Healthy Meal Prep

It goes without saying that if you want to get in shape, you have to eat healthy.  But, it's hard when there's so much going on in our lives and we feel like we don't have the TIME to prepare healthy meals.  For me, I eat five meals a day about 3 hours apart.  I have gotten used to eating the same thing twice a day (usually a grilled chicken salad).  I enjoy my salad, so it's no big deal.  And thank the Lord, my husband eats the same way, so I don't have to prepare another meal for him.  But, that's the caveat with this healthy meal prep, it's the same food twice a day, and lack of variety is fatal for some people.  With our family's busy schedule and needing to have so many meals to eat each day, it's just simpler for me to eat the same thing over and over.  No thinking about it, just prep once, then grab and go.  

My meal prep is incredibly easy.  Eating this way takes way less time than preparing several different meals for lunch or dinner.  All you really need to do is buy a big package of boneless, skinless chicken breasts and grill them at once on the grill.  My husband and I both eat about two chicken breasts a day, so he will cook 12-16 at a time, and I have found they are good refrigerated for four days, sometimes five.  The photo below is my meal prep that I took to my bikini competition because that's all I ate for two days but you could use these for lunch or dinner once or twice a day, along with your other meals.  

The twelve meals above were made from the few ingredients below.

HOW TO GRILL CHICKEN 

On the grill (we use a gas grill, but you can use a grill pan on the stove), turn the fire to medium to medium high heat.  For my "contest" chicken, no oil was used, just a sprinkle of Tony Chachere's Salt-Free seasoning.  Now that the contest prep is over, he puts a little olive oil on the chicken to keep it from sticking to the grill and to keep the chicken moist.

Cook the chicken for about 10-15 minutes per side, depending on the thickness of the chicken.  When it's done, remove from the heat and cover with foil.  Let it rest for at least 10-15 minutes.

Each meal gets five ounces of chicken.  I can pretty much eyeball how much 5 ounces is now, but otherwise, I have found this scale very beneficial.  I used it everyday while on bikini prep and sometimes still do. 

For the carbs, I usually eat potatoes, but you can substitute rice or quinoa.  Sweet potatoes are great too.  I was only eating 4 ounces of carbs for this prep, so I used small, red potatoes.  

COOKING POTATOES

After washing the potatoes (I used 12), I towel-dried them, poked them a couple times with a knife, then microwaved them all at once for 10 minutes, turning halfway through the cooking time.  They shrink when cooked, so they only averaged 3.5 ounces.  Now, I'd eat about 6 ounces, so two of these small guys.  What I really like to do (when I'm home) is chop them up after they are cooked and toast them up on the stove on a medium-high heat (just spray the pan with cooking spray). 

I use my Gladware that I found at the grocery store and then begin assembling. 

A big handful of romaine lettuce, a few tomatoes or a cup of frozen green beans . . . 

then the potatoes and chicken.

I eat the salad meals cold (and add dressing now), and microwave the meals with green beans for about 1 minute or so.  You have to be careful not to reheat chicken too much or it will get dried out. 

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Since I'm at home most days now, I haven't been assembling my food like this lately.  After the big batch of chicken is cooked, I put it in a large Rubbermaid tupperware container and keep it in the fridge.  We just pull out it as needed.  The variety for me now is just adding more and different things to my salad, like avocado, mango, sundried tomatoes, etc.  I was only eating Romaine lettuce before, but now I find I like a combo of Romaine and arugula.  When you add 5 ounces of chicken to your salad, it's really filling too. 

As long as you have chicken already cooked in the fridge, you're good to go for quick, easy meals, especially salads.  I need to look into other recipes using chicken (adding to pastas or casseroles) next.  

I made a Thai steak salad for dinner on Sunday and it was delicious!  I'll be sharing that recipe next!

Professional Physician Organizations: A Continuing Necessary Ingredient for Ongoing Health Reform

This JAMA article on "Professional Organizations' Role in Supporting Physicians to Improve Value in Health Care" reminds readers that "organized medicine" continues to have an important role in national health reform.  The Population Health Blog agrees and adds that these doctor professional organizations have not only been underestimated recently, but will continue to be a force to be reckoned with - both a national and state level.

The article points out that groups like the American Medical Association (AMA) along with the various sister specialty physician organizations, along with health systems, practice associations and various non-governmental entities, are critical to the success of the Affordable Care Act.  These doc groups been long-time advocates for health reform, are still trusted by a significant number of providers, collectively represent a majority of docs and bring insights to a complicated health system.

And what are they doing to help with reform?  According to the authors, they've been serving as "conveners," helping to marshal resources, are creating standards and helping regulators.  While the JAMA article naturally mentions a number of national initiatives (such as Choosing Wisely), the PHB points out the same kind of important activity is occurring at the state level.  A good example can be found here.

Before some PHB readers tut-tut the faux importance of the AMA and its many national and local affiliates by having you believe that docs have transitioned their loyalty from their profession to their employers, the PHB would point to three sentinel events that say otherwise:

1. Even the White House believed that organized medicine was important enough that it sought to circumvent the influence of the AMA by fostering its own professional doctor group called "Doctors for America."  While it hasn't worked so well, imitation is the sincerest form of flattery.

2. The Patient Centered Primary Care Collaborative's Board of Directors has a significant number of members with deep roots in organized medicine.  It's testimony to a vital constituency on which the success of the Patient Centered Medical Home depends.

3. While tort reform has been outside the scope of this blog, an important ballot initiative dealing with California's benchmark Medical Injury Compensation Reform Act (MICRA) will be put before the state's voters this fall.  The lead organization of an impressive coalition of labor, business and consumer groups that has been created to defeat the proposition and preserve MICRA is, you guessed it, a state medical association.

The lesson for population health providers?  Reach out to and work with the physician groups at all levels of reforming the system.

Baked Strawberry-Rhubarb Oatmeal

I would like to call this my baked oatmeal maiden voyage. That’s right, after having oats for breakfast practically every morning since the summer of 2011, I had not yet tried baking them, ever. I am a creature of habit and even more so when it comes to my breakfasts. They’ve slowly but surely evolved from being just plain oats cooked with water, an egg, a glass of juice and a sandwich, to more vegan-friendly, creamy, big bowls of dessert-flavoured porridge with lots of toppings and huge fruit platters on the side. Because vegan food is boring you know ;) But upon seeing all of my IG-friends (love you guys) with their beautiful baked breakies, I knew I had to give it a try. If you like myself, haven’t tried this yet, I highly recommend you do so immediately! Crispy and golden on the top, creamy and fluffy on the inside. Freshness and acidity from the fruit. What more can you ask for?

Baked Strawberry-Rhubarb Oatmeal

½ cup oats

½ cup unsweetened almond milk or plant-based milk of your choice

¼ tsp pure vanilla powder

2 tbsp date purée or liquid sweetener of your choice

¼ cup sliced rhubarb (1/2 inch slices)

¼ cup sliced strawberries

½ - 1 tbsp corn starch to toss the fruit in

½ tsp baking powder

Pinch of salt (optional)

How to:

1. Start by mixing your oats, almond milk, salt, date purée and vanilla powder in a small bowl. 
2. Let it sit on the countertop for about ten minutes or so to swell. 
3. Preheat your oven to 180^oC/360^oF and prepare the strawberries and rhubarb by tossing them lightly in the corn starch. 
4. Once ten minutes has passed, gently stir in the fruit and baking powder, pour the oats into a ramekin or a small pie shell and bake in the oven for 20-25 minutes. It should have a lovely golden colour on top when you take it out of the oven. 
5. Serve with fresh fruit and toppings of your choice. Nut butter is always a winner when it comes to oatmeal-toppings!

Love, Tilda

Love at First Bite - Basic Vegan Pancakes

We all love us a big stack of pancakes, don’t we? If your answer to that question is no, you’re obviously lying. I know you are. I used to be one of those (crazy) people claiming they don’t like pancakes. Here in Sweden, a pancake is usually a thin, flat disc that's quite dense in consistency. Growing up, I absolutely hated these. They were all too stodgy for my taste and nothing like the wonderfully fluffy American kind, which, I was yet to discover. So when each Sunday, my Instagram feed was flooded with beautiful stacks of golden pancakes, I felt nothing but perhaps a little envy of their gorgeous presentations. Then I decided to try it out for myself and everything changed. It was love at first bite. Pancakes are without question the ultimate comfort food and my previous attitude towards them could not have been more misguided.  

Although most people think of pancakes as an unhealthy treat, it’s actually very simple to make them both healthy and vegan. I’ll admit it took some tinkering around with this recipe before I was happy and confident enough to share it with you all but here it is, finally, my basic vegan pancake recipe!

Basic Fluffy Vegan Pancakes with a Caramel Sauce

Serves: 1

1/2 cup buckwheat flour (heaped) (70 g)

1/2 tsp baking powder

1/4 tsp baking soda

1 ripe banana, mashed (80 g)

1 tsp lemon juice or apple cider vinegar

1 chia egg (1 tbsp ground chia seeds mixed with 3 tbsp water), could sub for flax egg

3 tbsp almond milk (you may have to add a couple more tbsp if the batter is too thick!)

1 tsp melted coconut oil

Optional:

Coconut oil for frying 

1 tbsp maca or lucuma powder

1 pinch of vanilla powder

1. Start by preparing your chia egg: Grind one tbsp of whole chia seeds either by hand or in a coffee grinder, then mix the ground seeds with 3 tbsp of water. Stir well and let sit on the side for a few minutes to swell.
2. In a small bowl, mix all the dry ingredients with a fork until the baking powder is evenly divided. 
3. Mash/blitz the banana with the lemon juice (or vinegar) until smooth.
4. Pour in the chia egg, mashed banana, melted coconut oil and almond milk and stir until the batter is completely smooth. Let sit on the countertop for a few minutes (the batter should be THICK)
5. Fry in a spoonful of coconut oil (unless you have a non-stick frying pan) on medium heat for a couple of minutes on each side.

Caramel Sauce

2 tbsp peanut flour (or peanut butter if you don't have any peanut flour)

1 1/2 tbsp almond milk

1/2 tbsp date syrup

1/2 tsp maca powder

1. Mix all ingredients with a fork until you have a smooth, creamy sauce. You may have to adjust the amount of liquid if you use peanut butter instead of flour.

Put slices of banana in between the pancakes and top with the caramel sauce, quinoa pops and mulberries! Hope you like the recipe :)

Pancake-coma-love, Tilda

The Medicare Advantage Stars Program: Who Keeps the Money, Is it Evidence-Based and What About Variation?

The Population Health Blog has been practically banished from our living room when the spouse is watching TLC's Say Yes to the Dress.  This reality show follows the travails of young brides as they search for that perfect wedding gown while also dealing family expectations, tight budgets and dubious body art. 

When the PHB stops in and pauses to watch the bridal drama unfold over more than just a few minutes, it naturally wants to share.  Mysteriously, the spouse treats its helpful outreach like some sort of provocation.
 
Little wonder.  Years ago, the PHB medical director learned that the best way to make itself unwelcome at dreary management meetings dealing with the Medicare Advantage STARS Program was to inconveniently offer various insights, such as:

"If we hit the STARS target, let's not keep the millions in bonus payments; they should be distributed to our enrollees or used to lower premiums in the form of P4P4P."
 
"Too bad there is no randomized trial that shows that any of this help patients live longer.  Should we tell them that this isn't evidence-based?"

"If there is a small improvement, it could be the result of case mix or statistical variation."

And its innocent Yes to the Dress insights?

"All those dresses look pretty much the same!"

"I hope the groom takes a look at that mom, because if that's what the bride is going to look like years from now, he may want to reconsider."

"Seems to me she's trying to fit 50 pounds of potatoes into a 30 pound bag!"

Instant Pot Electronic Pressure Cooker: Two Years Later

I've had several people tell me that the Whole Health Source post that changed their lives the most was one I published in 2012-- about a pressure cooker.

In 2012, I first reviewed the Instant Pot-- a "pressure cooker for the 21st century" that also doubles as a slow cooker and rice cooker (1).  Since then, we've used it more than 400 times, and it has saved us countless hours of kitchen drudgery.  It's indispensable for my current cooking style, and a major time saver for anyone who leads a busy life but still wants to cook wholesome food at home.  It's extremely satisfying to be able to put your ingredients into the Instant Pot, push a couple of buttons, do something else until it beeps, and then eat a healthy, inexpensive, and delicious meal.

Pressure cookers are one of the most time- and energy-efficient cooking tools, but electronic versions are even more efficient than traditional stovetop pressure cookers.  They're more time-efficient because you don't have to fiddle with them-- for example, adjusting the heat.  They're more energy-efficient because 1) they stop heating when the interior has reached the appropriate pressure, meaning that they're only using energy for part of the cooking process and they hardly vent any energy-wasting steam, and 2) they're insulated well enough that the sides never get hot.

I've used my Instant Pot for a wide variety of cooking tasks, and this is what it does best:

Read more »

What's Next? The Post Bikini Competition Plan

A surprising thing about post-competition is that I'm not all that anxious to eat all of the food that's been off limits during contest prep.  You'd think I'd want to eat everything in sight, but that hasn't been the case.  In fact, the thought of a big, juicy cheeseburger and fries (something I love to indulge in once in a while before) doesn't really sound good to me right now.  I think it feels so good having worked so hard to get in shape, I don't want to "blow it" by eating bad.  It doesn't feel worth it.  

FOOD

The night the competition ended, we found a nice steak restaurant that was open and ate a late dinner there.  I had baked brie (a favorite of mine!) with dry toasts, filet minion, twice baked potato and iced-tea.  I only finished half of the steak and potatoes and I really wasn't ready for any alcohol.  The next morning, I indulged in Starbuck's banana bread for breakfast before we got on the road to come home.

After driving nearly four hours home, we stopped at Chipotle for lunch and I always get a bowl with rice, chicken and pico.  Back at home, I got back on my regular (contest prep) meals with the exception of the ice cream I had been craving.  I wanted Gelato (it has less fat) but they were out the kind I like (Sea Salt Caramel), so I got regular Carmel Cone ice cream.  I ate the whole pint.  It was GOOD going down!  

But, of course, my stomach really hurt the next morning.  Thankfully, my abs were still there! :)  Although a cheeseburger doesn't sound good, I could keep eating ice-cream every once in a while (just not a whole pint in one sitting!).

My trainer texted me the next morning telling me I should get back to Phase 1 of my diet.  And it's crazy that I was actually looking forward to it!  I really like my protein pancakes with all-natural fruit spread.  Meal 2 is usually fish, potato, and green beans.  Meal 3 is a grilled chicken salad with fat free dressing.  Meal 4 is chicken, potato or rice, and veggies.  Meal 5 is a cup or so of Muscle Egg.  Sometimes, I'll eat another pancake too in between Meal 4 and 5.  I typically eat at 9am, 12pm, 3pm, 6pm, and 9pm.  

On Tuesday night, my girlfriend invited me out for a drink and I went, but ordered tea. Wednesday night, I went to dinner with two friends at a new restaurant and I was excited to have something different.  I ate tuna tartare and a mini steak skewer.  

At the weekend blog conference I went to, I ate as best I could (even brought and drank 3 protein shakes while I was there).  We were fortunate that the conference had a fresh, healthy salad bar selection with fish and chicken.

BUT, I did indulge in THREE small desserts on Saturday (chocolate popsicle, shared milkshake at dinner, and scoop of ice cream at the late-night party).  Back at home on Sunday, I was back to my meals- and ready to be! 

I do want to find new healthy meals that I can feel good about eating that are different from my usual.  It's just nice to have a little variety.  And I'm sure my husband would appreciate it too.  

WORKOUTS

As for the workouts, my trainer recommended that I do only 30 minutes of cardio and no weights for about a week to give my body a rest and just recoup from the competition.  What's crazy is that just doing 30 minutes of cardio now feels very minimal.  I haven't even bothered to go to the gym for it (it would take longer to drive there and back) opting instead to just run out my door around my neighborhood with my iPod. 

I had a great run on my trip out of town too.  I knew I'd want to run at least one day, so I packed running clothes and my iPod.  Right outside our hotel was a beautiful bike trail filled with tall, lush trees.  I even found the cutest Startbuck's ever and popped in after my run for an oatmeal and black iced-tea.  It felt so good to start the day this way.

Before I started training for this contest, if you'd have told me I'd be doing 30-45 minutes of cardio 4-5 times a week in addition to my one hour workout, I'd think you were crazy.  I didn't think I was physically capable of doing that, but my body surprised me.  Yours can too. 

via

I'm not training with my trainer right now, opting to spend more time with my son and just workout at the gym that's closer to my house.  When my son goes back to school, I'll reconsider.  I got spoiled training with him - not because it's any easier - in fact it's physically harder.  But, he kept me accountable and pushed me to my limit.  I just did what he said.  I didn't have to think about what's next, what exercise to do, what weight to lift, how many reps.  So many times I'd say to him, "I'd never workout this hard on my own." 

I know his routine pretty well now though.  We would do 3 exercises in a row, not too heavy, but a weight I could get 15-20 reps.  One of the exercises might be something without weights, just to keep my heart rate up, like Burpees. We'd do the round 3-4 times, then start again with 3 different exercises.  We did this for one hour, sometimes stopping with 10 minutes to spare so I could finish with abs.

It will be interesting to see if I can keep it up on my own.  I'm going to try!