Happy Holidays!

Today is my second last day in my LTC rotation and to say I have enjoyed myself would be an understatement. I met some really interesting and intelligent people (staff, Residents, health care providers, Resident's friends and family, etc.) during my time at the Villa and I feel that my experiences in this internship rotation were enhanced by these interactions and they allowed me to grow in knowledge, experience, skill, and emotionally. Being a LTC Dietitian allows for so much more than providing nutrition and administrative assistance and leadership - it comes with an opportunity to bring joy, comfort, compassion, and a supportive ear or shoulder to the Residents. I would welcome the chance to have a career in LTC.

With the end of my rotation in LTC, comes some much needed time away with my fiance, Kev! I am so very very excited to fly out in the wee hours of Christmas Eve morning to join him for the holidays.

My next rotation, starting January 3rd, 2012 will be in Clinical with a Renal/Stroke Dietitian.

Merry Christmas and Happy Holidays!

Rotation #2: Long Term Care

Villa Saint Joseph-Du-Lac

I have now finished my first 2 of 4 weeks in my LTC rotation and I can honestly say, that I am loving it! Prior to this rotation I did have experience working in LTC facilities (in Lunenburg, NS; and Calgary, AB) so I knew that being in this setting was something that I enjoyed and thrived in - and this continues to be true.

The tasks and assignments that I have been working on include:

• Admission assessments;
• Dysphagia assessements;
• Menu analysis for number of servings daily available to Residents from Canada's Food Guide;
• Implementation of a new food to the menu;
• Staff in-service education sessions on "Celiac Disease and the Gluten-Free Diet"
• Attend multidisciplinary focus meetings
• Prepare for and present at Resident Care Plan meetings
• Assist with food-related events, such as a birthday party and Christmas tea;
• Charting;
• Prepare and present a detailed case study of a Resident;
• Assess Residents on nutritional supplements (Ensure, Boost) for means of continuation or cessation;
• Cost analysis of the nutritional supplements to determine daily, weekly, and yearly cost;
• Assist Residents with meals ("feeding" - but I hate to use that term so I shall refer to it as "assisting with meals" instead);
• Resident and staff interviews;
• SO much more!

I really am enjoying my LTC rotation!

A more descriptive entry complete with my reflections on my experiences in LTC will be completed when I'm at the airport waiting to board - only 10 days remain!

Lobster!

Dumping Day: November 29, 2011

Since I am doing my internship in a location where the main industry is fishing and lobstering, the other interns and I have been taking advantage of this and participating in as much as we can! 

Lobstering boats ready to depart

Our first lobstering event was Dumping Day. What is Dumping Day, you ask? It is the first day of lobster season when all the lobster fishermen head out on their boats at 6:00am and dump their lobster pots for the first time that season. On November 29th, we three got up crazy early for a Tuesday and were at the Cape Forchu lighthouse for 5:00am. There was a breakfast of bread pudding (incredible), muffins, coffee, and hot chocolate available for donation inside the lighthouse. There were gobs of people waiting outside to see the lobster boats approach the lighthouse. Then, at 6:00am, the horn blew and all the boats increased speed and headed out to sea to applause, cheers, and a message illuminating the rocks on the shore: "Have a safe and prosperous season". It was really great to experience such community spirit and camaraderie! Definitely worth getting up so early - and we were back to the residence in enough time to allow an hours nap before heading to work.

Eating lobster that was caught earlier that day

The next lobster inspired event happened just last night. Tina and I were invited over to our friend's parents home (who live in Pubnico, NS - about a 35 minute drive from Yarmouth) for a fresh lobster feast! Our friend's dad is a lobster fisherman and brought in the lobster from sea just hours before! It was by far the freshest and most tasty lobster I have ever tasted! I was even given a lesson on how to shell the lobster like a pro! 

It was an amazing evening filled with good food and great company! It also put me into the Christmas spirit so I am even more excited to fly home to Calgary for Christmas!

Oh Public Health, What Great Things I Learned During My Time in Thee

So this post is a little delayed due to mass amounts of internship-related work, but here is my final reflection of my public health rotation.

My Office in Public Health

 My rotation in Public Health: 

• Forced me to expand and alter the way I think – think about the bigger picture.  
• Increased my familiarity, comfort, and knowledge in Excel, PowerPoint, Word, and Publisher.
• Allowed me to participate in activities outside of meetings and committees and resource building that Public Health Nutritionists are involved with.
• Meet new people and see parts of Nova Scotia I wouldn’t have otherwise had the opportunity to see. 

Food Service Assessment Project

• Increased my knowledge and experience on how to quickly build rapport (and the importance of doing so) in getting genuine responses.
• It helped me to become familiar with the Food and Nutrition policy so I could better recommend required supports for schools to help them with their efforts to follow the FNP.
• Helped to increase my confidence level in myself and in my background in food service. It felt good to have my preceptors ask me questions to clarify food service-related questions they had. 
• This rotation exposed me to presenting on behalf of a department such as Public Health. It is much more different that a University setting – a necessary and interesting learning experience. 
• I learned so much about prenatal and breastfeeding (nutrition and otherwise). This is an area where I had had no exposure outside the classroom and the prenatal nurse was incredible as a teacher. I was able to create documents, do presentations, help out with prenatal classes and Friendly Feeding Line meetings. I enjoyed having an active role in my education.
• I really enjoyed going on a home visit with a Home Visitor. I hadn’t known that this program existed prior to this rotation, so it was a huge learning experience for me.
• Getting to know the staff of Public Health and meeting with most individually to hear about their roles in the department. 
• Learn about and create documents for the Child Care Regulations – worked with PH Nutritionists province wide for edits. These documents are now being circulated throughout the province. 

Everything hinges on education. Without it, you can't advocate for proper health care, for housing, for a civil rights bill that ensures your rights.

~Susan L Taylor

I Can See Clearly Now the Fog is Gone

This morning I was revamping my research proposal, which actually should have been submitted weeks ago but since I was having some issues with it, I refused to do so until I was happy with it. I know understand why I was having such intense issues - I wasn't seeing the bigger picture. 

Prior to this revamping, I had an epiphany whilst chatting with my fiance, Kevin. I asked him to describe to me the current state of the economy so I could better understand what has and is going on economy-wise in Canada and in Nova Scotia (Kev's my finance guru). This discussion was what I needed to understand - and I mean completely understand - the trials and difficulties with getting schools and people to comply with the Food and Nutrition Policy for NS Public Schools. 

An insane 40% of chronic diseases including obesity, cancer, cardiovascular disease, and type II diabetes are largely preventable through diet and physical activity. However, simply recommending healthy eating and physical activity will not benefit the population as there are underlying factors that inhibit healthy eating and PA. Geography, demographics, socioeconomic status, employment status of families, single parent households, etc. all contribute to the ability of families everywhere (not just NS) to be able to provide healthy foods and safe environments for physical activity. This is why the SFNP is so important! It ensures that for one meal a day, children who might otherwise not have the opportunity to eat healthy, nutritious foods, get this chance! This allows them to benefit from these nutrients and hopefully helps contribute to their healthy development and the possible reduction of the development of chronic disease later in life through developing health habits at a young age. 

Prior to my discussion with Kev, I was aware of the above predicament, but it wasn't until I was explaining why I wanted to know about the GDP and economic state of Canada (and the world in general) in regards to my research project, that I actually understood the importance of considering the big picture. 

Such an amazing feeling to finally have the mental fog cloud lifted.

Food Service Assessment Numero Tres

Yesterday was a very early morning which started with a pick-up by my fellow assessor at 6:30am to allow for our long commute towards the western coastal region of the SW Nova District Health Authority. It was an absolutely gorgeous drive and I loved seeing a part of the province I hadn't traveled to before.
Surreal landscape and ocean views.

An Aside:
From a comment I received a la Barb (a professor and the person who challenged me to reflect on a regular basis) who suggested that I clarify the parameters for my declaring how well a FS assessment went in each school - and I completely agree. So before I continue with this post, allow me to specify my parameters for the past and future FS assessments, as yes, if you can't read my mind - and I certainly hope no one can! - then how are you to know?

For a school to be reviewed in a positive light on this blog, it is based simply* on how well the FS assessment (and our presence observing their jobs/routine) was received by the FS worker, principal, and others we come in contact with - positively, negatively, or neutrally. Of course, the FS worker would have the greatest impact on how smoothly or how rough the FS assessment goes as we have the most direct and frequent contact with him or her. A FS worker who is simply nervous, timid, or unsure of how to respond to our presence tends to respond well when rapport is developed (asking about his or her family, how long they've been working in this position, sharing stories with them - I have found that tossing the "I'm getting married" frisbee in casually has loosened 2 out of 4 FS workers up and made them feel more comfortable with me).

*the term "simply" is used to refer to the fact that the parameter of this blog (not in the formal report or outlined in the official assessment results) consists of the attitudes of the person who was involved in the FS assessment at each school and not on other factors - as all the schools being assessed were identified as needing immediately help complying to the policy, so it can be assumed that the menus need some tweaking. "Simply" does not imply ease as building rapport and questioning/observing someone's job is these are neither easy nor simple, but rather complicated undertakings that require a certain delicacy in our approach as assessors.

For a negative (or "it didn't go well") designation, the FS worker may have been hesitant, reluctant, or showed outward irritation that we were there AND that this affected how well we were able to extract information from him or her and effected the flow of the assessment. I found that in schools, so far, where our presence was met with resistance or disdain (which are vastly different from nervousness as observed in a positive/smooth FS assessment), we found that getting thorough and detailed information was very very difficult and could have, in actuality, affected the outcome of the assessment. A FS worker who is already angry, irritated, or offended that we were assessing the school food service that they work in, will not be ass receptive to rapport making the FS assessment a true challenge when it need not be.
End Aside.

So, with the basics outlined above, the FS assessment yesterday was unpleasant and frustrating for me at times. Upon arrival we were overall very well received by the FS worker, admin assistant, and the principal. However, the questions we asked - even though they were neutral in nature and said with an inquisitive tone/phrasing rather than judgemental (which would have gotten us nowhere) - quickly caused an irritation with the FS worker. When I noticed this I waited until the FS worker was out for recess duty then discussed it with my fellow assessor. I was curious to know if a) she noticed it too, b) if it was the way I was phrasing the questions or through non-verbal communication, and c) how she felt we should proceed with the assessment. So, long discussion short, we feel that it was simply that she was being questioned and was taking offense to the questions, perhaps thinking that we were judging her. We decided not to ask her about her resistance, which I support, as she opened up later saying that she was concerned that her job was in jeopardy. However, even after telling us this and us reassuring her that our goal is to keep her in her position to ensure the students received healthy foods, she continued to show annoyance with us. But we were able to finish our assessment and complete the observation of all food services taking place in the school.

What did I discover about this school worth mentioning ?

Unfortunately, it was largely that the FS worker has become demotivated (through years of poor sales and recently reduced hours) and even though she was concerned about her job, she has made no effort to make herself and asset to the school (by means of creativity in food served, following the school food and nutrition policy more strictly, etc.). The menu offered daily is the same one every single day, every month. If I were a student and had the same limited options for lunch, I too would get bored and stop buying. She said that she likes how she can do her job on "auto-pilot" and then later said that there is no one trained to replace her because anyone can make the food on the menu (basic sandwiches, canned soup, chicken or veggie wraps, frozen individual pizzas, frozen potato wedges). Personally, if I were concerned about losing my job, I would make an effort to keep it. Hopefully she takes our recommendations and supports will will offer (which she identified as being interested in - have students taste test new foods and survey students on which foods they would buy if offered) so that she does gain some job security as the Principal mentioned that the cafeteria is losing money and may have to be shut down.

I am delighted to mention, that despite the lack of variety on the daily menu, the items served were overall fitting with the policy. True moderate items were being offered much too frequently, salad dressing and sauce portion sizes were much too large, the mini pizzas offered daily were cook from frozen made a white crust with pepperoni, sauce, reduced-fat cheese, and no vegetables, and the potato wedges which are a major seller were par-cooked in oil first and had far too much sodium to be offered daily, but what I didn't see was chocolate (other than in milk form)! Hooray for no chocolate!

I do think that a lot of positives came out of yesterday in terms of the FS assessment and what we will hopefully be able to offer in supports to the FS worker... I just hope the FS worker eventually believes/agrees that it was a worthwhile endeavor.

Sugar + Sugar + Sprayed on Nutrients = Breakfast?

Today I am determining the recommendations for menus/foods sold at the two schools that have undergone the food service assessment so far. In my quest to find some examples of maximum nutrition cereals for the Breakfast Programs, I stumbled upon the following horrific items that I have not seen before today and would now that I have, hesitate to call food. I would not recommend that these cereals be consumed, especially as the main component of a meal. Although if you're an adult and feel that you want to eat sugar coating wheat coating even more sugar, then may I suggest having protein with it so your blood sugars don't skyrocket nearly as high as without the protein?

(as I'm typing this while on a break at work, I was just offered a massive Tootsie-Roll by a co-worker, good intentioned but ironic that I'm offered it as I'm writing about how I feel these items should not be labelled as food.)

So which cereals get the designation of being so nutritionally-void?

         

             

Yuck.

Fruitopia ≠ Fruit

Yesterday was the 2nd school that underwent a food service (FS) assessment by moi. Unfortunately, this time the assessment wasn't as inspiring as the last.

Despite the claims of the full-time FS worker that she was trying to follow the policy guidelines, the only evidence of which we witnessed was the Maximum Nutrition Foods poster hanging in the kitchen (not at all faded which leads me to believe that it was recently hung), the change on this month's menu to whole-wheat/grain products, and selling baked chips. However, regular white bagels were still being sold at the canteen for purchase at recess, and refined flour muffins are offered as long as they are in the kitchen (which is at least 3x per week according to their menu). Chocolate was everywhere and anywhere (granola bars, pudding, cookies), a large bag of sprinkles was in the kitchen, hard taco shells were on the menu, large portions of donair sauce to be served with garlic fingers as an entree, hash browns served as a vegetable, and Cheez Whiz or jam sandwiches are offered as alternate lunches daily. The FS worker responded to our questioning her menu with the defense that "kids won't eat anything else." But this begs the question, "have they been given the chance?"

I've noticed a trend that FS workers seem to be confused about the 70:30 maximum:moderate nutrition foods served. The policy guidelines are that 70% of the time (each week, for instance) the foods served to students must be of maximum nutrition value, and only 30% of the time moderate foods are available. At no point during the regular week (or to be sold at any time at any function the school puts on) are minimum nutrition foods (like pop, hot dogs, and chocolate - other than chocolate milk... le sigh) able to be sold at the school. Minimum nutrition foods can be given away at special functions (total of twice per month) as long as maximum nutrition foods (like vegetables) are also provided free-of-charge. Back to the 70:30 ratio: FS workers, as it seems, believe that as long as they have some maximum foods for sale, they can sell as many moderate foods as they like, or only offer a certain number of baked chip flavors daily. Not so much the case. The idea behind the guideline is that students only have the option to purchase moderate foods twice per week (30% of a 5-day school week), therefore, if baked chips are offered for purchase daily from the canteen, this guideline is not being followed. This is because, as I observed yesterday so my idea has merit, kids will more often than not choose baked goods such as freshly baked (not necessarily homemade) muffins, granola bars, or chips over fresh fruit. Not providing them with an option to purchase these moderate foods 3 days a week ensures that they get sufficient nutrients on those days. Seems simple enough to me, but I also have a nutrition degree and am training to be a Dietitian. Both times when this concept was explained to the FS workers at the schools, it was met with resistance and the protest that students won't buy the healthier foods. I say: give THEM a chance to decide for themselves! Perhaps they haven't tried these foods before. School is a place to learn, why not also encourage them to learn about new and different foods? 

So where does the title of this blog entry come into play?

Product comparison courtesy of Coca-Cola's website

Yesterday, the FS worker was telling me about the homemade desserts she makes to sell to the students, and one of which that she was particularly proud of was a frozen fruit pop she makes by combining yogurt and Fruitopia. Fruitopia is neither a fruit nor is it even permitted to be sold in schools as it is a minimum nutrition food. Having "fruit" in the name of a product, does not make a healthy food.

This example shows the level and degree of education and resources that we'll need to provide to the FS workers and their schools to help them better follow the School Food and Nutrition Policy.

Unfortunately, my time in my Public Health rotation will be over before I can help administer the supports that were determined to be necessary for the schools. Perhaps a lucky integrated intern will catch the tail end of it in the spring.

Fun Food-Related Stuff I Stumbled Upon

I'm feeling like sharing a smile - so here are some fun things I came across while on a break from writing my research proposal. Enjoy!!

...Sigh...

 

Mini Food!

Van Gogh Cake

Rice Krispie Square Watermelon

"Never eat more than you can lift." 

-- Miss Piggy, Muppet extraordinaire

 

The "Absolutely Ridiculous" Burger weighing in at 338 lbs, 540,000 calories.

Wheat is the Devil: A Resurgence of My Former Frustrations

My Aunt Kathy sent me a birthday card with an article in it she photocopied from Maclean's Magazine, and asked for my opinion on it. I had read it, was slightly outraged, gave it to one of the Public Health Nutritionists at work to also have a wee giggle at this Doctor's extremist view. Then I forgot about it. 

Today, on Facebook, a holistic nutritionist who taught me while I attended the Canadian School of Natural Nutrition (CSNN) posted this article in support of it. A resurgence of all the fear mongering and lack-of-research based instruction I received while attending this school came flooding back. For the record, I enjoyed the experience but am still questioning the information I was taught - I crave factual backing to my education and they were unable to provide it. With that said, I have no problem with views that are different than mine - to each their own. What I do take issue with is when those views are published in widely circulated magazines and presented as fact (people will believe what they are told if they perceive the person doing the telling to be a professional).

Breathe.

Okay... so,

I am hesitant to promote an idea that could potentially scare people away from consuming foods that have nutritional value to them. Whole grains contain important nutrients such as B-vitamins (breads and cereals are largely enriched with vitamins that help to prevent health problems such as those developed by deficiencies like neural tube defects in newborns with a folate deficiency), vitamin E,  and soluble and insoluble fibre. The consumption of whole grains is recommended by such health bodies as the Mayo Clinic, Health Canada, the Harvard School of Public Health, Dietitians of Canada - and more! It is true that some people have food sensitivities and allergies and perhaps that is why they gain weight when consuming grains (as per the claims in the Maclean's article), although with celiac disease, people tend to be underweight, but celiac disease is just one type of allergy-related (gluten) health condition. Sensitivities and allergies present with numerous different signs and symptoms, so narrowing down which type and to which food (or other factor) a person might be reacting to can be tricky and require some allergy testing (although sensitivities may not show up in allergy testing). 

But I digress.

I think energy would be better spent focusing on the bigger picture - high cost of healthy foods, low cost of unhealthy foods, high fat high sugar foods, physical inactivity, obesogenic environments such as drive thrus... the list goes on. The scare tactic used to compare the consumption of wheat to tobacco use is, I believe, only hindering the progress of the credibility of the field of nutrition. Readers will see that the interviewee, Dr. Davis, is a medical doctor and will therefore believe, without question, that he is presenting research-supported facts. Some people can be sensitive to components of grains - and of many other foods as well - but the extremist view that wheat is largely responsible for present-day obesity, I feel, is unjustified. I had a biology teacher in high school who presented in class his idea that the reason North Americans have such a high rate of heart disease, is that we have flush toilets. His theory was based on the fact that people living in remote arctic regions do not have indoor plumbing and have also very low rates of heart disease. Therefore, they have a causal relationship.

Oh my. 

Perhaps if my teacher had done his research, he would learn that this relationship is actually correlational and not causational (if it is causational, I'll need to see the peer-reviewed research to prove it), and that perhaps the high quantity of healthy fats in the diets of Inuit peoples, healthy fats which have been proven to help mitigate atherosclerosis, are actually responsible for the low heart disease rates. Additionally, I do believe that there are fewer fast food restaurants in the arctic, restaurants, and grocery stores, so perhaps there is an absence of obesogenic opportunities to partake in up North. But regardless of what my biology teacher believed to be fact, at least his idea wasn't published in a national magazine.

I agree with the idea that wheat products are no longer the original crop that our ancient ancestors grew and consumed. However, I am interested to know why Dr. Davis isn't attacking the other 70-75% of foods that are in some way, shape, or form influenced by genetic modification?

Nutrition and Dietetics is a field where misinformation and incomplete information runs rampant. Dr. Yoni Freedhoff, author of the blog Weighty Matters, said it best when he commented on how some people feel they are qualified to provide nutrition advice simply because they eat. It is necessary for nutrition professionals to step-up to the plate to bat away... clarify... what is factual and what isn't. Not long after Dr. Davis' interview was published in Maclean's, a Dietitian was interviewed on CBC Radio and was given the chance to more calmly explain what Dr. Davis was talking about - better explaining his logic and whether or not she supports it. The PH Nutritionist whom I shared the article with originally heard this interview on CBC Radio and said she did a good job of talking down the accusations in Dr. Davis' interview and stating that she doesn't support his overall opinion of whole grains, including wheat, though agreed that it is no longer the same crop that it once was. However, in comparison to the viral spread of the Maclean's magazine, and my inability to find the CBC Radio interview online, I fear that this Dietitian's interview will not be heard.

Welcome to Public Hell-th

This morning in Public Health we decked out the office with Hallowe'en related paraphernalia.

Here are some of the ideas and themes we decided to use --> good for an end-of-week smile!



Witch's Brew: Alcohol Strategy, SWNDHA Public Health

Some other ideas for posters we had were:

• Let's Rot Your Teeth: Dental Hygienist
• I Want to Give You a Virus: Communicable Disease & Prevention Control
• The More Sugar, Fat, and Butter, the Better to Kill You With: Public Health Nutrition Services

  




Sugar Coma: Public Health Addiction Services



Mummy's Milk is Best for Babies: SWNDHA Public Health



"The supreme accomplishment is to blur the line
between work and play." 
~Arnold Toynbee



Aaaaaaaaaand We're Off!

Foodservice assessments in 7 schools in the Tri-County District here in the South West Nova District Health Authority has begun!

Over the next month, myself and 3 others (only one other and I assess a school at a time) will be doing a foodservice assessment of 7 schools who have been identified to be most likely to benefit from some one-on-one attention. We will be using a tool I developed with the help of the Public Health Nutritionists and will be focusing on areas such as food safety, compliance to the NS School Food and Nutrition Policy, and how much time is required by the foodservice worker to successfully prepare the food.

Today myself and my preceptor observed the breakfast and lunch programs in a local elementary school, and it went beautifully. The foodservice worker was an absolute delight and was extremely helpful. She admitted to being stressed about the idea of us coming in to do the assessment today as she had initially perceived our choosing her school to visit as a negative. However, she said after a few days she rethought it and instead decided to make it a positive situation and use the opportunity to ask us questions about the School Food and Nutrition Policy (SFNP) and her menu.

How did the assessment go?

Very well!

We were able to see that food safety was a priority to the foodservice (FS) worker through her actions, signage, and method of food holding and storage. We were able to answer her questions regarding the menu and she requested some healthy (and enticing) recipes to serve the students for dessert. We highlighted a few areas that will need to be improved, such as no longer serving chocolate cookies or pudding (as chocolate is not permitted by the policy), reducing the quantity of moderate snacks being offered for sale for recess snack, and removing a non-baked nacho chip from the menu. Otherwise, the meals are largely made from scratch by the FS worker (students purchasing meals vary from 30-70 students daily depending largely on when payday is for the parents versus what is being served). These freshly made items include: homemade soups, salads, sandwiches and wraps. Other items include mostly from scratch components, such as pizza where the FS worker purchases a frozen whole wheat pizza crust but then prepares the rest herself. I think she is doing an excellent job and shows a great interest in ensuring that she is complying with the policy and providing the students healthy meals, while trying to keep costs down.

We identified some supports that we could offer the FS worker including the aforementioned resource of healthy/yummy dessert recipes for kids that follow the policy.

I hope the other FS assessments go this smoothly. Next FS assessment is next Monday.

Away Goes the Once Healthy Breakfast

Tina holding up a box of oatmeal on sale at the Superstore.

Enter Quaker Oatmeal Cookies 'N Creme! 

Oatmeal is generally an excellent food to start the day with (or to consume at any meal). Consuming pure oats can help to lower LDL cholesterol (the "lousy" or bad cholesterol), decrease bowel transit time thereby assisting with regularity, can make you feel fuller longer due to the high fibre content (thereby can help with weight loss), can help reduce one's risk of developing heart disease (picture of a heart is even on the box) and type II diabetes, and so much more! But there are better ways to make oatmeal tasty (as oatmeal without anything added is quite bland and boring, I'll absolutely admit it) than to heap sugar and fat into it. Perhaps it was added in an attempt to "disguise" the actual product in hopes that it will entice, or perhaps trick, children into eating it - or at the very least, hope to induce "mommy mommy buy this for me" behavior in children. 

To keep oatmeal healthy one can add fresh or frozen blueberries, or other fruits to it, toasted almonds, cinnamon and raisins and/or cut-up apples, even adding a tsp of brown sugar with milk would be by-far more desirable than this fare offered by Quaker. Buying the quick rolled themselves would be cheaper to buy in bulk than in the boxed individualized packages and would be much healthier! Encouraging families to make their own oatmeal would be in the better interest of health versus encouraging and promoting the consumption of cookies to start the day. Quaker should put more effort into promoting their regular rolled oats - perhaps even team up with a frozen fruit (no added sugar) company. But instead of promoting health, Quaker opted to support the growing rate of childhood obesity.

Thumbs down, Quaker, thumbs down.

Front-of-Package Nutrition Rating System: Increasing Confusion in Already Confused Consumers?

 

On Friday, the Institute of Medicine (IOM) released Phase II of their recommendations for Front-of-Package Nutrition Labeling (FOP). Essentially, the IOM want to put a universal rating of stars on the front of each grocery store item (produce included!) according to the level of calories, sodium, sugar, and saturated and trans fats the product contains. Products can "earn" a total of 3 stars if they fit the nutrient criteria. However, if a product, such as a cola drink, exceeds the requirements by a certain amount, they will not be granted stars in the areas that it does pass.

Is this new FOP a good idea? 

Will this not confuse already confused consumers who are trying to figure out the many different FOP labeling offered by different companies? Sensible Solutions, Heart Check, Blue Menu, etc. have dominated the FOP in grocery stores and the grocery store shelves appear to be a endless ocean of nutrition and health claims. There has been such a great push, perhaps it has even blossomed in a fad, to make it easier for consumers to make better food choices, but very little effort put forth by these companies (in respect to the intensive marketing campaigns involving their own FOP nutrition labels) to educate on the basics of healthy eating. Why not educate consumers on who to properly read nutrition labels? They are already present on the packages of foods - except those that do not come in packages, like fruits and vegetables! With that said, I'm not even confident that if the money spent on these type of gimmicks, as good in intentions as they may be, were put into education of the already existing labels or even into a basic how-to-eat-healthy guide, that it would reach more people. Consumers, for a large part, know that items such as Pork Rinds are unhealthy, but people are still buying them. The question then begs to be asked, "will another package label actual bring about behavior change?" Should companies be forced to instead promote campaigns already in existence such as Canada's Food Guide and or My Plate put out by the USDA? Although I agree that it may be out of the scope of feasibility to further promote these government health documents on the population, and looking at the front of a food package is easier - how much of the original document put forth by the IOM will actually come into fruition? My guess is that a companies will do the bare minimum to follow the guidelines, and do their best to find loopholes (as I've learned with the School Food and Nutrition Policy, people are more apt to search for loopholes than abide by recommendations, perhaps as a way of rebelling against them).

My recommendations as a Dietetic Intern are as follows:

•  Push nutrition education! Start educating people about healthy eating, and this should start when they are young, when good habits can be easily formed. 
• Governments need to start making harsher regulations for what can be passed off as "food". Artificial fruit snacks and jube jubes are, in my opinion, not food as the only semblance to food on their nutrition label is the corn found in the high fructose corn syrup.

 Le sigh.


You can read more about the FOP nutrition labeling at the ScienceDaily website.

Healthy Eating Nova Scotia

In a discussion I had today with one of the Public Health Nutritionists, she revealed that her job is very much dictated by the Healthy Eating Nova Scotia (HENS) strategy. HENS outlines four areas of priority: breastfeeding, children and youth, fruit and vegetable consumption, and food security. Concentrating on these areas would allow for blanket of health promotion interventions to reach as many people as possible in an attempt to lower the occurrance of chronic diseases, such as obesity, cardiovascular disease, diabetes, and cancer. I knew that her job was focused on these areas, but I hadn't made the link that it was due to this document and the strategic plan outlined in it. HENS strategic plan was released in 2005 and statistics have since revealed that improvements are being made in these four priority areas in the public through policies, programs, regulations, etc., thereby showing that Public Health Nutritionists were an effective and necessary asset to Public Health.

It is really fascinating and inspiring to hear how dietetic professionals are making such incredible positive changes to the health of the public, and makes me excited to be involved in the field.

"The Mind Knows Not What The Tongue Wants"

TED Talks is a guilty pleasure of mine. This talk was recorded in 2004, but remains a favorite of mine. If you have yet to see it, I strongly recommend spending the next 17 minutes and 34 seconds of your life doing so. You will not regret it.

Such a simple concept that ended up changing the world - extra chunky tomato sauce.

If you're interested in seeing more, here's the link to the TED Talks website: http://www.ted.com/

Enthusiasm for New Breakfast Program

Last night I attended a menu-planning session for a school's breakfast program that was just starting up. The school provided the parent volunteers with a snack... it was cake.



On a refreshing note, however, last night's menu planning session went incredibly well! The parent volunteers were extremely excited and positive about the idea of offering a healthy breakfast free-of-charge to children. I found their enthusiasm and positive energy so infectious that I found it hard to sleep when I got home because I was so excited for the program to be started. Myself, Tina (fellow Dietetic Intern), and Lori who works at Tri-County Regional School Board office, each helped out a table of parents plan a week-long menu (to have three weeks of menus in total) consisting of maximum foods from the NS School Food and Nutrition Policy with each meal being comprised of at least 3 of the 4 food groups from Canada's Food Guide. Discussions from my table included how to get kids eating new and different foods, such as mango, papaya, and tofu. Conversations also touched on the current lunch menu served by the cafeteria with a specific example being the pancake lunches and how the son of one of the parents present refuses to eat this lunch since it is "swimming in butter". This school is one that I will be focusing on for my foodservice assessments and will be focusing on their menu content in order to provide supports to help the school better follow the School Food and Nutrition Policy, and apparently it is needed.

It was extremely interesting to discuss healthy and non-healthy foods with these parents as they genuinely want to provide healthy foods for all children in the school. I am excited to see how this new Breakfast Program advances in the next couple of months.

Close, but Missed the Mark...

Ugh...

Each morning I eat my breakfast in the hospital cafeteria, and today was no exception. I got my boiled egg, milk, and cereal that I top with ground flax seeds (I keep a baggy of ground flax in my purse - just one of the interesting items I keep in there) and went to sit down. Upon setting my tray down at a table I looked up to see a banner advertising "Healthy Workplace Month" and not 10 feet away was remnants of massive sheet cake (offering slabs of both chocolate and white cake) that had been put out the day before. My mind chose to block out the safe food handling issues related to leaving this cake out all night and focus on the fact that a healthy workplace, to whomever decided to include such a massive cake, did not include healthy eating. Perhaps the organizers thought that the healthy lunch specials served in the cafeteria each day this week would "cover it", even though for dinner the cafeteria still offers high fat, high sugar, and deep-fried fare. My disappointment lies not only in the fact that a cake was present, but also in that the organizers probably didn't even think of not having a cake. In my 6.5 weeks working in Public Health, I've learned that people are extremely attached to cakes and that any sort of celebration requires and is expected to have one.

 

Battling the unfortunate mind-set of the necessity of having cake is something that I'm currently trying to do, along with the Public Health Nutritionists, through tackling the NS School Food and Nutrition Policy. Fundraisers are common-place for schools to hold and one of the most popular and successful fundraisers, as reported by principals and parents, is a cakewalk. For those of whom are unfamiliar with what a cakewalk entails, it is essentially a game similar to musical chairs. Music is played and people walk around on squares with numbers on them. Music stops and if whichever number you're standing on gets called by the announcer, you win that cake. Seems like fun, however inappropriate especially considering all fund-raising activities by schools must abide by the School Food and Nutrition Policy (SFNP) Guidelines: all foods sold for fundraising purposes must be of "maximum" nutritional value. The SFNP classifies foods in three categories according to nutritional content guidelines: maximum, moderate, and minimum. Cake is in the minimum category and can only be served on special occasions such as Valentine's Day. Cakewalks were brought up at a Principal's meeting I was attending (Principal's from every school in the Tri-Counties were there) and the negative and borderline violent uproar that we received when it was mentioned that these were no longer to be accepted in the Tri-County made me speechless!  This came even after presenting every person in there a page full (front and back) of acceptable fundraising ideas. It all boils down to people's readiness to change: despite that the principals are all educated professionals and that they had in front of them resources to help them with changes to better follow the SFNP (including the person representing Public Health standing before them), they were not ready to even hear about the need for change. This is going to make our job of reinforcing the policy that much trickier.

Perhaps education in the form of an email informing the SWNDHA Workplace Wellness Committee of their faux-pas would allow for change for next year - this is definitely something I'm willing to find out. But as far as this year's Workplace Wellness Month goes... at least they tried.