Tuesday, October 21, 2014

Mediterranean Diet Leads to Better Heart Health”

     Although as future dietitians, I think it's important to remain neutral concerning specific diets, it's hard to deny the amount of information supporting the Mediterranean diet and its benefits for a myriad of diseases. This article discusses the Mediterranean diet's ability to reverse Metabolic Syndrome, characterized by three or more of the following risk factors: Low HDL, high triglycerides, large waist, high blood pressure and high blood sugar.

     The research compared a low-fat diet to a Mediterranean diet (whole grains, vegetables, fruits, fish, legumes), supplemented with extra fats from either extra virgin olive oil or nuts. The research, which was conducted on 6,000 men and women at increased risk for heart disease in Spain, found that although the Mediterranean diet didn't reduce the chance of developing Metabolic Syndrome, it did increase the chance of reversing this syndrome compared to a low-fat diet.

          “Those on the Mediterranean diet with extra olive oil were 45 percent more likely than those            on the low-fat diet to reverse the condition and those on the Mediterranean diet supplemented            with nuts were 28 percent more likely to reverse metabolic syndrome, according to the study”

Additionally, the research found that 28% of the subjects had reversed their Metabolic Syndrome in a five year follow-up.

     This study is important for CNM's, as it provides another way to supply medical nutrition therapy for patients. Metabolic Syndrome is a prerequisite to heart disease and its reversal could prevent heart disease and the costs associated with treating it.


Therapeutic Diet Ordering Privileges

The recently established Centers for Medicare and Medicaid Services (CMS) rule that will allow registered dietitians to place therapeutic diet orders will be beneficial for dietitians, the medical team, and hospitals alike. By RDs gaining order writing privileges, the medical team will save time, hospitals are projected to save large amounts of money, and there will hopefully be a decrease in inappropriate diets ordered.

In an article titled “CMS Final Rule on Therapeutic Diet Orders Means New Opportunities for RDNs,” in the Journal of the Academy of Nutrition and Dietetics, Brian Boyce discusses the opportunities this new rule will create for dietitians. In the article, Boyce (2014) makes an especially interesting point in relation to ordering privileges and CMS guidelines: “CMS has a long-standing interpretive guideline that hospitals may technically hire non-RDNs with sufficient qualifications for dietary and nutrition services. Under the new rule regarding therapeutic diet orders the Academy is confident hospitals will continue to demand the expertise and competencies assured by the RDN credential, despite having the option of hiring non-RDNs.” While dietitians will be able to use their expertise to order therapeutic diets, the new rule will also assist in showing why it is essential to have registered dietitians, the food and nutrition experts, on staff.

Boyce, B. (2014). CMS final rule on therapeutic diet orders means new opportunities for RDNs. Journal of the Academy of Nutrition and Dietetics, 114(9), 1326-1328.


Monday, October 20, 2014

Being Innovative in Dietetics

As a nutrition manager, it is essential to not only handle the day-to-day challenges that your facility faces, it is also necessary to stay on top of the trends and innovations in the field. An article featured on SupermarketGuru, a publication centered around "smarter shopping, healthier eating, and better living," discusses the need for supermarkets to differentiate themselves in the competitive grocery store scene.

This article suggests that entrepreneurs generally have the freedom to be creative because they are not tied down by a structured buying or selling system. Grocery stores, on the other hand, may lack this creativity because they often don't have the time or mindset to look creatively at the future.

The central question from this publication is "How can retailers innovate - and integrate worthwhile finds - without impending their ability to compete today?". This question is challenging, and one that may lay on the footsteps of a manager of dietitians at a large retailer. Many grocery retailers are now employing dietitians to emphasize the store's focus on healthy eating. Dietitians can bring creativity to the store by building weight-loss programs, implementing incentives for employees, finding new ways to promote healthy products, and engaging the community in nutrition. Dietitians are more than capable of bringing a fresh, new perspective to the grocery store!

Lempert, P. (2014). Team up with entrepreneurs and innovate. URL: http://www.supermarketguru.com/the-lempert-report/team-up-with-entrepreneurs-and-innovate!.html


Integrating New Technology into Practice

As a nutrition manager in any field, the impact that new technology has on practice is important to consider. Big technology companies including Apple, Google, Samsung and the like, are inventing products that are making news in the healthcare scene.

Healthcare practitioners are left wondering how to appropriately incorporate these technologies into their practice. New products to hit the shelf like Apple's iWatch can track blood pressure levels and activity throughout the day. Innovative apps on the iPhone can help patients track their blood glucose levels and record their food intake. Nike's Fitbit can track a person's energy expenditure via calories burned during everyday activity.

How reliable are these new tools? Have they been tested and proven to be accurate? As a nutrition manager, this is an issue that must be thought out. One healthcare facility mentioned in this article is predicting that doctors may be able to tap into some of these apps that track blood glucose levels and make changes to a patient's medication without the patient having to even come in for an office visit. Would you trust this technology to counsel patients without even seeing them in person? How would a healthcare provider charge for such services? Could this new technology bring about more telehealth counseling? Many questions exist for a nutrition manager to consider in our fast-moving, constantly changing world of technology and healthcare.

Pallarito, K. (2014) Report identifies game changers for U.S. healthcare. URL: http://consumer.healthday.com/general-health-information-16/doctor-news-206/report-identifies-health-care-game-changers-691988.html


Sunday, October 19, 2014

Birthday Cake Ban

In the past several years, many rigorous guidelines have been adopted by the National School Lunch Program due to federal regulation. Going even further than remodeling school lunches and snacks, one local school district is now banning birthday cake.

The PTA helped to push the ban on sugary snacks at birthday celebrations. Non-food rewards are still acceptable like pencils, erasers, small toys, etc. Teachers were having a difficult time covering everything that needed to be taught after so many of these celebrations. They also felt that students were increasingly distracted by the junk-food and that it decreased their attention. School officials are concerned with the rate of obesity and how they can help to control it during the school day.

As a school foodservice manager, how should this situation be handled? This local school district was flooded with phone calls from angry parents wondering why their child is no longer able to bring in a treat to share with their classmates for his or her birthday. Every school is required to have a wellness policy in which restrictions such as this would be addressed. It is also seen as a positive due to the prevalence of food allergies among students such as to peanuts or gluten. Few districts have adopted such policies at this point, but there will likely be more following suit in the near future. Topics such as this are important for a manager of a school district to consider.

Brown, J. (2014). Burlington schools ban birthday cake, sweets. URL: http://www.cincinnati.com/story/news/2014/10/10/burlington-elementary-bans-birthday-cake-school/17052501/


Managing Gluten-Free Requests at Restaurants

One of the top-trending diets today is gluten-free. Approximately 1% of the population has been identified as having Celiac Disease and another 6% have a gluten intolerance. The only cure for these conditions is a life-long gluten-free diet. Seeing that this diet is more than a trend, but rather a necessity for these affected individuals, many restaurants have developed a gluten-free menu and are doing everything they can to accommodate this population.

The challenge comes in implementing a gluten-free menu. Whereas in facilities such as hospitals and long-term care facilities, dietitians are present to assist with going gluten-free, many restaurant managers do not have this luxury- or the educational background to be familiar with the extensive precautions that need be taken.

Many don't realize the extensive changes that must be implemented to go "gluten-free". Not only can the menu items labeled as gluten-free not contain any wheat, rye, or barley; they also cannot be subject to any cross-contamination. A designated gluten-free toaster must be used, a separate gluten-free fryer  must be added, special gluten-free utensils must be used in preparation, and all condiments and dressings must be checked to guarantee they are free of gluten-containing ingredients.

For a restaurant manager, this may seem overwhelming. There are several businesses that now offer consulting services for restaurants that need help going gluten-free. These services include a review of the menu, help implementing safe practices, and most importantly, educating the staff on the necessary precautions. Managing a large staff is challenging, and communication and education are key to the success of an operation.

Menu Trinfo is one of these companies that offers such services. With a dietitian on staff, this company offers training that may be beneficial to a restaurant considering going gluten-free. These resources are important for a manager to consider and a step in the right direction to educate and involve the staff.

National Restaurant Association. (2014). Gain business by adding gluten-free options. URL: http://www.restaurant.org/Manage-My-Restaurant/Food-Nutrition/Food-Safety/Gain-business-by-adding-gluten-free-options

Mazza, K. (2014). C is for communication: How to handle gluten-free requests. URL: http://www.menutrinfo.com/c-communication-handle-allergen-free-requests/


Linking Facebook and Healthcare

With Facebook’s continuing growth and a vast amount of health “advice” from different sources available to the public, there is talk about linking healthcare to Facebook or developing an app owned by them but under a different name. An example they give of this linking would be to offer support groups and education to those diagnosed with certain conditions such as type 2 diabetes. The hope is to provide support and evidence based advice from medical experts in that area. As nutrition managers, it is good to be aware of current trends with technology. This could bring opportunities to the dietetics department such as possible new forms of outpatient counseling. With expanding technology trends comes the opportunity to become more creative and expand beyond the traditional methods.