Black Bean Patties

28oz         Canned No/Low Sodium Black Beans

1 ea          Red Bell Pepper, diced

1 ea          Small Yellow Onion, diced

3 ea          Garlic Cloves

2 ea          Whole Eggs

½ C           Oat Flour

1 Tbsp     Worcestershire Sauce

1 Tbsp     Olive Oil

1 tsp        Cumin

1 tsp        Chili Powder

1 tsp        Garlic Powder

1 tsp        Paprika

1 tsp        Salt

1 tsp        Black Pepper

8 ea          Iceberg Lettuce Leaves, for lettuce wrap

1. Preheat oven to 325 degrees. Drain and rinse Black Beans, then pat dry with a paper towel. Spread Beans on a baking sheet and bake for 10-15 minutes until slightly dried out.
2. Chop Red Bell Pepper by removing the stem, seeds, and pith, then cut into small dices and add to a bowl.
3. Remove both ends and outer layer of onion, then cut in half through the ends. Dice Onion into small pieces then add to the bowl with the Bell Pepper.
4. Roughly chop 3 Garlic Cloves, then add to the bowl.
5. Heat 1 Tbsp Olive Oil in a medium saute pan, then cook Onion, Pepper, and Garlic for about 5-6 minutes until soft and translucent. Add Cumin, Chili Powder, Garlic Powder, Paprika, Salt, and Pepper and stir until all veggies are coated.
6. Transfer sauteed veggies to a food processor or blender and pulse until almost paste-like. Pour into a bowl and mix in the Eggs, Worcestershire Sauce, and Oat Flour.
7. Add in the Black Beans and mash them with a fork, leaving some larger chunks of Beans for texture.
8. Form into balls using about 1/3 Cup of mixture for each. You should end up with 6 and any leftover mix can be spread into each of the balls. Form the balls into patties then transfer patties to a baking sheet lined with parchment and bake at 375 degrees for 10 minutes on each side, flipping them will help both sides get that crispy texture.
9. Use the Lettuce Leaves to wrap 2 of the patties for your meal. Allow the rest of the patties to cool completely, then wrap them individually with plastic wrap and freeze for up to 3 months. Reheat the frozen patties in the oven, microwave, air-fryer, or even on the grill!

Chicken Salad

8 oz Chicken Breast

2 Stalks of Celery

3 Tbsp Chopped Parsley, save the rest for seasoning the chicken

½ Cup Whole Grapes

¼ Cup Sliced Green Onions

1 Lemon, cut in half

½ Cup Chopped Unsalted Almonds

¼ Cup Plain Nonfat Greek Yogurt

2 Tbsp Avocado Mayo

1 tsp Dijon

¼ tsp Salt

¼ tsp Black Pepper

1. Before preparing our salad, we will need to fully cook the Chicken Breast. You can do this any way you would like, but I will describe the poaching method. If you have a large Chicken Breast, cut it in half and place it into a medium pot. Cover the Chicken with water and add half of the lemon to the water, as well as a few stalks of parsley. Turn the heat to medium-high and bring the water to a simmer. Once simmering, reduce heat to medium and continue cooking for 10 to 15 minutes, or until chicken reaches 165 degrees. Remove Chicken from the water and place onto a plate in the refrigerator to cool.
2. While the chicken is cooking and cooling, we will prepare the vegetables. Start by cutting the Celery into thinner sticks, then dicing into small pieces and add them to a mixing bowl.
3. Remove a small handful of tops from the Parsley and give it a rough chop, then add 3 Tbsp to the bowl.
4. If you purchased whole Almonds, carefully chop them into ½ cup of finer pieces with your knife, or mash them with a bowl. You can also pulse them in a food processor if you wish. If you purchased already chopped Almonds, simply add ½ cup to the bowl.
5. Add ½ cup of Whole Grapes to the bowl as well. If you wish to cut them in half instead, feel free. I prefer the “pop” of Whole Grapes in my Chicken Salad, but the choice is yours.
6. Slice ¼ cup of Green Onions by starting at the green end and making very thin slices until your reach the thick white end. Discard the white ends and add the sliced Green Onions to the bowl.
7. Add ¼ cup Greek Yogurt, 2 Tbsp Avocado Mayo, and 1 tsp of Dijon to the bowl.
8. At this point, the Chicken should be cooled. Dice the Chicken into ¼ inch chunks and add them to the bowl.
9. Squeeze the other half of the Lemon into a smaller bowl, remove any seeds that may have fallen in and add the juice to the salad bowl. Then season everything with a pinch of Salt and Pepper.
10. Use a rubber spatula or spoon to mix everything together, making sure to incorporate all of the “saucy” ingredients as well. Once you have everything evenly distributed and mixed together, you can eat it as is, or add it to salads, sandwiches, or wraps! Keep in mind, the Nutrition Facts only cover this recipe, so be sure to account for any added ingredients like bread or tortillas. Enjoy!

Chicken Tostadas with Guacamole

3 Cups             Roasted Chicken, shredded

6 ea                 Tostada Shells, or 5-inch Corn Tortillas

1 ea                 Avocado

2 ea                 Roma Tomatoes

1 ea                 Small Yellow Onion

1 ea                 Lime

3 Tbsp Fresh Chopped Cilantro

3 Tbsp             Queso Fresco or Cotija Cheese

¾ Cup              Refried Beans, Fat Free or Lowfat

1 tsp                Cumin

1 tsp                Chili Powder

1 tsp                Salt

1 tsp                Olive Oil

1. For this recipe, we will use a whole pre-roasted Chicken. You can find these in the deli area of most grocery stores. This will help cut down on prep time, as well as leave you with plenty of leftovers for other meals. Start by pulling the meat from your favorite section of the Chicken. Be sure to remove the skin and any bones that may be hiding. Tear 3 cups of meat into smaller chunks or strips, season with Cumin, Chili Powder, and Salt then set aside, reheating if necessary.
   
   
2. For the Tostadas, you should be able to find them premade in the tortilla aisle. If you cannot find precooked Tostadas, you can use 5-inch corn tortillas, however this will require a little extra oil. To make your own Tostadas, preheat your oven to 400 degrees. Lightly brush or spray both sides of the tortillas with Olive Oil or Cooking Spray and place in a single layer on a baking sheet. Bake for 3-5 minutes, then flip them over and cook for another 3-5 minutes, or until crispy like a tortilla chip and let cool.
   
   
3. Next, place the refried beans into a small pot and warm over low heat to prevent them from burning. If they seem too thick, you can add 1 tbsp of water to loosen them up. Be sure to stir them every few minutes.
   
   
4. Now we will prepare the Guacamole. Cut the Avocado in half all the way from top to bottom, circling the pit. Twist both halves of the Avocado to separate them, then lightly chop the pit with you knife and twist to remove. Scoop out the Avocado and place into a medium mixing bowl. Cut the Lime in half, then squeeze the juice over the Avocado. Use a fork to mash up the Avocado and mix the Lime Juice in to make a paste and set aside.
   
   
5. Dice the Tomatoes and Onion into small cubes. Add ¼ Cup of each into the Avocado and save the remainder for a little extra topping. Remove the Cilantro leaves from the stems and roughly chop the leaves into a small pile. Add 2 Tbsp of Chopped Cilantro to the Guacamole mixture and save the rest for topping as well. Add a pinch of Salt to the Guacamole, then mix it all together with a spoon.
   
   
6. To build your Tostadas, gently spread 1tbsp of Refried Beans onto the shells. Add ½ Cup of the seasoned Chicken to each shell, then add a scoop of Guacamole on top of that. Top the Guacamole with some Fresh Tomatoes, Onions, and Cilantro, if you wish. Lastly crumble 1 tbsp of Queso Fresco or Cotija Cheese over the top of each Tostada and enjoy! (Feel free to jazz them up with your favorite homemade Salsa or Hot Sauce, but this will change the Nutritional Value accordingly.)

Check out the cooking video here!

On The Go Breakfast Burritos

3 each             Red Potatoes, small dice

1 each             Bell Pepper (any color), small dice

1 each             Yellow Onion, small dice

2 Cups             Spinach

4 each             Sausage Patties or Faux Sausage Patties

1 Cup               Egg Whites

1 tsp                Olive Oil

½ tsp               Salt

¼ tsp                Black Pepper

½ tsp               Garlic Powder

1. Cut potatoes into ¼ inch circles, then cut them into ¼ inch cubes. Heat a pan with 1 teaspoon of Olive Oil over medium heat and add the diced potatoes to the pan. Stir them around to make sure they get coated in a thin layer of oil to prevent burning. Cover the pan with a lid to create steam and continue cooking the potatoes while you prepare the other ingredients.
2. Dice the onion by removing both ends, then slicing it in half through the root ends. Cut the onion into ¼ inch slices, then rotate the onion and slice the other way to create ¼ inch dices. Add them to the pan and cook with the potatoes.
3. Cut the Bell Pepper by removing the top. Pull out the center seeds with your fingers, then remove as much of the white pith as you can. Turn the Pepper upside down over the garbage and lightly tap the bottom to knock any extra seeds loose. Cut the pepper in half through the bottom, then cut it into ¼ inch slices. Dice the slices into ¼ inch pieces and add them to the pan.
4. Add Sausage Patties to the pan and break them into smaller chunks as they cook. Faux Sausage is usually already pre-cooked, so you’ll only need to heat them until they are hot enough to eat. Raw Sausage Patties will need to be cooked until fully browned.
5. Add the Spinach to the pan and cook until wilted.
6. Turn heat to medium-low then add the Egg Whites. If you are using whole eggs, separate the yolk from the whites by cracking 6 eggs into a bowl, then gently scooping the yolks out with your loosely cupped hand or half of an eggshell. You can also use liquid egg whites in a carton if you are going for simplicity. Season with Salt, Pepper, and Garlic Powder.
7. Once the Egg Whites are in the pan, let them cook for about 20 seconds before stirring. This will help you get nice chunks of Egg instead of little pieces. You can also cook the eggs separately in another pan if your wish.
8. Heat a tortilla in the microwave for 10-15 seconds to get it moist and warm. Add about 1/3 of the burrito filling into the tortilla right in the center. Fold the sides into the middle nice and tight against the filling, the fold the bottom flap all the way over the filling, tight once again, then roll it the rest of the way, tucking in any extra flaps as you roll. Now you’re ready to enjoy, or wrap it in tin foil and freeze until your ready to eat again!
9. To reheat, place in the oven at 400 for 10-15 minutes or until warm in the middle. You can also microwave it instead, but be sure to remove it from the tin foil first.

Game Changer

People often ask me what is different about my program than other “diet” programs.  Why will my program work when all others have failed them?  What special food do I use, what magic pill do I prescribe, what cleanses, shakes or juices do I have that will do the trick? 

The answer is complicated because humans are complicated.  Any program that offers a simple solution is probably not all it promises to be, except if that promise is a box of food and an empty wallet.  What I offer is a solid understanding of human physiology and how to use your body’s normal responses to get to your desired outcome: weight loss. 

This is different for every person and there are so many variables (food, medicines, exercises, hormones, etc.), but a simple example is using intermittent fasting to specifically reduce insulin levels which improves weight loss. 

Intermittent fasting has been used for centuries by many different cultures for health and religious reasons.  It simply refers to a time where a person abstains from eating.  In the Muslim religion, Ramadan is a good example.  During the time of Ramadan (April in 2022), Muslims do not eat from the hours of sunup to sundown.  In the U.S., intermittent fasting is often used for health purposes with common periods of fasting lasting 16 to 24 hours. 

How does it work?  Each time we eat, we cause our insulin levels to go up.  How high and how fast the insulin spikes are dependent on the food we eat.  A loaf of bread will cause insulin to go up faster and higher than an apple.  Insulin is the fat storing hormone in the body.  It allows our body to bring glucose from the bloodstream into the cells and store the extra calories (energy) as fat in our cells.  We would die without insulin.  It is what allows us to store energy (fat) for use in times of famine or starvation. 

However, insulin also has a secondary effect.  When insulin levels are elevated, it does not allow us to access our fat stores for energy.  Insulin is focused solely on storage of energy.  Most of the time this would be fine as usually when your insulin levels are high you have just eaten and have plenty of energy from the calories you just ate.  However, we are now finding significant numbers of people who are insulin resistant and have elevated levels of insulin all the time.  This means they cannot access their fat stores for energy, making it hard, if not impossible to lose weight. 

Correctly identifying and treating people with insulin resistance is crucial to their success in weight loss.  Many of these patients have diabetes and pre-diabetes, however a portion do not and only show elevated insulin levels or blood sugars that easily rise and fall.  By running the appropriate tests and determining a patient’s insulin sensitivity, I can make recommendations that will drastically improve their likelihood of long-term successful weight loss. 

One dietary treatment is intermittent fasting.   Intermittent fasting allows insulin levels in the blood to fall and the body to access fat stores for energy.  The longer the time in the fasting phase, the longer the body has access to fat storage.  This not only leads to weight loss but improves the body’s sensitivity to insulin when it is present, reducing patients’ Hemoglobin A1C’s (average blood sugars over 3 months).  Intermittent fasting can even help prevent diabetes. 

When I talk with patients about intermittent fasting, I help them understand that there are many ways to go about their fasting periods.  Many are worried about being hungry or “starving” and certainly, that is NOT our goal.  In fact, diets that cause the body to go into “starvation mode” – such as many very low calorie, prepackaged fad diets cause the body’s metabolic rate to slow way down.  This is the opposite effect of what happens with intermittent fasting when properly done under a physician’s supervision.  Our goal is to increase your metabolic rate (burn more calories) while allowing your body to access your fat storage for the additional energy it needs.  No one needs to “starve” and there are many tools to help you achieve your goals such as proper meal timing, maintaining hydration and electrolyte levels and even foods such as FAST bars. 

Intermittent fasting isn’t for everyone, but it is one tool in a wide selection of helpful techniques known to physicians practicing medical weight loss.  So, when people ask how my program is different, my answer is that knowledge is the game changer.  Having a physician’s understanding of human pathophysiology and additional training in obesity medicine is the magic bullet.  After that, success involves just a tincture of time and a motivated patient.

Eating healhy doesn't mean you can't enjoy your favorites! This goes great with a little bread or soft pita chips.

1 lb                  Extra Lean Ground Beef (90% lean, 10% fat)(Alternatively, you can use 1 lb Impossible Beef or even Ground Turkey)

2 Medium       Zucchini

1 Small            Yellow Onion

5 ea                 Button or Crimini Mushrooms

4 ea                 Garlic Cloves

8 oz                 Fresh Spinach

24 oz               Organic Marinara

8-10 ea            Fresh Basil Leaves

1 Cup               Low-Fat Cottage Cheese (optional)

¼ Cup              Shredded Parmesan (optional)

1. Start by cooking the Ground Beef in a large skillet until browned and all fat has been rendered out. Pour Beef into a strainer to drain any excess fat. Do not dump the fat into the sink, as it can clog your drain. Instead place a bowl under the strainer to catch the fat, then dump into the garbage once it has cooled. Save the meat in the strainer for now.
2. Cut your Zucchini by slicing it in half lengthwise, then into ¼ inch half moons and discard the ends. Place Skillet back onto medium heat, add the Zucchini to the pan, and let it cook.
3. Dice the Onion by removing the top, then cutting it in half through the bottom root. Lay one half of the Onion flat, then make ¼ inch wide cuts towards the root, but do not cut all the way through the root end. Then cut perpendicular to you first slices as close to the root as you can. Discard the root and add the diced Onions to the pan, then repeat with the other half of the onion.
4. Remove the stems of the Mushrooms simply by pulling or cutting them off. Cut the top of the Mushroom into quarter inch slices, then roughly chop up the stems and add it all to your pan.
5. Mince the Garlic by chopping them into very small pieces and add them to the pan.
6. Roughly chop the Spinach by piling it up and cutting until they are about ½ inch pieces, then add them to the pan.
7. Deglaze the pan by pouring in 3 Tablespoons of Balsamic Vinegar. Allow all your veggies to cook for 5 or 6 minutes to get rid of their excess moisture and absorb the Balsamic Vinegar flavor.
8. Once all your veggies have become soft, pour in the Marinara sauce and stir to coat all the veggies, and bring to a simmer.
9. Once the sauce begins to simmer, add the Ground Beef From earlier and continue cooking everything in the Marinara for 3 or 4 minutes. This will help the sauce thicken and absorb into all of the ingredients.
10. While everything in the pan is cooking, pluck about 8 to 10 Basil Leaves and stack them on top of each other like a deck of cards. Roll them into a tube then slice down the tube of Basil until you have a small pile of Basil strips, then add them to the pan and stir it up. Cook for another 2 minutes or so to thicken the sauce to your desired consistency.
11. At this point we will add our cheeses if you are choosing to use them. If not, reduce the heat to low and let it cook slowly. If you are adding cheese, spoon a few dollops of Cottage Cheese around the top of your Lasagna. Then sprinkle ¼ cup of Parmesan all around the top.
12. If your pan is safe to put in the oven, place it on the bottom rack and set your broiler to the lowest setting. Close the oven and melt the cheese. Broilers can be tricky to gauge, so be sure to check on it every 30 seconds or so to make sure it doesn’t burn, but a little bit of browning and bubbling is ok. Remove from the oven once cheese is melted to your preference.
13. If you do not feel comfortable placing your pan in the oven, you can also just place a lid on top of it and reduce the heat to low and allow the steam to melt your cheese.
14. Once the cheese is melted, you can scoop yourself a serving of this tasty One Skillet Lasagna and garnish it with some leftover Basil or just eat it as is. There should be about 4 to 5 servings in this pan, depending on your appetite, so eating about ¼ of the pan will be between 450-550 calories. Enjoy!

My last day of work was April 3^rd, 2021.  I remember it well.  I went home and poured my husband and I a shot of Johnny Walker Blue that we had bought for the occasion.  It was a celebration of the end of my clinical career in medicine.  Over a decade gone since I graduated residency.  Down the hatch it went, burning the whole way down. 

That nasty turpentine like taste stayed with me long after that night.  In fact, whiskey happened to be a great metaphor for my last 10 years in medicine.  It’s sterile, hard to swallow, heartburn inducing nature is either something you can get used to or a bitter liquid that gets harder to choke down every day.  Indeed, medicine today has gone so far away from the sweet, bubbly, prosecco like quality that we all either remember or expected to find that I doubt you could locate anyone other than medical students who are still excited about the practice.  The ability to save someone’s life, change someone’s family tree or work with them to meaningfully improve their quality of life lies in stark contrast to the day-to-day existence of documentation requirements, billing and coding denials, HIPAA regulations, organizational KPIs, online training, etc. etc. etc. 

No one really knows when the wine changed to whiskey, but the insidious nature of it indicates it started with our language.  Years ago, when physicians were owners of their clinics and leaders of their hospitals, people were patients and not customers.  Patients were neighbors, friends, coworkers, and family.  Doctors provided care, not services.  Surgeons performed surgery, not billable procedures. The focus was on how people felt, not outcomes.  The language described what people did, not what insurance billed. 

When our language changes, so does our perspective.  With layers of administration, come new terms like ROI, value-based care, market share, etc.  Business terms previously had no business in the doctor patient relationship and in my mind, they still shouldn’t.  We all know this instinctively, so we change our wording to make the words that burn more palatable and easier to swallow.  Sales becomes marketing, payment becomes compensation, and mistakes become medical errors.  In the numbing process, we lose the humanity of medicine.  Hugs become handshakes, time in the room gets shorter and everyone feels rushed.  No one (doctor or patient) feels heard.  Interactions become about conveying information and less about the feeling and living.

April 3^rd, 2021 was my last day of work.  My last day of working within a system designed to separate the patient from the doctor.  After 8 months of decompression, deep introspection, and a lot of long runs, I was ready.  In 2022, I started a clinic designed to strengthen the doctor patient relationship.  Discreet Reductions is my answer to the question “What will I do now, now that I can do anything?”.  There are no layers of staff between myself and my patients.  When you call, you talk to me.  If you email or message through the patient portal, I answer.  I take your vitals, examine you, listen to your concerns and dispense medications and advice.  Discreet Reductions is not a business, but a passion project about bringing the joy back to medicine for both the patient and the doctor.  I want to show the world that the impossible can be done.  That medicine is not a business but can pay a fair wage.  That we should work towards improving health, not treating disease.  That while the doctor customer relationship burns, the doctor patient relationship can still effervesce. 

I know a lot of people struggle with fitting in exercise into our day-to-day activities.  It seems almost impossible to carve out an extra 30 minutes to an hour from an already jam-packed day.  As someone who has run almost every day for the past 26 years, I can honestly say it’s not always easy to find the time.  However, through the years, I have learned some tips/tricks to make exercise happen. 

First, schedule it!  Treat exercise like any other appointment on your calendar.  Treat it like your job or your haircut, dentist visit, or kid’s after school play.  You wouldn’t just blow off your job for a week or two at a time randomly, would you?  You wouldn’t just no show your dentist, right?  Exercise is as critical to your health (or more) as getting your hair cut, keeping your teeth clean, or any other regularly scheduled appointment.  The only difference is that it needs to happen a lot more frequently.  Each week, look at your calendar and plan those appointments with yourself.  If you have an erratic schedule, this becomes even more important.  You may decide to just wake up earlier in the morning, because there are no guarantees after 8am.  You may need to put it on the calendar after the kids go to bed or you may need to change it depending on the day.  It doesn’t have to be pretty, it just has to get done.

Second, no backsies!  After you make the commitment, stick to it.  If I say I’m going to run tomorrow at 6:30a, I will be running tomorrow at 6:30a.  Nothing short of fire raining down from the heavens is going to stop me.  I don’t leave it to my 6:30am self to decide anything…ever.  I know that if I consider not running even a little, my 6:30am self will abandon all hope, pull the covers up and snuggle in.  I have even slept in my running clothes to ensure that I would get that run in.   Some common excuses that go through my brain are the weather (too hot, too cold or really any form of precipitation – even if just predicted, but not actual), feeling too tired, my day is so busy, or I might be getting sick.  I remind myself frequently that I won’t melt in the rain, that the extra 30 minutes of sleep isn’t going to make me bright eyed, and bushy tailed, and that my day will still be busy whether or not I go for this run.  The key is to not think about it.  The only exception I ever make is illness.  I have a rule that if the symptoms are from the neck upwards (headache, stuffy nose, etc.) then I’m going for a run.  If the symptoms are from the shoulders down (body aches, cough, etc.) then I give myself a pass.  It’s rare that I’m sidelined for illness because most of the time, the symptoms are usually in my head – real or imaginary ;).

Lastly, be consistent!  I generally go for a run every day.  My default is to run and if don’t, it’s because we have something on the calendar that makes it reasonable to take a day off.  For example, I may run 10 days in a row, but on the 11^th day I’m getting up early to fly to a conference, so I let myself take the day off.  However, it’s planned well in advance.  I know that I’m traveling that day and I have exercised every day that week already.  Every day I plan for exercise regardless of where I am or who I am with (traveling for work, visiting family, on vacation, etc.).  Being consistent is critical to success for a couple of reasons.  First, and probably most importantly, it means you don’t lose ground on your goals.  If you take a few days or a week off randomly here and there, it’s easy to slide backwards.  If you are consistent with exercise every day (even when you don’t want to), at a minimum you will maintain what you have.  Second is that the body loves routine.  You will get stronger, find it easier to lose or maintain your weight, and sleep better at night with daily exercise.  It will become like brushing your teeth – a weird uneasy sensation will wash over you when you accidentally skip a session.  Finally, to quote Simon Sinek: “Consistency is more important than intensity” in achieving our goals.  We all know that the person that works out once in a while, hard core for 45 minutes is not going to achieve nearly as much as the person who works out every day for 20 minutes.  The key to progress is consistency.  It’s not sexy or glamorous and some days, it’s a grind.  However, it’s showing up on those days when you don’t want to, putting in those workouts consistently day after day that make change happen. 

This idea that “consistency is more important than intensity” applies to every part of life and I got to experience this again recently with my German language studies.  As some of you may know, I’m relearning German to speak with my 7-year-old Godson who lives in Germany.  I lived there briefly in college in a study abroad program where I had a semester’s worth of German before I left (to say I was an A1 level learner was a stretch).  The levels are A1, A2, B1, B2, C1, C2 with C2 being a native language speaker.  The girl who was my roommate while I was there became my best friend and we have been best friends ever since.  She spoke Ukrainian, Russian and German at the time (no English), so my German improved rapidly and by the time I left 3 ½ months later, I was a level B1.  Over the next 20 years she learned English (and Polish) and I forgot German. 

When my Godson was 6 and speaking full sentences, I decided it was time to relearn German.  I realized I hadn’t learned anything in 20 years, despite saying I would – so I scheduled classes.  I also paid for these classes, so there was no excuse good enough for me to miss them.  I started in A2 and quickly remembered a lot of what I had forgotten and over the course of 6 months moved back into B1.  However, over the last 6 months the struggle has been real.  I’ve been stuck in B1, despite taking a 1-hour class per day and sometimes 2 hours on the weekends.  I have thought more than once that maybe I will never become fluent and should just give up and get an hour of my day back.  However, I have been reminding myself that if I keep showing up and learning every day consistently, I will get there eventually.  After a rough 6 months, I’ve finally had some breakthroughs.  Akkusative and dative cases are making more sense, my vocabulary is expanding, and B2 is getting closer by the minute.  The key has been and will always be to be consistent, especially when times are tough. 

So, as we go forward, I hope you can use these tips to help motivate and sustain you on your health journey.  It’s not always easy, but being consistent and showing up every day for yourself will get you where you want to go.  Lass uns gehen!

Orders that are placed between Monday and Friday will ship out within two business days, and orders placed over the weekend will ship out by Tuesday. There are exceptions to this based on unforseen circumstances including inventory, personnel and shipping delays.

We strive to keep our costs low so we can pass these savings onto our customers. As a small, locally owned business, shipping costs are by far our most significant expense. We will always try to accommodate returns within 14 days of delivery, but unfortunately do need to charge for return shipping (unless the product was damaged during shipping). Once products are opened we are unable to accept them for return. Items that are damaged in shipping may be returned, but please take pictures of the damaged items so we can make a claim with our shipping service. We will ask for pictures of the damaged product as well as pictures of the damaged shipping box. If your items were damaged in shipping we must be informed within 5 business days of delivery to be able to submit a claim and accept your return. In the event of package theft, we are not liable for replacement. The carrier (UPS, Fedex, USPS, etc) will also not assume liability for the loss. After the package is successfully delivered to your address the carrier and Discreet Reductions are no longer liable for package loss. If your package notes as "delivered" but the package was not delivered to your address, please let us know and we will open a claim with the carrier. At our discretion we may hold on issuing a replacement or refund until the carrier completes their investigation (as if they determine your package was stolen from your property they will not reimburse us for the claim). Thank you for your understanding.

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Have you ever heard of a “crime of opportunity”?  It’s a crime that is unplanned but happens when the perpetrator is in the “right place at the right time” to take advantage of a situation for their benefit.  While it has a negative connotation, I often look for “activities of opportunity” in the winter.  

For those of us who are not really into winter sports, December through April is a pretty rough time.  There’s usually a fair amount of snow and going outside in the cold can be quite unpleasant, especially when temperatures hover in the single digits.   After months working out inside, around February, the treadmill at the gym starts to look pretty boring.   If you’re anything like me, soon my motivation wanes and the cookies add up.  

However, opportunities to change things up while still getting in a great workout for free do exist!  You just need to remain vigilant and open minded.  For example, this morning I walked out on my driveway to 9” of new snow that had fallen overnight.  On any other day, this amount of snow could provide me with a decent 15-minute cardio workout.  However, I had the unfortunate luck of getting a new plow guy that piled up 5 feet of that snow onto a portion of my driveway…the portion I need to use in order to get out of my garage.  Sigh.

I was feeling rather burned out of treadmill running anyway, so I picked up my shovel and got to work.  An hour later the snow was relocated, and I had a great workout!  My back, arms and chest muscles are sure to be sore tomorrow, but I gave my legs a day off and feel mentally refreshed.  

Snow shoveling isn’t the only “activity of opportunity” in the winter though.  The possibilities are endless if you’re willing to bundle up and get moving.  We took our dogs out for a longer walk in the deep snow last night before the plows came through and our German shepherd loved it!!  Walking through deep snow requires significantly more leg strength and endurance than walking on a treadmill or around a track.  Use this to your advantage to improve your workout while taking in the fresh air and getting a little sunshine.

Digging out your car (or someone else’s) can snag you 5 minutes of cardio up to a couple times a day and may even give you the warm fuzzies in the process.  Pulling your kids around in their sled or building a huge snowman can get your heart rate up quickly.  Chopping or carrying firewood can be a chore…or a great opportunity to move around and work on your upper body strength.  Finally, cleaning up after everyone tracks in the snow and wetness into the garage or entry way by mopping, vacuuming or sweeping can add another 5-10 minutes of unplanned activity.  

The biggest thing is to keep your eyes open for these opportunities and take advantage of them when they arise.  Keep your planned daily physical activities going, but don’t be afraid to sprinkle in some good old fashioned outdoor chores regularly. 

Lately, every time I go to the grocery store, I feel like prices have gone up.  Everywhere I look, foods that used to be “cheap” are suddenly marked up and stores seem to be holding fewer sales.  For the sales they do hold, I feel like these were the same prices a year ago when the items were NOT on sale. 

Unfortunately, according to the Consumer Price Index, my instincts might be right.  Prices for food have gone up 7% in the last year and certain categories have been hit harder than others - meats, poultry, fish and eggs are up over 12%!

For many, this has placed additional challenges on already strained budgets.  One of the most common refrains I hear now is that it’s too expensive to eat healthy.  However, when I say that doesn’t have to be true, I’m met with skeptical glances and side eyes…

From a bird’s eye perspective, fruits and vegetables are up only 5.6% year over year.  When compared with other categories, these may be less of a financial strain.  Pantry staples such as grains, beans, and legumes also remain more modestly priced and can be bought for pennies in the bulk section.  Both categories are full of fiber, vitamins, and minerals and are part of a healthy diet. 

However, the temptation for some people may still remain with “cheap” fast food.  After all, we all remember the dollar menu at the McDonald’s drive through.  Even though that’s long gone, some people point to the daily deals and value meals as cheaper options.  However, to prove this is not actually the case, my husband volunteered (meaning raced right over to the closest McDonald’s) to order a value meal for a side-by-side comparison.

On the day he shopped, it was “buy one, get one” Big Macs.  He bought two Big Macs, a medium fry and medium diet Coke for $9.38.  The total calories: 1,420 with 55g protein. 

The next day we went shopping for the makings of a tuna melt.  We went to Natural Grocer’s to look for high quality ingredients and tried not to purchase anything on sale.  We bought Dave’s Killer 21 Grain Burger Buns (160cal, 5g protein.  $5.85/8 = 73 cents), a can of Wild Planet albacore tuna (150cal, 32g protein.  $3.79/can), and Natural Grocers brand Cheese (1 oz – 110cal, 7g protein.  $6.36/8oz, 79 cents).  We used 1 tbsp of Mayo from the fridge (100cal, 0g protein) and a bag of Proti Chips (120cal, 14g protein. 10/$14 or $1.40).  For the tuna melt, we paid $6.71 and the total calories: 640cal with 58g protein. 

For these two meals, the tuna melt from home was $2.67 cheaper.  We also tried to get a deal at McDonalds and tried NOT to get any sales and buy only the highest quality, most ethically sourced food possible at Natural Grocers.  However, you can definitely find tuna, cheese and whole wheat bread for cheaper if saving money is the priority!  The tuna melt also has more protein, less saturated fat, less cholesterol and less sodium.  Plus, the tuna melt won’t set you back on your weight loss goals and it’s easy to throw together.  You can buy multiple cans of tuna, a block of cheese (or slices), and a package of whole wheat buns to make the entire week’s meals. 

If you wanted to step up your game even more, consider making a soup or stew from scratch.  A homemade lentil vegetable soup can be made over the weekend and frozen in lunch size portions to pull out of the freezer anytime during the week.  The recipe linked below costs $16.85 for all the ingredients (minus a few pantry staples) or $2.10 per serving.  Each serving is 475 calories with 21g of protein and 8g of fiber.  If your blood pressure is a concern, omit or reduce the salt and/or use low sodium broth. 

https://www.foodnetwork.com/recipes/ina-garten/lentil-vegetable-soup-recipe-1948822

McDonald’s meal:  $9.38 per serving

Homemade Tuna Melt with Chips: $6.71 per serving

From Scratch Organic Lentil Soup:  $2.10 per serving

Ultimately, it’s almost always cheaper to eat from home and definitely a lot healthier!  When doing your shopping for the week, plan for easy to make sandwiches or prep a large meal to break into lunch sized portions to reheat throughout the week.  With a little preparation, you’ll avoid paying more for food, both now and later.

It's time to stop trying diets that do more harm than good.

The year is 10,000 BC, a time when sabertooth tigers and wooly mammoths are still walking the earth. Humans lived in small tribes, and survived off of a hunter and gatherer lifestyle. The men would traditionally hunt, while the women would gather berries, fruits, plants and other food sources that they could find. Food wasn’t a guarantee, and no one ever knew for sure when they would have their next meal.

Luckily for the human race, our bodies are experts at preserving energy so we can stay alive when times are hard. Our resting metabolic rate is the number of calories we burn while we are sleeping, resting or not moving. Commonly referred to as our metabolism, this has the ability to be turned up or down, depending on whether food is scarce or plentiful at the time. 10,000 years ago, this was integral to the survival of the human race. Unfortunately, the evolution of our bodies has yet to catch up with our current lifestyles where calorie rich foods are readily available. As such, it continues to be easy to turn down our metabolisms, but much more challenging to turn our metabolisms up.

Why is this important? Our resting metabolic rate determines the minimum number of calories we need a day to maintain our weight. If your resting metabolic rate is higher, you burn more calories on a daily basis when you’re doing absolutely nothing. If it’s lower, you need to eat significantly fewer calories than another person in order to maintain your weight.

Thanks to evolution, when you starve your body for calories it goes into survival mode and turns down its metabolism. A modern day example of this is the popular TV show from the 2010’s called “The Biggest Loser”. Contestants would go on very low calorie diets and exercise in order to lose weight. And it worked! Of 16 contestants who participated in a scientific study during their time on the show, they lost an average of 128 pounds. However, this weight loss came at a cost.

During their time on the show, these contestants on average decreased their resting metabolic rate by 600 calories a day. That means in order to continue losing weight, they had to eat 600 fewer calories a day than they did prior to joining the show. Six years later, well after the show ended, the scientists who conducted the study followed up with the contestants. Six years after the show was over, the contestants had gained back 90 pounds of the weight they lost. Despite this, their basal metabolic rate was 700 calories lower than it was before they started the show. That was even lower than it was when they were on the show!

We have heard from our patients time and time again the same story:

"I did one of the very low calorie diet plans for 6 months, and during that time I lost 60 pounds. But the diet wasn’t something I could keep doing, and when I stopped the diet I gained back all the weight. And I didn’t just gain back the 60 pounds I lost, I gained an additional 15 pounds on top of it”

 Why is this? Because they significantly decreased their basal metabolic rate while on the very low calorie diet. When they started eating a normal diet again, their body immediately began storing the extra calories as fat. And it continued to do so. Our bodies still think it’s 10,000 years ago, and our body is worried that soon there won’t be enough food and it wants to store every calorie it can for when that day comes. Even though the diet works initially, it sets your body up for long term weight gain when you return to a normal diet.

That’s why we specifically recommend against very low calorie diets. Diets of 600 or 800 calories a day will lead to rapid initial weight loss, but this is not sustainable life long for most people. Rather than looking for the rapid, short term fix, we focus on strategies you can use life long to steadily lose weight and then maintain your goal weight. Through intermittent fasting you decrease your daily insulin spikes (which in turn leads to less fat storage). And through exercise and building lean muscle, you can increase your basal metabolic rate. This allows you to eat more calories, not less, and maintain your goal weight in the future.

Before you consider a very low calorie diet, pre-packaged food based diet or other “fad diet plans” out there come sit down with Dr. Katherine Dietrich to talk about other strategies that are going to work better in the long term.

I’ll admit, I did about as much research into this topic as it takes to do one of those little scratcher lottery tickets at the local gas station.  A couple swipes back and forth and you know you’ve lost the game.  The reason I didn’t have to do much research though, was that the results were obvious as soon as I started scratching the surface.  Based on what I found, protein products on your grocery store shelves are disappointing at best and dangerous at worst.  Read on to understand what exactly is going into your OTC supplements.

Protein bars and shakes are a go to for a lot of people nowadays.   We keep them at work, in our cars, backpacks, gym bags, purses, and in the pantry for easy go to snacks for both kids and adults.  Ideally, they’re jam packed with vitamins, nutrients, and a good amount of protein to keep us fueled for a few hours while we are running during the day.  However, many come with added sugar,fat, excess calories,and some even come laced with heavy metalslike arsenic, lead and cadmium. 

This actually came to light over 10 years ago when Consumer Reports did an expose on Muscle Milk, EAS Myoplex, GNC, and several other well-known protein supplements. They found dangerous levels of contaminants including arsenic, cadmium, lead, and mercury in multiple supplements that could easily exceed maximum limits with normal daily intake of these supplements.  (https://www.consumerreports.org/cro/2012/04/protein-drinks/index.htm).   Unfortunately, the FDA does not require that dietary supplements like protein shakes and bars be tested to ensure they are safe and free of contaminants.  Many of these supplements do not list where they source their ingredients on their websites and, to cut costs, will source from questionable protein supply sources, such as many Chinese manufacturers.  In looking briefly into Muscle Milk, I found they were owned by Cytosport Inc. (which also makes Monster Milk and Cytomax brand), which was acquired by Hormel Foods Corporation which was then acquired by PepsiCo Inc.  Having trouble keeping up?  Yeah, me too…. I couldn’t find on any of their sites where they source their protein from and considering the results from the Consumer Reports study (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7509468/) I’m very concerned the right hand may not know what the left hand is doing.  Plus, I didn’t see any third-party certification of safety and purity such as GMP or NSF anywhere on their websites.

Since the Consumer Reports article came out in 2012, there are some new tricks being played on the public by protein companies.  In 2015, a lawsuit was filed against several major companies alleging a practice called “protein spiking” where cheaper non-protein substances are added to fool lab tests into indicating higher protein levels in protein products (  https://www.forbes.com/sites/alexmorrell/2015/03/12/lawsuits-say-protein-powders-lack-protein-ripping-off-athletes/?sh=594eebb07729).  CVS Health, Giant Sport, Body Fortress and MusclePharm are some of the companies named in the lawsuits.  In one test, a supplement containing “High Quality Protein” contained less than half of the protein it advertised.  Worse yet, the newest concern is for hydrolyzed leather protein (from animal skin scraps) being added to supplements from China and Hong Kong to increase the protein content.  The scraps often contain metallic contaminants that are unfit for human consumption.

After being thoroughly horrified by the protein powder industry, I decided to check out protein bars.  While I didn’t find multiple lawsuits on the first page of Google, what I did find was, in many ways, just as bad.  I haven’t purchased an over-the-counter protein bar in quite a long time so I decided to see if the protein bar selection had improved in the last 10 years.  I went to Natural Grocers on 24^th Street and picked up every protein bar they had to do a side-by-side comparison. 

Despite being labeled words like “healthy”, “natural”, “low glycemic”, and “the ultimate energy bar”, these bars were no better than most candy bars.  I included a chart below of the bars I picked up, but specifically I wanted to call out Clif Protein Builders bar.  They are labeled as “low glycemic” with 17 grams of sugar and ALL of it is added sugar…for shame Clif Builders, for shame!  The American Heart Association recommends a maximum of 24 grams of sugar (6 tsp) per day for women.  One of those bars and a teaspoon of honey and you’ve hit your maximum quantity of sugar consumption for the day!  Just for fun, I looked at a couple of my favorite candy bars and Kit Kat has 220 calories with 21 grams of sugar.  A snickers bar is 250 calories and 25 grams of added sugar.  If you’re going to eat candy, it might as well be real candy.

When I compared any of the grocery store bars to one of the DR bars, there was no comparison.  Calorically, each of the grocery store bars were significantly higher and often contained much more added sugar.  The only one that even came close was the Think High Protein Bar in Cookies and Cream Flavor.  Though topping out at 100 calories more than DR Vanilla Choco Protein and tasting like someone put chalk in a blender with a little glue, I’m not sure “close” is the right word. 

They say “you get what you pay for” and everything I am seeing in the protein supplement industry tells me that is true.  Over the counter/grocery store protein bars and shakes are often a little cheaper, but the safety of the product and the nutritional value is questionable at best.  If you’re going to use supplements to help navigate our crazy busy lives, I would highly recommend purchasing medical grade nutrition supplements from reputable companies like Celebrate, Robard, and Bariatrix.  Sure the packaging isn’t as flashy and you won’t see them on TV, but they often taste better, are lower calorie, have higher quality protein and are third party vetted, so you know they are safe.