ASU TRANSCEND Trainees Attend Obesity Week Conference

By: Armando Pena and Kiley Vander Wyst

Nestled between businesses and bars around every corner, The Obesity Society’s Annual Meeting took place right in the heart of downtown Nashville, TN. The conference was four-days long with scientists and clinicians from all over the world in attendance. The lecture topics ranged from bariatric surgery and pharmacokinetics to basic science and community- or school-based research. With such diverse experts gathered in one place, it was easy to feel like you didn’t belong. However, the common theme, treatment and prevention of obesity, that brought all of these unique individuals together was apparent. The conference demonstrated that innovations and breakthroughs in obesity science is only the tip of the iceberg if we do not share our ideas and collaborate on projects.

There was a whole section devoted to perinatal and infant obesity research where three speakers presented on early life influences of the infant gut microbiome, the utility of a novel measure of body composition in infants, and behavioral aspects of food preferences impact on child growth. These presentations really stood out to two ASU TRANSCEND trainees who attended the conference. As the trainees continue to learn about maternal child health outcomes, it is critical for them to understand where the field is currently and, perhaps, where the field is going in order to become experts. These trainees also had the opportunity to attend the meeting this year. Here is a little bit about the posters they both presented.

Armando Peña, MS

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Pictured above is Armando Pena with Dr. Gabriel Shaibi, his doctoral mentor, standing by his poster at Obesity Week.

I presented my poster entitled, Evaluating a Novel Measure of Insulin Sensitivity in Latino Youth. The Matsuda Index is a measure of insulin sensitivity that is formulated from insulin and glucose values collected during an OGTT at 0-, 30-, 60-, 90-, and 120-minutes post-glucose stimulus. The originators of this index came out with a later study deeming it appropriate to estimate the Matsuda Index by only using samples collected at 0- and 120-min. However, this measure has not been compared to the Matsuda Index in a sample of obese Latino youth, which was the objective of the study. In brief, the data suggests that it is an acceptable measure for use in obese Latino youth with prediabetes (defined by a 2-hour OGTT glucose ≥ 140 mg/dl) compared to those without prediabetes. In addition, it is approximately one-third the cost of the Matsuda Index, making it a measure of interest for researchers with funding limitations or those looking to generate preliminary data. Overall, I had a good turnout of visitors to my poster session, with about 8-10 visitors. A majority were pediatric physicians that were interested in the measure since it already follows clinical diabetes screening practice guidelines. It was gratifying to know that most of those who stopped by had seen the program ahead of time and found interest in my poster.

Kiley Vander Wyst, MPH

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Pictured above is Kiley Vander Wyst standing by her poster at Obesity Week.

I presented my poster entitled, Comparison of Prenatal Health Parameters & Nutrition Counseling Among Macrosomic Deliveries. The prevalence of obesity in Arizona is 25.7% among women of childbearing age. Although prenatal nutrition counseling has demonstrated a reduction in gestational weight gain, weight retention, and decrease in pregnancy complications it is seldom done by clinicians due to lack of knowledge and insufficient time. The aim of these retrospective chart review was to evaluate the type of nutritional counseling provided to women who delivered a fetal macrosomic (>4000 grams) infant and compare differences in health outcomes by pre-pregnancy BMI category. Of 2,689 deliveries, 225 resulted in fetal macrosomia, of which 188 were included in the study. Regardless of pre-pregnancy BMI, 59% of women received nutritional counseling (NC). Although, 97% of diabetic women received NC of which 80% met with a Registered Dietitian (RD), only 49% of non-diabetic women received NC, with only 3% meeting with a RD. Of the 41% of women that did not receive NC, 20% were normal weight, 33% were overweight, and 48% were obese prior to pregnancy. Nutrition topics discussed during prenatal visits varied based on pre-pregnancy BMI category; however, healthy foods and snacks, general pregnancy diet information, and carbohydrate counting were the three common topics across all BMI categories. There were no differences in weight-related outcomes among women who received NC. The prevalence of c-sections, diabetes, and hypertension were highest among OB pregnant women. However, OB women had the lowest GWG and smallest 3rd trimester fetal AC but the highest one-hour glucose. Presenting my poster was really fun with several visitors ranging from physician assistants and nurses to physician-scientists and dietitians. It was such a unique experience to talk about my poster to such a diverse group of people!

Despite the weather being wet and cold, the barbecue was delicious and the live music was plentiful. The ASU TRANSCEND trainees had a great time at the Obesity Week conference and plan to attend again next year. Hopefully, we will see the sun at least once in Vegas, unlike in Nashville!

UTK Former Trainee Spotlight: Amber Ford

41863277_1627707123999886_4560250744220942336_nAmber Ford, an alumnus of the Maternal and Child Health Leadership traineeship, is a registered and licensed dietitian at the Knox County Health Department. At the University of Tennessee, Amber completed a dual Master’s program in Public Health and Public Health Nutrition, and completed the dietetic internship. As a Public Health Educator, Amber has focused on school health for the past three years.  

I completed the dual master’s program in public health and nutrition along with the dietetic internship through the University of Tennessee in December 2015. Serving as an MCH trainee was one of the biggest highlights of my time in the program, and the training and experience I received have been so valuable in my current position. I’ve worked as a Public Health Educator focused on school health at the Knox County Health Department for the past three years.

In my role, I specifically partner with Knox County Community Schools to help improve the health of students and families as it relates to nutrition and physical activity. The Community Schools initiative aims to use public schools as hubs for community resources to improve health and academic success. This involves working alongside teachers, students, and families to identify their specific needs and bringing in partners and resources to address these needs. We currently have 18 Community Schools in Knox County, and most of my work is aimed at creating and enhancing access to places for physical activity, promoting increased physical activity and physical education, creating supportive nutrition environments, and increasing access to healthy foods for students and families.

Throughout my time as a trainee, I had the opportunity to lead the cultural and linguistic competency workshops, Interactions that Make a Difference, for graduate students and frontline staff of health departments in East Tennessee. Countless times, I’ve used the skills I developed in presenting and leading trainings for diverse audiences, but I also use the cultural competency knowledge I gained on a daily basis. Our Community Schools are some of the most diverse and economically disadvantaged in our county, and the knowledge and skills provided by these trainings have improved my interactions with the students and families I serve and have helped me develop more culturally competent interventions.

Further, my time as a trainee equipped me with other skills for which I am consistently grateful. Working with a team to plan and implement the bi-annual Promoting Healthy Weight Colloquium improved my long-range planning skills, efficiency, and ability to delegate and recognize the strengths and weaknesses of others and myself. Assessment and evaluation of community needs and effectiveness of our interventions are important for sustained funding and effective utilization of limited resources, and I’m able to rely on the practices of regular evaluation and responding to evaluation outcomes used throughout my time as a trainee. All and all, I can’t say enough about how much serving as an MCH trainee impacted me and shaped the work I do. Well worth every minute!

 

UMN Trainee Spotlight: Noelle Yeo

IMG957309Noelle is a second-year MPH Nutrition student in the coordinated masters program and an MCH Nutrition trainee at the University of Minnesota Twin Cities. She completed her bachelors of science at the University of Nebraska- Lincoln in nutrition, exercise, and health sciences in 2017 with minors in Spanish and business administration. After graduation in August 2019, Noelle plans to work in school nutrition. 

This summer I had the opportunity to complete one of my dietetic rotations at the Minnesota Department of Education (MDE) working with the School Nutrition Programs team. Over the course of ten weeks, I…

  • assisted with school nutrition program and summer feeding program reviews
  • learned about the USDA School Nutrition Program policies
  • created training materials for school food service directors and workers
  • worked on projects to increase the efficiency and effectiveness of the school nutrition program review process
  • and much more!

One of my favorite projects was creating Visual Portion Size Guides for training food service workers on visually identifying portion sizes of fresh fruits and vegetables as students bring their trays through the lunch line. Many schools in Minnesota have begun implementing salad bars in cafeterias which is great for allowing students more choices and access to fresh fruits and vegetables. However, because students are serving themselves, it can be more challenging to determine if they have taken enough of a fruit or vegetable to meet the meal pattern requirements for a reimbursable meal. The nutrition consultants noticed this issue while visiting schools on reviews and wanted to create something to help.

After discussing with the team, we came up with the idea to take photographs of fresh fruits and vegetables on a school lunch tray in different portion sizes and create life-size photo cards. These cards could then be used for training to become more familiar with the various quantities or even be kept at the registers for reference. We selected common fruits and vegetables, purchased them, cleaned and chopped them, set-up the lighting, and took the photos. There was definitely a lot of questions from other MDE staff in the kitchen area and lots of snacks to pass around once we were done! The final product was cards of 9 fruits and 14 vegetables that showed portion sizes of ¼ cup, ½ cup, and ¾ cup of each.

At the end of the summer, I was able to attend the Minnesota School Nutrition Association annual conference in Rochester, Minnesota. We gave out samples of the visual portion size guides at the MDE booth during the expo and it was really exciting to talk to school food service directors. They all seemed really happy that this resource was available to help train their staff and were excited to use it. Now, the cards are available online on MDE’s website so anyone can print and use them.

Here are some examples of the  cards (not to scale):

grapes

carrot

Full versions can be found at:

Vegetables

https://education.mn.gov/mdeprod/idcplg?IdcService=GET_FILE&dDocName=MDE074461&RevisionSelectionMethod=latestReleased&Rendition=primary

Fruits

https://education.mn.gov/mdeprod/idcplg?IdcService=GET_FILE&dDocName=MDE074442&RevisionSelectionMethod=latestReleased&Rendition=primary

The Fate of Nutrition Research and the Dietary Guidelines: Is It Time for a National Institute of Nutrition?

The United States government continues to pour trillions of dollars into the treatment of lifestyle-related diseases while spending only a fraction on programs designed to improve health. Annual spending on nutrition research averages to only $1.5 billion annually, which may DSC_8252_FINAL.jpglike plenty but is almost nothing compared to the over $1 trillion in direct and indirect costs of diet-related diseases in the U.S. each year. To put it into an even smaller context, the U.S. also spends over $5 billion on marketing for candy products.

At the same time, the fate of the USDA’s 2020-2025 Dietary Guidelines for Americans, which will aim to include nutrition needs for pregnant women and young children, hangs in the balance of unpredictable funding and competing industry interests. The Dietary Guidelines Committee is experiencing an onslaught of commentary from entities like the American Beverage Association and the Peanut Institute, who each wish to have their agendas addressed within the Guidelines. While outside funding certainly plays an important role in fueling national nutrition efforts, it is often insufficient and may also come at the cost of a balanced and neutral approach to national nutrition recommendations.

Of the 27 agencies within the National Institutes of Health, not one is focused primarily on nutrition or diet quality. While the U.S. Department of Agriculture (USDA) has been at the forefront of all nutrition-related efforts within the federal agencies, its primary focus continues to be agricultural science and farming practices, and is influenced disproportionately by industry interests as a result. The lack of emphasis on the nutritional factors of health is helping to perpetuate the health consequences of poor diet and health disparities among communities prone to adverse dietary choices due to food insecurity and other socioeconomic factors.

Will a National Institute of Nutrition help to resolve these issues?

The call n for a National Institute of Nutrition and Food Health (NINFH) is spearheaded Dr. Joon Yun, a Salk Institute trustee and partner of a hedge fund who has helped fund millions of dollars into longevity science research. Dr. Yun argues that nutrition research should have a space to operate apart from agricultural research The NINFH would also be responsible for providing research-based, expert opinion to inform programs to improve nutrition and public health. Accomplishments that may be made by the NINFH include bridging the gap between diet and health outcomes, filling the funding gap for nutrition research and programs, keeping human nutrition science separate from agricultural science, and acting as a trusted authority for the public to seek information about optimal nutrition. Dr. Yoon suggests that the NINFH may be proposed in one of two ways: as an additional agency with the National Institutes of Health or as an independent entity, like the National Cancer Institute.

Plus, with the NINFH there is a chance that the Dietary Guidelines for Americans will no longer be in the hands of the USDA and may be more independently created in a more streamlined fashion. Implications for public health nutrition include better data and funding to support community programs like Head Start, WIC, and the Supplemental Nutrition Assistance Program (SNAP), providing better-quality nutrition support for communities in need.

What are your thoughts on a National Institute of Nutrition in the United States?

By: Emily Masek, ASU TRANSCEND Trainee

Emily is a first-year Master’s degree student and dietetic intern at Arizona State University’s College of Health Solutions. She began her nutrition studies at the University of Nevada, Las Vegas, earning a Bachelor’s in nutrition sciences with a minor in kinesiology, and has helped publish two papers about the role of dietary polyphenols in inflammatory diseases. Her current thesis research will involve a pilot study about the effects of a parenting education intervention on the diet quality of Hispanic and Latino adolescents in Phoenix, Arizona.

Sources:

  1. https://www.ucsusa.org/our-work/food-agriculture/solutions/expand-healthy-food-access/why-we-need-national-food-policy#.W9hMzC-ZOgR
  2. https://thehill.com/opinion/healthcare/410620-the-case-for-a-national-institute-of-nutrition
  3. https://www.prnewswire.com/news-releases/donor-to-longevity-science-advocates-for-establishing-a-national-institute-of-nutrition-300674383.html

UTK Former Trainee Spotlight: Megan Rodgers

IMG_2898Megan Rodgers, an alumnus of the Maternal and Child Health Leadership traineeship, is a registered and licensed dietitian at the Knox County Health Department. At the University of Tennessee, Megan obtained a Bachelor of Science in Nutrition, a Master of Science in Public Health Nutrition and completed the dietetic internship. Megan’s work at the health department focuses on planning, implementing and evaluating an afterschool program that teaches children about the importance of healthy eating and physical activity. She also strives to improve the afterschool environment through policy, systems and environmental changes that positively impact all students who attend afterschool care at these sites. Megan’s work directly engages the MCH population, which she grew to love through her time as a trainee. She is an active member of the Knoxville Area Afterschool Network and is on the Board of Directors for the Knoxville Academy of Nutrition and Dietetics.

Leveraging a Community-Academic Partnership to Address Childhood Obesity: A poster presentation at the Tennessee Public Health Association annual meeting in Franklin, TN

At the Tennessee Public Health Association annual meeting in September 2018, I presented data from a recent plate waste study completed at three afterschool sites in the Knoxville area. Results from this study showed very high plate waste at all sites for all dinner meal components. This is of concern for many reasons, but especially because these afterschool centers serve many low-income, food insecure children.

During this study, collaboration between the Knox County Health Department and the University of Tennessee’s Departments of Nutrition and Public Health created an opportunity for graduate level students to gain hands-on experience and to apply academic training to a community setting. The value of the community-academic partnership enabled successful data collection and project execution.

On two separate occasions, a stratified random sample of dinner meals were collected at three afterschool sites. Standard dinner meals were obtained from the community kitchen that provides meals to the afterschool sites. These standard meals were used to calculate an average amount of each meal component and served as a comparison reference for participant meals collected. The amount of food wasted was astonishingly high and indicates a need for an evidence-based intervention to increase acceptability and consumption of the dinner meal at these afterschool sites. The community-academic partners will seek additional funding to plan, implement and evaluate an intervention that seeks to accomplish this goal. Collaborative partnerships are essential to addressing public health issues such as food insecurity and childhood obesity while training the future of the public health workforce.

As a registered dietitian, I am passionate about improving the health and well-being of children. The afterschool time serves as a prime platform for providing children with healthy, nutritious foods. Many of these children may not have access to healthy foods outside of the afterschool program’s doors, so we need to take this opportunity and make the most of it. Of course, we want our children to be well fed and to be successful inside and outside of the classroom. Adequate nutrition can play a key role in that.

ASU TRANSCEND Trainee Spotlight: Kenzie Millner

Version 2Kenzie is a first-year master student in Nutrition at the Arizona State University (ASU) College of Health Solutions. Kenzie received her undergraduate degree in Nutritional Sciences with a Dietetics Emphasis from the University of Arizona-Tucson. She began as an MCH Trainee in August 2018 through the ASU TRANSCEND Program. In this blog post she describes her thesis research and work with a family-focused intervention program in the Phoenix Metropolitan area.

Obesity is a major public health concern for adolescents in the United States. According to the CDC, 18.5% of youth in the United States were considered obese in 2015–2016 (NCHS Data Brief, 2017). Rates of adolescent obesity are even higher in many ethnic minority populations, including Hispanics and Non-Hispanic Blacks (NCHS Data Brief, 2017). Current programming for obesity prevention has been unsuccessful in reaching and preventing obesity in ethnic minority populations. In order to understand the complex factors leading to obesity in ethnic youth populations, we must determine links between physical health behaviors such as substance use, sleep, physical activity, and food choices and obesity, while also understanding the role of mental health in obesity prevention.

The Research and Education Advancing Children’s Health Institute at ASU is a multidisciplinary team that developed and implemented an interdisciplinary project called Family Check Up for Health. Family Check Up for Health is based on a previous evidenced-based model called Family Check Up, which focused on a “strengths-based, family-centered intervention” as a foundation to improve family management skills and address child and adolescent adjustment problems. Family Check Up has shown a variety of health benefits for children and adolescents, including lower rates of obesity among individuals receiving the intervention. The next step is to investigate how a similar intervention impacts health behaviors among an ethnically diverse population. Family Check Up for Health utilizes this foundational framework but also aims to address familial support of positive health behaviors to improve obesity among children and adolescents in the Phoenix Metropolitan area.

My thesis project will focus on data from the Family Check Up for Health intervention. The primary objective of my project is to determine whether there is an association between ethnicity and obesity in adolescents in the program. I will also determine the link between health behaviors in adolescents in the program, and their mental health markers including depression and perceived stress. Uncovering these relationships is the first step in developing evidenced-based interventions which will help bridge the gap of health disparities in ethnic minority populations, especially in obesity treatment and prevention. My work in Family Check Up for Health has been very rewarding thus far, as I really enjoy getting to see first-hand how an intervention can transform peoples’ lives. I hope to see this intervention continue to be adopted by healthcare practitioners around the country so that more lives can be improved.

UMN Trainee Spotlight: Junia N Brito

DSC_0513 - CopyJunia is a first-year PhD student in Social/Behavioral Epidemiology at the University of Minnesota School of Public Health (SPH). She is originally from Brazil, where she received her dietetic training and worked as both a clinical dietitian and as a dietitian food service manager. While living in the U.S., Junia has completed an MBA with a Healthcare Management concentration at Bellevue University and received an MPH Nutrition degree from the University of Minnesota. This post describes her experiences as a student and MCH Nutrition trainee.

Here in the U.S., some of my previous leadership-volunteer experience included being a Nutrition Educator Specialist for Urban Ventures focused in teaching ethnically diverse children from public schools about food and health. Additionally, I have engaged in a community & health development project as a Nutritionist Manager consultant for the Green Garden Bakery -a minority youth-led garden and bakery enterprise supported by the not for profit organization Urban Strategies Inc.

Since I joined the SPH, I have been engaged in multiple research projects and related activities. During the Summer of 2016, I completed the field experience requirement for the MPH Nutrition program at the Women, Infants & Children (WIC) Program’s Office at the Minnesota Department of Health. Using Minnesota’s WIC program data, I explored two main questions: First, what are the predominant reasons given by mothers enrolled in Minnesota WIC program for stopping breastfeeding during the first year of their child’s life, and second, do these reasons vary according to race, ethnicity or country of origin. These findings can be found at the Breastfeeding in Minnesota’s WIC Program FACT SHEET 2018 webpage. I have also been working as a research assistant in multiple research projects, with areas of study encompassing child nutrition & parenting behavior, dietary intake & sedentary behavior among sedentary office workers, and other health related outcomes.

As an MCH Nutrition Trainee, I have attended multiple professional development opportunities, updated and reviewed book chapters focused on overweight and obesity, sports nutrition, diabetes mellitus and eating disorders in children and adolescents, and engaged in quarterly trainee conferences and collaborative discussion calls with fellow MCH Nutrition trainees. It has been a fun and exciting journey!