Carrot Sticks Wrap-Up

Last week’s lesson brought an end to this summer’s Carrot Sticks program and my Child/Adolescent rotation. Since early June, we (another intern and I) have had Carrot Sticks every week (for a total of 10 weeks) on Tuesday mornings/afternoons at the Shack Neighborhood House. The program consisted of three 45 minute classes for children k-2; it was designed to educate children about proper nutrition and the importance of a healthy diet. Each class included a lesson, activity, and snack. We wanted to create educational content that was interesting to children and decided on a program “theme”, focusing each lesson around different food cultures. We decided to use European countries, with each lesson highlighting a different country for a total of 10 different countries including:

• Lesson 1: Italy
• Lesson 2: France
• Lesson 3: Ireland
• Lesson 4: Spain
• Lesson 5: Germany
• Lesson 6: Portugal
• Lesson 7: Hungary
• Lesson 8: United Kingdom
• Lesson 9: Czech Republic
• Lesson 10: Austria

The lesson for each class focused around each country’s food guide pyramid and our MyPlate. Each week, the children deciphered the differences and similarities between the two. Each lesson introduced the children to 5 different food staples from the country and each of the 5 foods was from 5 separate food groups. I wanted the lessons to be as interactive as possible to help the children learn as best (and to have as much fun) as they could. Therefore, each lesson was similar to the game of pin the tail on the donkey; children got to come up and pin pictures of the country’s 5 food staples to where they belonged on both our MyPlate and the country’s food guide pyramid. I believe this ended up being a very successful way to introduce children to new foods, by showing them pictures of what the food looks like and what food group it belongs in. The children enjoyed being an active part of the lesson, which kept their most of their focus throughout the entire lesson. In addition, our lessons also included educating the children on specific nutrients. Because of the age range of the population, we focused on different nutrients every 2 weeks. We believed that introducing a nutrient in one lesson and then reiterating it in the next lesson would help the children retain valuable information. The featured nutrients were as follows:

• Lesson 1 and 2: Calcium
• Lesson 3 and 4: Fiber
• Lesson 5 and 6: Iron
• Lesson 7 and 8: Vitamin E
• Lesson 9 and 10: Potassium

Each week also featured snack time, which was often the children’s favorite part of the class. Some of the snacks included fruit and yogurt parfaits, veggie pizzas, smoothies, and even guacamole! We made sure that each snack was made with healthful ingredients and incorporated creative ways to introduce the children to new foods. For example: one lesson included veggie pizzas that were made into faces. We learned that making food fun for children is an effective way of getting them to try new things. Also, as we spent more time with the children and they began to like us more; therefore, they were more willing to try our snacks, even if they thought they looked “gross.” My favorite snack out of the entire summer was when I brought homemade guacamole on celery sticks. Almost every kid said that the snack looked nasty and that they knew they didn’t like it….but they were willing to try it. Once they tried it, almost EVERY one of them liked it and was asking for seconds!

Overall, I am sad that this summer’s Carrot Sticks has come to an end. After 10 weeks, it was easy to grow attached to the little ones, running around pretending to be nutrition ninjas. I love working with kids, as they can teach you as much about life as you can teach them. I believe they learned valuable nutrition information from our program this summer, like how to shop smart, cook healthy, and eat right (our nutrition ninja chant)! I am glad they received this type of education at this age because I believe that teaching nutrition to children early and often is the key to developing healthy eating habits for life.

WIC Clinic

Last week was the final week of my rotations at the WIC clinic. I have been given amazing opportunities to work with pregnant and post-partum women as well as infants and children up to the age of five. Clinic locations for my rotation were in both Marion and Taylor County. I have also been rotating at the Mon County WIC, where I have attended breastfeeding class, provided nutrition education to clients, and am creating an online module for supermarket tours. On clinic days, I have been working side by side with WIC nutritionists to present current nutrition education and practice effective counseling skills involving VENA (Valued Enhanced Nutrition Assessment) principles to facilitate behavior change. Also, I have been able to:

• Provide nutrition education and counseling services in a collaborative environment considering patient needs and resources for pregnant, post-partum, and breastfeeding women as well as infants and children up to the age of 5
• Use effective education and counseling skills to facilitate behavior change
• Refer clients to other professional services when needs are beyond individual scope of practice, such as the Tobacco Quit Line and Right from the Start Program
• Perform the Nutrition Care Process

During clinic, WIC nutritionists provide nutrition education and counseling to clients. Throughout my clinic experiences, I recognized a trend among WIC clients of high intake of sugary drinks; sugary drinks include soda, juice, kool-aid, Gatorade, sweet tea, etc. Juice is very popular among children, drinking several cups each day. Juice is part of a healthy diet, but don’t drink too much. No more than 4 ounces is recommended per day. I was responsible for providing nutrition education/counseling to clients on this topic and had to provide parents/caregivers with ways to decrease their children’s juice consumption and encourage their child to drink more water. These include:

• Serve juice for breakfast. The Vitamin C in juice will help absorption of iron from breakfast cereal, oatmeal or toast
• Add more water to the juice. Offer a glass of ½ water and ½ juice
• Freeze juice to make a slushy on hot summer days
• Freeze juice in ice cube trays. Add a few juice cubes to a pitcher of water

Too much juice in a child’s diet can lead to unnecessary weight gain or dental problems, such as cavities. Make sure children are consuming the RIGHT choice (water) when they’re thirsty and find creative ways to cut down juice consumption!

I enjoyed my time working at the different WIC clinics within my area. I have gotten to work with wonderful, knowledgeable dietitians and nutritionists and am very thankful for this rotation opportunity!

Day 1 of Carrot Sticks

Today was the first day of Carrot Sticks at the Shack Neighborhood House. If you didn’t read my first post about Carrot Sticks, the program is designed to educate children, ages k-2, about proper nutrition with a twist of culture. Throughout this program, we’ll explore European culture through its cuisine and today’s lesson featured Italy. At the beginning of today’s lesson, I wanted the kids to get excited about nutrition as much as I am. So, I had the idea of the children acting like “nutrition ninjas.” Who doesn’t like to pretend to be a ninja? Well, what exactly do nutrition ninjas do? Fight off “bad” foods? Exactly. But how do they do it? We decided to advocate the Academy of Nutrition and Dietetics Kids Eat Right slogan: Shop Smart. Cook Healthy. Eat Right. So, nutrition ninjas fight off bad foods by shopping smart, cooking healthy, and eating right. We had the kids chant this throughout the lesson to get excited about nutrition. They loved it.

Today, each group learned about 5 different foods from different food groups that are staples in Italy. These included:

• Whole wheat pasta
• Olives
• Fava beans
• Broccoli
• Mozzarella cheese

The children participated in an activity where we compared Italy’s Food Guide Pyramid with our MyPlate. Volunteers came up and played a game similar to “pin the tail on the donkey” and put each food in the correct food group on both Italy’s Pyramid and MyPlate. This allowed the children to understand the different concepts between the two.

After the activity, I explained to the children that 3 of these foods are high in calcium. Some of the children had heard of calcium before but believed that it was only in milk. I told them that more foods (like broccoli, cheese, and whole wheat pasta) contain calcium. I also highlighted that calcium is necessary for growing strong bones and teeth and to make sure eat foods with calcium every day to get the amount you need (1,000 mg).

The last thing we did in today’s lesson was healthy snack time. We fixed veggie pizzas that looked like faces, which we knew the kids would enjoy. We used mini whole wheat bagels and cream cheese for the head. We had black and green olives for eyes, red, yellow, and green peppers for the mouth, and carrot sticks for the nose. It was exciting to introduce children to new foods. Making healthy snacks seem fun, as in a veggie face pizza, is an effective way for kids to try new foods or foods they claim “they don’t like.” I heard more than once someone say, “I don’t like vegetables but I ate them anyway!” Today was great and I am really looking forward to the rest of this rotation. Until next week, nutrition ninjas!

Carrot Sticks: Preliminary Stage

Today marks the end of the second week of summer semester in my dietetic internship. During this week, I have been developing lesson plans for a program, called Carrot Sticks, for Child and Adolescent nutrition education. Carrot Sticks is an educational program, started at the Shack Neighborhood House, to help children learn about proper nutrition. This program is a fun and educational way for children to explore European culture through its cuisine. As well as being able to celebrate the food of a country, the program also promotes MyPlate and the foods that comprise each of its 5 food groups. For children to be healthy and get the nutrition they need, they need foods from each of the food groups. The lessons have been designed in line with the U.S.D.A. Guidelines for kids including the Nutrition Education Key Behavioral Outcomes identified by the Food and Nutrition Service of the USDA through SNAP-Ed (The Supplemental Nutrition Assistance Program Education). Carrot Sticks will highlight healthy foods, with a cultural twist, and educate about why these foods are healthy and exactly how they can be incorpated into our diets.

Starting in June and continuing into August, myself and another dietetic intern will implement Carrot Sticks every Tuesday morning at the Shack Neighborhood House to children ages k-2. We will have 3 groups and present each lesson 3 separate times. Each lesson is 45 minutes. I am very excited to work with this population as I believe that teaching nutrition and physical activity to children early and often is the key to developing healthy eating and active lifestyle habits.

Take a Chill Pill

Is stressed out the new normal? According to the survey Stress in America, 35% of Americans reported an increase in stress over the last year. And one in five Americans consider his or her stress extreme. Stress affects our health and spirit, but does it lead to food cravings and weight gain?

Stress is the combination of a stressor and the body’s reaction to it. A stressor can be thought of as a trigger, causing us to experience stress, whether it’s from a major life event or small daily hassles. We experience two types of stress. Eustress, or positive stress, refers to the stress felt while taking a test, during a job interview, or before public speaking; this type is termed as positive as it can often enthuse or excite. Undoubtedly, we can’t always avoid stress, and in this case, we may not want to. Eustress can provide a burst of adrenaline, helping us focus and meet deadlines, giving us our “competitive edge.” Eustress provides mental alertness, motivation, and efficiency; this is why individuals (including myself) often claim they work best under pressure. However, we all know that this is not true for everyone. Each individual perceives stress differently. Research suggests that people who view stressful situations as chances for growth usually avoid stress-related symptoms. But this is definitely not the case for all of us. Negative stress, or distress, occurs when your body cannot return to a relaxed state even in the absence of the stressor. For most, distress is caused by financial woes, work struggles or family pressures; this stress produces conflicting feelings [from eustress] that can take a toll physically and emotionally. Physical signs of negative stress include: changes in eating or sleeping patterns, weakness, dizziness, frequent headaches, neck and back pain, and frequent colds and infections. Emotional signs of negative stress include: persistent hostile or angry feelings, increased frustration with minor annoyances, nervousness, lack of concentration, anxiety, and depression. Left unchecked, chronic negative stress can contribute to high blood pressure, heart disease–and even obesity.

Does Stress Affect Weight?

Not every individual has mastered the art of successfully coping with stress. Each of us handle it in a different way. I seek stress-relief through distance running, which may not seem so awful to anyone unless you’re asking my kneecaps. So whether we want to admit it or not, we all have methods of madness we generally resort to. Stress in America reveals that 36% report overeating or eating unhealthy foods, and 27% report skipping meals in response to stress. Despite the common belief that stress directly leads to weight gain, research shows inconsistent results. A study published in the June 2011 issue of Obesity looked at over 14 studies and found only a very small association between stressors and weight gain. But a separate article, published in Nutrition, found evidence that stress contributes to either under- or over-eating and that long-term stress contributes to weight gain, perhaps because of the quote we’ve all heard, “eating our feelings.”

Comfort Through Food

Research suggests that while stress may not always lead to eating more–some people eat less and lose weight when stressed–it’s likely to lead to less healthy food choices. One study found that both normal weight and obese women who felt stressed had a greater drive to eat, were less able to control their eating (binge), and were therefore more likely to gain weight. More research is needed for concrete conclusions about how stress relates to body weight, food intake and food preference but that doesn’t mean you should wait to learn to stress less. Here are 3 tips to help:

• Relax. It’s vital to learn how to physically relax. Progressive muscle relaxation, visualization, and mindfulness are techniques to help better manage stress. Also, simply breathing through your diaphragm rather than only your chest can calm your body.
• Change your thoughts. The way in which we interpret stressful situations usually adds to stress. Changing the way you think about stressors can help you cope with current stress in a more positive, productive way.
• Get moving. Physical activity is one of the most effective ways to temper stress. Exercise releases endorphins throughout our body and help us to feel good and stress less. Also, try simply stepping outside to get some fresh air as it can really improve your outlook and perspective on life.

If you find that your stress is interfering with your ability to function as a parent, spouse, worker or student–seek help. Professional help can allow you to manage stress and enjoy your life.

National Nutrition Month

The month of March marks the celebration of National Nutrition Month. This month is dedicated especially to nutrition and is a great opportunity for each one of us to do something that will better our health. National Nutrition Month is a nutrition education and information campaign created annually in March by the Academy of Nutrition and Dietetics; this year marks the 40th anniversary. The campaign focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits.

The theme of National Nutrition Month 2013 is: “Eat Right, Your Way, Every Day.” It was designed to encourage personalized healthy eating styles and recognizes that food preferences, lifestyle, cultural, and ethnic traditions and health concerns all impact individual food choices. In other words, professionals in the field of nutrition realize that each one of us is different in the foods we choose to eat and why. Individuals may choose to eat certain foods based upon hectic schedules, religious beliefs, specific health concerns (i.e. food allergies), or other factors. This campaign is aiming to increase awareness that there is no specific diet that people must follow in order to be “healthy” and that it is possible for individuals to eat right, their way, every day and still be healthy.

5 Health Tips For You to Try

1. Eat breakfast. There’s no better way to start your morning than with a healthy breakfast. Include whole grains, lean protein, fruits and vegetables. My favorite breakfast is oatmeal cooked with low-fat milk with an added scoop of chunky peanut butter and berries.

2. Make Half Your Plate Fruits and Vegetables. Fruits and veggies add color, flavor, and texture plus vitamins, minerals, and fiber to your plate. Set a daily goal for your intake of both fruits and vegetables. It may be harder to find fresh options, but frozen and canned are nutritious alternatives. Just make sure to purchase the low-sodium option.

3. Be Active. Regular physical activity can drastically improve health in many ways, including lowering blood pressure, helping your body control stress, and maintaining a healthy weight. It is recommended that adults get at least two hours and 30 minutes of physical activity per week. You don’t necessarily have to hit the gym–instead play your favorite sport, walk the dog after dinner, or ride your bike around the neighborhood. If you feel like exercise just “isn’t your thing,” choose activities that you enjoy and may not feel like working out, such as a zumba class.

4. Choose Healthy Snacks. Replacing your normal potato chips with healthy snacks can sustain your energy levels between meals. Whenever you can, make your snacks combination snacks, which means incorporating more than one food group; for example, whole grains + lean protein or fruits + low-fat dairy. A few of my favorite snacks are 2 tablespoons of crunchy peanut butter on whole wheat toast or a handful of almonds + one cup of blueberries. These types of snacks will help keep your blood sugar stable and sustain hunger throughout the day.

5. Drink More Water. Our bodies depend on water to regulate temperature, transport nutrients and oxygen to cells, carry away waste products and more. During this month, put down the sugary sodas and artificial diet sodas and pick up a water bottle. The general recommendations for water are 13 cups for men and 9 cups for women. Hydration is a very important factor for our health. Individuals often mistake hunger for thirst, which can lead to overeating. Make sure you are hydrating throughout the day!

Information obtained from Academy of Nutrition and Dietetics

For more information on National Nutrition Month, visit www.eatright.org

What, Exactly, Makes Up a Nutritious Diet?

A nutritious diet has five principles; however, any one of these alone cannot ensure a healthful diet. If you establish the habit of using all of the principles described below, you will find that choosing a healthy diet becomes automatic. It may take some effort, but the payoff in terms of improved health is overwhelming. The five principles include:

1. Adequacy: the foods provide enough of each essential nutrient, fiber, and energy in amounts sufficient to maintain health and body weight.
2. Balance: providing foods of a number of types in proportion to each other; the choices do not overemphasize one nutrient or food type at the expense of another.
3. Calorie control: the foods provide the amount of energy you need to maintain appropriate weight—not more, not less.
4. Moderation: keeping certain parts of the diet within set limits; the foods do not provide excess fat, salt, sugar, or other unwanted components.
5. Variety: the foods chosen differ from one day to the next; providing a wide selection of foods.

Adequacy

Any nutrient could be used to express the importance of an adequate diet; for example, iron is an essential nutrient. You lose some iron every day, so you have to keep replacing it by consuming foods that contain iron. If you aren’t eating enough foods rich in iron, you may develop iron-deficiency anemia: with anemia you may feel weak, cold, tired, sad, and unenthusiastic; you may have frequent headaches; and you can do very little muscular work without extreme fatigue. Adding iron-rich foods to your diet will ensure you do not suffer from iron-deficiency anemia. Meat, fish, poultry, and legumes are in the iron-rich category and should be incorporated into your diet regularly.

Balance

To appreciate the importance of a balanced diet, consider a second essential nutrient, calcium. A diet lacking calcium causes poor bone development during adolescence and increases a person’s susceptibility to bone loss in adult life. Most foods that are rich in iron are poor in calcium. Calcium’s richest food sources are milk and milk products, which happen to be extraordinarily poor iron sources. Clearly, to obtain enough of both iron and calcium, individuals must balance their food choices. Incorporating meals that combine rich sources of nutrients can help people achieve dietary adequacy and balance from each recommended food group.

Calorie Control

Energy intakes should not exceed energy needs. The bottom line to weight gain, loss, and maintenance is not very scientific; each of them comes down to calories in versus calories out. Calorie control ensures that calories in (intake from food) balance calories out (energy spent on body functions and physical activity). Consuming a well-controlled diet helps to manage body fat content and weight.

Moderation

Intakes of certain food components such as fat, cholesterol, sugar, and salt should be limited for optimal health. A healthy diet consists of keeping fat intake below 35% of total calories. Some individuals take this principle to extremes and believe that they can never indulge by enjoying a juicy cheeseburger or an ice cream sundae, but they are misinformed: moderation, not total abstinence, is the key. Eating cheeseburgers and ice cream sundaes every day might be harmful, but once a month, consuming these foods would have practically no effect at all.

Variety

As humans, we are creatures of habit; however, it is agreed that people should not eat the same foods, even highly nutritious ones, day after day. The main reason is that a diet consisting of a variety of foods is more likely to be adequate in nutrients. Additionally, some foods are better sources than others in nutrition content important to health. Variety also adds interest—trying new foods can be a source of pleasure for the food lovers.

What’s Today’s Excuse for Not Eating Well?

If you find yourself saying, “I know I should eat well, but I’m too busy” (or too fond of fast food, or have too little money, or a dozen other excuses), take note:

• No time. Everyone is busy. In reality, eating well takes little time. Convenience packages of frozen vegetables, jars of pasta sauce, and prepared salads are abundant in today’s markets; truthfully, these take no longer to pick-up than chips and sodas. You must make a priority change, because we can always find time for the things we really want.
• Too little money. Eating right costs no more than eating poorly. Chips, colas, and fast food are expensive. By a 2005 USDA estimate, the needed fruits and vegetables can cost as little as 64 cents per day.
• Like to eat large portions. If you find yourself to be an overeater, change the size of your plate to smaller. The plate being completely covered with food will trick your brain into believing you are still consuming enough food to feel full. An occasional splurge, like once a month, is a healthy part of moderation.
• Take vitamins instead. Vitamin pills cannot make up for consistently poor food choices.
• Love sweets. These foods often contain high amounts of fat, sugar, and calories and should not be consumed every day; however, sweets in moderation are an acceptable part of a balanced diet.

Cooking Up Some Fun

At West Virginia University, innovative activities and solutions are being implemented to address the health and wellness of its students. Within the state of West Virginia, obesity levels are reaching alarming levels and there is a dire need for food and nutrition education programs. Additionally, not just any type of programming is necessary, but fresh and sustainable interventions that can stimulate change in both individuals and communities.

The recipes students created during A Taste Around the World

Yesterday, the WVU ISPP Dietetic Interns (that’s me) held the first of four sessions in the series titled, “A Taste Around the World,” on campus for a group of WVU students. The program’s aim is to increase students’ nutrition knowledge by exploring different culture’s food-related traditions and incorporating new foods into their diets. Throughout the program, students will gain culinary experience, experiment student-made recipes, and improve their overall health.

A student mincing cilantro

Yesterday’s Taste Around the World Lesson was a “Mountaineer Mexican Fiesta” where each student learned about a few food staples in a Hispanic diet and the health benefits of incorporating them into their diets. The program focused on four recipes influenced by Mexican culture, including baked tortilla chips, pico de gallo, chiles rellenos, and chilaquiles. Each recipe was substituted with nutrient dense ingredients that provided healthy alternatives by reducing the fat and calories and adding nutrients. Before the cooking began, students received a brief knife skills training, in which the proper cutting technique was demonstrated and taught for each ingredient in the featured recipes. Students were taught how to properly slice and dice tomatoes, cucumbers, onions, peppers and mince cilantro.

Pico de Gallo prepared by WVU students

One of the best ways to learn is through participation. A Taste Around the World implements hands-on activities to engage students in learning how to incorporate healthy lifestyle behaviors into their routines. WVU Dietetics wants to help its students learn how to shop smart, cook well, and eat healthy! Moving one step at a time in the direction of fighting obesity!

Article in the DA, “Gettin’ Fresh”

Buying Healthy on a Budget

One of the most common phrases I hear from my family and friends is, “eating healthy is expensive!” Well, as a future dietitian, my goal is to help people understand that eating well doesn’t have to break your bank. With careful meal planning, smart shopping, and a few changes in preparation techniques, you can make the most of your budget by always including fruits and vegetables in your meals.

1. Meal planning. Preparing meals and eating at home saves money and gives you the opportunity to enjoy meal time with your family. But your busy, so how do you do this? Plan ahead! This will save time and you will be less likely to resort to fast food or pre-prepared food that is more expensive.

• Make a list and stick to it. This strategy will help you avoid spending money on unnecessary items
• Include frozen, canned, and dried forms of fruits and vegetables on your list. These are all nutritious and handy for quick-fix meals
• Plan for vegetables or fruits to be the CENTER of your plate, then add protein and grains. Example: Stir-fried vegetables with rice and chicken.
• Plan meals around fruits and vegetables that go a long way. Plan to include fruits and vegetables that you can grab as quick snacks or turn into soups and casseroles that you can eat a few times during the week. Example: Apples make a great, easy-to-grab snack as well as baked apples for dessert.

2. Buy in season. Most fresh fruits and vegetables are available year-round, some are less expensive when they are in season. When certain produce is out of season, look to buy frozen or canned forms, keep in mind they’re all nutritious! Below I have listed the season of some common fruits and vegetables:

• Fall: acorn squash, broccoli, brussels sprouts, cauliflower, grapes, jalapeno peppers, mushrooms, pear, pineapple, pumpkin, and sweet potatoes
• Winter: brussels sprouts, clementines, collard greens, grapefruit, kale, kiwifruit, mandarin oranges, passion fruit, pear, sweet potatoes, and tangerines
• Spring: apricots, artichokes, asparagus, broccoli, collard greens, corn, green beans, honeydew, limes, mango, oranges, pea pods, pineapple, rhubarb, spinach, strawberries, and watercress
• Summer: apricots, Asian pear, beets, bell peppers, blackberries, blueberries, cantaloupe, cherries, corn, cucumbers, eggplant, figs, grapefruit, grapes, green beans, edamame, honeydew melons, jalapeno peppers, lima beans, nectarines, peaches, plums, raspberries, strawberries, tomatillo, tomatoes, watermelon, and zucchini
• Year-round: apples, avocados, bananas, bell peppers, cabbage, carrots, celery, cherry tomatoes, coconut, lettuce, mushrooms, olives, onions, and potatoes

3. Buy more. When there are special sales on fruits and vegetables, buy extra. They can be frozen, or you can prepare a dish to be frozen for a future dinner during a busy time. With that said, don’t buy it if you won’t use it or you’ll just be throwing out your money in the garbage.

4. Store your produce so they don’t go to waste. Spoiled foods cost you money! Remember, you can freeze foods and meals to use in the future.

5. Prepare more. This strategy will allow you to have leftovers that can be used for lunch, or to create a new entree. Leftovers vegetables can always be used to make a delicious crock-pot soup.

6. Replace half the meat. Substituting half the meat in a recipe with beans and/or vegetables will increase fiber and reduce fat, as well as save you money!

Eating healthy doesn’t have to be expensive; however, it does require technique. With careful planning and smart shopping, you can shop well, shop wisely, and eat healthy.