The cost of good health…

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. 

 Two Big Macs Pic 2 e

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. 

Tuna Melt Pic e

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.

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.

The Road Less Traveled

This month I traveled to Germany to see family.  Between having family in multiple different countries (not to mention both coasts), vacations, work and medical education, I actually travel quite a lot – usually 1-2 times per month.  However, after so many years of practice, I feel like I have healthy living in any city down pat.  This trip was something special though…it was as if all the years of practice and training left me the second the plane took off.   

It started with not having much of a plan.  I had been so busy the last 2 months at work that I hadn’t gotten around to planning anything around our trip to Germany beyond booking the flights and a car.  I even forgot to book a hotel for parts of our stay.  I certainly didn’t look at the towns where we were going and forgot to see if the hotel had a gym.  (It didn’t, BTW).  After a really busy last week at work, packing and cleaning furiously on Saturday, we headed to the airport Sunday morning only to be turned around for a 6-hour delay as our flight got bumped.  We normally don’t eat in the morning, but since we had ample time, the trip started with brunch at Sophies.  Somehow with the travel, we ended up catching a late dinner in SLC and most definitely were not within an 8-hour window.  The next morning, we were up early and started the epic adventure that is traveling to Europe.  A very long red eye and multiple plane meals later (as you know, not my recommended meal plan) we arrived and had a 3-hour drive to Gernsbach.  We arrived at the hotel, tired, somehow hungry again despite multiple meals and not exactly sure what day it was.  Apparently committed to bad decision making at that point, we had a multiple course meal with wine and then went to bed.  Exercise had not even crossed my mind.  We also made the rookie mistake of going to bed later than we should have and ended up sleeping 14 hours until noon the next day.   Yes, you read that right, noon…

We had planned to go to Baden-Baden about 45 minutes away, so after a quick breakfast, we hopped in the car and headed over.  Again, exercise somehow got pushed back another day.  The next day we made it out of bed at 10a but had to pack and wanted to take advantage of the free hotel breakfast.  I figured I would get in a run when we got to our family’s house in Köln that afternoon, but what is normally a 3-hour drive turned into a 5-hour traffic nightmare on the autobahn.  We ended up just driving to a local restaurant they suggested to have dinner with them.  It was a lovely meal, but we had anticipated a healthy, home cooked meal and once again were thwarted from our good intentions by time and circumstance.  The next day I did manage to sneak in a run, but it was the only one for the entire trip.  We normally plan the days’ schedule in advance of our trip (the Germans are known for their love of plans and schedules ;) and we had forgotten to check in with them.  They had a full calendar for us!  Beyond the normal family brunch and visits, champagne and wine with friends, there was a 4 hour visit to the local pumpkin patch for my 7-year-old Godson complete with delicious German pastries.  There was also a 6-hour trip to pack medical supply boxes for the Ukrainian relief in Köln, and a 6-hour dining event at a famous local restaurant complete with 6 courses and wine pairings. 

Everything was amazing and so much fun, I don’t regret a minute of it!  However, the reality of the week’s culinary events and sedentary lifestyle hit me as we embarked on our 22-hour duration flights home.  A series of flights that, once again, I hadn’t planned for as I usually do with a more prolonged fast or at least some healthy meal options.  I realized that I was NOT looking forward to getting back to the grind and losing those pounds that found their way on while I was on my 10-day culinary world tour. 

However, this is not my first misadventure.  While I normally plan well ahead to avoid airport food, get daily exercise, and keep to an 8-hour eating window, I know that 10 days of poor eating and no activity does not end in complete destruction of a healthy lifestyle.  It may feel like it when you get started again, but the reality is that I can apply myself to my normal routine and be back on track within a month.  The first few days are always tough with a lot of fresh salads and sluggish workouts, but ultimately, I will feel much like myself again in a week or two.  

Why do I tell you this?  Because I want you to know that we all make mistakes.  No one lives perfectly and a healthy lifestyle SHOULD have occasional bumps in the road that make you go off course.  If I look back in my life, the best times were often when I did something I probably shouldn’t have (i.e. staying up too late with friends, going to that concert the day before a big test, etc.).  A little misadventure now and again is good and the road less traveled often comes with wonderful surprises and memories.  Often, I hear patients talk from an “all or nothing” perspective, but it’s what we do on a day-to-day basis that really matters.  It's being consistent with healthy decisions the MAJORITY of the time that makes for a healthy life.  It’s getting to the gym or going for that walk 5 times a week, consistently getting 8+ hours of sleep, or making good food choices 85% of the time.   It’s the day-to-day choices that shape us and make us who we are. 

I can’t tell you the last time this happened (definitely not in recent years), but I can tell you it will happen again at some point and I’m glad.  A perfect life is not worth living and black forest cake enjoyed together with your 7-year-old Godson is priceless.  My life lesson: take the road less traveled occasionally but make healthy choices daily.  Viel Spass!

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Very Low Calorie Diets - More Harm Than Good

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.

What is Sleep Hygiene?

What is “Sleep Hygiene”

The term “Sleep Hygiene” is all too well known to anyone who has ever struggled with insomnia, or poor sleep in general. Whether it was with your doctor, or doctor google, you invariably have come across this term at some point while researching what you can do to sleep better. And if you happen to take a board licensing exam, the answer to the question of improving sleep is in fact sleep hygiene, and not prescription medications as one may believe.

So first off, let’s talk about insomnia versus non-restorative sleep (or poor sleep as it’s called). Insomnia can be short term (less than 3 months) which is often in response to a life stressor, or it can be chronic. Chronic insomnia is defined as difficulty falling asleep or maintaining sleep more than 3 times a week for longer than 3 months. Difficulty falling asleep means it takes longer than 30 minutes to fall asleep, and difficulty maintaining sleep means you spend more than 30 minutes awake each night after having been asleep for a period of time. In addition to the difficulty sleeping, this lack of sleep must impair your day-to-day life. This can be through daytime fatigue, mood swings, increased errors, poor concentration, etc.

True chronic insomnia is less common than people who intermittently have difficulty sleeping. Remember, you need to have problems more than 3 times a week, for longer than 3 months, for it to meet criteria. And it has to impact your day-to-day life. For true insomnia, the best treatment we have is cognitive behavioral therapy in addition to improved sleep hygiene. For the more common condition of difficulty with sleep, that’s where sleep hygiene can play a major role.

So what is sleep hygiene? It’s practices you can utilize to try and improve sleep quality while limiting the time it takes to fall asleep. As you’ll see below, many of these come down to common sense. But if you truly think about how often you or people you know follow these practices, you’ll be shocked just how uncommon that common sense may be.

Sleep Hygiene Recommendations



 Regular bedtime and rise time

This seems simple enough, but it’s harder in practice. It means going to sleep every night at the same time (let’s say 10pm) regardless of what you’re doing. It also means getting up at the same time, even if it’s the weekend and you can sleep in, or if you were up the whole night before.

Avoid napping

Napping for longer than 1 hour total during the day will impact your ability to maintain a sleep schedule at night. Even if you slept poorly the night before, try not to nap.

 Limit caffeine

Avoid any caffeine containing products (including soda) after lunch. The time between lunch and bed is enough time for most caffeine to have been metabolized from your body.

 Limit alcohol

This one sounds counter-intuitive as alcohol tends to make us sleepy. Initially alcohol is sedating, but as it is metabolized it is actually stimulating. It’s why people often wake up in the middle of the night after drinking. Alcohol also negatively impacts sleep architecture (the natural REM sleep cycle)

Avoid nicotine

Nicotine is a stimulant and should be avoided at night and near bedtime.


Daytime physical activity is encouraged 4-6 hours before bedtime. Strenuous physical activity should be avoided for 2 hours prior to bedtime. So exercise is good, but keep it to earlier in the day.

 Keep the sleep environment quiet and dark

This means two things. Number one your room should be dark and quiet. Either black out blinds or an eye mask is encouraged, and depending on the environment ear plugs may also be beneficial. However, this also means avoiding the TV, cell phones and other backlit screens for at least 30 minutes before bed. It has been shown the light from these devices will impair sleep.

 Bedroom clock

Avoid checking the time as you are trying to fall asleep. Looking at the clock increases cognitive arousal (wakes you up) and causes anxiety which will further impair initiation of sleep. This includes alarm clocks, phones, watches (and even bathroom mirrors if it has a built in clock).

 Evening Eating

Avoid a large meal just before bedtime. A healthy and filling meal should be eaten earlier in the evening, and late night snacking should be avoided as well.

Now that you’re an expert in the textbook version of sleep hygiene, it’s time to put it into practice. Rather than trying to tackle the entire list at once, it’s often better to pick one thing and incorporate it into your sleep routine every few days. For example, start with setting a bedtime and an alarm clock that you stick to every day – once you’ve become used to this you can look at getting rid of your bedtime Facebook binge. Just like Rome, you can’t build your foundation of sleep hygiene in just one day.

Guten nacht!

What’s in Your Protein Bar?

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.  (   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 ( 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 (  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 24th 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. 

Workout with Greg 5/12/2022

Video Link:

Come join Greg and Kat as they walk you through one of Kat's workouts! It's been specifically designed for you to do at home with little to no formal gym equipment!

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