Monday, April 24, 2017

Food Insecurity in Montgomery County

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Over 42 million Americans suffer from food insecurity, which is over 13% of people in the U.S. People are considered food insecure if they do not have reliable access to a sufficient quantity of affordable, nutritious food. In other words, someone who is food insecure may not know where their next meal is going to come from or may fear that they will run out of food before they have money to buy more. In Montgomery County, Maryland, around 80,000 people are food insecure, including many children. This, along with other things I learned during my rotation at the Manna Food Center, has inspired me to write this blog post.

Food Insecurity in Montgomery County

According to Montgomery County Public Schools, over 30,000 elementary school students are eligible for Free and Reduced Meals (FARM), but only 11% of those are actively participating in the FARM program. Other programs aimed at reducing food insecurity are the Supplemental Nutrition Assistance Program (SNAP), the National School Lunch Program (NSLP), and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Unfortunately, some Americans don’t know about these programs or don’t know how to enroll in them. To help increase enrollment in these programs, some local organizations offer information, resources, and services to food-insecure members of the community. The Montgomery County Food Security Collaborative partners with other local organizations to address this issue. Their mission is to reduce hunger in Montgomery County by 2020 by redistributing fresh, perishable food and increasing collaboration among businesses, non-profits, food providers, and families in need for this purpose. Their partners include Manna Food Center, Women Who Care Ministries, GaithersburgHELP, Full Plate Ventures, and more. I also recently heard about Volunteer Income Tax Assistance (VITA), which helps low-income individuals prepare taxes free of charge. There are many dietitians who volunteer to help sign these individuals up for food assistance programs while they are waiting for their appointment.

Get Involved

If you’ve read this far and you would like to help reduce food insecurity in your community, one of the easiest ways to get involved is to volunteer your time to a local food bank. Other ways to get involved include donating money or food, organizing a fundraiser, or organizing a food drive. I volunteered at Manna Food Center by helping put together boxes of food for distribution. Each box consisted of fresh fruits and vegetables, non-perishable canned and boxed goods, a few pounds of protein foods, and bread. For most families, it was enough food to last two to three days. That may not sound like much, but it could be the difference between eating and going without until the next paycheck.  

Food Insecurity and Health

Good nutrition is one of the most important factors that affects a person’s health. People who suffer from food insecurity are also at risk for developing chronic illnesses, such as cardiovascular disease and diabetes. I want to continue to help these individuals by reducing food insecurity and promoting good nutritional health wherever and whenever I can. One way that I was able to do this during my rotation at Manna was to create educational inserts for the food boxes. These inserts accompanied boxes that were designated for special diets. For example, some of the inserts were related to diabetes. Each diabetes insert contained information about diabetes and how it relates to food and had a recipe using five or fewer ingredients so that clients could learn new ways to use the foods that are provided for them to create healthy meals. I’ve included an example below for you to see. This concept can continue to be expanded on so that every box that a client takes home has good, nutritious foods and information that will help make Montgomery County healthier and happier.

Diabetes Myths

Monday, April 17, 2017

Joint Class Day: Nutrition Taking A Frontline Role in the Military

The Walter Reed National Medical Center is one of the nation’s largest military medical centers, and it’s located right in Bethesda, MD! Earlier this spring, our class was able to attend a joint class day to gain a deeper insight on the role RDs play in nourishing the country’s military. Many dietitians influence the success of the US Military, whether they deal directly with the civilian or military population. The nutritional health of civilians determines how many civilians are eligible to become a part of the military. Once enlisted, soldiers are expected to maximize their health and performance, but this isn’t always happening. Currently, 5% of active duty soldiers are prescribed sleep medications, 5% fail their Army Physical Fitness Test (APFT) and 13% are clinically obese. The Performance Triad has been designed to address these issues.

The Performance Triad is a strategic initiative aimed at improving soldier performance by targeting the areas of sleep, physical activity and nutrition. Each of these categories have targets and goals that soldiers work toward in order to maximize their performance:

  • Get 8 hours of quality sleep per 24 hour period
  • Go caffeine free 6 hours before bedtime
Physical Activity
  • Aim for at least 10,000 steps per day, with the ideal goal of getting an additional 5,000 steps throughout the day
  • Include at least 2 days of resistance training per week, plus one day of agility training
  • Incorporate at least 150 minutes of moderate aerobic exercise, plus 75 minutes of vigorous intensity exercise per week
  • Eat at least 8 servings of fruits and vegetables per day
  • Re-fuel 30-60 minutes after strenuous exercise

Nutrition is now on the frontlines of improving military effectiveness. Accomplishing these nutritional targets and goals requires teamwork. It starts with meal planning so that the right nutrients are available. The diet developed to support the Performance Triad consists of 4,875 kcal and 155 g pro, strategically timed as follows:

Breakfast (06:00)
Hot Line and Beverages
1,000 kcal/40 g protein

Morning Snack (09:00)
Complex carb, produce, protein source
500 kcal/10 g protein

Lunch (12:00)
Meal Ready-to- Eat (MRE)
1,345 kcal/45 g pro

Afternoon Snack (15:00)
Complex carb, produce, protein source
500 kcal/10 g protein

Dinner (18:00)
Hot Line with Beverages, Salad Bar and Dessert
1,200 kcal/45 g protein

Midnight Snack (23:00)
Complex carb, produce
350 kcal, 5 g pro

I am surprised to see how much higher, the recommendations are for the active duty military compared to those for the civilian population, but providing all those calories helps support the increased physical activity of active duty military members. This meal pattern is coupled with nutrition education that teaches the importance of different nutrients and promotes increased fruit and vegetable intake. To make it easier green, yellow and red labels are used to make healthier choices immediately identifiable with one glance. Green foods should be eaten often, yellow occasionally and red avoided.

The Performance Triad has shown to increase fruit and vegetable intake by 1.5 servings/day, as well as increase the frequency of refueling after exercise. Food is fuel and this program is the perfect example of the impact food choices have on overall health and performance!

Learning how the military is shifting its focus to nutrition was very encouraging to hear as a dietetic intern. Research has proven that proper nutrition improves performance and the military is listening! As the focus on nutrition continues, RDs will need to continue their advocacy and research to support and empower our country’s military.

Monday, April 10, 2017

Renal Nutrition Class Day

One of my favorite things about being an “almost dietitian” is that there are so many career options: clinical, community, communications, and food service to name a few. The possibilities seem endless! Along with fellow University of Maryland dietetic interns, I recently visited a DaVita Dialysis Center in Annapolis to learn about renal nutrition from several Registered Dietitians (RDs) and other experts.

Fellow intern, Julia, and me at our renal nutrition class day.

The day started out with a brief dialysis overview which touched on the different stages of Chronic Kidney Disease (CKD), including when dialysis is needed (stage IV and V), and what the dialyzer does and how it works. It really helped me understand the incredible filtering capability and limitations of the dialyzer, which will be helpful when I am counseling patients. The next speaker dove a little bit deeper into the stages of CKD by explaining how nutrition needs are different in each stage. She also discussed different options for dialysis home modalities. Before this day, I had no clue that doing dialysis at home was even an option! How cool – and convenient!

Next on the agenda was the renal nutrition lecture which covered calorie, protein, fluid, and mineral (specifically sodium, phosphorus, and calcium) requirements for patients receiving dialysis and their “lab value goals.”  I learned that no two patients are alike. It is important for RDs to tailor their care to fit each individual’s lifestyle and meet their specialized needs. As the disease progresses, patients’ needs will likely change, and dietitians can help them transition their diets.

The last speaker talked to us about the role of a renal dietitian at DaVita including their day-to-day responsibilities, their electronic medical record system, and what to expect when working with dialysis patients. This lecture was particularly valuable because it opened my eyes to what life would be like as a renal dietitian.

During the day, DaVita’s divisional vice president popped in to welcome us, share his experience working with DaVita, and answer our questions.  All of the speakers seemed very passionate about their work and were very knowledgeable. Overall, I learned a lot from this day and feel more prepared for my renal rotation. I am looking forward to learning even more during my renal rotation next month.

Monday, April 3, 2017

Celebrating National Nutrition Month at UMD

What better way to spend National Nutrition Month than promoting healthy lifestyles to the University of Maryland’s (UMD) students and staff? During my 3 week long rotation with UMD’s dining services, my internship partner and I created “Wellness Walls” with fun posters and infographics filled with tips about nutrition, exercise, cooking, and healthy recipes. Our artsy and creative sides were definitely put to work!

To encourage informed meal choices and variety, we focused on a different food group for each week of March. With fun colors, titles, and pictures, we encouraged our audience to live healthier lifestyles. It was a great time for us to promote healthy habits since the University advanced to “Any-time dining” halls, offering all-you-can-eat food. Some of our tips included: switching from regular to low-fat milk, looking for whole grain ingredients, and eating a variety of colorful fruits and vegetables. We even created some content in Spanish, in order to reach out to employees whose first language was Spanish. Although we were only there for 3 weeks, we were able to design ahead of time and create content for all 4 weeks of National Nutrition month:

Week 1: “Live a Legen-dairy Lifestyle” focused on choosing healthy dairy options, such as low-fat milk in order to reduce saturated fat intake, while still getting the same vitamins and minerals as whole milk!

Week 2: “Lettuce Turnip the Beet” focused on the importance eating a variety of fruits and vegetables. According to CDC’s 2013 State Indicator Report on Fruits and Vegetables, an average of 37.6% of Maryland adults and adolescents reported eating less than 1 fruit per day and 30.9% reported eating less than 1 vegetable per day. Hopefully our wall encouraged UMD students and staff to reach for fruits and veggies more often!

Week 3: “Promote Health with Protein” introduced different protein sources and snack ideas to promote strong muscles. We made sure to include plant-based protein for those who don’t eat meat!

Week 4: “Use Your Brain, Choose Whole Grains” introduced a variety of whole grains and their benefits, such as a healthier GI tract!
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We had an "egg-cellent" time trying out some "punny" titles for our Wellness Walls! Aside from putting together these walls, we also participated in tabling events inside one of the diners, where we distributed handouts about a different food group each week. It was great seeing students eager to learn more about nutrition. In addition, we helped put together newsletters and wrote blogs for the campus’ student nutritionists.  Working on all of these unique projects during this rotation made me realize how much I love being creative.  

National Nutrition Month is a great time to focus on improving eating habits. Even though the month just ended, I hope the UMD students and staff will continue to put their best forks forward.