What happens when you meet a future dietitian??

Various rotation environments have helped me strengthen the ability to adapt to different settings and allowed me to quickly adjust. I thought I learned all that I need to know about foodservice when I did my first rotation at Riderwood but that was not the case. There is always room for new ideas where you will learn or share information. I have spent the last three weeks of October at the University of Maryland Dining Service preparing nutritional messages such as nutrition tips, exercise tips, cooking tips, and recipes on the Dining Services bulletin board for the employees. Other tasks included writing a monthly article, distributing educational materials for the students and also training employees on safely handling hazardous chemicals.

UMD dining service tries to offer a wide variety of healthy selections made by seasoned and certified professionals from the freshest ingredients. They handle resident dining including cafes and quick convenience shops, pick up catering, and full service restaurants. In addition, the dining service has a green dining program which tries to reduce, reuse, recycle, conserve and innovate any resource they use. I had the opportunity and pleasure to meet everyone from the Director to the servers who ensure that hundreds of people to eat safely and comfortably. My partner and I have spoken to UMD Dining employees about their job duties that includes budgeting, employee training on food and chemical safety, scheduling, and management. One of my favorite experiences of this rotation is “Meet the Dietitian Day”. It is a program that runs twice a month in South and North Campus Dining Halls during lunch time. The purpose of this program is to answer any student questions related to healthy or unhealthy meal choices, nutrition, and various other topics. During this rotation I had the opportunity to participate in two of the meetings. I was concerned that since I am not a dietitian yet, how can I do this? When I tell the students that I am not a dietitian but an intern, how would they respond? I was also afraid that they would not be attentive and listen to what I told them because I am not a dietitian. Most of the students assumed we were dietitians and some didn’t even question. I knew this was a great chance for me to apply all the nutrition knowledge I gained back in college. I had the opportunities to have a small conversation with students who have diabetes, high cholesterol, and others who just need nutrition tips. Most of the students were knowledgeable enough to discuss their questions and concerns.

The field of dietetics often involves working with different populations and this rotation taught me to develop good people skills and visualize the bigger part that an RD can contribute to college students. In addition, I also learned the different roles of an RD in school dining service. An RD may have many responsibilities in food service including personnel management, menu planning, budgeting, purchasing, marketing, and advertising in food service.

FSNE Fall Conference: Technology and Real Food

By: Sasha B. Bard, MSN

Last week all of the dietetic interns had the opportunity to attend and present at the University of Maryland (UMD) Extension 2011 Food Supplement Nutrition Education (FSNE) Fall Conference. The FSNE program employs numerous nutrition educators that work in low-income areas throughout the state. Many of the FSNE educators work in public schools, teaching our children, but there are classes for adults as well. The annual fall conference is an opportunity to get all of the educators, interns, and program organizers in one room to share ideas, network, learn, and discuss the future of FSNE programming. The main focus of this year's fall conference was the use of social media and technology in nutrition education.

One of the highlights was the discussion of public health texting programs. Rebecca Dineen from the Baltimore City Health Department spoke about the Text4Baby program used to promote maternal and infant health. Texting programs are one example of how technology can help health professionals extend a message and reach a larger audience. The UMD Extension FSNE staff revealed their plan to launch a similar text campaign to promote healthy eating and regular exercise. The pilot program will start later this year and targets parents of school-age children.

The other interns and I contributed to the conference by presenting short technology tips throughout the day. My partner, Erika Wincheski, and I presented on Twitter and talked about its benefit for nutrition professionals. Other tech tools presented by our intern class included QR codes, Animoto, Poll Everywhere, and Dropbox. It was great to share our knowledge with the FSNE staff and get them excited about some of the tools we have been learning about in the internship.

We also got to hear Jackie Haven from the USDA Center for Nutrition Policy and Promotion speak about the launch of MyPlate. She discussed the role that technology has played in the promotion of the new food icon, specifically the online tools and resources available on the choosemyplate.gov website.

The day ended with the viewing of a documentary about school nutrition called Cafeteria Man. The film featured Tony Geraci, a chef and former food-service director of Baltimore City Public Schools, who challenged the school system to redefine its approach on nutrition. He is an advocate for garden based nutrition education and fought to get fresh and local foods into the public schools.

Take away message from the conference: It is a great time to be a nutrition professional!

There is a lot of attention on nutrition right now, in the media, in government, and thanks to the First Lady. Being able to navigate and utilize technology is an important part of working with today’s audience, but it’s not everything. As Tony Geraci might say, a bigger part of our job has to do with getting back to the basics. Grow real food. Eat real food.

Photo: Erika Wincheski (left) and myself, Sasha Bard, playing with MyPlate freebies at the UMD Extension 2011 FSNE Fall Conference.

For more information about:

Maryland Extension FSNE http://www.eatsmart.umd.edu/

Text4Baby http://www.text4baby.org/

Center for Nutrition Policy and Promotion http://www.cnpp.usda.gov/

Cafeteria Man http://cafeteriaman.com/

Dinosaurs

My current rotation, at the International Food Information Center (IFIC) Foundation, focuses on communicating the latest food-related news to the public via the latest technologies.  Indeed, the IFIC Foundation makes it their responsibility to effectively communicate science-based information on health, nutrition and food safety to the public for the public’s good. The information they distribute is both timely – meaning that it relates to what’s in the media – and current, that is, up to date. This rotation speaks to my anxiety of becoming an “outdated” dietitian. Information on nutrition is constantly changing, largely due to new research and ever-changing technologies. 

Last week, I participated in an interview with Omega 3 “fat expert” Dr. Bill Harris. He will be discussing the Omega 6:3 ratio during a free webinar on December 1^st. Here’s where my anxieties emerge: had I not been present for this opportunity, I may not have had such timely access to this new information on the Omega 6:3 ratio. Ultimately, I may have made inaccurate recommendations to my future patients, or created an inaccurate handout!

I think the anxiety of staying current is an issue in nearly every profession. But in health care, following current standards of practice is fundamental in providing optimal care to your patients. For that reason, it is so important for dietitians to use resources like IFIC’s website: www.foodinsight.org to keep abreast of new research and new methods for educating your audience. Resources such as these can also guide us in our responses to alarming food and nutrition information in the media :)

Traveling through Technology: International School Meals

By: Rachel Coury

Three weeks ago I started my Technology/Information Management rotation at FNIC (Food and Nutrition Information Center). This rotation has been an eye opening experience for me as it is completely different than the other rotations I have completed to date. At FNIC dietitians have more of a behind the scenes role. They essentially act as a resource center; their job to manage websites for food service personnel, nutrition educators, and others in the field to upgrade their skills and knowledge. They are constantly adding/updating resources to coincide with the current nutrition recommendations and trends. Since I have been here, we have added a “Sodium Reduction” page to go along with the 2010 Dietary Guidelines (they emphasize lowering your sodium intake), updated a Farm to School page as sustainability is a big trend right now, and added a page of webinar trainings- hello 21^st century.

My favorite project though was helping to develop an “International School Meal Programs” page. This page is completely different from any other on their site as it takes into consideration a global perspective on child feeding. I had a fun time researching different school meal programs around the globe and comparing them to ours. I learned that many countries are facing the same problems as us- developing healthier meals and promoting good health to combat the obesity epidemic that is affecting our population from a younger and younger age. On the other end of the spectrum are the third world countries in which humanitarian school feeding programs have focused their efforts. For many children in these countries, school lunch is the only meal they get all day. On the menu- usually porridge.

Although it is disheartening to hear about these struggles, I found many inspiring stories through my research. Organizations are dedicated to bringing food to schools in countries where children normally wouldn't have this luxury; kids are being taught how to start a farm in food deserts so that they can have access to food in the future; children are taking part in the process of growing/preparing meals so that they understand and appreciate where food comes from. We are making great strides in the area of global child nutrition, and I am thankful that, because of technology, I am able to learn about them.

Clinical Rotation Milestone #1: Mini Case Study

By: Angela Farris, MA - UMD dietetic intern

Five weeks ago I started my clinical rotation, a rotation that I was both excited and nervous to begin. The clinical rotation requires an intern to learn an endless amount of medical terminology, abbreviations, and drug/nutrient interactions on top of mastering electronic medical record systems and assessing/counseling patients in a critical care environment. This is by no means a small fete!

Before I started I knew I had a databank of medical nutrition therapy knowledge stored up in my cortex; it was retrieving this info that took effort. Homework assignments and intern class day lectures restored my confidence and enabled me to complete my first clinical nutrition screen, assessment, and patient education. I’m proud to say I've achieved many personal milestones since I began the rotation. I've performed a chronic heart failure (CHF) diet education, taught carbohydrate counting to a diabetic patient and charted a complete nutrition assessment for an enteral nutrition patient.

During the fourth week of my rotation I was scheduled to present my mini case study. The mini case study is one of the ‘official’ milestones every intern must complete during the first half of their clinical rotation. This mini case study profiles a specific patient and provides a suggested plan of care including any interventions. Additional information found in the case study includes a patient’s background, past medical history, medications, anthropometrics, lab values and estimated nutritional needs.

I’m happy to report I successfully presented my mini case study to four clinical preceptors. As an intern I realize there is always room for improvement. Below I've provided a few tips for my fellow interns that have not yet presented their mini case studies:

1. Know your patient’s medications - review the drug's purpose, specific action, & any drug/nutrient interactions.
2. Bold face lab values that are high or low. This will make it easier for your audience to detect abnormalities.
3. Include references! Document where you found your information.
4. Be prepared for questions.
5. Use feedback & constructive criticism to empower yourself. Couldn’t answer every question? Don’t feel frustrated – that’s why we’re interns :)

I’m excited to begin the second half of my clinical rotation. Next ‘official’ milestone? Major case study!

Nutrition Education at Its Best

As a dietetic intern, I will spend approximately eight weeks in information technology training, nine weeks in foodservice management, and fourteen weeks in the clinical environment. Though these are some of the core areas in the dietetic profession, community nutrition is definitely gaining momentum as public interest about nutrition and health grows. Therefore, I was excited to jump into my community nutrition rotation with the Food Supplement Nutrition Education  (FSNE) program. FSNE is sponsored by the University of Maryland Extension and provides nutrition education to participants of the federal food assistance programs.

Last week, I worked with four different FSNE nutrition educators to deliver four different curricula to over 800 Pre-K kids, kindergarteners, fourth graders, and Head Start children. Two of my favorite experiences both included Pre-K children and kindergarteners chowing down on their fruits and vegetables. On Monday, we assisted the nutrition educator prep and present Growing Healthy Habits—Parts of the Plant Salad. It may be a simple concept, but the kids were excited to see the school garden and learn how the plant starts from a seed and grows to have roots, stems, leaves, flowers, and fruit. We then made a salad composed of romaine lettuce, shredded carrots, chopped celery, broccoli florets, mandarin oranges, and sunflower seeds. Most kids loved the salad and said that is was the best one that they ever had! I also felt that the kids had a sense of pride knowing exactly what they were eating and where it came from. I had some fun watching them try to pronounce broccoli florets, too.

My second memorable experience from last week was at Moravia Park Fall Festival where the nutrition educator hosted a “Mock” Farmers’ Markets. This event provided over 400 preschoolers, kindergarteners, and Head Start kids with the opportunity to discover what they might find at the farmers’ market. In addition, they were able to sample the apples, pears, carrots, cucumbers, tomatoes, and lettuces. I must say the faces were priceless as some children bit into their first tart grape tomatoes, and others were pleasantly surprised by how much they liked the pears.  

Overall, it was a great first week at my community nutrition rotation. I am always impressed when young children not only eat their fruits and vegetables but also like them! Exposing children to healthy foods and habits while reinforcing positive social environments is definitely a step in the right direction in tackling the childhood obesity problem in America. I feel privileged to be part of the FSNE program and to witness the changes being made in children’s nutritional health.

Are Dollar Stores Really a Bargain?

I have a retail chain dollar store not too far from where I live. I’ll go visit every once in a while. I’m usually looking for inexpensive party decorations, kid’s party favors, gift bags, candles and miscellaneous items for kid’s school projects. I’ve always by-passed the food and household goods sections. I just assumed it was all non-brand or generic of inferior quality. Now, I’m not a person who only buys brand name products. I’m feeding a family of five, so I look for sale items, use the club cards, buy grocery store brands, and clip coupons. But, the dollar store has never been on my radar for food buying bargains.

Last week, our group of interns went on a little field trip. We went to a dollar store on a scavenger hunt. We had to find a set of small microwavable storage containers, plastic wrap or foil, a bottle of soap, detergent or cleanser, a jar of spice, a piece of kitchen equipment, one unhealthy food item and two healthy food items. This was much easier to do than I thought. Then I started wondering if the items we found were really bargains. If you compare these items with their grocery store counterparts, are you saving money?

Here’s a sample of some of the price comparisons:

Pineapple fruit cups/4 pack: Dole $3.69 (regular price at major grocery store chain), DelMonte $2.50 (sale price at major grocery store chain), Major grocery store brand $2.00 (sale price) – Dollar store wins!

Unit price comparison of Reynold’s aluminum foil: Dollar store $0.05/sq ft, Major grocery store chain $0.06-$0.07/sq ft depending on package, Major grocery store brand $0.04/sq ft (sale price) – If you have to have Reynold’s, the dollar store wins. If not, buy the store brand on sale.

Unit price comparison of Brillo Soap Pads: Dollar store $0.13/pad, Brillo brand at major grocery store chain $0.25/pad, SOS brand at major grocery store chain $0.28/pad, Major grocery store brand $0.22/pad – Dollar store wins! (Money saving tip: Cut pads in half before using, brings cost down to less than $0.07/pad)

Unit price comparison of Quick Cooking Oatmeal: Dollar store $0.06/oz, Quaker brand at major grocery store chain $0.11/oz, Major grocery store brand $0.09/oz – Dollar store wins!

Nutritional/unit price comparison of Reduced Fat Soy Milk: Dollar store (WestSoy Plain Low Fat) $0.03/oz, WestSoy Milk Plain 1% Lite brand at major grocery store chain $0.08/oz, Silk Soy Milk Original Light brand at major grocery store chain $0.06/oz – Dollar store wins!

It looks like the dollar store is a real bargain! If you’re not shopping at one near you, maybe it’s time to at least check it out.

There are a few things to keep in mind when bargain hunting at any store:

• Check expiration dates – even the best stores can miss these.
• Only buy in quantities you know you can use before the product expires. Throwing away food you spent hard earned money on doesn’t save you anything.
• Don’t buy dented cans or opened packaging.
• Compare the unit pricing, not the overall price.
• If you are unfamiliar with the product, read the nutrition facts label! Make sure it’s healthy. Unhealthy food isn’t a bargain.
• Look beyond the claims on the front of the package. Again, read the nutrition facts label!