Flavorful, Healthy Almond-Crusted Tilapia

Tilapia is a good source of lean protein. In fact, the 2010 Dietary Guidelines for Americans recommend eating eight ounces of fish each week to help prevent cardiovascular disease. The best part? This rich, nutty-flavored recipe tastes delicious and its three easy steps takes just minutes to prepare.

Ingredients:

• 1/4 cup whole natural almonds
• 2 tablespoons dry breadcrumbs
• 1 teaspoon salt-free garlic and herb seasoning blend (such as Mrs. Dash)
• 1/8 teaspoon freshly ground black pepper
• 1 tablespoon canola oil
• 1 tablespoon Dijon mustard
• 2 (6-ounce) tilapia fillets
• Chopped fresh parsley (optional)

Preparation:

1. Place first four ingredients in a blender or food processor; process 45 seconds or until finely ground. Transfer crumb mixture into a shallow dish.
2. Heat oil in a large nonstick skillet over medium heat. Brush mustard over both sides of fillets; dredge in crumb mixture. 
3. Add fish to pan; cook for three minutes on each side or until fish flakes easily when tested with a fork. Sprinkle with parsley if desired.

Nutritional Information
Amount per serving

• Calories: 367
• Calories from fat: 47 percent
• Fat: 19 g
• Saturated fat: 2.1 g
• Monounsaturated fat: 10.6 g
• Polyunsaturated fat: 4.8 g
• Protein: 38.9 g
• Carbohydrate: 9.9 g
• Fiber: 2.5 g Cholesterol: 85 mg
• Iron: 1.3 mg
• Sodium: 321 mg
• Calcium: 28 mg

Total preparation and cooking time is 11 minutes.

This recipe is courtesy of Cooking Light Fresh Food Fast, Oxmoor House (2009).

Drinking Alcohol after Weight Loss Surgery

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains how to incorporate alcohol in a healthy diet after weight loss surgery.

People considering weight loss surgery often ask if it is possible to safely incorporate alcohol into a healthy diet and lifestyle after surgery. The short answer is “yes,” but gradually and with modifications. Here’s why:
       
Altered metabolism
Research shows that blood alcohol levels peak higher and faster and take longer to return to normal due to altered metabolism after gastric bypass surgery. In addition, many post-surgical patients consume less food when they’re drinking alcohol, which contributes to expedited absorption of alcohol in the blood stream. For many post-surgical patients, all it takes is a single drink to elevate blood alcohol level to the point of legal intoxication. This is important to remember for maintaining a healthy diet and before getting behind the wheel.

Low blood sugar
Rapid weight loss and low carbohydrate intake can lead to reduced sugar or glycogen in your body. Alcohol consumption further depletes glycogen, which causes your blood sugar levels to drop, putting those who have had bariatric surgery at higher risk for developing low blood sugar.

Hypoglycemia, or low blood sugar, is a dangerous condition that can lead to loss of consciousness, brain and nerve damage or even death if left untreated. As a result, it’s important to be on the lookout for symptoms, which include loss of coordination and balance, slurred speech, poor vision and confusion.

If you experience symptoms of hypoglycemia, drink diluted juice or take a glucose tablet immediately to raise your blood sugar level, and then have a snack with complex carbohydrates and protein to sustain it. If hypoglycemic episodes occur frequently even without alcohol consumption, make sure you seek proper medical treatment.

Excess calories
Alcohol is high in calories and low in nutrients, which is why excess calories from alcohol can slow weight loss or even contribute to weight gain. 

Addiction transfer
Patients with a history of addiction are at higher risk for developing a new addiction. With the dramatic reduction of food consumption after bariatric surgery, some patients may trade their food addiction for other addictive behaviors, including drugs, shopping, gambling, sex and alcohol.

Guidelines for drinking:
Follow these guidelines to re-introduce alcohol without compromising your commitment to a healthy lifestyle after weight loss surgery:

• Avoid alcohol for the first six months after bariatric surgery.
• When you get permission to start drinking alcohol again, avoid carbonated beverages and sugary drink mixers. 
• Remember that after surgery, even small amounts of alcohol can cause intoxication and low blood sugar. 
• Never drink and drive, even after consuming only minimal alcohol. 
• Only drink with meals or while eating to help slow absorption of alcohol. 
• Be aware of the calorie content of alcohol.
• If you find yourself drinking regularly to cope with emotions or stress, seek help by consulting with your doctor.

- Cara Stewart

Healthy Bites for People on the Go: Meal and Snack Bars

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains the nutritional value of meal and snack bars and provides a guide for making healthy selections. 

It can be hard to fit healthy eating into a busy lifestyle. Between work, family, social obligations and more, sometimes it feels like there’s not enough time to prepare or sit down for a healthy, balanced or home-cooked meal.

But a shortage of time does not mean you have to sacrifice your commitment to healthy eating!

In fact, snack and meal replacement bars are perfect items to stock up on for those moments when you’re strapped for time and need a healthy bite to eat. They are easy, convenient, portable and if you make smart choices, they can be healthy, too.

From breakfast bars to granola bars to energy bars and protein bars, it’s hard to know which variety is the best, most healthful choice. The wide variety of bars on the market can make selection overwhelming and it doesn’t help that many bars masquerade as healthy despite being packed with sugar and fat.

Use this guide to find a healthy snack or meal replacement bar for the next time your stomach is grumbling but you’re on the way out the door.

Meal Replacement Bars
These bars are ideal when you’re in a rush and otherwise would skip a meal. Look for the following nutritional requirements per serving when making a selection:

• 200 to 300 calories
• At least 15 grams of protein
• At least 5 grams of fiber
• Less than 20 grams of sugar (Less than 10 grams of sugar for people who had gastric bypass surgery)
• Less than 10 grams of total fat
• Less than 2.5 grams of saturated fat

Snack Bars
Snack bars are great for quenching hunger between meals or as fuel before a workout. Make sure that your snack bar contains the following nutritional requirements per serving:

• 150 to 200 calories
• At least 5 grams of protein
• At least 3 grams of fiber
• Less than 15 grams of sugar
• Less than 7 grams of total fat
• Less than 2 grams of saturated fat

These general considerations are helpful to keep in mind when deciding which meal or snack bars to purchase:

• Bars that are low in carbohydrates are generally low in fiber or high in fat, especially saturated fat. Be careful that you’re not trading one unhealthy nutrient for another.
• Some bars, especially those that are low in sugar and carbohydrates, contain sugar alcohols, which can cause bloating, gas and diarrhea.  
• Bars that contain fruit naturally have more sugar. With fruit bars, you can be more flexible with the sugar content per serving.
• Pay attention to flavor and consistency. Make sure that you actually enjoy the taste of the bar!

Snack and meal bars made specifically for people who have had bariatric surgery are available on the following websites:

• BariatricAdvantage.com
• BariatricChoice.com
• BariatricEating.com
• DoctorsBestWeightLoss.com

- Cara Stewart, RD, LDN

Buon Appetito: Eggplant Parmesan – the healthy way

An Italian favorite, Eggplant Parmesan is typically made with fried eggplant and loads of high-fat cheese – a dieter’s nightmare! But there are ways to modify the recipe so it fits into your healthy diet. To reduce the calories, fat and sodium while retaining the flavor, try this healthy recipe for Eggplant Parmesan.

Ingredients:
Eggplant

• 2 large eggs, lightly beaten
• 1 tablespoon water
• 2 cups whole-wheat panko (Japanese breadcrumbs)
• 1/4 cup (1 ounce) grated fresh Parmigiano-Reggiano cheese
• 2 (1 pound) eggplants, peeled and cut crosswise into ½-inch slices
• Cooking spray

Filling

• 1/2 cup torn fresh basil
• 1/4 cup (1 ounce) grated fresh Parmigiano-Reggiano cheese
• 1/2 teaspoon crushed red pepper
• 1 1/2 teaspoons minced garlic
• 1/4 teaspoon salt
• 1 (16 ounce) container part-skim ricotta cheese
• 1 large egg, lightly beaten
• 1 (24 ounce) jar premium pasta sauce
• 1/4 teaspoon salt
• 8 ounces thinly sliced mozzarella cheese
• 3/4 cup (3 ounces) finely grated fontina cheese

Preparation:

1. Preheat oven to 375 degrees.
2. Eggplant: Combine 2 eggs and 1 tablespoon of water in a shallow dish. Combine panko and 1/4 cup Parmigiano-Reggiano in a second shallow dish. Dip eggplant in egg mixture; dredge in panko mixture, pressing gently to adhere and shaking off excess. Place eggplant slices 1 inch apart on baking sheets coated with cooking spray. Bake at 375 degrees for 30 minutes or until golden, turning once and rotating baking sheets after 15 minutes.
3. Filling: Combine basil, Parmigiano-Reggiano cheese, red pepper, garlic, salt, ricotta cheese and egg.
4. To assemble, spoon 1/2 cup pasta sauce in bottom of a 13 x 9 inch glass baking dish coated with cooking spray. Layer half of eggplant slices over pasta sauce. Sprinkle eggplant with 1/8 teaspoon salt. Top with about 3/4 cup pasta sauce. Spread half of ricotta mixture over sauce and top with a third of mozzarella and 1/4 cup fontina cheese. Repeat layers once, ending with about 1 cup pasta sauce. Cover tightly with aluminum foil coated with cooking spray. Bake at 375 degrees for 35 minutes. Remove foil; top with remaining third of mozzarella and 1/4 cup fontina cheese. Bake at 375 degrees for 10 minutes or until sauce is bubbly and cheese melts; cool 10 minutes.

Nutritional Information:
Amount per serving

• Calories: 318
• Fat: 15.1 g
• Saturated fat: 8.2 g
• Monounsaturated fat: 2.7 g
• Polyunsaturated fat: 0.6 g
• Protein: 19.3 g
• Carbohydrate: 26.8 g
• Fiber: 4.8 g
• Cholesterol: 99 mg
• Iron: 1.6 mg
• Sodium: 655 mg
• Calcium: 365 mg

The recipe yields 10 servings. Serving size is one slice. Preparation time is one hour and 45 minutes.

This recipe is courtesy of Kathy Kitchens Downie, RD, Cooking Light (September 2010).