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B-Fit: Staying Active in the Winter

March 3rd, 2014

Hello Everyone,

Staying physically active is a challenge all year long, but can seem extra daunting during the winter months when our options may seem limited by the weather. The following is a review of the importance of staying active and provides some ideas on how this can be done in the winter.

The Canadian Society for Exercise Physiology recommends that adults should accumulate 150 minutes of moderate- to vigorous-intensity physical activity per week. For many of us this is difficult to achieve, and even more so during the winter months when our options seem limited. During the winter months getting yourself bundled up for a walk, run or to head to the gym may seem inconvenient, especially when compared to alternatives such as curling up on the sofa with a cozy blanket and cup of hot tea.

Inactivity is a risk factor for several chronic diseases and fortunately for us, it is modifiable. Regular physical activity can reduce your risk for premature death, cardiovascular disease, stroke, high blood pressure, type 2 diabetes, osteoporosis and assist with weight management. It also leads to improved fitness, strength and mental health. Studies show that moderate increases in physical fitness levels can produce large increases in overall health status, especially for previously sedentary individuals. The benefits of physical activity clearly outweigh the inconvenience of the cold weather, so it’s time to get active!

Some activities such as running and walking can be done year round if you’re willing to brave the weather. These can be done safely but require making sure that you have appropriate gear, clothing and being smart about when it is and is not safe to go out. Some days you might be better off using a treadmill, indoor track or just walking at an indoor facility. Several other sports can be taken indoors and there may even be indoor sports leagues in your community. Some possible options available in your area may include soccer, floor hockey, volleyball and dodge ball.

Winter is only here a few months a year, and with it comes a short season for many fun and exciting activities. A non-exhaustive list of the options include downhill or cross-country skiing, snowboarding, tubing, skating, snowshoeing, tobogganing, snowmobiling, curling, and hockey. For even more ideas, consider all the events that are taking place right now in Sochi for the Winter Olympics, which include variations of some activities listed above. If you’re really adventurous, you may even consider participating in a “Polar Bear Dip” next year as these most frequently occur on January 1^st.

Many winter activities are more accessible than you think and several can be done without having to travel very far! Visit your city’s website to find out where to go and if you’re willing to go the distance, you can also look into provincial or state parks to increase your options. 

For those of you at Brampton Headquarters, here is a list of where to go:

Chinguacousy Park for skiing, snowboarding and tubing http://www.brampton.ca/EN/residents/Community-Centres/DMG-Chinguacousy-Park/Mount-Chinguacousy/Pages/Fees.aspx

Gage Park or Mount Pleasant Square for outdoor skating (free if you have skates!)

http://www.brampton.ca/en/Arts-Culture-Tourism/Tourism-Brampton/Visitors/Pages/WinterSports.aspx

Community Centres for indoor skating

http://www.brampton.ca/EN/residents/recreational-Activities/Pages/Skating-Schedules-Fees.aspx

Brampton Wilderness Centre for snowshoeing:

https://www.brampton.ca/EN/residents/recreational-Activities/Documents/BWC-FULLBOOK.pdf

Brampton Curling Club or Chinguacousy Curling Club

http://bramptoncc.com/home.php?club=101

http://chingcurling.com/home.php?club=111

In some parts of North America we have the opportunity to participate in a plethora of winter activities, so take advantage of the short season. Now that you know where to go to stay active this winter, get out there and B-fit!


 

 

 

 




 

 

Photo Credit: Duda Arraes via Compfight cc

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Sweet Potato Biscuits in a Retherm Cart?

February 18th, 2014

The overall patient experience in healthcare institutions is one that foodservice strongly influences. The smell of anything freshly baked can make a patient feel more at home and help them look forward to meal times. Recently in the Burlodge Kitchen, I was experimenting with a recipe for sweet potato biscuits that can be prepared entirely using rethermalization carts. I initially tried out the recipe using a bulk system and got the approval of the staff at Burlodge Canada HQ after they followed the smell of cinnamon and brown sugar to the kitchen to do some taste testing. I then tested the recipe again using a tray system, where the biscuits cooked perfectly on a small plate or simply placed on a muffin liner. These biscuits can be prepared in both bulk and tray systems and turn out light and fluffy. They can be used as a breakfast item or alongside a meal. The best part about this recipe is that the dough can be prepared in advance and refrigerated so it will work even if your meals are plated several hours before being heated. Try serving them to your patients and give them a meal to remember!

 



 

Recipe Rating
Total Time	80 minutes
Cooking Time	55 Minutes
Total Labour	25 minutes
Knife Skills	Basic

 

Equipment

Cutting board Peeler Potato Masher/Mixer Whisk 4 oz scoop ½ size – 2” deep production pans Bulk Retherm Cart (or regular oven) or Tray Service Retherm Cart   24 Portions 48 Portions   Metric Standard Metric Standard Sweet Potatoes 600 g 1.3 lbs 1.2 kg 2.6 lbs Melted butter or vegetable oil 250 ml 8.3 fl oz 500 ml 16.7 fl oz Brown sugar 90 g 3 oz 180 g 6 oz All-purpose flour 630 g 1.4 lbs 1.25 kg 2.8 lbs Baking powder 30 g 2 tbsp 60 ml 4 tbsp Baking soda 6 g 1 tsp 10 ml 2 tsp Salt 10 g 1.5 tsp 14 ml       1 tbsp Ground cinnamon 1 g ½ tsp 6 ml 1 tsp buttermilk 325 ml 11 fl oz 650 ml

Method
	Prepare sweet potato mash: Peel and cut sweet potatoes into 1” pieces. Place in production pan and cover with water. Cover with plastic wrap and aluminum foil. Place in Multigen for 75 minutes. Remove potatoes from Multigen and drain off water. Using a mixer or masher, mash potatoes until smooth. Can keep extra mash in fridge for up to 1 week.
	2. In large bowl, mix butter, brown sugar, 500 g sweet potato mash until smooth.
	3. In bowl, sift together flour, baking powder, baking soda, salt and cinnamon.
	4. In 3 additions, mix in the dry ingredients and buttermilk, starting and ending with dry ingredients.
	5. Bulk: Use 4 oz scoop to portion dough into pans prepared with cooking spray Place in Multigen for 55 minutes.    Cold plating: Scoop raw dough onto small plate or muffin liner. Place on the hot side of the tray prior to service.
Note: To make buttermilk add 1 cup of milk to 1 tbsp of lemon juice or white vinegar
Food Accompany: Serve with butter/jam at Breakfast or alongside a salad or entrée

 

 

 

 

 

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How can we help patients in long-term care mindlessly eat more?

January 31st, 2014

The cause of malnutrition is multi-factorial and patients in long term care (LTC) are at increased risk due to swallowing disorders, disabilities and health issues (2). The Canadian Malnutrition Task Force (CMTF) reports that 45% of elderly patients in LTC are malnourished (1). The traditional food first model of nourishment can provide patients with adequate energy through meals and snacks, but what do we do if the patients aren’t eating what they are given? Before rushing to recommend nutritional supplements, let’s consider what other options we have.

Mindless Eating is a concept that has been studied over the past decade by food psychologists and focuses on how eating behaviours are influenced by environmental factors causing individuals to “increase consumption norms and decrease consumption monitoring” (8). In other words, environmental cues can affect our eating behaviours, causing us to stop paying attention to what we’re eating which results in overeating. The numerous studies in this area have identified several ways that we can change our environment to prevent us from overeating. In LTC, overeating is something that may be beneficial for a large proportion of the population, so why not try manipulating the environment to promote increased intake

The complete dining experience can be seen as a combination of the eating environment and the food environment. The eating environment consists of factors that are associated with food but independent of food. This includes atmospherics, food accessibility, social interactions, and distractions. The food environment consists of factors that are directly related to the way food is provided or presented (7). Let’s examine each of these a bit more closely to see what principles can be manipulated in LTC foodservice settings.

The Eating Environment

The atmosphere or physical environment encompasses the light, temperature, colours, smells and sounds, all of which can be varied. Bright lights have been found to activate humans, causing them to eat faster, whereas warm light is considered to be relaxing and slows down movements. Dim lights promote disinhibited eating leading to longer duration of meals and increased intake (6). Warm environments seem to decrease intake, while the cold encourages increased intake (6). Colours and other visual cues from the walls, carpet, paintings window or furniture placement cause an environment to be perceived as either stimulating or relaxing (5,6). Smells play an important role in stimulating appetite and unpleasant odours may decrease the desire to eat. We seem to be more sensitive to smells before and during meals and good smells will actually make our food taste better (6). Background noise in general increases intake and appropriate music selection can decrease feelings of depression and anxiety, leading to a more pleasant dining experience (6,7). Overall, these findings suggest that a relaxing environment is conducive to increased intake (5,6,7).

Food accessibility refers to the effort required to get food. When food is more readily available to us, we have the tendency to eat more (5,7). Social interactions, such as who and how many people are present for a meal, have a significant impact on intake. Family and friends produce relaxation which increases the length of mealtimes (6,7). It is suggested the number of people at a meal is positively correlated with the amount of food consumed (6).

Distractions are anything that will divert attention away from eating. These include watching television, listening to the radio or books on tape, or reading (6,7). There is often increased intake when distractions are present because people stop paying attention to how much they are eating. Additionally, some distracting behaviours can become associated with eating such as the need to eat while watching television (5,6).

The Food Environment

The overall presentation of a meal will determine how appetizing it appears and therefore how much will be consumed. Factors that have an influence here include the colours, shapes, portions, packaging, and temperatures.

The colour of food tells us how good it will taste. Food is more appealing and tastes better if it brighter in colour (6). The colour of food can be intensified or muted depending on the colour of the dish in which it is served. If food is served in a dish that contrasts the colour of the food, the colours will be intensified and food will be more appetizing (4). We may also have emotional responses to some colours, which will affect our mood and how we perceive the flavor of a food or beverage (3).

Shapes and sizes of plates, bowls, glasses and utensils have a strong influence on our intake. The sizes of these items serve as indicators of what is an appropriate amount to serve and consume (7). The size of a dish can change our perception of how much food is actually on it. The same amount of food will look like much less when on a 12” plate compared to an 8” plate. Additionally, the shape in which food is presented impacts our perception of quantity. For example a round scoop of mashed potatoes will appear smaller than the same amount spread out (5). The shapes and sizes of our tableware are directly related to portion sizes. The portions that are served suggest an appropriate amount of food to consume. Increasing portion sizes will increase intake even for unfavourable foods which may be related to the “clean your plate” mentality that many of us have (5, 7).

Food temperature is an important factor which can influence the acceptability of a food. Food is most acceptable when it is served at what is considered a usual temperature for the person receiving it. This usual temperature is based on past experience and exposure with that item. It is also suggested that hot foods are preferred in cold weather and cold foods preferred in hot weather (6).

Packaging is another factor within the food environment. Packaging can impact intake in two ways. The physical shape or size of a package will influence our perception of portion size and intake rate. For example, bottles or cups with a wider openings produce faster drinking. Additionally packing can affect our perceived accessibility to food. When packaging is clear we are able to see the food which promotes intake, whereas opaque packaging may cause us to forget that a food item is present (6,7).

Mindless Eating in LTC

It is easy to identify several of the ways that the eating environment can be altered in a LTC setting to encourage increased intake, many of which will require little or no additional costs. It can be made more relaxing through changing the lighting, colours, smells and sounds to make it feel more home-like. Changes such as dimming the lights, adjusting the temperature and playing enjoyable music are simple changes that require very little additional effort from staff.  Making food more accessible is also something that can be done with minimal effort. This would involve doing things such as making sure food items are within reach, unwrapped or uncovered. Using clear lids and packaging would make foods visible and more likely to be consumed.

Central dining rooms are already used in most LTC facilities (2), but encouraging family and friends to stay during mealtime could make the social experience even more pleasurable. Additionally, lengthening mealtimes within reason could positively influence intake. Patients in LTC often require some assistance at meal times. When feeders are responsible for several patients, they may feel rushed and stressed to get all patients fed within the designated time frame, which may be transferred to patients – this burden could be remedied through an extension of meal times. The company of family or friends can have a calming effect on patients, so having them present could help to reduce the feelings of anxiety that may come with meals for some patients. Central dining rooms also offer a good venue for providing distractions such as showing a television show or movie, playing talk radio or a book on tape.

Changing the food environment is also possible within the LTC setting, though will require more effort and cooperation from food service and in some cases a financial investment. Reassessing the menu while keeping in mind the tableware that is available can help identify meals that may be bland in appearance. For example, white fish or mashed potatoes served on a white plate would be seen as less appetizing than the same items served on a coloured plate.  Without making major changes to the menu a few of the things that can be done are finding new ways to plate foods and adding of garnishes that create visual interest and appeal.

Think about the different ways that the environment might be influencing intake in your patient population and what changes are feasible at your facility. Encouraging mindless eating is one way we could try to produce a reduction in the incidence of malnutrition and improved patient outcomes in LTC.

References

1. The Canadian Malnutrition Task Force. Toronto: Abbott; [cited 2013, Dec 16]. Malnutrition is a Big Problem in Hospitals; [about 3 screens]. Available from: http://nutritioncareincanada.ca/files/CMTF-Brochure-Eng.pdf
2. Dietitians of Canada: Ontario Long Term Care Action Group. Best Practices for Nutrition, Food Service and Dining in Long Term Care Homes. Dietitians of Canada. April 2013. Available at: http://www.dietitians.ca/Downloadable-Content/Public/2013-Best-Practices-for-Nutrition,-Food-Service-an.aspx
3. Harrar V, Spence C. The taste of cutlery: how the taste of food is affected by the weight, size, shape, and colour of the cutlery used to eat it. Flavour. 2013. 2(1):21.
4. Piqueras-Fiszman B, Aldaide J, Roura E, Spence C. Is it the plate or is it the food? Assessing the influence of the color (black or white) and shape of the plate on the perception of the food placed on it. Food Quality and Preference. 2012. 24: 205-208.
5. Sobal J, Wansink B. Kitchecapes, Tablescapes, Platescapes, and Foodscapes: Influences of Microscale Built Environments on Food Intake. Environment and Behaviour. 2007. 39(1): 124-142.
6. Stroebele N, De Castro JM. Effect of Ambience on Food Intake and Food Choice. Nutrition. 2004. 20: 821-838.
7. Wansink B. Environmental Factors That Increase the Food Intake and Consumption Volume of Unknowing Consumers. Annu. Rev. Nutr. 2004. 24: 455-479.
8. Wansink B. From mindless eating to mindlessly eating better. Physiology and Behaviour. 2010. 100: 454-463.

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Snow Shoveling Advice!

January 24th, 2014

Every winter we spend countless hours digging our way through the snow. Shoveling is a strenuous activity and is a common cause of slips and falls leading to back injuries and other strained muscles in the winter months. These injuries can be quite severe and may even result in broken bones if you aren’t careful.

Dressing appropriately for the outdoors is the first step to clearing that driveway. Putting on the appropriate gear will help keep you warm and safe. Having a pair of boots with good treads is important to keep you from slipping and falling as well as keeping your feet warm and dry. It may be necessary to wear multiple layers to keep warm – using light layers will allow you to remove items if you start to overheat. Remember to wear a hat and gloves or mittens as heat is most easily lost through these extremities.

Things to keep in mind when selecting a shovel:

• Shovels with plastic blades are ideal because they are lightweight and will reduce the amount of weight you are moving
• Pick a shovel that is an appropriate size for you: Larger shovels result in pushing and lifting heavy loads compared to small shovels which require many paths and a longer duration of shoveling
• Curved handles or adjustable handle lengths can minimize painful bending

Use proper technique to avoid injury:

• Always stretch or start slowly with small loads to warm up your body
• Position your body with your hands about shoulder width apart to provide leverage and greater stability
• Push snow to one side of the driveway or walkway instead of lifting it
• Make sure to bend at the knees and hips and avoid bending and lifting solely with your back
• Keeping heavy loads close to your body will help reduce the risk of muscle strains
• Avoid twisting your back – toss snow directly in front of you or pivot by turning your feet
• For some DOs and DON’Ts  please see the following video: http://www.youtube.com/watch?v=pKue33V8704

Other tips:

• Shoveling frequently can lighten your load on days with expected heavy snowfall – going out every couple hours will result in several smaller and lighter loads rather than one large, heavy load
• Salt, sand and kitty litter can help to speed up melting and provide traction to minimize slips and falls
• Shoveling can be strenuous, so take breaks as necessary and make sure to stay hydrated – have a glass of water or a hot beverage when you finish
• If you have health concerns that may impact your ability to shovel safely, such as heart disease, high blood pressure, a sedentary lifestyle and back or joint pain, you may want to consult a health professional and take extra precautions during snow removal

Finally, if it is financially feasible, you may want to consider investing in a snow blower or hiring someone else to do the job!

 
Photo Credit: moominmolly via Compfight cc

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