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Ask the Avera Dietitian

Personalize your nutrition. If you have nutrition questions, this site allows you to chat with Registered Dietitian Mary Beth Russell, RD, LN, CDE about diet and lifestyle modification.

Question:

I would like to know if I could make an appointment with you to discuss diet and exercise. I know there will be a fee for this that will not be covered by insurance. Can you tell me what your initial consultation costs are?

Answer

Cost of Registered Dietitian Outpatient Visits

  • 1 time visit: $93
  • 1 initial and two follow up visits: $140
  • Basic Heart healthy diet education (30-45 minute visit): $75

Please contact us at 605-977-7000 if you would like to schedule and appointment with a dietitian.

 

Question:

How often should a person do the screenings? We had one a few years ago and found calcium deposits in the heart. I would like to see if it is getting worse or not.

Answer

Recommendations are based on your past Planet Heart scores. It is recommended that if you have gone through Planet Heart and had a calcium score of 400+ you should follow up with your physician or a cardiologist. If you had a 0-100 calcium score with low risk factors, the calcium scoring could be repeated in 4-5 years. If you had a 101-399 calcium score the calcium score could be repeated in 2-3 years. Remember the CT scan exposes you to radiation, if you have not discussed your previous results with your doctor you may want to get their recommendations. I hope this information is helpful. If you would like to schedule another visit to Planet Heart you can do so by calling 1-877-282-8372.

 

Question:

When My husband had his heart surgery, the meals we had were outstanding. Is there any way that I can get some of the recipes? I purchased the cookbook but most of the meals that we had were not in it.

Answer

We promote heart healthy diets throughout the entire Avera Heart Hospital and it is great to hear that you enjoyed the food. Our first cookbook that contained our recipes from the hospital is currently out of print. However, we do have other recipes available for no charge on our website. 

 

Question:

Is it healthy to eat cereal for breakfast and lunch?

Answer

Due to the processed state of most cereals and the fact that they are limited in protein, we do not suggest this as the main part of a meal. It is important to have a variety of foods at all meals to ensure adequate nutrition, like lean protein, vegetables, fruit, low-fat dairy and whole grains. When choosing a cereal for breakfast, find one that has less than 5 grams of sugar and more than 5 grams of fiber per serving. We also suggest adding protein to this breakfast to control hunger, like almonds, walnuts, peanut butter or an egg.

 

Question:

I have seen in the grocery store the milled flax seed. How does the milled compare to grinding your own?

Answer

To ensure freshness and high quality, we would suggest grinding your own whole flaxseeds. If you struggle with finding time to grind your flaxseed, then buying it ground would enable you to still get it into your diet. If you are purchasing the ground flaxseed, purchase this in a dark container instead of a clear bag. This keeps the ground flax from being exposed to light which could decrease it's nutritional value. Whole flaxseeds can be stored at room temperature for at least one year but only for 4 months once ground. While newer research indicates ground flax is much more stable than previously thought, keep ground flax stored in a sealed container in the refrigerator to preserve maximum nutritional value and freshness.

 

Question:

What makes a good fish oil supplement?

Answer

Fish oil is highly unstable. As soon as it is extracted from the fish and exposed to oxygen, metals, light and heat it begins to be damaged. Therefore it is essential to look at the following when choosing a fish oil capsule: Company has Good Manufacturing Practices Free of pesticides and heavy metals (like mercury, lead, dioxins, PCBs, yeasts, molds and bacteria) Third-party certified for purity and optimal quality Antioxidant blend added for freshness and stability Meet label claims for EPA/DHA content Look for the Following on Labels of Supplements: USP and NSF - This is not there to guarantee that the product is safe and effective, but it does indicate the manufacturer has submitted the product for testing to show it contains what is stated on the label. If in doubt, contact the manufacturer for their analysis or purity statement.

 

Question:

I am on Coumadin and I am confused as to the amount of Vitamin K in some foods. What is the best way to manage these foods that contain Vitamin K?

Answer

Coumadin is a medication used to help prevent blood clots. Vitamin K is a vitamin needed to help blood clot. Therefore the amount of Vitamin K in your diet can change the way Coumadin works for you. There are some misunderstandings about Vitamin K for example, thinking it is best to avoid foods that contain Vitamin K however these foods are very nutrient rich and healthy choices. Therefore, the best advice is to try to be as consistent as possible with your Vitamin K intake, consuming about the same amount each day. There is no need to eliminate foods that contain Vitamin K. Foods that contain high amounts of vitamin K include green leafy vegetables, broccoli, brussel sprouts, cabbage, asparagus, pistachios and some oils. Consistency is key. We suggest eating a normal, balanced diet while maintaining a consistent amount of Vitamin K and avoiding drastic diet changes.

 

Question:

I would like to purchase the Avera Heart Hospital's Cooking for Life Volume 2 cookbook, where are these available for purchase?

Answer

Our cookbook is available for purchase here within the Avera Heart Hospital or by contacting the Avera McKennan Foundation at 605-322-8900. This cookbook focuses on 30 minute heart healthy meals with most recipes using less than 10 ingredients. We also provide education by having our Prairie-Mediterranean Diet discussed in detail throughout the first part of the cookbook.

 

Question:

What is the daily dosage of flaxseed and how should I eat it?

Answer

Flaxseed contains ALA which is alpha-linolenic acid a plant form of omega 3 fatty acids. It is generally recommended for people to consume 1-2 Tablespoons of ground flax daily. It is important to start slowly with ½ tablespoon and gradually increase the dose to avoid intestinal upset. Flax seeds have a hard outer crust that prevents the body from digesting the whole seed, therefore it is important to grind the flaxseed using either a coffee grinder or food processor before eating to get the most health benefits. Flax is available in either brown or golden colors but either color has the same health benefits.

 

Question:

When looking for omega 3 or fish oil supplements what are the best ones...or what should I be looking for?

Anwer

It is very important to choose a high quality fish oil capsule to get the most advantages. Fish oil is highly unstable. As soon as it is extracted from the fish and exposed to oxygen, metals, light and heat it begins to be damaged. Therefore it is essential to look at the following when choosing a fish oil capsule: Company has Good Manufacturing Practices Free of pesticides and heavy metals (like mercury, lead, dioxins, PCBs, yeasts, molds and bacteria) Third-party certified for purity and optimal quality. Antioxidant blend added for freshness and stability. Meet their label claims for EPA/DHA content. Look for the Following on Labels of Supplements: USP and NSF – This is not there to guarantee that the product is safe and effective but it does indicate the manufacturer has submitted the product for testing to show it contains what is stated on the label. If in doubt, contact the manufacturer for their analysis or purity statement.

 

Question:

I’m interested in substantial weight loss. Are the calorie controlled programs a safe, nutritionally complete option?

Answer

When looking at losing a substantial amount of weight, remember it will take time. It is important to work with a Registered Dietitian to ensure that your program for losing weight is safe and nutritionally sound. A concern with the calorie controlled programs is that they focus only on calories. When the focus is on one item, it is easy to miss the bigger picture. There are many very healthy food choices like nuts, peanut butter and whole wheat bread that are an excellent addition to a weight management program however they are higher in calories.

 

Question:

I take ¼ cup of ground flaxseed every morning with breakfast. Will this affect the absorption of my medications?

Answer

At this time, we are not aware of any complications with absorption of medications with flaxseed. However, food items that contain high amounts of soluble fiber like flaxseed, may change how quickly food leaves the stomach or the rate at which it is absorbed. We would suggest dividing up your flaxseed dose to avoid any potential problems with medications. Therefore, take half of the dose in the morning and half at night.

 

Question:

I find it hard to cook for just myself, any suggestions?

Answer

When cooking for one person, it is important to take advantage of that freezer space. By making meals and freezing them into smaller, single serving size you have the ability to enjoy a variety of meals without having to consume the same foods many days in a row. There are also many quick simple tricks to make foods more enjoyable, for example: make a roast or chicken in the crockpot and use that in quesadillas, sandwiches, salads or casseroles and don’t forget eggs which are very versatile and convenient.

 

Question:

I have a hard time eating enough fruits and vegetables, what do I do?

Answer

When cooking for one person, it is important to take advantage of that freezer space. By making meals and freezing them into smaller, single serving size you have the ability to enjoy a variety of meals without having to consume the same foods many days in a row. There are also many quick simple tricks to make foods more enjoyable, for example: make a roast or chicken in the crockpot and use that in quesadillas, sandwiches, salads or casseroles and don’t forget eggs which are very versatile and convenient.

 

Question:

I am wondering which is more accurate for proper daily recommendation for water consumption, 8 glasses per day or half your body weight in ounces?

Answer

There are no specific recommendations for water. Remember these methods of determining your water intake are just estimations for how much water a person should consume. Water remains an excellent choice for a beverage and one that should be chosen first before others.

 

Question:

What are your recommendations for healthy grains? I am 56, ovo-lacto vegetarian, moderately active, have no health issues and not gluten intolerant.

Answer

There are an abundance of healthy grains including whole wheat flour, brown rice, wild rice, steel cut oats, bulgur, barley and quinoa. Since some of these are not commonly used it is important to research the proper preparation methods for them. If purchasing these items in a package, cooking directions and sample recipes could be listed on the side. If choosing these items from a co-op, they usually have additional info on preparation techniques. As more and more grain varieties make the mainstream market, it adds variety to wholesome meals.

 

Question:

What is the healthiest bread to eat – 12 grain or 100% whole wheat?

Answer

When choosing a heart healthy bread it is important to have whole wheat flour as the first ingredient. Typically the 12 grain breads have a variety of grains in them however enriched flour is the first ingredient. Therefore look for a bread with whole wheat flour as the first ingredient and that also contains more fiber.