Helping Patients and Clients Upgrade Their Food Choices

Here’s Part 2 of our Best Practices series on “soft” skills – practical tips, tricks, and substitutions to help your patients and clients get better, and, more importantly, stay better via sustainable lifestyle change.

An introduction to the series and Part 1 which focuses on beverage swaps can be found here. Part 3 which focuses on movement can be found here.

You already know that the habit of eating real food is non-negotiable in sustainable health. However, the advice to “just eat real food” is not enough – not specific enough (do people even know what real food is?), not understandable (isn’t a drive-thru burger “real food”?), not always accessible (I can’t find or afford foods I’ve read I should be eating), and not always doable (I don’t have time to cook, how do I prepare real food?).
We need to do more to facilitate lifestyle change.  

I offer these to you on behalf of the whole SAFM community. This is specific, practical, hands-on guidance they offer every day. All of us can benefit from the understanding, wisdom, and clinical experience of those who Do this work. Successfully. With many different patients and clients. Meeting them where they are at and allowing space for “less than optimal” – accounting for the lifestyle choices that they are willing and able to make.

SAFM practitioners understand that what patients need goes way beyond a standard, everyone-do-this handout. If healthy lifestyle guidance is too big of a leap, overwhelming, or unachievable – patients often give up in frustration – it doesn’t really matter how scientifically credible it is. Our scientific know-how – no matter how advanced – doesn’t really matter much until someone is actually Using it to transform their health. Sustainable nutrition is about what a unique person can find, afford, prepare, and enjoy – on an ongoing basis.   

An SAFM education teaches practitioners to be savvy at lifestyle interventions. And they generously share their ideas and success stories with their peers. The pearls below are just a small, recent sampling of commonplace fare on our Practitioner Forum. This article is Part 2 of a three-part series.

Is your toolbox overflowing with tools like these? Will you add to it right now? Please do.  

Our movement for good medicine that actually prevents and reverses chronic disease – and the patients you’re passionate about serving – need You to be highly capable and confident in facilitating lifestyle change.

 

 

 

 

 

Part 2 – Food

Asking patients to change the way they eat or even worse, to go on a restrictive diet means we have to provide a lot of support with swaps that still allow them to enjoy their favorite dishes. From pasta to fries to cheese (yes, cheese), smart swaps enable clients to enact lasting changes which promote health.

Pasta and Rice

• “Foodles” – many people love pasta. They love feeling “filled up” and having a carrier for favorite sauces.  Many clients do well with a pasta replacement made from vegetables. Zoodles (zucchini), swoodles (sweet potato), sqoodles (squash) and many others. Suggest your patients purchase a spiralizer if they like the idea; it’s a fun family-friendly activity to make these noodles actually. Otherwise, most stores now carry pre-made Foodles in the produce aisle (more expensive but very convenient). Spaghetti squash (shredded with a fork after roasting) is always a great option too.
• Cauliflower rice – a winner for rice lovers. Start out by replacing half of the regular rice with riced cauliflower in recipes and work up to complete rice elimination. Buy frozen cauliflower rice to avoid the possibility of mold contamination and add it just in the last minutes of rice cooking for optimal texture.
• Shirataki / Miracle Noodles – convenient and made from konjac yam, a resistant starch, these can hit the spot for pasta and rice lovers. Prepare your clients for a different texture – these are a bit gelatinous and sticky and soften nicely when cooked in a sauce for at least 5 minutes. A great source of prebiotic fiber for the microbiome too.  Start slow, though, and build up to ensure they are well tolerated; begin with 1/4 or 1/3 of a bag if the diet has not yet contained much soluble fiber. In the US, stock up and save via online resources for healthy foods such as Thrive Market. 
• Bean and legume pastas – many varieties in a bunch of shapes – from spaghetti to rotini; have your clients try to find one that works for them. Popular brands are made from black beans, lentils and chickpeas. A high fiber, grain-free alternative to flour-based pasta. Great for kids too. 
• Veggie Extravaganza – as patients progressively reduce refined or excessive carbohydrates in their diet (especially in grains), they may enjoy trying a bed of various types of vegetables as a base for a sauce. Try chicken in peanut sauce on top of a mound of steamed broccoli or your favorite bolognese sauce atop a bowl of stir-fried green beans. There are endless, nutrient-dense and flavorful possibilities here!  

Potatoes and Fries

Perhaps the hardest food category for patients to shift. It’s just hard for many to say no to French Fries or roasted potatoes. But there are many substitution possibilities, including these below. Use melted ghee, coconut oil or avocado oil instead of highly refined vegetable oils. Roast, bake, or air fry for a crispy, nutritious side:

• Kohlrabi
• Celeriac root
• Parsnip
• Sweet potato
• Sunchokes
• Turnips

For a healthier mashed potato dish, substitute steamed cauliflower for half (or more – all!) of the potato. Whip (or for best results, cream in a food processor or with a hand mixer) until smooth with generous olive oil and ground pepper and salt to taste. For variety, try well-steamed turnip, parsnip, or kohlrabi as well – your clients will be surprised at the flavor in this swap!

Vegetables

An area most of our clients could benefit from much greater intake!  To increase both the amount and the variety of vegetables they consume on a day-over-day basis. Show clients how to incorporate veggies in unconventional ways. Yes, spinach and leafy greens in smoothies, but what about left-over cooked veggies in a breakfast scramble? Or in a lunch wrap?

• Frozen Freedom – one of the most accessible ways to introduce veggies into the diet:  ask clients to buy a bunch of frozen bagged vegetables and eat a bag a day. You can also stock up on favorite varieties when they are on sale. Help clients find a cooking method and spices that work for them. Steaming is quick and simple; an air fryer can add more texture. Be sure to include generous use of olive oil or ghee (for air frying, toss in the oil before cooking), a sprinkle of sunflower or pumpkin seeds or a healthy sauce to help take the edge off the bitterness, especially for tentative palates. An easy, customizable habit which can work 365 days a year.
• Crudité – why not clean and prep raw veggies just once or twice a week. Keep in containers in the fridge and use as snacks (with hummus, guac, or nut butter) or for quick meal prep. An easy answer to “mom, there is nothing to eat.” If clients struggle with this, encourage them to buy a prepared crudité tray from the grocery store. Do this prep with your kids; give them choices and make it fun by serving up different vegetables and dips in a muffin pan. Especially for adolescents, it’s a great opportunity to teach them about knife safety and involve their handiwork in the food (hint: they are Much more likely to eat it as a result of participating!).  
• Sweet Roasting – when we slow-cook vegetables in the oven (toss with oil and salt/spices and put on baking sheet or air fryer in a single layer) until they are just light caramelized, we free up the sugars in them and ease the bitter flavor of many vegetables, especially cruciferous varieties.  Many people will not come near steamed Brussels sprouts, but they will gobble up a bowl of roasted ones.  Try this for root vegetables too which become very sweet and creamy in texture.  Use avocado or melted coconut oil and roast at 375 or 400 degrees F. 
• Bagged salad – no need to be snobby. Bagged, prewashed leafy greens hold the key to salads, smoothies and quick meal prep. Salad kits are popular and are truly a 1-bag wonder – all the ingredients including the dressing included! Choose organic as these vegetables often carry a high pesticide burden.
• Veggie Steaks – ever heard of cauliflower steaks?  Well, most of your clients haven’t!  Slice to ½ inch thickness, coat with butter or oil, and roast with your favorite spices until quite tender. Ditto for portobello mushrooms. Makes a beautiful side or a centerpiece of a vegan meal.

Dairy

Those who love their milk, butter and cheese don’t need to suffer. The stores are filled with plant-based dairy replacements.  If they are dairy lovers, then the suggestion “just don’t eat it” is very unlikely to be successful.

• Non-dairy milks – the varieties are astounding. Make sure that your patients choose organic products without unnecessary glues and additives. Great as a base for smoothies, creating creamy sauces or soups, and with granola.  Making your own with almonds, cashew, or even brazil nuts  is fun and easy, but likely too daunting for those just exploring (to make your own, find copious guidance online; it only requires a mixing bowl, high speed blender, and cheesecloth). Many options are sold in cartons, but they often contain questionable additives/preservatives, including poor quality oils. Coconut milk out of a can is often a higher quality option. 
• Almond yogurt – while other dairy-free options are veterans in this category, many find that almond yogurt is the most like traditional dairy yogurt, especially Greek. Can also suggest cashew and coconut-based ones to see which variety hits the spot.
• Butter replacement – In the US, the Miyoko’s coconut/cashew brand is highly butter-like in all aspects. Seriously, this has been vetted by butter aficionados.  Clients won’t believe “it’s not butter”.
• Cashew or Almond cream cheese – many clients are not even aware these options exist!  In the US, Kite Hill seems to be the closest in taste and texture to a milk-based variety. Comes in many flavors too.
• Not-Missing-It Alternatives? – over time, patients who feel much better eliminating dairy from their diet tend to open up to other whole-food alternatives. So much of what we crave in cheese is about a rich, creamy, salty addition to a dish. Encourage them to try adding pine nuts, crushed cashews or hazelnuts to a savory dish; sauté them briefly in a little olive oil in a sauce pan with some spices (e.g. thyme, oregano), seasalt, and, if tolerated, a dash of nutritional yeast.  

Food Prep

Convenience is likely the #1 reason why a client will try a new food but eventually gravitate back to less healthy options.  You’ve got to get in front of this boomerang! Help your clients avoid situations where they have to create a meal from scratch on a daily basis. Bulk meal prep and smart shopping can help (don’t go grocery shopping while hungry!). These hacks can aid in throwing together a quick, healthy meal in a pinch.

• Cook once, eat many times, every time – leftovers are king. Make more than you need, repurpose leftovers or eat as is. Most food is safe in the refrigerator for up to 4 days (unless you have histamine intolerance). For favorite meals, make extra and freeze to forego food prep on future, busy days.
• Ready-to-go proteins – frozen fish filets, meatballs, and chicken sausages. Roasted prepared whole chicken from the grocery store.  Canned salmon and sardines. Canned beans and chickpeas (always rinse very thoroughly!). Choose organic, clean varieties. These provide a quick protein to build a meal around.
• Ready-to-go grains – frozen organic brown rice, quinoa, and wild rice can be used as a quick side dish or base for a grain salad. Don’t microwave in the bag – dump into a glass dish and cover with an unbleached paper towel instead.
• Sauces, dressings, and marinades – always have some on hand. Choose options that are “dump and go” – no need to add anything. Yes, over time, they can indeed make their own, but for many patients, they need more convenience upfront in order to explore and lock in new healthy habits.
• The night before prep – lay out the first meal “kit” before bed – e.g, clean blender or fry pan, measure and prep dry ingredients, clean and cut veggies/fruit and pre-assemble a smoothie to just stick into a blender in the morning. Having things ready in sight will also help discourage any impetus to drop a healthy intention and just grab a bagel or a donut on the way in to work. 

Smart Snacks

Everyone needs snack options, especially clients with hypoglycemia or poor stress resilience. A key to a smart snacking is to make sure it contains all three macronutrients – fats, carbs and protein – to provide satiety and blood glucose stability. Here is just a small sampling of snacks suggested by SAFM students pairing protein and fat with a fruit or a vegetable:

• pistachios & strawberries
• olives & baby bell peppers
• hummus & carrot sticks
• guacamole & crudité
• hard-boiled egg & grape tomatoes
• almond butter on apple slices
• grapes & cheese sticks
• turkey jerky with orange segments or cucumbers
• sunbutter with celery sticks

Desserts

An after-meal treat is almost a given in the Western diet. Lucky for our patients and clients, many healthy alternatives exist – deprivation not necessary. Look up some of the recipes for the items below and research widely available premade options to recommend. If there is a high demand for this in your practice, consider compiling a dessert recipe e-book or handout – your clients and patients will appreciate the healthy suggestions.

• Fresh fruit sautéed in a little coconut oil with vanilla extract and/or cinnamon (with a few drops of stevia or tsp. of honey if family members need it sweeter) and topped with some crushed nuts (and maybe a drizzle of melted dark chocolate?!). Try blueberries with almonds. Banana with walnuts. Nectarines with cashews. Figs with pecans.  Pineapple with macadamias. 
• Chia pudding (gets even better after sitting in the fridge for a few days)
• Avocado based puddings
• Frozen banana ice cream
• Fruit sorbet
• Fat bombs (great for keto)
• Nut and seed balls
• Frozen cherries and grapes (you can dip these in warm, melted dark chocolate too – a wonderful hot/cold treat)
• Or even just a square or two of organic dark chocolate. We recommend looking for 70% cacao or higher and a brand with as few ingredients as possible. Teach your clients that pleasure is about slowing down and savoring. Don’t “gobble” up a treat. Put a small bit of one square in your mouth and just let it melt. That one square can give you 5 seconds or 5 minutes of pleasure depending on How you enjoy it! 

And remember you can visit this clinical tip for an introduction and Part I of this series which features beverages.