Introducing The Dash Diet

Introducing the DASH Eating Plan

The Dietary Approaches to Stop Hypertension or DASH eating plan was developed by the National Heart, Lungs and Blood Institute. The plan emphasizes fruits, vegetables, fish, poultry, whole grains, low –fat dairy, nuts and legumes while scaling back the intake of saturated fats, cholesterol, and added sugar. Although the DASH plan was originally developed as a treatment for elevated blood pressure, when coupled with a moderate exercise program it can provide an excellent framework for weight management and an overall healthy lifestyle.

Getting Started with DASH Your journey with the DASH plan will start with a food diary and this exchange booklet. You will find a list of foods, sorted by exchange category (corresponding to the columns in your food diary) and serving size. If you are eating a food that is not featured on the list, consult the guidelines for estimating the appropriate exchange at the end of each food category. If you should find yourself unsure of a food’s exchange value, don’t’ worry! Just make a note of it and we will talk about it at our next meeting.

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Sodium 1,500-2,300 milligrams (mg) per day Currently, the average American consumes well above the recommended amount of sodium each day. The DASH plan suggests a range of 1,500-2,300 mg of sodium per day to maintain or achieve a healthy blood pressure. *Be mindful that the sodium content of fresh and whole foods is very low, while processed foods, packaged foods, fast- food and restaurant foods typically have a much higher sodium content. On average: Fruits = 1.6 mg of sodium/ serving Vegetables = 15 mg of sodium/ serving Low fat Dairy= 184 mg of sodium/ serving Lean Meats= 195 mg/ serving * Be weary of fast food and restaurant food that may be extremely high in sodium, for example: O’Charley’s Island Salad with Honey Dijon Dressing= 5,560 mg sodium O’Charley’s Black and Bleu Caesar Salad= 2,065 mg sodium McDonald’s Grilled Chicken Salad= 1010 mg sodium KFC Chicken Breast= 1150 mg sodium Sonic Ham, Egg and Cheese Toaster= 2079 mg sodium Panera Pumpkin Spice Bagel= 670 mg sodium Hardee’s Biscuit and Gravy= 1550 mg sodium Dairy Queen Onion Rings= 740 mg sodium

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Grains One bread serving of grains contains approximately 15 grams of carbohydrates and 90 calories. Try to get most of your grains from whole grain sources. Whole grains are more nutrient dense foods and will also contribute to your daily intake of dietary fiber. Grains Bagel, large unsweetened from coffee or bagel shop Bagel, small (ex. Original, frozen Lender's bagels)

Portion 1 1

Bagel, sweetened dessert-type bagel (ex. Panera's Cinnamon Crunch Bagel) Bread/Pretzel type sticks, crisp (4-5" long x 1/2" wide) Biscuits, canned (Pillsbury type) Biscuits, frozen (Pillsbury type) Chips, baked (i.e. Baked Lays, Baked Doritos, etc) Croutons, low-fat Dinner breads (small dinner roll, small slice Italian) English muffin Hamburger/ Hot Dog bun Muffin, plain small (from mix, made with milk) Pita, 6" across1 Raisin Bread, unfrosted Sandwich bread (white, wheat, rye, etc) Sandwich bread, light Soft-baked restaurant bread sticks Tortilla, 10" across Tortilla, 6" across Cereals, Grains, and Pasta Cooked cereals (plain or unsweetened oatmeal, cream of wheat, cooked grits) Cooked cereals, sweetened (i.e. individual packets of Quaker oatmeal) Granola Pasta (cooked) Rice, white (cooked) Sweetened cereals, ready-to-eat (Frosted Flakes, Honey Nut Cheerios) Unsweetened cereals, ready-to-eat (Special K, Corn Flakes, plain Cheerios, etc) Wheat germ Grains with Added Fat Exchange Biscuit, fast food (i.e. Hardee's) Biscuit, restaurant (i.e. Cracker Barrel) Chow mien noodles

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1 2 1 biscuit (2.5 "across) 1 biscuit (3.5 across) 15 chips (or 1 oz bag) 1/2 cup 1 slice

Exchange 6 2 6 +1Sweet 1 1 1 + 1 Fat

1 1 1 1 1 slice 1 slice 2 slices 1 1 1

1.5 1 1 2 2 1 2 1 1 1 1 2 + 1 Fat 1

1/2 cup 1 packet 1/4 cup 1/2 cup 1/2 cup 1/2 cup 1/2 cup 3T

1 biscuit 1 biscuit (2.5" across) 1/2 cup

1 1 +1 Sweet 1+1 Fat 1 1 1 1 1

3 + 2 Fat 1 + 1 Fat 1 + 1 Fat

Cornbread, 2" cube Cracker, round butter-type (Ritz) French fried potatoes (2-3.5" long) Store/ Bakery- bought muffin (i.e. Otis Spunkmeyer) Pancake, 4" across Stuffing, bread (prepared) Taco shell, 6" Frozen waffle, 4.5" square (i.e. Eggo) note: do not count fat for low-fat varieties Granola Bar note: do not count fat for low-fat varieties Snack chips (potato chips, corn chips, tortilla chips, etc) Popcorn, regular fat

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1 cube 6 crackers 10 fries 1 muffin 3 pancakes 1/4 cup 2 shells 2 waffles

1 + 1 Fat 1 + 1 Fat 1+ 1 Fat 2 + 1 Fat 2 + 1 Fat 1 + 1 Fat 1 + 1 Fat 2 + 1 Fat

1 small bar

1 + 1 Fat

15 chips (or 1 oz bag) 8 cups popped

1 + 1 Fat 1 + 1 Fat

Vegetables 25 calories and, unless otherwise noted, one serving size for vegetables is as follows: • ½ c of cooked vegetables • ½ c of vegetable juice • 1 c of raw vegetables Focus on non-starchy vegetables and try to limit starchy vegetables. Examples of starchy vegetables are given below. Non-Starchy Vegetables

Starchy Vegetables

Artichoke (1/2 medium) Asparagus

Corn Corn on the Cob, 6" long

Bean Sprouts

Lima beans

Beets

Peas, green (canned or frozen)

Broccoli Brussels Sprouts Cabbage, cooked

Plantain Potato, baked (small, the size of a tennis ball) Potato, mashed

Carrots

Squash, winter (acorn, butternut)

Cauliflower Cucumber Eggplant Greens (turnips, mustard, collard) Kohlrabi Leeks Mushrooms, cooked Okra Onions Pea Pods Peppers (sweet, green or colored) Romaine lettuce and other dark leafy greens (not iceberg) Rutabaga Sauerkraut Spinach Summer squash (yellow crookneck) Tomato (one large) Tomato/Vegetable/ V-8 juice Turnips Water chestnuts Zucchini, cooked

Yam (sweet potato, plain)

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1/2 cup 1 ear 1/2 cup 1/2 cup 1/2 cup 1 potato 1/2cup 3/4 cup 1/2 cup

Fruits 15 grams of carbohydrate and 60 calories. Fruits are great snack options because they are very nutrient dense, providing a high level of nutrients for every calorie of energy. In addition to adding fiber to your diet, fruits provide potassium and magnesium, as well as powerful antioxidants like Vitamins C and E. Fruits, Fresh Apple, raw, 2" across Apricots, medium, raw Banana (9" long) Blackberries, raw Blueberries, raw Cantaloupe, 5" across Cantaloupe, cubes Cherries, large, raw Grapefruit, medium Grapefruit, sections Grapes, small Honey dew melon, medium Honeydew melon, cubes Kiwi, large Mandarin oranges (unsweetened) mango, small Nectarine, 1.5" across Orange, 2.5" across Papaya Peach, 2.25" across Pear Persimmon, medium, native Pineapple, raw Plum, raw, 2" across Pomegranate Raspberries, raw Strawberries, raw, whole Tangerine, 2.5" across Fruits, Processed Applesauce, unsweetened or in its own juice Apricots, canned (unsweetened) Cherries, canned (unsweetened) Fruit cocktail, canned (unsweetened) Peaches, canned (unsweetened) Pineapple, canned (unsweetened)

Portion 1 whole 4 whole 1 3/4 cup 3/4 cup 1/3 melon 1 cup 12 1/2 fruit 3/4 cup 15 1/8 melon 1 cup 1 whole 3/4 cup 1 1 whole 1 whole 1 cup 1 whole or 3/4 cup 1/2 large or 1 small 2 whole 3/4 cup 2 whole

1

1 1 cup 1.25 cup 2 whole

1/2 cup 1/2 cup or 4 halves 1/2 cup 1/2 cup 1/2 cup or 2 halves 1/3 cup

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Exchanges 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 1

1 1 1 1 2 1 1 1

1 1 1 1 1 1

Dried Fruit Apples Apricots Dates, medium Figs Prunes, medium Raisins Banana chips

4 rings 7 halves

1 1 1 1 1 1

2.5 1.5 3 2T 1 ounce

Fruit Juice Apple cider/juice Cranberry juice Cocktail Grapefruit juice Grape juice Juice blends (i.e. Juicy Juice, Ocean Spray Cran-Grape, etc) Orange juice Pineapple Juice Prune Juice

1 + 2 Fat

1/2 cup 1/2 cup 1/3 cup 1/3 cup

1 1 1 1

1/2 cup 1/2 cup 1/2 cup 1/3 cup

1 1 1 1

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Low-Fat Dairy One dairy exchange contains approximately 30% of the Daily Value (DV) for calcium. This is the same as 300 milligrams (mg) of calcium per dairy serving. Focus on fatfree and low-fat dairy products. Special Note: Remember that the dairy group includes food items you may not think about. For example, remember to count pizza, the cheese on your sandwich, etc. The dairy group also includes foods made with milk such as homemade pudding, hot chocolate, milk- based soups, etc. Also remember to add a fat exchange for dairy products that are made with whole milk (i.e. regular cheese, whole milk yogurt, a serving of whole milk). Low-Fat Milk/ Dairy Skim, 1% or 2% milk Low fat buttermilk Evaporated skim milk Dry nonfat milk Plain nonfat or low fat yogurt Nonfat or low fat artificially- sweetened flavored yogurt Nonfat or low fat sugar-sweetened flavored yogurt Fat-free or 2% cheeses

Portion 1c 1c 1/2 c 1/3 c 8 oz (or 1 cup) 8 oz (or 1 cup) 8 oz (or 1 cup) 1.5-2 oz

Exchange

1 cup 1/2 c 8 oz (or 1 cup) 8 oz (or 1 cup) 8 oz (or 1 cup)

1 + 1 Fat 1 + 1 Fat

1.5 oz 2 oz

1 + 1 Fat 1 + 1 Fat

1 1 1 1 1 1 1 + 1 sweet 1

Whole Milk/ Dairy Whole milk Evaporated whole milk Whole plain yogurt Whole artificially- sweetened flavored yogurt Whole sugar- sweetened flavored yogurt Natural cheese (such as cheddar, Monterey Jack, Swiss, Colby, etc) Processed Cheese

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1 + 1 Fat 1 + 1 Fat 1 + 1 Sweet + 1 Fat

Lean Meats and Proteins 7 grams of protein and 5 grams of fat Each serving size listed here is equal to one lean meat and protein exchange. Focus on lean meats, poultry, fish and plant-based protein for your protein sources. Plant based protein sources are listed below. If you are eating a serving of full fat meat, add 1 F exchange per serving of meat. Each serving size listed here is equal to one lean meat and protein exchange. Tips for Selecting Healthier Meats: • Bake, roast, broil, grill, or coil meats rather than frying them with added fat. o Reminder: If you cook with added fats, such as oil or butter (or if you eat the skin on your chicken), you will need to count the added fat as a fat exchange in your food diary. o You will see some meats listed below that require that you count a fat exchange with your meat exchange. This is because these cuts of meat contain more fat than others. Please limit these high fat meats to no more than a total of 3 per week. • Use a nonstick pan spray or a nonstick pan to brown or fry meats. • Trim off visible fat before and after cooking • Weigh or measure meat after removing bones and fat, and after cooking. 3 oz. cooked meat is equal to 4 oz raw meat. • How many ounces is the meat I eat? o 2 ounces (these meats would count as 2 lean meat exchanges)  1 small chicken leg or thigh  ½ c tuna fish o 3 ounces (these meats would count as 3 lean meat exchanges  1 medium pork chop  1 small hamburger Siri Khalsa-Zemel MS, RD, LDN [email protected] • 865.329.8897

 1 average chicken breast  1 fish filet  Any cooked meat about the size of a deck of cards Beef Best Choices: USDA Good or Choice grades of lean beef (round, sirloin and flank steak) Tenderloin Chipped Beef

Portion 1 ounce

Next Best Choices: Ground Beef Roast (rib, chuck, rump) Steak (cubed, Porterhouse, T-bone) Meatloaf

1 ounce

Count a fat exchange for the beef cuts listed below Most USDA Prime cuts of beef; ribs, corned beef

1 ounce

Pork

Best choices: Fresh Ham Canned, cured, or boiled ham Canadian bacon Tenderloin

1 ounce

1 ounce

Next best choices: Chops Loin Roast Boston butt Cutlets Count a fat exchange for the pork cuts listed below: Spareribs Ground pork Pork sausage (patty or link) Veal

1 ounce

Best choices: Chops Roasts Next best choices:

1

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ounce Cutlets: ground of cubed, unbreaded Poultry

Best Choices (skinless): Chicken Turkey Cornish hen Ground chicken or turkey breast Next best choices: Domestic duck or goose Ground turkey Count a fat exchange for the chicken cuts listed below: chicken with skin or any fried chicken product

1 ounce

1 ounce

1 ounce

Fish 1 ounce

Best choices: All fresh and frozen fish Crab, lobster, scallops, clams (fresh or canned in water) Shrimp (without breading or fat) Oysters, medium Water-packed tuna

2 ounces 5 large 6 1/4 c

Next best choices: Tuna canned in oil (drained)

Count a fat exchange for any fried fish product

1 ounce

Wild Game Best choices: Venison, rabbit, squirrel, pheasant, duck, goose (skinless)

1 ounce

Other Best choices: 95% fat-free luncheon meat Egg Whites Egg substitutes with less than 55 calories per 1/4 c Low-fat frankfurter (such as Healthy Choice) Next Best Choices:

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1 ounce 3 1/4 c 1

86% fat-free luncheon meat 2% cottage cheese Egg (high in cholesterol-limit to 3 whole eggs per week) Egg substitutes with 56-80 calories per 1/4 cup Tofu (2.5" x 2.75" x 1")

1 ounce 1/4 c 1 1/4 c 4 ounces

Count a fat exchange for the products listed below Regular luncheon meat (bologna, salami, pimento loaf Sausage (Polish, Italian) Knockwurst (smoked) or Bratwurst Frankfurter (turkey) Frankfurter (beef, pork, or combination) *Count 2 F exchanges

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1 ounce 1 ounce 1 ounce 1 frank 1 frank

Nuts, Seeds and Legumes Aside from being rich in energy (this group is a rich source of polyunsaturated and monounsaturated fatty acids), nuts, seeds and legumes also provide magnesium, protein and fiber. Special Note: It is important to remember the low sodium focus of the DASH eating plan when selecting nuts, seeds and legumes. Choose unsalted, raw and dry roasted varieties whenever possible. If a serving of nuts, seeds or legumes does include added sodium, refer to the sodium exchange section and adjust your food diary entry accordingly. Nuts

Walnuts

Portion 1/3 cup (1.5 oz) 1/3 cup (1.5 oz) 1/3 cup (1.5 oz) 1/3 cup (1.5 oz) 2T 1/3 cup (1.5 oz) 1/3 cup (1.5 oz)

Seeds Pine Nuts Pumpkin Seeds Sunflower Seeds (no shells)

2T 2T 2T

1 1 1

Legumes Boiled soybeans Roasted soybeans Lima beans Peas, green (canned or frozen) Beans (green, waxed Italian) Lentils, cooked Beans and peas, cooked (i.e. kidney, white, split, black- eyed)

1/4 cup 2T 1/2 cup 1/2 cup 1/2 cup 1/3 cup 1/3 cup

1 1 1 1 1 1 1

Almonds Cashews Other nuts Peanuts Peanut Butter Pecans

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Exchange 1 1 1 1 1 1 1

Fats and Oils One fat exchange contains approximately 5 grams of fat and about 45 calories. Focus on healthy, unsaturated fats from whole foods and make an effort to limit saturated fats. Each serving listed below is equal to one fat exchange. Unsaturated Fats (Healthier) Avocado Guacamole Light/ Low-Fat Salad dressing (see "free" list for fat free and low caldressing) Low- Fat/ Light Margarine (Trans-fatty acid free) Low- Fat/ Light Mayonnaise Margarine Margarine (Trans-fatty acid free) Mayonnaise Oil (any type) Olives, small Olives, large Regular Salad dressing Saturated Fats (limit if possible) Bacon Bacon grease Beef suet Butter Chitterlings Coconut, shredded Coffee creamer, liquid Coffee creamer, powdered Cream cheese Fat back Heavy whipping cream Lard Pork jowl Salt pork Shortening Sour cream ( see "free foods" list for fat-free and light sour cream)

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Portion 1/8 medium 2T 2T 1T 1T 1 tsp 1 tsp 1 tsp 1 tsp 10 olives 5 olives 1T

1 slice 1 tsp 1/4 oz 1 tsp 1/2 oz 2T 2T 4 tsp 1T 1 tsp 1T 1 tsp 1/4 oz 1/4 oz 1 tsp 2T

Sweets and Added Sugars Special Note: When counting your sweets and added sugar exchanges, remember that this applies both to a slice of cake or a cookie, and also to adding sugar to your morning coffee or drinking a sugar-sweetened beverage (i.e. a can of regular soda). Item

Portion

Exchanges

2 Grains 1 Grain + 1 Sweet + 1 Fat

Carrot Cake, with icing Cheesecake Cupcake, with icing Fruit- Filled pie Pecan pie

1/12 of cake 2" square 1/12 of cake or 3" square 1/12 of cake or 3" square 1/12 of cake or 3" square 1/8 of pie 1 cupcake 1/8 of pie 1/8 of pie

Cookies Animal Crackers (unfrosted) Chips Ahoy chocolate chip cookies Chocolate chip cookies, made from dough Fig Newtons Gingersnaps Little Debbie Snack Cakes Oatmeal cookies Oreo Cookies Sugar Cookies Vanilla Wafers

8 crackers 2 cookies 1 small (2") 2 cookies 3 snaps 1 pack (2 cakes) 2 small 2 cookies 2 small 6 small

1 Grain 1 Grain + 2 Fat 1 Grain + 1 Fat 1 Grain + 1/2 Fat 1 Grain 1 Grain + 2 Sweet + 3 Fat 1 Grain + 1 Fat 1 Grain + 1.5 Fat 1.5 Sweet + 1 Fat 1 Grain + 1 Fat

1 regular bar 1/4 cup 1 regular bar 1 regular bag 1 regular bag

1 Grain + 2 Sweet + 2 Fat 3 Sweet 1.5 Sweet + 3 Fat 2.5 Sweet + 2 Fat 2 Sweet + 2 Fat 1 Grain + 1 Sweet +3 Fat 1 Grain +3 Sweet 1 Grain + 1 Sweet + 3 Fat 4 Sweet 1 Grain + 1 Sweet + 3 Fat

Cake/ Pie/ Baked Desserts Angel food cake Brownie (prepared from mix) Cake, no frosting Cake, with frosting (basic van/choc cake)

Candy Butterfinger Candy Corn Hershey Bar M&M's, plain M&M's, peanut Reese Peanut Butter Cups Skittles Snickers Starburst Twix

2 Grain + 2 Fat 2 Grain+ 1 Sweet + 1 Fat 1 Grain + 2 Sweet + 6 Fat 1 Grain + 1 Sweet + 7 F 1 Grain + 1 Sweet + 1 Fat 1 Grain + 1 Sweet + 3 Fat 2 Grain + 2 Sweet+ 4 Fat

2 1 regular bag 1 regular bar 1 regular pack 1 pack (2 bars)

Ice Cream/ Frozen Desserts

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Specialty ice cream Ice cream Frozen Yogurt (note: add 1/2 Fr exchange for fruit varieties) Other BBQ Sauce Hershey's chocolate syrup Icing (store bought) Pudding, sugar-free, made with skim milk Pudding, regular, made with milk Regular soft drinks Sugar/ Honey/ Pancake Syrup/ Jelly Sweet tea, Kool- Aid, and other sweetened drinks Soda Lemonade

1/2 cup 1/2 cup 1/2 cup

2T 2T 2T 1/2 cup 1/2 cup 12 oz can 1 T (or 3-4 tsp) 4 oz (1/2 cup) 16 oz bottle 1 cup (8 oz)

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2 Sweet + 1 Fat 1 Sweet + 2 Fat 2 Sweet + 1/2 Dairy + 2 Fat

1 Sweet 2 Sweet 2 Sweet + 1 Fat 1/2 Grain + 1/2 Dairy 1 Grain + 1/2 Dairy 3 Sweet 1 Sweet 1 Sweet

Combination Foods These combination foods do not fit into any one food list. This is a list of average values for some typical combination foods; specific brands or recipes can vary greatly. Always check labels for serving sizes—as well as grams of carbohydrates, protein, and fat- to fit the correct exchanges. Special Note: Pay special attention to the sodium content in combination foods as it is highly variable based on the preparation methods. When eating out, realize that foods will most likely be higher in sodium than their homemade counterparts and note the difference in your food diary. Food Item Casseroles, homemade Chili with beans (canned) Chow mien (without noodles or rice) Fried green tomatoes Hoppin' John Lasagna Macaroni and Cheese Pizza, cheese Pizza, meat Soups: Bean Chunky, all varieties Cream, made with water Cream, 98% fat-free, made with water Cream, 98% fat-free, made with milk Vegetable Spaghetti and meatballs

Portion 1 cup 1 cup 2 cup 1 tomato (4-6 slices) 1 cup

Exchange 2 Grains + 2 Lean Meat + 1 Fat 2 Grain + 2 Lean Meat + 2 Fat 1 Grain + 2 Lean Meat + 2 Vegetable

1 cup 1 cup 2 slices of a 14" 2 slices of a 14"

1 Grain + 1 Vegetable + 1 Fat 3 Grain 2 Grain + 1 Lean Meat + 1 Dairy+ 1 Fat 2 Grain + 1 Dairy + 2 Fat 4 Grain + 1 Dairy + 2 Fat 4 Grain + 1 Dairy + 4 Fat

1 cup 10 3/4 ounce can 1 cup

1 Grain + 1 Lean Meat + 1 Vegetable 1 Grain + 1 Lean Meat + 1 Vegetable 1/2 Grain + 1 Fat

1 cup

1 Grain

1 cup 1 cup 1 cup

1 Grain + 1/2 Dairy 1 Grain 2 Grain + 1 Lean Meat + 1 Fat

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Beverages Alcoholic Beverages Drink Wine Liquor Beer Light Beer Margarita Daiquiri Wine Cooler Whiskey Sour Tom Collins Screw Driver Bloody Mary Pina Colada Rum and Soda Other Specialty Beverages Starbucks low fat Frappuccino Carmel/ Mocha Macchiato Latte (non fat milk, no sugar added) Cappuccino (unsweetened) Specialty Coffee syrups Cappuccino from machine Cappuccino from machine

Portion 6 oz 1 oz/ 1 shot 12 ounces 12 ounces 6 ounces 6 ounces 12 ounces 3.5 ounces 7.5 ounces 7 ounces 7.5 ounces 6 ounces 8 ounces

Exchanges 1.5 Grain or 2.5 Sweet 1 Fat 1 Grain + 1 Sweet 1 Grain or 1.5 Sweet 2 Grain + 2 Sweet + 2.5 Fat 2 Grain + 1 Sweet + 2 Fat 2 Grain + 3 Sweet 2 Sweet + 1 Fat 2 Sweet + 1 Fat 2 Sweet + 1 Fat 1 Sweet + 1 Vegetable + 2 Fat 2 Grain + 1 Sweet+ 2 Fat 1 Sweet + 2 Fat

1 bottle 12 ounce (tall)

1 Sweet + 1 Dairy

12 ounces 8 ounces 1 shot 1 cup (8 oz) 2 cup (16 oz)

1.5 Dairy 1/2 Dairy 1 Sweet 1.5 Sweet +1 Fat 1 Grain +1.5 Sweet +1/2 Dairy + 1.5 Fat

1 Sweet + 1 Dairy + 1/2 Fat

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Abbreviations Key When recording the amount of food eaten, feel free to refer to these units of measure

Measures:

• T= Tablespoon • tsp= teaspoon • c= cup • oz= ounce • (“)= inches • 8 fluid ounces= I cup (4 fluid ounces= ½ cup) • 16 ounces by weight= 1 pound • 1 T= 3 tsp • 4 T [liquid measure]= ¼ cup • 2 T [liquid measure]= 1 fluid ounce

Siri Khalsa-Zemel MS, RD, LDN [email protected] • 865.329.8897

Siri Khalsa-Zemel MS, RD, LDN [email protected] • 865.329.8897