Roanna Martin

"make [food] simple and let things taste of what they are." {Curnonsky}


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It’s Really Happening

After two years of graduate school, this Friday is a day that I have been eagerly awaiting:

I’m going to be defending my thesis. 8 AM. If you’re in the area, you’re more than welcome to come! The more the merrier. There might even be a delicious snack. No promises, but it’s a good possibility.

Here’s the official announcement. Because I’m WordPress illiterate, I couldn’t manage to figure out how to embed a PDF in this post. Apparently I need to install a Plugin, but I can’t find that in my administrative dashboard, and I was driving myself crazy trying to figure it out.

And trying to have a beautiful high-resolution image to share with the blogosphere is probably one of the least of my worries at the moment. So you’ll have to settle for this smaller jpeg image, and click on the link below if you want to see the beautiful PDF. That’s all for now- wish me luck!

 

Screen shot 2013-04-02 at 9.16.13 PM

Click here to view PDF: Defense Announcement

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Text4Baby

At the beginning of this month I attended a joint intern class day on Nutrition Informatics at the National Agriculture Library in Washington, DC. Various speakers were discussing ways that technology is being used to distribute health information.

One of the presentations was about the national program text4baby a completely free program that provides health information directly to the cell phones of pregnant women and mothers of infants up to one year old. And by free- I really mean free- major cell phone companies have agreed to not charge recipients of the text messages, even if they don’t have a texting plan! It’s a really neat concept, and I was eager to learn more about it.

One of the presenters suggested that we sign up for the program and receive messages, just to see what kind of things mothers are receiving. So I did, setting my graduation date as my false “due date”- and I’ve been getting reminders to take my prenatal vitamins, and visit my doctor, and even info about access to health insurance! 

Last week at my WIC rotation, I was able to sit in on a webinar where I learned that text4baby is partnering with WIC to offer free appointment reminders to WIC clients. Like anything, it’s not perfect- it does take a minute or two for a mom to sign up for the program (but that is a small amount compared to what a lot of people spend on their phones), and she has to text the system every time she wants to schedule her next appointment.

So, as one of my projects for WIC, I made a brief powerpoint that can be used as an inservice for nutritionists- to help them share about the program with their clients.

 

 

My experience at WIC has been really great so far. I was able to personally do nutrition education and issue checks for about 15-20 families in the past few days. I needed an experienced nutritionist beside me, though, because I am still learning the computer system!


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Farmers’ Market Gleaning Project

As a member of the Academy of Nutrition and Dietetics, I get to choose a state affiliation. Since I’m living in West Virginia for grad school, I am currently a member of the West Virginia Academy of Nutrition and Dietetics (WVAND), and it’s been a fun way to get to know other dietitians in the state.

At the 2012 WVAND meeting, I committed to supporting local foods in my community, and I met that challenge by coordinating a gleaning project from the Morgantown Farmers’ Market.

I enjoyed coordinating this pickup and subsequent distribution to the local Salvation Army soup kitchen. 

My project description was just posted on the WVAND Website, and I thought I’d share it here as well!

“This past summer, after a suggestion from RoundRight Farm, and in collaboration with a graduate student in Ag Economics at the Davis College of WVU, I coordinated a market gleaning program from the Morgantown Farmers’ Market to the Morgantown Salvation Army Soup Kitchen.

Every Saturday as the market closed, myself or another volunteer walked around to each stand at the market to ask vendors if they had extra produce would like to donate. At the beginning of the summer, when there were just a few bags of greens, it was easy to walk the produce down the street to the soup kitchen. However, as the season progressed and beans, beets, tomatoes, and other hefty veggies were abundant, a car was necessary to transport the bounty.

The vendors were glad to see their produce being put to use, and the soup kitchen was creative in their use of the veggies. When I stopped by to see what they had made, they were serving green beans with sliced radishes!

We would love to see this project continue in the future, and are in the process of making plans to formalize, improve, and expand upon our current model. Perhaps this is even something that could be replicated around the state in other farmer’s markets.

If anyone is interested in providing future assistance in this program, either by helping with pickup, or potentially making a special dish out of the produce to serve at the kitchen, we would love to hear from you! 

Much thanks to Jessica Kozar, a WVU Human Nutrition and Food major, for her assistance with the pickup and delivery!”

Produce on its way!

Produce on its way!

And one of the creative dishes:

Green Beans and Radishes

Green Beans and Radishes


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Family Mealtime

“It’s dinnertime!”

What does that mean for you? Is it grabbing some food and eating in front of a TV, is it picking up take-out on the way home from Junior’s late basketball practice, or is it dinner around the table with your family- perhaps chicken with mac & cheese and broccoli and a glass of milk?

Increased frequency of family meals has been associated with increased intake of fruits, vegetables, grains, and calcium-rich foods, and decreased soft drink consumption (1). In addition, having more meals together as a family may reduce chance for disordered eating behaviors (2), and curtail other high-risk behaviors among adolescents (3).

The kitchen table is a wonderful place to build relationships, nourish the body, and rewind after a long day.

As part of my graduate program, I am working with a West Virginia early childhood obesity prevention project called Choose to Change

A few weeks ago, we hosted a “Family Fun Night”, where families simply came to a community center for a free meal, and engaged separate activities for kids and adults, promoting the importance of family meal time. 

The tables were set and waiting for families to arrive. 

The benefits of family meal time aren’t about a beautiful table setting or fancy courses. It’s simply having people together, talking and sharing life with one another.

However, we did put a bit of extra effort into creating some masterpiece centerpieces- turkeys crafted out of melons, grape skewers, and pepper slices.

Fruit and Vegetable Turkey

After the meal, I hung out with the little preschoolers. We had fun activities like a relay race to set the table, and bean bag games where some colors were “healthy foods” and others were just “sometimes” foods.

Choosy, the mascot for the program, showed up. This was a huge hit with the kids. I managed to get a picture with him too!

Celebrity Shot

Family meals were always a priority in my home growing up, and I’m incredibly thankful that my parents chose to make these evening rendezvous an essential part of our day. I learned a lot around the kitchen table.

As a college student, family-style meals can’t always happen, so I’m even more thankful when they do occur.

These past 6 weeks I have been completing a clinical rotation about 2 1/2 hours from where my apartment is. I’ve been blessed by living with a great couple here, who have graciously opened their home to Emily and I.  Here we are, enjoying a family-style meal together. A bit of Thanksgiving dinner and sparkling cider at the dining room table- this didn’t happen every night, but we did enjoy eating dinners together when able.

Late Thanksgiving Dinner

It’s hard to believe that this clinical rotation has come to a close already. Good-bye, Charleston!

The Gold Dome of the West Virginia Capitol Building

 


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Preventive Maintenance

So, this past week brought a bit of extra (unwanted) excited in regards to my mode of transportation.

I drive a 1999 Ford Escort- a basic, run-of-the-mill, get-me-from-point-A-to-point-B type of deal. I try to take good care of it, and regularly check the oil before long trips, get my oil changed every 3000 miles or so, keep plenty of windshield washing fluid inside, wash the outside whenever I’m at my parent’s house and have easy access to a hose, and vacuum it out with moderate frequency.

When I went to get my oil changed this past week, the mechanic called me in to the shop to look at my tires. Much to my chagrin, the inner part of my front tires was worn completely bare. I was aghast, and he informed me that I should probably have my alignment checked. Alignment?! I didn’t know that was part of car maintenance. But alas, apparently it is. So I promptly purchased new tires, and had my tires aligned. The front tires were so badly aligned that it was off the charts. If  the alignment had been checked earlier, I could have saved myself the expense of buying new tires. As an added note, I’m going to make certain to take a quick look at my tires from time to time. Because even I can easily do that, and it would have clued me in to the issue before I went for an oil change.

I felt so, well, STUPID, because I didn’t know that alignment should be checked (every 6,000 miles according to one dealership site, 20-30,000 miles according to another site) with moderate frequency. Obviously, I don’t know much about the world of mechanics and automobiles, so I’m thankful when others can teach me things that I do not know.

I was thinking about how there are likely many people who don’t know about preventive health maintenance. Things that seem obvious to me may not be so obvious to others. As I proceed in the field of dietetics, I need to remember that what seems common sense for health may not be for other people.

This analogy was taken even further in a hospital room at my internship on Friday, when there was a newly diagnosed diabetic who already had several diabetic ulcers on his leg. Ironically, this patient was an auto mechanic.

If he had spoken with a health care professional earlier, regarding his symptoms of increased thirst, increased urination, and blurry vision that accompany hyperglycemia, he may have been diagnosed earlier. At that point, he could have begun to control his blood sugars through diet, exercise, and perhaps medication if necessary. With this preventive care, much like my tire alignment, he could have saved himself the complication of the diabetic ulcers in the same way that I could have saved myself a pair of tires!

Maintaining good health is the best kind of preventive maintenance.

Here are 5 lifestyle habits for health maintenance:

  • Adequate physical activity
  • Good nutrition
  • Decreased tobacco use and exposure
  • Decreased alcohol use
  • Positive thinking

Source


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Maintenance of Weight Loss

A brief article published on Eatright.org- the website of the Academy of Nutrition and Dietetics, the world’s largest organization of food and nutrition professionals- caught my eye recently.

Entitled “Four Ways to Shed the Weight for Good”, the article puts forth a few strategies employed by people who lost 10% of their body weight and successfully kept it off, as compared to those who lost similar amounts and regained the weight.

  • Weigh yourself regularly: it’s best to weigh in at the same time of day and on the same scales to monitor progress.
  • Keep it going: continue to employ the habits that helped you to lose weight. Keep food and activity logs, and continue to practice portion control.
  • Plan ahead: Use problem-solving skills to prepare for upcoming potentially difficult situations, as well as catch yourself mid-stride.
  • Engage in positive self-talk: using positive reinforcement mentally, verbally, or even journaling can be a great place to do this.

Speaking of journaling, I’m a huge fan. I haven’t implemented this practice as much for weight loss/maintenance in my life as much as I have used it for mental and spiritual health. The blank white pages present a clean white slate to scribble, scratch, design, paste, sketch, and scrawl.

I began journaling when I was about 6 years old, and I’ve filled nearly 26 journals since then. Journaling and introspection are a big part of who I am, and as I am in the midst of taking steps towards becoming an RD, I find it important to have habits in my life that are grounding and provide balance. My journal is a place where I can process emotions and have a creative outlet, without fear of judgment or rules.

But back to the practice of journaling for weight loss and maintenance, I found a great list of journal prompts. When modified to exclude the term “diet” in it’s mainstream definition as “a restrictive food pattern” because I think that overall food habits should be the most emphasized, these are some great questions.

Here are a few of my favorites:

Having a healthy weight is important to my health because… 

When I lose a few pounds it will be fun to…

One year from now the foods that I consume will be… 

I feel wonderful in my body when I eat… 

The thoughts that help me most with weight loss are… 

Eating sweets makes me feel emotionally… 

 


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Medical Ethics

Through my clinical dietetics rotation today, I had the opportunity to attend two medical ethics meetings- a meeting of the Ethics Committee this morning before work, and an “Ethics in the Round” lunch and learn event.

“Medical Ethics” is a term used to refer to the values and guidelines that govern decisions in medical practice. All health care professionals need to be cognizant of the ethical issues that they make each and every day, and dietitians are no exception.

One of the areas that most relates to the work of a clinical dietitian is the use of enteral or parenteral nutrition. Enteral nutrition refers to feeding through the gastrointestinal (GI) tract using a tube, catheter, or stoma that delivers nutrients from a location further down the tract than the mouth (1). Parenteral nutrition refers to administering nutrition directly into the circulatory system (1). Most of the time, being able to use these methods to deliver nutrition to an individual is a wonderful thing that can sustain them while they are recovering from trauma or illness.

However, there are cases in which artificial nutrition will prolong life, but not necessarily promote a high quality of life.

Many of you have likely heard of the Terri Schiavo case. In this case, there was dispute between family members (which lasted from 1998 to 2005) over whether or not to continue feeding through her PEG (percutaneous endoscopic gastrostomy) tube, although doctors declared her to be in a “persistent vegetative state”. Eventually, after the case escalated to a point of federal involvement, the feeding tube was removed for the final time.

An excellent article from Today’s Dietitian addresses the issues related to PEG tube feeding at end of life. Associated risks and indications for placement should be considered prior to using a PEG tube. Although the dietitian is typically not involved in the decision of whether or not to place the PEG, they should be aware of the rationale behind the placement.

Risks include:

  • Potential complications of the surgery to place the PEG
  • Possible infection around the PEG placement site
  • Tube malfunctions (such as a blocked or leaking tube)
  • Intolerance of feeding
  • Possible fluid overload and electrolyte imbalance

 

The most evidence-based and clinically useful indications for placing a PEG tube include:

  • head and neck cancer
  • acute stroke with dysphagia
  • neuromuscular dystrophy syndromes
  • gastric decompression

 

While some practitioners may believe that tube feedings are a level of basic humane care, the wishes of the patient and family must be considered.

One of the best things that can be done is to have advance directives or living wills that clearly spell out your desire to have or not have artificial nutrition placed in case of a medical event.

Other topics discussed today were the use of “bloodless surgery centers”, in order to eliminate the need for blood transfusions during surgery for some religious groups.

As I am diving more in depth into patient cases and medical histories, I am learning so much about the world of health care. I am realizing that I still have a LOT to learn, and I am so thankful for the many things that I am being exposed to over the course of this internship.

(1) Nelms, Sucher, and Long. Nutrition Therapy and Pathophysiology, 2007.