Showing posts with label RD. Show all posts
Showing posts with label RD. Show all posts

09 March 2019

When should I worry about my weight?

Usually on this blog, I answer my own questions. But when an old friend tells me that my answer to his question was helpful to him and could be to others too, well, I’ll break format for that.

How do I know I’m healthy?


The question:
So when it comes to being fat/body positive, I've been pretty successful in applying that to other people, but I'm not sure how/whether to use my own weight fluctuations to assess my own health. How do I assess my diet/exercise level? Should I evaluate weight gain/loss? Are there measurable signs that my diet and exercise routine are working for me? At what point (if ever) does weight gain/loss become a concern?
There are at least two ways to understand your weight changes and health status: with your head and with your heart. We’ll explore both. Before we do, though, let’s assume that you are a disease-free, able-bodied person who eats a reasonable diet, i.e. you’re not getting 40% of you calories from, say, alcohol or donuts.

29 December 2017

Earnin' Cred and Makin’ Bread: Dietitians Riding the Career #strugglebus

This post was written by Elizabeth Briasco, whom I precepted fall 2015. She is now a dietitian pursuing a Master of Science degree in Sport and Exercise Nutrition in the United Kingdom.

Several words typically come to mind when we hear the word "intern": naive, coffee, and free labor might be some of them. Most internships pay nothing or, at the very most, minimum wage.

However, there are actually internships out there with a less than 50 percent acceptance rate that require interns to pay thousands of dollars just to participate. No stipend is offered for housing, food, materials, transportation, or any other miscellaneous internship costs. The internship consists of at least 1200 hours of practical experience across three to ten different sites and can last anywhere between eight months and two years. Hours range from forty to fifty hours a week, giving interns very little leeway for a part-time job, assuming their internship director even allows them to get one.

Welcome to the confusing, costly, and demanding world of dietetics.

19 November 2014

MyTake: A Story to Nurture in Five Food Groups

This five-poem cycle was debuted tonight at Gigi's Cafe in Minneapolis, MN (thank you, Eric! #MNYFP) and The White House in Fayetteville, WV (thank you, Garnet! #RDpoets).

Grain

For my second birthday, my mother stacked bagels
into a pyramid and lit a candle.
My aunt and uncle glanced
at each other.
I grasped and cooed
at my first flickering food.
When I was old enough to balance on a chair,
I stood at the counter next to my mother as she
turned and folded,
turned and folded
nascent bread.

My hands worked, too,
on a knob, brown and hard.
She divided her mass of dough, all curves, into four,
and tucked the soft edges under.
We greased our pans—
wide and accommodating for her, a narrow box for me—
and tapped flour across the bottom, the sides.

Her loaves sprang in the oven.
Mine were obstinate,
until I developed the patience to follow the recipe exactly, to
turn and fold,
turn and fold.

Dairy

I knew cow’s milk belonged in my diet 
the same way I knew I would go to a liberal arts college—
from context and culture.
In America’s dairyland, sheltered by the Lawrence Bubble,
I ran with Russian
and lounged with Linguistics.
Then one sunny spring afternoon,
I stepped into the dark.
The Lawrence University Vegans and Vegetarians were screening Eat:
Giggles from the back row when rhetoric leapt,
but hush when furtive footage rolled.
My cognitive construct of Milk
curdled.
I stepped out of the dark, the bubble—
burst.
How could I cipher Cyrillic, compare conjugations
in this savage light and sharp air?
I made curt changes,
homemade soy milk for cow’s milk,
coconut oil for butter,
sorbet for ice cream,
and on and on.
Ossified academia lumbered along—
I semestered in Russia:
my brain in St. Petersburg, my belly in Minnesota,
and delectable dairy products in my face:
smetana, tvorog, syrok.
Russia, like so many kefir grains,
fermented the familiar to a
teeming,
complex
tang.

Protein

One thing broke me;
           two built me back.
Fall in FScN 4612, Human Nutrition,
each lecture softening the edges of my circumscribed truth.
Studies strive for stolid statements,
           but humans refuse to cooperate.
We fictionalize what we ate yesterday,
we guess at how often we eat fish,
we tick the same box for grass-fed beef,
for venison,
for McDonald’s Hamburgers.
I crumbled under the weight of peer-reviewed articles,
at odds with each other,
squinting their way to the truth.
Winter, and I watched a dietitian speak with precise passion
of an ecological approach to food and health,
           of environmental health and natural resources,
           of starting with oneself.
Essential building blocks condensed
into a strand stretching
from a protein machine, bending and twisting
into a tertiary structure,
The Food System.


Summer, and I was swept along on a sustainability safari:
landing in locations
         from labels off co-op shelves,
scuffling with scripts
         from scholars and scientists,
facing furrowed facts
         from farmers and foragers.


Now, feet planted in soil,
eyes raised to the sun,
I throw my arms open to complexity.

Vegetables
The anorexic client’s favorite tallies 
are vegetables.
The anorexic client’s favorite colors
are black and white.
I watch the clients serve themselves.
“That’s enough salad,” I say to one
           and she glares at me.
Here, dessert is more important than vegetables,
and clients purse their lips at it,
wishing one of them would disappear.
Here is the bitter pill to swallow:
there is no black and white.
Only a magnificent muddle of color.
 

Fruit

A child with her first fig 
Doesn’t know what the seeds look like
Until she has ripped open the skin.
I labored four years eating from the tree of knowledge,
facing bracing questions,
planting enchanting answers.


I rested two days with a dietitian turned farmer,
who sat on a hay bale and recalled with remorse the advice she once gave patients,
who stood by a fire and wept over the death of her son.
She planted rows and rows of trees for him, the fruit of her land.


Mary, Mary, quite contrary,
how does your orchard grow?
---
Revised April 2015. You may also be interested in the poem Sunbeam, the lyric essay Renewal. Retool. Remake., or my 2015 poetry project, Right Now Is Your Life.

14 December 2011

Minnesota Sunset Act

Catching up on email, I finally read the Minnesota Dietetic Association's educational document on licensure and learned about an intriguing act passed at the end of the the 2011 Legislative Session. But first...

What does licensure mean for dietitians?
Public safety. While the Commission on Dietetic Registration gives RDs that "R," it is not a legal authority and cannot restrict RDs who may harm the public. The Licensure Board does have legal authority and so can tell unlicensed practitioners to cease and desist, etc. In addition, being licensed conveys greater credibility to those insurers from whom we'd like reimbursement.


What is the Minnesota Sunset Act?
A MN sunset, courtesy of D. Bjorn
This act established an Advisory Commission to review the merits of departments, agencies, and other government entities to make sure they are
  • efficient and effective,
  • meeting their goals and objectives,
  • complying with federal and state laws,
  • addressing complaints in a timely manner, and
  • not duplicating or overlapping with other agencies,
among other criteria. The law places agencies into six groups, each with a scheduled review date and possible expiration date.

Who's up first?

The first batch is set to expire June 30th, 2013:
  • the Amateur Sports and Combative Sports Commissions
  • Capitol Area Architectural and Planning Board
  • the Councils on Asian-Pacific Minnesotans, Black Minnesotans, Affairs of Chicano/Latino People, Indian Affairs, and Disabilities
  • all health-related licensing boards
  • all advisory groups associated with these agencies
You can see that the Minnesota Board of Dietetics and Nutrition Practice falls neatly under that fourth bullet point.

What does this all mean?
As far as I can tell, the Minnesota Sunset Act is a means to shrink government and save money.  Whether it will do so and how it will affect RDs remains to be seen.

26 September 2011

Dietetic Internship, Explained

I've come to realize that the name "dietetic internship" leads some people to think of summer-long affairs of tedious work. And when I mention The Emily Program, some think I'll be working there for the duration. So it's time to clear up what exactly I'm doing for the next eight months.

What is a dietetic internship?

A dietetic internship is a supervised practice program accredited by the Commission on Accreditation for Dietetics Education (CADE) whose completion is required to write the national examination  administered by the Commission on Dietetic Registration (CDR), which, when passed, earns you the Registered Dietitian (RD) credential.

Without the alphabet soup:  internship → exam → credentials! 

This program must provide at least 1200 hours of supervised practice in Foundation Knowledge and Competencies, which cover cover all dietetics practice functions (clinical, community, foodservice). Competencies look like this:
DI 3.1 Perform the Nutrition Care Process and use standardized nutrition language for individuals, groups and populations of differing ages and health status, in a variety of settings
And this:
DI 4.2 Perform management functions related to safety, security and sanitation that affect employees, customers, patients, facilities and food
DI 4.4 Participate in public policy activities, including both legislative and regulatory initiatives
Mastering all these "upon completion of the DI, graduates are able tos" requires a good deal of observing RDs in their natural environments; i.e., hospitals, foodservice settings, nonprofits, WIC, and more. It also includes a healthy dose of projects, such as designing a themed meal, presenting on a nutrition topic to a group, charting, presenting case studies, pricing out a menu and completing nutrition care plans.

So there's the DI in a nutshell. Next up: What does The Emily Program have to do with it? (If you can't stand the suspense, click here.)

06 May 2011

"Food and Nutrition Information You Can Trust"

I renewed my student membership to the Academy of Nutrition and Dietetics (the Academy). I did not make this decision lightly.

I recently joined a group of "Progressive Nutritionists," started by members of the Hunger and Environmental Nutrition dietetic practice group. These RDs are fed up with the company the Academy keeps. Partners include the following:
  • ARAMARK - a food services, facilities management, and uniform and career apparel company
  • The Coca-Cola Company - no explanation needed
  • Moderation Nation - a national consumer education campaign sponsored by the Hershey Center for Health and Nutrition
  • National Dairy Council - providing science-based nutrition information to the public on behalf of dairy farmers
The Premier Sponsors line-up includes General Mills, Kellogg Company, Mars, Inc., SOYJOY, PepsiCo, Truvia, and Unilever (owner of such brands as Ben and Jerry's, Hellman's, Skippy, and SlimFast), as well as two companies that sell various nutritional products.

How credible does the nutrition advice from an organization that takes money from these companies seem to you?


Revised 8/4/12.

19 March 2010

RDs on the Hill

Photo from Deb Greene
Late in February, I attended the Minnesota Dietetic Association’s Legislative Day on the Hill. Given that public policy affects the dietetics profession, this annual event was geared to show dietetic professionals and students how to affect public policy. This year’s attendance was triple that of last year's – we were packed into what I had thought was a spacious conference room.

We heard first from Carol Brunzell, MDA Public Policy Committee Member and ADA delegate. Brunzell presented Policy 101, an introduction to how a bill becomes a law (something we had covered recently in Community Nutrition) and when/how we can get involved. Maggie Powers, author of Eating Right When You Have Diabetes
, followed with a description of her role in drafting health care reform legislation. She emphasized the importance of being at the table when legislation is being written and building relationships that provide support for the legislation.

Next, we broke into groups to role-play a visit to a legislator, a useful exercise. The RDs’ goal in the role-played visit was to introduce themselves to the legislator; outline the many roles that an RD can play; raise issues of concern, such as health care access and reform, access to safe and healthy food, and chronic disease prevention; and establish themselves as an expert on nutrition and as a ready resource.


Our sessions came to an end as Representative Kim Norton (DFL-Rochester) made her way to the front of the room. She painted a bleak picture of our economic situation and mentioned three current bills that require no funding, such as the current Farm to School Proclamation to raise awareness of Farm to School Programs in Minnesota. Rep. Norton urged us to spread the word about SHIP, the Statewide Health Improvement Program that promises to reduce health care costs in the future by working to lower obesity rates and tobacco usage.


At this point, we broke for lunch in the Great Hall, which was literally just a hall. I chatted with Louanne Kaupa from Owatonna, who had been in my break-out group, and Ramona Robinson, who had worked with Chery Smith on a couple of papers about sustainability. Then I joined a small group on the hunt for some action. We ended up in a committee meeting on Commerce and Consumer Protection. As we entered, Sen. Kelash was introducing a bill on lead acid battery purchase, return, and collection provisions modifications. What struck me was that the senator was not personally familiar with all the details of battery purchase, return, and collection – that’s why Brad Bergstreser, from Savage Auto Parts was there. He explained the reasoning behind the provisions modification and fielded most of the questions from the committee members. I could easily imagine a dietitian sitting in that seat next to a bill’s cosponsor, answering questions as a nutrition expert.


We left the hearing before the issue was resolved to visit Rep. Rick Hansen in the State Office Building. He had stepped out for lunch, but when he returned, we were welcomed into his airy office. After introductions, Sue Parks, RD, mentioned some of the talking points suggested by the MDA. Rep. Hansen described to us the difficulties facing Minnesota’s budget, which made our desires for SHIP funding to remain constant or for health care reform seem entirely out of reach.


In any case, the message of the Day on the Hill came through loud and clear: RDs must advocate for themselves if they wish to be reimbursed for their services. This event was a great stepping stone into getting more involved in public policy in the future.



Edited 2/28/11