Farewell "Dumb Phone, I Got An iPhone

I was nervous coming into the UMD internship program,which has a technology emphasis, because I didn’t have a smart phone. My trusty red phone that looked like it survived a stampede could only call and text; it had no apps, no web browsing, no touch screen. I thought how am I going to survive this program when I can’t even send an e-mail or get directions on my phone?
Admittedly, at first I wasn’t excited to get a smart phone. I didn’t want to learn all the ins and outs of a complicated phone. Trusty red and I had a long history together and I knew how to use it well. But recently the time came for me to upgrade phones, so I finally said goodbye to my little red phone and upgraded to a shiny new iPhone.

I felt pretty clueless in the store surrounded by all the smart phone options. The clerk spoke highly of the iPhone, so I thought sure I’ll take that one! I got it home and spent the entire weekend playing with all the features and functions of the phone. It wasn’t always smooth sailing because of my smart phone learning curve. But after about a week I’m happy to report I am successfully using my iPhone for things I never knew I could!

My favorite part so far has been taking pictures and being able to e-mail them and upload to twitter or facebook right from my phone. I was amazed at how easily I was able to take a picture at a rotation and upload it to a powerpoint presentation within a few minutes. I used to not even use the camera on my old phone because it was such as hassle. I’m also really enjoying all the apps. There are some really cool nutrition related apps I never knew about, like the MyDS dietary supplement app from the Office of Dietary Supplements.

I’m still getting used to using my new smart phone but overall I’m happy I upgraded. When I had my “dumb phone” I was blissfully unaware of all I was missing by not having a smart phone. I used to think all I needed a phone for was to call and text; who needs all that other stuff? But all that other stuff is useful technology that can help me be a better dietitian. Now, if given the option to go back to the old trusty red phone, I think I’ll stick with my iPhone.

This is posted on behalf of Emily Izer, Dietetic Intern

Food Sensitivities: Hocus Pocus or the Secret Weapon?

The newest craze among people, especially professional athletes, is the IgG Antibody testing for food sensitivities and the coinciding food elimination diets. While at my elective/second hospital rotation in Arizona, I got to work alongside many professional and collegiate athletes. As a performance nutrition professional, my preceptors are often asked, “if I am already eating right for my body, what else can I do that will provide me with that edge?” or if they are a rehabilitation client, “what will aid in a faster recovery time?”.

There has not been a lot of research on the significance of IgG testing and food elimination diets. However, I myself, have seen a great difference in those who have followed their tailored food sensitivity list and have heard comments of those who have changed their eating habits around this idea.

For those of you who have not heard about these “food elimination diets” or want some further clarification on what they are, let me explain. It first starts out with a blood draw. Your blood samples are then tested against a panel of different food antigens to see if your body reacts to any of the additives. If there is a sensitivity present, your body produces an antibody (IgG) and then each of those receive a grading of a +1, +2, +3, or +4 in regards to the strength of the sensitivity (remove from the diet for three months, six months, nine months, or one year, respectively). Immunoglobulins G (IgG) are found in all body fluids, they are the smallest and most abundant of the antibodies in the body. They are the most important antibodies for fighting bacterial and viral infections. Since these antibodies are so prevalent in our bodies you might wonder what kind of a reaction you might get when for example consuming some items you show a sensitivity to. Anywhere from the obvious signs/symptoms such as a stomach ache, delayed digestion, and heartburn to a slower reaction time or mental clarity.

While in Arizona, I got to analyze many of these results just as a nutrition professional would for their client. Once the lab results are received, I would go through the food items that elicited a reaction, then determined if there were any similar food families present, most commonly: Bovine (cow’s milk, goat’s milk, eggs, beef, dairy products, etc.), Nightshade (peppers, potatoes, tomatoes, etc.), Legumes (all beans, peas), Grains/Grasses (rice, wheat, oats, corn, etc.), and Fungi (baker’s and brewer’s yeast, cheese). Many foods fall into “families”, this means that they have a similar structure and make-up, therefore, also causing a similar “reaction”. These foods are then eliminated from their meal plans and substitutions are made when necessary (almond or coconut milk instead of cow’s milk). After the allotted time for elimination foods are then cycled back in (one at a time) so the individual can try and read how their body feels upon reintroduction.

Many of the athletes found this plan difficult and hard to follow at first, then you would start hearing the responses about how they “cheated” and for instance, ate a wheat product when they weren’t supposed to and how they felt so slow and sluggish the rest of the day. This is when you start believing that some of this really might make a difference even on a smaller level.

There still needs to be a lot of research done to prove the significance of eliminating foods that your body shows a higher sensitivity to from the diet. You must remember that this testing does not prove you have a full-blown allergy, but that your body shows sensitivity. However, I believe that the ideas behind the diet are good. If you eat the same items over and over again, your body will most likely show sensitivity to them due to overexposure. It probably is a smart idea for everyone to start cycling food items most often consumed and add some variety into your refrigerator and pantry. Stay tuned for more information!

Location, Location, Location

You don’t have to be in the realty business to have heard this one: Location, location, location. It’s the right place at the right time. Things just happen to fall into place. Lauren and I just completed our second of three weeks at UMD Dining Services and we’re thankful for (just in time for Thanksgiving!) our timing there. On top of the standard assignments and experiences throughout this rotation, we’ve been lucky enough to take part in extra programs and events solely due to timing in the internship. On our second day, we were invited to attend a stress management workshop held at College Park for the Mid-Atlantic region of the National Association of College & University Food Services (NACUFS). Anyone can benefit from this program: students, employees, management, and of course, dietetic interns. Our keynote speaker, Julie Gaver, said it’s all about choosing your attitude by keeping a smile on your face and bringing humor to the workplace.

Now that we were both feeling stress-free and energetic, we were invited to work at the Student Government Association sponsored UMD Crab Fest. WOW. I don’t know if these students know how lucky they are to have an event like this on campus. They had everything there. Potato salad: check. Macaroni salad: check. Adorable single-serving butterballs: check. The list goes on. Dining services purchased sixty-six bushels of crabs. (I’ll admit, to me that meant “a lot” so I had to dig further for a number). At an average of sixty-seven crabs per bushel, that turned out to be a whopping 4422 crabs ordered for about 900 students. That’s a lot of crabs! I’m not even a student and I had a blast.

After our much-needed Thanksgiving break, we’ll be entering our third and final week at this rotation just in time to see the pilot launch of the “OZZI” reusable to-go containers in the dining hall. This program is an effort to reduce not only waste, but costs associated with disposable containers used in the dining hall. If we had left before the holiday we wouldn’t have been able to see this happen! Like I said; it’s all about location. It’s those extra things we were fortunate enough to experience that made this rotation all the more special to me. We got lucky!

Until next time,
Marion

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!