blood sugar rather fast. So, it is best to just drink one cup of milk at a time.

Limit Concentrated Sugar:

The moment you are told no sugar allows are the times you crave them the most. Daily intake of cakes, cookies, ice creams, candies and pastries can raises your blood sugar too high that you will require insulin injection to keep it under control. While sweets are hard to resist, but remember, they offer high amount of fats and little nutrition values to you and your baby. Occasional treat once in a while is totally acceptable.

If you can’t curb your sweet tooth. The sugar free products are usually safe in moderation. Here’s a list of sugar substitute that is considered safe during pregnancy:

  • Aspartame (Equal, NutraSweet, Natra Taste)
  • Acesulfame K (Sunett)
  • Sucralose (Splenda)
  • Rebaudioside A (Stevia)

There’s sugar substitute that is not safe which is saccharin (Sweet N’ Low) and cyclamate (Sugar Twin). So, make sure you read the ingredient list.

Don’t try to cut out all the carbohydrates in your diet, which I’ve heard a lot of my patients told me that’s what their doctor instruct them to do (most of the time is a misunderstanding or miscommunication of info”.  Find a local Registered Dietitian in your area, she/he can help with personalized your diet and help you eat a balance diet for pregnancy and keeping the blood sugar in control.

Bottom Line:

  1. Keep carbohydrate consistent at meal time (30g at Breakfast, 60-75g at Lunch/Dinner).
  2. Avoid fruit/fruit juice/yogurt in the morning.
  3.  Limit concentrated sweets and added sugar in foods.
  4. Eat smaller but frequent meals.
Advertisements

Easy Pickled Beets

Beets is a great roots vegetables, not only it is a good source of folate, iron, calcium, potassium, vitamin C and fiber, it is also packed with antioxidant and anti-inflammatory properties that can help reduce the risk of developing heart disease.  If you haven’t tried beets before, maybe now is the time to venture out your comfort zone.

I liked beets but usually after a few bites I can’t help but noticed the earthy taste (other people describe it as dirt taste) becoming more intense in my mouth.  One of my colleague had brought in her pickled beets for us to try and I enjoyed it much better cold and when pairing it with salad, it’s a delightful dish!

She said that most of the recipes online that she found has too much sugar or too much spices so she altered some and added different spice to it and it has since becoming her signature dish. She is kind enough to share her recipes with me and has allowed me to post it here as well. Thank you Susan W.

My daughter doesn’t like this at first but after about the fourth introduction, she started enjoying it and has been asking for it as a snack, *weird* I know, but nonetheless I’m grateful that she’s an adventurous eater after all.

Ingredients:

1 large beet or 2 medium beets = yield about 2 cups when sliced
1/4 cup water
1/3 cup apple cider vinegar (can use regular vinegar)
1/4 cup sugar
1/2 teaspoon ground cinnamon
1/4 teaspoon salt
1/4 teaspoon ground clove (or 1 clove)

Instructions:

  1. Bring a pot of water to boil, put in the whole beets in and cook till tender. About 45 minutes.
  2. Let the beets cool down, peel the skin off, cut the beets in half and slice it.
  3. In a separate pot, add in 1/4 cup water, vinegar, sugar, cinnamon, salt and clove. Mix well and bring to a boil.
  4. Add the sliced beets into the spiced vinegar mixture, stir to evenly coat beets with the spices, cover for 6-8 minutes.
  5. Remove from heat and let it cool down and serve.

Is Probiotic Safe for Babies/Toddler?

Embed from Getty Images

You’ve probably heard all the good things about probiotic for adults and then you started wondering if it will benefit your babies and young children as well.  The short answer to this question is YES!  Although the research on safety on probiotics for infants are limited but of all the available research out there, side effects are rarely reported.

What are Probiotic exactly ? Probiotic are the “good bacteria” itself that’s helps with our digestive system and with consumption will enhance the health of the host (a.k.a -human). It may also improve outcome of pregnancy, certain intestinal problem such as irritable bowel problem or antibiotic associated diarrhea.  Probiotic often shows up on food as “live culture” such as yogurt, cheese, kefir, or probiotic drink (such as Yakult). Probiotic also presents in the non-dairy products such as fermented foods – Kimchi, tempeh, miso, natto beans, sauerkraut, Kombucha to name a few.

Of course we don’t anticipate young infants (<6 months of age) to eat all this probiotic foods but guess what ?! Human milk is full of probiotic properties (specifically Bifidobacterium Infantis) that was discovered in the intestinal tract of babies, which is the reason why breastfeeding infant does not get sick as often compared to formula fed babies.

If you are formula feeding your babies, don’t feel guilty. You have done the best you could to provide what you can either first few days, weeks or months of available breast milk to help your baby kick start a better immune system.  There’s also probiotic formula available on the shelf these days, mostly labeled as “Formula for supplementing”.

Also, don’t get confused between prebiotic and probiotic. There’s a big differences.

What are Prebiotic? Prebiotic are non-digestible dietary fibers that fuel the good bacteria in our gut (a.k.a bacteria’s food). The more of prebiotics that we consume, the more gut flora will grow and stays to help keep us healthy.  Prebiotic also helps produces vitamin B, helps with calcium digestion and absorption as well. Good prebiotic sources includes: Artichoke/Jerusalem Artichoke, chicory roots, leeks, garlic, onions, asparagus, banana, whole wheat products, scallions, apples and legumes.

Therefore, once your babies reaches the age to introduce solids. Try to introduce as much prebiotic food sources in their diet to help colonize their little gut with the good bacteria and ward off illness as much as possible. When prebiotic and probiotic combined, they are a dynamic pair to keep the digestive system healthy.

I always recommend to get your probiotic sources from food before opting for the pill forms.

 

 

 

Discover Columbia Gorge/Hood River

Sorry if I’ve been slacking.  It’s been awhile since my husband and I got any alone time since the little one was born couple years ago.  So, he took me away for the weekend and I also have been busy at work too. But, I promised I will slowly get back into my grooves to start updating the blog again.

I just wanted to share the scenery and the food I ate on my trip here, just in case you would like to visit the area someday.

Hood River is along the Columbia River Gorge area (Northwest of Oregon) and you get to enjoy the beautiful scenery and lots of outdoor activities to indulge yourself in such as hiking, rock climbing, biking, kayaking, sailing, para-sailing etc.  There’s a lot of family friendly easy to moderate hikes. We did a short Bridal Veil Falls hike and then a longer Multnomah falls hike (45 mins up 620 feet elevation).

 

If you are not an adventurous outdoor person like myself, no worries, you can go and enjoy the food. Which is exactly we did for the most part 🙂

2016-07-31-14-10-54
This spicy squid with tomato sauce over the focacia bread was one of my favorite. Restaurant Solstice @ Hood River.
2016-07-31-14-27-13
Local Zion Farm pear on a pizza….delish.
2016-07-31-14-28-20
Shrimp Caesar Salad 🙂
2016-07-31-18-41-24
Assorted Local Cheese & Fresh berries with Vegetable ash crackers
2016-07-31-19-11-14
Slow Roast Lamb with Green Beans and Cauliflower.

Also, if you wanted to relax and get a massage. I do recommend to go to Holistic Massage Hood River and the service was great and the massage therapist is good at taking care of your sore spots and work on the trouble areas.

 

Monthly CSA Updates

It’s been more than a month since I joined the CSA and has been very pleased with my weekly produce that I picked out.  Most of the time is the same type of veggies that I eat all the time but I tried to be a little bit adventurous from time to time to pick a vegetables that I’m don’t usually cook at home such as patty pan squash, lemon cucumbers and swiss chard.

I enjoyed all the seasonal produce that are available weekly at the farm stand where I picked up my small share.  They are fresh, delicious and worth the extra money that I paid for instead of sifting through the produce isle in the store.

One surprised thing was that my daughter even know that each week I will bring home the “goodies bag”. As soon she sees the red bag I brought home, she immediately says “Mama…strawberries !” and start digging through the bag.  I enjoyed letting her discover all the produce and using it as a tool to teach her the fruits and vegetables that are healthy for her.

2016-06-30-17-00-53
Week 3: Strawberries, cucumber, patty pan squash, carrots, plums, italian kale, & garlic.      New Menu Item: Roasted patty pan squash & Asian Cucumber Salad
2016-07-07-17-30-21
Week 4: Swiss Chard, Cauliflower, Lemon Cucumber, Strawberries, Plums, Carrots, Zucchini.           New Menu Item: Swiss Chard with spaghetti & meat sauce,  Lemon Cucumber Salad
2016-07-14-17-16-30
Week 5: Italian Kale, Eggplant, Cauliflower, Plums, Strawberries, Zucchini, Basil                 New Menu Item: Basil Eggplant Stir Fry

 

Quick & Easy Blueberry Peach Smoothies

2016-07-02-08-16-27

I love the blueberries season, and enjoy taking my daughter going to the farm and pick out the largest and sweetest blueberries on our own.  I get to teach her where the food comes from, and letting her explore in the blueberries bushes and pick out the raw and ripe berries to taste.

We had a blast and of course ended up with pounds and pounds of blueberries because you just get caught up in the picking process and before you know it, the bucket is full and you have lots more blueberries than you can ever consume. The nice thing is that you can freeze the berries and use it as a snack or make smoothies with whatever combinations you prefers.

We decided to use peach yogurt and the frozen berries this time. Hope you enjoy this combination too !

This recipes makes about 14-16 oz of smoothies (2 servings).

Ingredients:

1 Cup frozen blueberries
5 oz of regular peach yogurt
1 Cup  of milk
*A few fresh blueberries or 1-2 teaspoon of sunflower seeds as topping (optional)

Instructions:

  1. Just add all ingredients into a blender and mixed it till smooth.
  2. Or, you can use an immersion blender it works just as well.
  3. Top off with a few fresh blueberries or you can add a few sunflower seeds to give it a crunch too.

 

 

Easy Asian Cucumber Salad

20160702_170536

This refreshing cucumber salad is perfect for a hot summer day ! It’s good as a side salad or just as delicious when mixed in with rice.

This recipe serves 2-3 and it is recommended to eat right away before the cucumber becomes soggy. Hope you enjoy this as much as I do. My little tot loves it but my husband only give it a 6 out of 10 as he doesn’t like cucumber dishes in general.

Ingredients:

1 English Cucumber (Julienne or thinly sliced)- Regular cucumber works too.
1 teaspoon sugar
1 teaspoon salt
1 teaspoon soy sauce
1/2 teaspoon sesame oil
A dash of sesame seeds
Raspberry or Cherry tomatoes for garnish (*optional)

Instructions:

  1. Wash cucumber, peeled off the outer skin then thinly sliced it into matchsticks. If you are using regular cucumber, just deseed the middle part before slicing it.
  2. Mix all the sugar, salt, soy sauce, sesame oil into the sliced cucumber in a chilled bowl, give it a few toss to evenly coat the cucumbers.
  3. Sprinkle with a few toasted sesame seeds and garnish with raspberry or cherry tomatoes.

 

Baked Garlic Parmesan Zucchini

Zucchini is overly abundant in the summer and since I’ve gotten a few from my CSA share last week. I’ve decided to bake it and add a few extra ingredients to style up a little.

Zucchini itself is a low calories vegetable, per one cup chopped only contains about 20 calories. It is also a good source of vitamin C, B6, Riboflavin(B2) and Manganese, these nutrients will help skin integrity and energy productions. So, take advantage of this summer vegetables.

 

image

Ingredients:
One medium size zucchini
1/8 teaspoon salt
1 tablespoon olive oil
A dash of freshly ground black pepper
1/2 cup panko/bread crumbs
1 cup grated Parmesan cheese
1/8 teaspoon of garlic powder
1/2 teaspoon orange zest

Instructions:

  1. Preheat oven to 350 degree.
  2. Spray a baking pan with cooking spray.
  3. Use a mixing bowl, add olive oil, garlic powder, salt and pepper together.
  4. Slice zucchini into 1/4 inch thick and toss zucchini into the mixing bowl with the oil mixture. Stir to evenly distribute the seasoning.
  5. Add in panko or bread crumbs and Parmesan cheese, evenly coat zucchini in the mixing bowl.
  6. Lay zucchini in baking pan and baked for 20-25 minutes.
  7. Grate additional Parmesan cheese and some orange zest on top as garnish when it is done.

Exploring Community Supported Agriculture (CSA)

Eating local and practicing sustainability in Oregon has always been at the forefront of their residents.  Organics/whole food groceries and small family farm has bloomed dramatically, particularly in the Eugene/Springfield township that I lived in thanks to the local demand. Farmers market has turned into the hot spots for the locals to hang out and enjoy the local produces/fruits, dairy and pasture during the peak growing season.

I love shopping at farmers market compared to patronizing whole foods stores because I know I’m supporting local business. I enjoyed going to Whole Foods, Market of Choice or Trader’s Joe don’t get me wrong, but their items are overpriced as it is and the items may be organic but it doesn’t necessarily is local. Eating healthy sometimes can be very expensive if you didn’t plan ahead.

So it’s time to go back to basic: eating seasonal and local foods. Foods that are the closest to our home tends to be a little bit environmental friendly as well, therefore, choosing local farmer’s market or joining a community supported agriculture (CSA) makes more sense to me. Since I don’t have the green thumb to grow my own food (friends have laughed at me for this since anything grows in Oregon’s ground), I’ve decided to join CSA to try it out instead. To my surprised, just in our county alone, there’s more than 50 farms that provides CSA services, choosing one definitely is not easy.

I’ve decided to join Food for Lane County youth farm because I liked their objectives to teach limited income teenager about food/nutrition, helping them gain skills about leadership and teamwork. Another plus for joining the youth farm for me was convenience of picking up my own CSA shares right at my work place. Most CSA has full share (feeding 3-4 people), and half shares (feed 2 people) available through the season.

The total half-share for 20 weeks cost me $350, averaging out to be $17.50 per week. Really not a bad deal for fresh, local produce. After two weeks of picking up my CSA box, I noticed that I have minimal waste on  the veggies compared to before that I’ve always had some wilted veggies in my fridge waiting for me to throw away.  It also forces me to be creative in making dishes with those items as well.

If you wanted to learn more about CSA, visit  “IFOAM organic international” website to explore what’s available in your area (North America, Japan and Europe).

2016-06-09-15-30-18
Week 1 Bag: Strawberries, beets, garlic, carrots, lettuce, broccoli, Italian kale.

Menu Created for Week 1: 

  •  Steamed Carrots with Butter
  • Strawberries Lemonade
  • Roasted Beets
  • Sautéed Beets Greens with Garlic
  • Lettuce Wraps
  • Steamed Broccoli
  • Sautéed Kale with Chicken
2016-06-16-17-14-11
Week 2 Bag: Strawberries, Bok Choy, Italian Kale, Broccoli, Zucchini, Carrots, Green Onions

Menu Created for Week 2:

  • Strawberries Greek Yogurt Popsicle
  • Beef with Bok Choy
  • Roasted Kale
  • Broccoli & Tofu Stir Fry
  • Roasted Carrots
  • Zucchini & Carrots Soup
  • Garlic & Scallions Chicken

This is quite fun and I will continue to share my weekly finding and what menu item that I come up with. Hope you all can start exploring your local CSA and share your experience with me !

Homemade Infant Formula…What seems best may not be!

We all know breast milk is the best food a mother can provide for your precious newborn. But there’s time when you aren’t able to provide enough breast milk for your infant and formula automatically becomes the next best thing we turns to.  In the past 3 years, homemade infant formula has becoming more popular thanks to parenting website such as wellness mama and celebrity Kritin Cavallari sharing her recipes on magazine and blog post.

It really boggle my mind that 1.27 million hits on google search with homemade formula has come up in less than .5 seconds. This does concern me as a healthcare professional and a mother of a young toddler. I would steer away from making my own homemade formula at all cost. This is because there’s too much variation in homemade formula and the ingredients that they called for might not be the safest for your baby’s tiny body.  I’m certainly not “Pro commercial formula” but when it comes to infant’s health, I’ll stick to what I know is best 1) Breast milk and 2) Commercial Formula.  My recommendation is to stick with Organic or Non-GMO labeled commercially prepared formula if financially able to do so.

Parents often complaints that formula is so horrible because there’s sugar, corn syrup plus a long list of other ingredients that they are unable to pronounce. If they can’t pronounce and don’t know what that is, it must be bad, correct? Answer is no.  I think parents’ need to understand that corn syrup and high fructose corn syrup are two different things. One is a natural derivative of sugar from corn (mostly made of glucose), and the latter is a chemically altered to produce fructose from corn syrup.

You will only see corn syrup on the formula that is made for babies with sensitivity as it is easier for the digestive system. Babies need carbohydrate to grow, without it they simply wouldn’t thrive whether the sources is lactose, sugar or corn syrup.   And that the other ingredients listed (most of them are less than 2% of the formula content) are the vitamin and minerals scientific name carefully crafted to suites the needs for newborn to match the content similar to breast milk.

Commercially prepared formula is being monitored by the FDA, USDA and EPA and they have been subjected by thousand of research before to ensure their nutrient adequacy to be served to the most vulnerable populations.

Homemade formula on the other hand looks great in a glance but it carries a lot of hidden danger of food borne illness, nutrient imbalance and other potential health risk to your baby if you are not mixing it correctly.  Just one misstep can send your child into the emergency room.

Here’s the reason why homemade formula might not be the best after all:

Unpasteurized raw cow’s milk/ Raw goat’s milk

Any type of raw food products possess a certain type of risk for food safety. According to Center of Disease Control (CDC), unpasteurized dairy increases a staggering 150x of your baby’s risk of Campylobacter, Listeria, E.Coli infections.  Most dairy product related outbreaks are associated with consuming raw dairy products and children are the most affected populations.  You wouldn’t even drink raw milk when you are pregnant because it can increase your chances of food borne illness and affecting your unborn baby, now why would you want to feed your baby raw milk then? Seriously, think about it.

Here’s a link to the CDC hand out on raw milk statistics.

Raw Liver

This is another food source that can foster bacteria Campylobacter jejuni especially when using it raw. Campylobacter food poisoning can cause damages to your baby’s intestine and can easily leads to bacteremia (bacteria in bloodstream), a serious condition which requires hospitalization and heavy dose of antibiotics.  In rare cases, it can cause Guillian-Bairre syndrome, an autoimmune disorder that the body defense mechanism start attacking the healthy cells.

Nutrient Imbalance

I carefully read through some of the most promising homemade formula out there, there’s no nutrient analysis of them anywhere. Only one I read was all the nutrients gathered according to the ingredients from the food database. Please be reminded, data gathered from food database is not a detail nutrient analysis of the formula, nutrient displacement can occur during mixing process.

Another scary discovery was whether it is cow milk based or goat’s milk based homemade formula, both contain excessive calories and protein per serving. To adults, a little higher calories or protein here and there doesn’t hurt but in tiny infant, every single one matters. If the infant doesn’t require extra calories and protein, it will make them gain too much weight too quickly. Excess calories will lead to extra fat accumulation which in turns link to adult obesity later on in life.  Liver based formula on the hand has the right amount of calories, but protein still slighter higher and what was lacking is sodium and calcium, two key nutrients that needed for bone and cell formations.  The extra protein in the homemade formula will put extra stress on their tiny kidney to process and can easily leads to dehydration.

So, if you think you are doing your child a favor, think twice before you jump into the homemade formula bandwagon. Just be aware of the potential risk of giving homemade infant formula, every baby’s body digestive system is different. Homemade formula is definitely not recommended for infant younger than 6 months of age.

Always consult with your child’s pediatrician or meet with a pediatric nutrition specialist to discuss your formula choice/decision. They can help you analyze the formula and let you know if it is safe.