Ready To Go Nuts? 6 Tips for Adding Nuts to a Healthy Diet

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains the health benefits of nuts and provides tips for incorporating them in a healthy diet. 

They say good things come in small packages and nuts are no exception. Filled with protein, fiber, phytonutrients and antioxidants, nuts pack lots of good things into a small, convenient and healthy package. They keep you satisfied, help curb unintended grazing and have powerful cancer-fighting properties.

Previously shunned by healthy dieters because of their high fat content, it turns out that nuts actually contain heart-healthy mono- and poly-unsaturated fat, which has been shown to lower LDL or “bad” cholesterol levels.

In addition to being healthy, nuts are inexpensive and have a long shelf-life, which makes them perfect for throwing in your purse or briefcase when you’re on the go.

Before going nuts with nuts, check out the following tips to incorporating them into a healthy diet:

Control portions
Nuts are high in calories, so moderation is key. Limit serving size to one to two ounces per day. 

Use nuts as a substitute
Instead of simply adding nuts to your diet, use them to replace foods that are high in saturated fats like meat, or contain empty calories.

Always read the nutrition label
Look for items with nutrition labels that say “dry-roasted” or “raw” and avoid those that just say “roasted.” Roasted nuts often contain added oils. Also, choose unsalted nut varieties.

Love the nutty flavor? Try nut butters
There are a variety of nut butter options available today including peanut, almond and cashew. Before making your purchase, make sure the nut butter does not include added ingredients like sugar or hydrogenated fat.

Store properly 
If you’re buying a large bag of nuts, store them in the freezer for maximum freshness and to aid in portion control.

Chop or grind nuts as an add-in or topping
Add nuts to yogurt, oatmeal, salad or stir-fry to infuse them with the nutty flavor while keeping portions in check. You can also mix nuts with herbs to use as a crunchy coating for fish or chicken. Sound good? Check out this healthy recipe for almond encrusted tilapia.


- Cara Stewart, RD, LDN

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Eat Right When Eating Out

Karen Buzby, RD, LDN, and Cara Stewart, RD, LDN, members of the Penn Metabolic and Bariatric Surgery team, offer these tips for eating healthy when dining out.

Dining out can be a challenge for anyone trying to follow a healthy eating plan, but it is especially difficult if you have had weight loss surgery. Restaurant portions are notoriously large and the meals are often packed with sodium and hidden calories from fats, sugars and sauces. Before weight loss surgery, larger portions may have tempted you to eat more than you wanted or needed. After weight loss surgery, the food may go to waste or cause discomfort. 

The following tips can help you enjoy your meal out while sticking to your diet plan.

Limit calories:

• Be conservative with food selection, especially during the first few months after surgery. Stick with simple prepared foods.
• Before ordering, ask yourself: “Is this food pouch worthy?” Make sure you order foods that are a good source of protein and fiber.
• Look for heart-healthy, low-fat or light options. U.S. Food and Drug Administration (FDA) regulations require restaurants to back up their health claims. Feel free to ask for nutrition information if it is not already provided.
• Stay away from the bread and chip baskets as well as dessert and alcohol menus. Ask the server not bring out the dessert cart. If you choose to eat bread, opt for a small, plain yeast roll and avoid items with added fat like garlic bread, cornbread, croissants and muffins.  
• Salad dressings are often high in calories and fat. Always order dressing on the side and ask for low-fat dressing, a lemon wedge or flavored vinegar instead of the full fat and calorie version. 
• Don’t drink your calories. Quench your thirst with calorie-free drinks like water or unsweetened iced tea. Limit or avoid alcoholic beverages.
• If your job requires socializing or doing business over meals, call ahead or go online to learn about your options in advance. Inform the restaurant manager of your dietary restrictions and make special requests ahead of time if necessary.
• Savor each bite of food, enjoy the company and take your time. Allow at least 20 to 30 minutes for each meal. Remember, conversation is calorie-free!

Control portion sizes:

• Watch your portion size. People who have had bariatric surgery receive a “restaurant card” to request smaller portions when dining out. Use it to make sure your meals are an appropriate size.
• Share a meal or order a smaller portion. This reduces portion size and the expense as well.  
• Order from the lunch menu if it is available. Often the lunch menu offers smaller and less expensive entrees.
• Order from the children’s menu if there are healthy selections available.
• Order an appetizer as a main entrée. The portions of appetizers are usually two to four ounces, which is the ideal meal size after weight loss surgery. 
• Ask the waiter to split the main dish and box half before serving it. You can also request a “doggie bag” as soon as you feel satisfied to avoid the temptation of overeating. 
• Try a tapas restaurant, which serves snack-sized appetizers and entrées.  

Manage leftovers:

• When you take home leftovers, remember to refrigerate the food promptly to avoid food-borne illness. Food left out for more than two hours may not be safe to eat.
• Write the date of purchase or preparation on leftovers and remember to discard the food after three to five days. Always follow the mantra: “When in doubt, throw it out.” Plus, you don’t want your refrigerator to turn into a jungle of leftover containers. 
• Reheat food thoroughly.

- Karen Buzby, RD, LDN and Cara Stewart, RD, LDN

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Convenient and Healthy, Too! Finding Diet-Friendly Frozen Food

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, provides tips for finding healthy frozen food.

Although it gets a bad rap, the supermarket’s freezer section is actually brimming with time-saving, nutritious food choices: as long as you know what to look for on the label.  By learning about healthy frozen foods, you can stock up on diet-friendly options to have on hand when you do not have time to cook.

Produce – Frozen fruits and vegetables are often more nutritious than fresh produce because they are frozen shortly after harvesting, preserving nutrients.

• Vegetables: Look for plain frozen vegetables without added butter, cheese or sauce.  Heat them in the microwave for a quick side dish or tasty addition to your favorite soup or casserole.
• Fruits: Look for products without added syrup or sugar.  Add frozen fruit to yogurt, smoothies and cereal or eat them straight from the freezer as a snack.

Frozen meals – Although they typically do not taste like a fresh, homemade dish, frozen meals can be helpful for those times when you do not have the time or energy to cook.  Choose products with no more than 3.5 grams of fat per 100 calories and 600 mg of sodium or less.  Make sure the frozen entrée has at least 4 grams of fiber and 15 grams of protein to keep you satisfied.  Reliable brand options include Kashi, Lean Cuisine, Healthy Choice and Smart Ones. 

Waffles – Choose 100 percent whole grain varieties.  The first ingredient listed on the label should be whole wheat flour.

Pizza – Choose a pizza product with a thin, whole wheat crust if possible.  Avoid high-fat toppings like pepperoni and sausage. Opt for vegetable toppings or get a plain pizza and top it with your own favorite vegetables at home. 

Desserts –Choose pre-portioned novelty ice creams with 150 calories or less, like Skinny Cow or Weight Watchers varieties. Sugar-free or 100 percent fruit popsicles are also good options.

Vegetarian – There are several options for vegetarian burgers, patties and sausages.  Choose varieties with 300 mg of sodium or less per serving.

- Cara Stewart, RD, LDN

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Tips for bringing your diet on vacation

Karen Buzby, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, offers tips for maintaining your post-surgical diet during your vacation.



Following the recommended post-operative diet after bariatric surgery is always a challenge, but it is especially difficult when traveling. By planning ahead, you can maintain good eating habits and continue to meet your nutritional goals – even on vacation.



If you are traveling by car, here are tips for healthy eating on the road:

• Pack plenty of water. If you are traveling by car, pack an insulated cooler filled with water, sugar-free beverages and protein drinks.
• Bring high-protein foods. Light yogurt, cheese, cottage cheese singles, hard-cooked eggs and individual packets of tuna or lean deli meats can be kept in the insulated cooler with ice packs or frozen water bottles to keep them cool.
• Always keep healthy snacks on-hand. Protein bars, nuts and soy crisps are easy, nutritional snack choices that also are high in protein. Fresh fruit, light fruit cups, vegetable medleys and cherry tomatoes make excellent are also great choices.
• Read the nutrition facts. Before making any purchases on the road, use the nutrition label to guide your selection and portion size to make sure you stay on track with your diet. Highway rest stops carry a variety of calorie-free beverages, but their healthy snack options are often much more limited.
• Stick to plain or simply prepared foods. When purchasing meals on the road, simple is usually best. If you have any questions about sugar content, ingredients or method of preparation, ask the restaurant for clarification. Many restaurants have brochures with nutrition information available upon request.
  
  
• Find a nearby grocery store. Once you reach your final destination find a local grocery where you can replenish your beverages and diet essentials.
• Request an in-room refrigerator. It it easier to eat healthy if you have a place to keep your healthy beverages and snacks. Also, take advantage of the complimentary ice machine to fill your beverage container or cooler when you pack up to leave.
  
  

If you are traveling by plane, here are tips for healthy eating in the air:

• Buy a calorie-free beverage after you are through the security checkpoint. The Transportation Security Administration (TSA) requires that all carry-on liquids fit inside a 3.4-ounce or smaller container that is stored in a quart-sized, clear, plastic, zip-top bag. Each passenger is limited to one zip-top bag of liquids. Purchase calorie-free beverages to bring on the flight after you have been cleared by security.
• Pack protein powder in your carry-on bag. Dense foods items like peanut butter and sugar-free preserves should be packed in your checked luggage, but carry a quick protein fix in your carry-on. Just remember to leave time for any additional screening.
• Order special in-flight meals in advance. Many airlines offer meal accommodations for passengers with specific dietary needs on long or international flights, including low-fat and sugar-free meals. Special meals need to be ordered at least 24 hours before your flight.
  
  

Regardless of your means of traveling, keeping a food diary is a foolproof way of ensuring that you meet your nutritional needs no matter how far you are from home.



It may take extra planning on your part, but it is possible to stay on-track with your diet on vacation.



Safe travels!



- Karen Buzby, RD, LDN

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How Big is One Serving? Use everyday objects as a guide

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, provides everyday objects as a guide for standard serving sizes of common food items.

Today, portion sizes are notoriously larger than ever before. With restaurants serving super-sized meals and food packages often containing more than one serving, it can be difficult to figure out how much you are eating. Uncertainty about portion size is particularly problematic when trying to lose or manage weight. For successful weight loss, it is essential to know and keep track of your food intake. Use these comparisons to everyday items as a guide to standard serving sizes of common foods.

• 3 oz. of meat = A deck of cards
• 3 oz. of fish = A checkbook
• 1 ½ oz. of cheese = 3 dice
• 2 tbsp. peanut butter = A ping pong ball
• 1 medium-sized fruit = A baseball
• 1 cup of cooked vegetables = A baseball
• 1 medium potato = A computer mouse
• 1 cup pasta = A baseball
• 1 bagel = A hockey puck
• ½ cup of ice cream = A light bulb
• 1 tbsp. butter or oil = A poker chip

- Cara Stewart, RD, LDN

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