How to Eat Well This Summer with Dietitian Beth Czerwony

Podcast Transcript

Deanna Pogorelc:  Hi and welcome to the Health Essentials podcast brought to you by Cleveland Clinic. I'm your host, Deanna Pogorelc, joined today by our guest, Beth Czerwony. Beth is a registered dietician in Cleveland Clinic's Digestive Disease & Surgery Institute. And today we're going to be talking all about how to navigate the joys of summer while still eating and drinking as healthy as possible. Welcome, Beth. Thanks for being here.

Beth Czerwony:  Thanks for having me.

Deanna Pogorelc:  Please remember, this is for informational purposes only and is not intended to replace your own healthcare provider's advice. So Beth, it's officially summer and there are so many amazing seasonal fruits that are available right now and vegetables. Can we start with your list of maybe your top five seasonal fruits and veggies that are going to be eating this summer and that we should all be eating this summer and why?

Beth Czerwony:  Yeah, absolutely. And I always think about gardening, right? So I don't know if a lot of people have started their gardens yet, but I always think about that, like the top things that we would normally have around this time of year. So of course, the first thing that I always think of is berry. There's so many different varieties between your strawberries and blackberries and blueberries, but those are always going to be in season. They're really low in sugar. They're high in fiber. So you always want to try to include berries throughout the day. Watermelon. Now finally it's summer. So it's hot enough. The watermelon is really, really good. What I really appreciate about the watermelon is because it's so full of water and fiber. That's what's going to fill you up and keep you fuller longer. And it's just going to be nice and hydrating. So try to get watermelon into the diet as well.

We're thinking about squash, right? So zucchini and summer squash. We just started planting those in the garden. So that'll be exciting when they start popping up. But what I like about those too, again, lots of fiber, but remember we always talk about those zoodles, right? Those zucchini noodles that we can make. And so lot of times people in the summertime don't want to eat very heavy. They want to eat a little bit lighter. So you can always convert that summer squash or that zucchini into those zucchini noodles and be a little bit healthier that way. I'm thinking ahead too of cucumbers. So cucumbers, again, another thing that we get it year round, but really it's something that is really great in the summertime. Lots of water, lots of fiber, but not a lot of calories. So those are probably my top five that we want to try to include into your diet now that it's summertime.

Deanna Pogorelc:  Are there any specific benefits of eating produce that's in season or produce that local from our neighborhood farmer's markets?

Beth Czerwony:  Yeah, absolutely. I think it's really important that first of all, that we always support our local farmer's markets. I mean, it's really very, very important. But when we're thinking about location and things that are going to be close to us, time is of the essence. So when we have something that we get from the farmer's market, typically it's picked that morning, which means that it's going to end up saving a lot of... It's going to be a little more cost effective, right? Because you don't have to worry about the transportation and the cost with that. But the nutrition is going to be there because when we have to pick and pack and then transport, the nutrition gets lost over time.

So eating seasonally and also eating locally means that you're going to get more nutrition and you're going to be able to preserve that a lot faster. So yeah, absolutely. I mean, we're very, very fortunate that we do have produce that we can get all year round, but again, it could be from across the country. And like I said, if you're going to sit there and it's going to take weeks before it gets to you, you've lost some of that nutrition.

Deanna Pogorelc:  Summer also means heat, which means we need to be hydrated. Do we need to be drinking extra fluids during the summer or about the same as we usually do?

Beth Czerwony:  So I think it's really important that we always try to maintain our hydration. A lot of times people think that we don't need to drink more in the winter time or if we're in the air conditioning in the summertime, those types of things. But the air conditioning certainly can dehydrate us, that cooling of that air can dehydrate our skin and dehydrate our mucus membranes. So it's really important that we stay hydrated throughout the year. Typically we recommend four water bottles, 64 ounces a day. It depends. Everyone's different. You might need a little bit more fluids depending on your own personal needs if you're taking extra kind of medications, that type of thing. But it's really important that you make sure that you not only are hydrated, that you stay hydrated, but that you are drinking throughout the day so that you're not just going all day and then try to over hydrate because it's really not going to be as beneficial as if you stay hydrated the entire day.

Deanna Pogorelc:  What are some of the signs that you might be dehydrated?

Beth Czerwony:  Yeah. Unfortunately people end up being dehydrated and not knowing. It's very subtle. It comes on. And then by the time that you are dehydrated, like I said, it makes it hard to kind of double up and catch up. So typically the first always sign that we always look for is decreased urine output. So you haven't gone to the bathroom all day. When you do, the urine is dark colored. That is a very common sign of being dehydrated. But there's also other subtle signs. So you might have dry skin or maybe you have cracked lips. You may have a headache. You might feel dizzy. You might feel nauseous. Your blood pressure may drop. So when you get up, you feel, like I said, lightheaded or dizziness. Some people get sunken eyes. I mean, that's a little bit more severe cases. Might be confused.

So I think it's really important that you pay attention to other people and kind of notice and keep it to... Especially for the elderly, sometimes their decreased sense of thirst is really subtle and they don't know that they're thirsty and then they could go all day and not drink anything. And then, like I said, so then you can see some little changes. With my patients, it's very, very easy. Again, I work in the Bariatric & Metabolic Institute. So it's very easy for patients to get dehydrated because the volume is very limited. So encouraging. I always tell people that you want to be a sophisticated houseplant. And I know that sounds really silly, but when you think about it. So I am the worst. When I go on vacation, I water all my plans and I hope for the best. And then when I get back from vacation, there's that dried crust and you try to water it and then the water goes all over the place. And then it just takes a while for the soil to soften and to get rehydrated.

The same thing with our bodies. So you can't go all day long and not drink, and then think that you're going to be able to at the end of the night hydrate, because you're going to end up staying up all night, going to the bathroom and it's really not beneficial. Your body really needs to be hydrated throughout the day. So I know that's a really silly way of thinking about it, but it makes sense when you kind of do think about it a little bit.

Deanna Pogorelc:  Absolutely. And is plain water always best even if it does maybe get a little boring sometimes?

Beth Czerwony:  I mean, ideally yes. We like to be as pure as we can. Water is going to be the best. But let's be honest, not everybody likes plain water. So it's fine if you want to infuse it with flavors. Again, use those berries, use those cucumbers, use citrus. Back and jazz it up a lot without adding extra sugars or artificial colorings or those types of things.

What you really don't want is you don't want to do a lot of sodas and juices and extra calories and those types of things. I discourage a lot of times to the sports drinks, unless you are really being very, very active, you're sweating profusely for many, many hours. I think a lot of times people drink the sports drinks maybe because they're out for an hour or so and they really think that they needed. And they really don't. For the most part, water is really going to be your best. But like I said, if you are perhaps a teenager and you're at football practice for hours and hours and hours, and you need to replace some of those electrolytes, that might be warranted, but most of the time water really is going to be the best. But you just have to get a little bit creative if you don't like the plain water.

Deanna Pogorelc:  Sure. And can certain foods be hydrating also? You mentioned watermelon a little bit earlier. Are there others?

Beth Czerwony:  Oh, absolutely. Fruits and vegetables in and of themselves do contain a majority of their volume is going to be water, which is the fiber in the water is really what helps keeps us full when we're eating those fruits and vegetables. So berries, melons, cucumbers, iceberg lettuce. Who would have thought, right? A lot of people think that it doesn't really do us any good. It's mostly water. So yeah. So really trying to get a good variety of fruits and vegetables. Because again, if you don't like water, this is a good way to get some extra fluids into your body without feeling like you have to drink that four bottles of whatever it is.

Deanna Pogorelc:  Yeah. So while we're talking about beverages, I want to ask you about smoothies because they can be so refreshing on a hot summer day. What are your components of a good, well balanced smoothie?

Beth Czerwony:  So I'm always going to be a fan of some sort of protein. If you know me at all, that's kind of the first thing I ask everybody is, where's your protein? So having some sort of Greek yogurt, or I have different kinds of milk, almond milk, those types of things. So really a good base. What we want to make sure we don't make it into so much sugar because we can add fruit. Too much of a good thing is still too much of a good thing. So we don't want a lot of fruit from the sugar. So if we can do more vegetables, so we can do kale and spinach and those types of things. That would be a good base because what happens is any time that we take that fruit and we break it down and we put it in the blender and we blenderize it, it we're breaking down that fiber. And the fiber is again what's going to keep us full.

Fiber also helps with blood sugar control. It helps regulate the blood sugar a little bit better. It also helps decrease cholesterol with the insoluble fiber and the soluble fiber. So again, we want to maintain the integrity of the fiber as much as we can. So just limiting how much I think is important too. And if you can do lower glycemic fruits, things like berries and melon, that's going to be a little bit better than if you were to do like papaya or banana or pineapple. Those have a little bit higher sugars. Any of those tropical fruits have a little bit more sugar, so I would avoid those.

Deanna Pogorelc:  Okay, great. So another great part of summer is the cookouts. And can we talk about making good choices while grilling out? What's your approach to going to a cookout? I want to enjoy this great grilled food, but also want to make good choices.

Beth Czerwony:  Absolutely. So again, if anybody knows me, and I talk a lot about this, because I really do enjoy cooking. I love it a lot. I always like to bring something. I like to be a good guest. I like to help the hostess. So a lot of times I will bring either a vegetable platter with some dip or some fruit, that type of thing, because then at least I know that those are some safe options, right? So then we can go to that.

I don't have to be tempted with maybe the potato salad or the heavier dessert or those types of things. So I think having a game plan first and foremost is really important. Bring something with you.

I think I always like to peruse the cookout. I like to see what is being offered, right? Because a lot of times I see people, I see my family, myself. I can't say I haven't done it. Well, you take the plate and you start to start filling food up on the plate because everything looks really good. And then you really wanted something, but there's more room on your plate, right? And so maybe putting it on top or whatever. So I think if you can actually stand back and look and see what's being offered, you're going to make better choices because there might be something you're like, "Give or take, I don't really care about that. I really want to make sure I eat this."

So I think by really going back, having that plan, filling up a lot, if you can, and again, those fruits, those vegetables, that's going to be a really good way. And I think just portioning it out. If you want to taste something, that's fine. Don't think that you have to have a big mound of everything just to kind of try it out. And then take your time. I know it's really hard. Don't go hungry. I think a lot of times we want to make sure we have enough room to eat everybody's good food. But if you go so hungry, you're going to have a really hard time making good choices because you're going to think that you're overly hungry, and then you're going to end up overeating.

Deanna Pogorelc:  Yeah. So when it comes to that, kind of the main dish of the grill out, what we're throwing on the grill, the meat, the meat substitutes, what are some of the healthiest choices that you would recommend?

Beth Czerwony:  There's so many good options out there. What we typically recommend is if you want to have a lean cut of meat, it's going to be a center cut. It's not going to have a lot of that marbling. I know that's where the... Fat is flavor, and I get all that, but try to really eliminate the amount of marbling that's in within something. Like I said, a loin or around for beef. Same thing with pork would be fine. Any of your poultry. And then of course your fish or seafood, and then your plant alternatives, those plant-based protein burgers that are coming out that are super popular. Now there's lots of varieties out there. So those are going to be better choices. Again, if you want to get a heavier fatty or meat, I would say maybe really decrease the frequency or certainly decrease the amount that you're having.

Deanna Pogorelc:  Yeah. And what about those side dishes? Which ones are you avoiding and which ones are you going to?

Beth Czerwony:  They can get us every time. You can have great intentions. So I think the best really is if you can get some sort of vegetable salads, broccoli salads. Radishes are a good contender. Fruit salads, those types of things. Those are going to be the ones that we kind of want you to focus a little bit more. Avoiding things that are going to be a little bit of fattier kinds of things. So if there's mayonnaise-based, if it's higher fat, certainly things with butters and sauces and those types of things. So you want to avoid them. Don't think that it's insulting to ask how things were made. I think that's important too, because if you know that maybe that's something you don't necessarily want to have, you can enjoy a couple of bites of it and not feel so terrible that you are giving up on those things. But again, I think it's just important to ask, see how they're made, and then just really kind of just portion it out.

Deanna Pogorelc:  Okay. So with cookouts, I often wonder about the food safety aspect of it because sometimes we cook things and then they just sit there for hours and hours and we pick at them. And so how long food safely sit out, especially if it's hot outside?

Beth Czerwony:  Yeah. So when we're talking about food sanitation, food safety, there is a term that we use called the food temperature danger zone. And so that is 40 degrees to 140 and that's where the food should not be. So we want foods to be under 40 degrees. We want food to be over 140 degrees and we don't want food to sit out in that food temperature danger zone for two hours or more. So you really want to make sure that you make food in small batches, that you bring it out to keep it hot. But again, even if it's kept hot, you want to make sure that you take it, you wrap it up and you cool it pretty quickly.

One of the ways that a lot of times that I like to store food when it's out is I had to take a nice ice bath underneath the food to keep the salads to be cold. Then you're less likely to be worried about them being in the food temperature danger zone. But again, I think it's really important too that when we're cooking the meats that you cook the meat thoroughly. When you're putting the food on the grill, you use one set of utensils. When you take the cooked meat off the grill, you use a different set of utensils. You really want to decrease the chances of cross contamination. You want to cook your foods thoroughly. And I know sometimes that can be really time consuming, but especially when we're looking at poultry, we want to make sure that it has at least an internal temperature of 165. You really don't want to end up giving your guests food poisoning. I don't think they're going to want to come back, right?

Deanna Pogorelc:  Right. So I also want to ask you about vacations because I think people's vacations are going to look maybe a little bit different this summer. We're still in the middle of a pandemic. So maybe less air travel, maybe more road travel.

Beth Czerwony:  Absolutely.

Deanna Pogorelc:  So if people are going on a road trip, and they're in the middle of nowhere, they got to stop at a gas station or hungry, what are some of the best options we can find in a gas station or a convenience store?

Beth Czerwony:  Yeah. I mean, I think things are a lot better than they used to be. I think more people are traveling. So there's a lot better options than there may be used to be. So it's not just, so I'll get a cup of coffee, a donut, maybe a bag of chips. Now they're having more options. So a lot of the time convenience stores, gas stations will have a cooler. I've seen hard boiled eggs already premade and packaged up yogurts, string cheeses, beef jerkies. Those are all going to be really good choices. Fruit. Who knew that gas stations and convenience stores now are going to have whole pieces of fruit? So grabbing a couple of pieces of fruit, packages of nuts, or maybe some nut butters, those would all really be good options. They have lots of different protein bars or snack bars that are a little less sugar, higher protein, higher fiber. So those are all going to be really good grab and go options.

Deanna Pogorelc:  Okay. And what about camping? What are some healthy, maybe shelf-stable things we can bring as a snack on the trails or to cook around the campfire?

Beth Czerwony:  So as a former Girl Scout leader, this is my area of expertise. So we would camp and those girls, we would be prepared. So I think again, being prepared, making sure you know how long are you going to go for, how many people are coming, making a lot of things ahead of time. I think that's going to save a lot of time, a lot of space because you really don't want to have to sit there and make a lot of food and have a lot of scraps left over. So, you can do a lot of foil packets on the fire. You could grill trail mix rather. It doesn't have to just be raisins and M&Ms and nuts and those types of things.

You can do things like popcorn. You could do things like dried cereals and seeds. I'm a big fan of dehydrated fruit versus dried fruit. You're going to have less sugar. You're going to have a little bit more fiber than the traditional dried fruit. Who doesn't love little bit of chocolate, right? So you do a little bit of those mini chocolate chips instead of doing a lot of the chocolate plus your hands don't get dirty because it doesn't melt, those types of things.

So I think camping is actually going to be more popular because you are going to be more socially distanced from other people. We can still get out and enjoy. But again, you just got to be a little bit smarter about how to pack because you're not necessarily going to have a convenience store or a grocery store down the street from where you're camping. So you got to make sure you bring everything with you.

Deanna Pogorelc:  Right. Great. Well, thank you so much. Is there anything else we didn't talk about that you think is important to talk about when it comes to summer nutrition?

Beth Czerwony:  No. I think the biggest thing is just thinking ahead and planning. We always get ourselves maybe in a little bit of a trouble because we're kind of going on the go. We don't think ahead. You never want to be in a position where you can't make good choices because you didn't have anything with you. So having a little cooler with you I think is important. Even if you want to just take a day trip and just go for a drive someplace, having a little bit of a cooler and keeping all your beverages in there or some snacks, I think that that would be a good idea too. So just doing things to take care of yourself I think is really going to be an important thing, especially during this pandemic.

Deanna Pogorelc:  Great. Well, that was super helpful as always. Thank you so much for being here.

Beth Czerwony:  Thank you.

Deanna Pogorelc:  For more information on nutrition therapy, visit clevelandclinic.org/nutrition, or to speak with a dietician or make an appointment, call 216-444-3046. And for more podcasts with our Cleveland Clinic experts, visit clevelandclinic.org/hepodcast or subscribe wherever you get your podcasts. You can also follow us at Clevelandclinic, one word, on Facebook, Twitter, and Instagram for more health tips. Thanks for joining us.