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!

Slow Down! No, Speed Up! My Struggle with Time

I can remember being in elementary school staring up at the clock and counting down the hours until it read 3:00 so I could hop on the bus to go home. When I was older as a freshman in college I wished the time until graduation would fly by, and it certainly did. Now I’m feeling geared up to start working so I’m counting down the months until the internship is over.

My mind has always operated in “on to the next one” mode. I’m constantly thinking of the future and pushing the present out of the way to get there. On one hand, this type of thinking helps me get through tough days because I’m looking forward to bigger and better things. On the other hand, it’s hard for me to slow down and actually enjoy the moment. I end up speeding through a period of time and when it’s over I can’t help but look back and wonder how it would have been different had I not taken the fast lane.

Looking back college did fly by, even faster than I wished for and now I’m left wanting more. Learning from that experience, I don’t want it to happen again during this internship. This is a once-in-a-lifetime opportunity for me to experience things I will probably never get to experience again. I want to be present in the moment and take the time to appreciate what I’m doing.

Some experiences I’ve had so far through my rotations that I’d like to take a moment to appreciate are:

- Driving through scenic Montgomery County to get to elementary and middle schools so I could observe the school lunch and breakfast programs in action
- Eating a large bowl of fresh pineapple as part of my lunch at UMD dining services before meeting with students in the dining hall to discuss nutrition
- Discovering the sport of bacci ball from the staff at Food and Friends and packing and delivering meals for clients with HIV/AIDS and cancer
- Making pumpkin pie pudding and reading Max Goes to the Farmer’s Market to kindergarteners through 5th graders in Baltimore City schools
- Meeting all of the wonderful people in my dietetic internship program!

So instead of living life wishing time would hurry up so I can start the next thing, my goal is to slow down a bit and savor my time. Because before I know it I’ll be a new RD looking back at my time as an intern; I want to be able to say I did all that I could and had as much fun as I could along the way.

Cooking with a Chef

One of my favorite experiences in the internship so far had me step outside my nutrition comfort zone and enter the culinary world. During the Campus Dining rotation at College Park, my partner Emily and I were responsible for making a farewell lunch on our last day as a way to say thank you to everyone who helped us along the way. Doesn't sound like anything special? Well just you wait! We were able to cook in College Park’s new dining facility on campus, 251 North, which is more like a hip upscale restaurant than a dining hall. We also got to work closely with the head chef of dining services.

Chef John helped us develop a menu (Emily and I still need to work on our culinary creativity) and scale it to the 20 people we were expecting. At first, I was a little nervous to work in the kitchen with a chef. I didn't know if my skills would measure up- very basic skills I should add. It ended up being a truly educational, rewarding, and enjoyable experience; more like a private cooking lesson than work! The chef taught us how to roast peppers, knead pizza dough, and make our own vinaigrette. We learned the proper way to cut various vegetables, a homemade tomato sauce recipe, and how to do a chiffonade. Overall the five hours we spent in the kitchen flew by, and our end result was a delicious meal that everyone enjoyed. The best part of the day? Eating our creation!

Hard at work in the kitchen! Using a chiffonade technique on basil.

Pasta with grilled chicken and homemade tomato sauce with grilled zucchini, squash and roasted peppers. Grilled onions, asparagus, and shitake mushrooms marinated in a balsamic vinaigrette.

Food Insight and Plain Old Insight

With great sadness I must report that tomorrow is my last day at the International Food Information Council (IFIC) in DC. Finished. Fin. Finito. It happened so fast that I barely noticed that October flew by! I now know foodinsight.org like the back of my hand. (Yes, I’m very familiar with the appearance of the back of my hand.) Have I gained food insight from this? Absolutely. But more importantly, I’ve gained just some plain old insight.

It’s not every day that you sit in a room with ten other people and you’re completely floored. This was me on my first day at my first meeting. Every member of this organization has their finger on the pulse in the media. They know every newspaper, every article, and every journalist. New book announced this morning to have a release date of November 30, 2050? Already noted. To be quite honest, they were intimidating.

Day one was the first of many meetings to come, but the highlight was the Feeding Future Generations conference held by The Atlantic. Dan Glickman, former Secretary of Agriculture, quite possibly the most influential position you can hold in the world of nutrition, was the first speaker at the conference. Talk about intimidating! Not that I plan on being the USDA Secretary of Agriculture (Let me get through my internship for now, please!) but my eyes are open wide to the possibilities ahead of me. He, like the staff at IFIC, has made me think about how eager I am to learn about the field that I feel like I’ve only just grazed the surface of.

After spending a mere three weeks at IFIC, I feel like I could ask a string of questions starting with “did you know...” Who knew it was possible to learn so much in so little time? I feel infinitely more informed about nutrition, food safety, agriculture, and frankly the news in general. Three weeks doesn’t feel like enough, but I’m grateful for the time I’ve had at IFIC! My finger may not be on the pulse of the media yet, but it's getting there and I'm starting to feel something. Isn’t that what road to being an RD’s all about?

Until next time!
Marion

“Home is not where you live but it is where they understand you”

I have to admit, I was so animated to start my food service rotation at Riderwood. Since Cooking and creating new recipes are what I enjoy, a company like Riderwood is the best place to practice what I already knew and learn new skills.

At first I said to myself a retirement home? Why Riderwood? Well after I have been in each village and seeing the residents how well they have been treated by the Riderwood employees, I believe home is not just where you live but where people understand you. Leaving your house behind and moving to a new place is overwhelming and unimaginable to the most of us. Looking for retirement home is a devastating task. Where do you begin? How would you choice the best one? I understand why anyone would choice Riderwood as their future home. There are different activities such as wellness program, clubhouse, music, pottery, which the residents love and enjoy doing. In addition to these, in house services like salon, bank and gift shop are available for the residents. I was amazed when I heard from some of the residents how they enjoy their stay at Riderwood. Most of the residents have been there more than 10yrs. The residents also said that the love and the care they get make them feel like they are at home. After hearing these and seeing, I even said to myself, “I want to move in right now!!”

These Riderwood employees are not only compassionate to the residents but also to the interns. From the six weeks of experience at Riderwood, planning a theme meal for the residents was the most challenging and fun part of all. I was able to prepare meal in a mass quantity. The kitchen staffs were never hesitated to teach or give me some tips for preparing various dishes. Indeed I learned a lot more than I expected. I had the opportunities to be exposed to new challenges and learned new strengths which helped me to insight about myself. I was able to connect with employees of various educational, cultural and social backgrounds. They welcomed me into their workplace and treated me like one of them the entire time I was there.

Now I understand how I can share my knowledge in a place like Riderwood once I become an RD.

By Betanya

Case Studies: Decisions, Decisions

Well it feels like just yesterday that I was writing about my first few weeks at the hospital and now I'm finishing up with my last week of the rotation. I cannot believe how fast it has gone by. I have learned so much during these last few weeks and just like my partner who just posted last week, I have been involved in many aspects of the daily routine of a clinical dietitian including:

-Calculating a fair share of enteral and parenteral nutrition support recommendations

-Educating on a variety of topics including: diabetic, renal, diverticulitis, low sodium and fluid restriction diets

-Assessing and following-up with patients of all conditions and disease states

-Observing a modified barium swallow with the Speech Language Pathologists (SLP)

Now as my closing project for the rotation I'm working on my major case study, which let me tell you, like it says in the description, is a MAJOR task! After the last 7 weeks you would think that I would have a better idea of a clinical segment or condition that interests me, well…guess again. Since I really enjoy the medical etiology and pathophysiology more than a specific condition I found it extremely difficult to pick someone to model my case study after. In the end, I decided on putting the deciding on a back burner and waiting around until a patient and their condition “spoke to me”. This did not happen as quickly as I had hoped and I ended up letting patient past medical histories (PMH) decide it for me as the weeks passed by.

It was really difficult to make a decision on someone that you are going to spend so much time researching and examining. Plus, I was told not to choose anyone “too difficult” or with “too many problems”. Well nowadays, especially in a smaller community hospital within a lower economic status neighborhood, the PMH section is usually quite lengthy.

Then, I found a patient (more like the CHF order set found me) in need of a low sodium/fluid restriction diet education with NO PMH except for one condition and a treatment that was associated with his current diagnosis! I couldn’t believe it and swiftly claimed him among my preceptors as “my case study”. Unfortunately for me…few problems lead to a shorter hospital stay. Therefore, he didn’t have a lengthy clinical course for me to follow in depth, but after looking into congested heart failure (otherwise known as CHF) a little more I realized that there was still a lot to work with.

I am still making progress on the project as a whole, but really enjoying all of the research behind the condition and with this marking the end of the rotation I will be sad to see it fall into the “rotations completed” section of my internship.

Round one: Clinical Nutrition

I just want to start by saying that I absolutely love my clinical nutrition rotation!

For my very first rotation as a University of Maryland dietetic intern I was assigned to 10 weeks at a community hospital. Each week I work side-by-side with a different Registered Dietitian. Some have years of experience and some are new dietitians, not too long ago interns themselves. But each has generously offered their time to help me learn the trade, for which I am grateful.

I have seen a variety of patients at the hospital- some old, some young, some with acute conditions, some with chronic illness. Each patient is a new experience and a new challenge. I’m learning every day!

Here are some highlights:

-Educating an El Salvadorian woman, newly diagnosed with diabetes, on blood sugar control (in Spanish).

-Calculating TPN and PPN for patients with non-functional GI tracts.

-Monitoring a preterm infant struggle to gain weight as she was going through opiate withdrawal.

-Assessing nutrition needs of a vented patient.

-Selecting appropriate formulas for long-term enteral nutrition support and determining volume and rate of feeding.

-Completing calorie counts to assess nutrient intake of patients.

Being part of the medical team in a community hospital for the past 6 weeks has been a valuable experience. The dietitians are my number one resource and serve as resources for each other as well. This has given me a stronger appreciation for teamwork within a hospital. I’ve seen how important it is for dietitians to collaborate, not only with each other, but also with the other health care professionals involved in a patient’s care. Communicating with the doctors, speech therapists, nurses, social workers, case managers, pharmacists, and physical therapists at the facility has allowed me to provide higher quality patient care.

I’m six weeks closer to becoming a RD and know that I have so much more to learn. . . but I’m loving every minute of it (and that’s what matters most)!

Sasha B. Bard, MSN

The Ultimate Diet Sabotage, Vacations?

By: Rachel Coury

Do you find that your diet goes to the wayside when you take vacations with your friends? I just got back from my annual October girls weekend at the beach and am pleased to report that I was able to maintain some semblance of my healthy lifestyle this year. Sure I did eat more than usual and my fruit and veggie intake was under par, but it could have been way worse. Cue the July 2007 weekend when I split a 5-scoop ice cream sundae with my best friend, or the December 2008 get-to-together where 5 of us polished off two pizzas in less than 10 minutes. Somewhere along the way, maybe after the meatball massacre of December 2009, we made a conscious group decision that we needed to start eating healthier on our vacations together...and we’re actually doing it! Here are some healthy tips you can utilize next time you and your friends are planning a trip. Weekends away don’t have to mean diet sabotage anymore.

1. Set the tone before you go. Planning a weekend away but still trying to eat healthy? Make it known. That way everyone can come in the right mindset.
2. Getting physically activity in when you’re away doesn’t have to be a chore. Plan a walk or hike together. Bring a Frisbee and throw it around on the beach. Put on some music and dance.
3. Stop at a local produce stand if you pass one. It’s an easy way to stock up on fresh in season fruits and vegetables for the weekend.
4. Non-perishable items can be healthy! Whole wheat crackers/pretzels/bread, nuts, salsa, granola bars, apples, bananas, and canned fruits and vegetables are all healthy items that can withstand a long car ride.
5. Make dinners in. It’s generally healthier and more affordable, plus it can be fun! Divide the tasks up so everyone is involved. Try making a stir-fry and experimenting with spices, or make your own personal pizzas with whole wheat crusts and lots of veggies.