Veronica is a first-year graduate student in the Nutrition program at the University of Tennessee, Knoxville (UTK). Veronica also received her Bachelor of Science in Nutrition at UTK in 2014. She then went on to complete her dietetic internship at Vanderbilt University Medical Center. Veronica worked as a registered dietitian in the Women, Infants and Children (WIC) program in South Carolina, and served as a clinical dietitian in the island of American Samoa. Veronica has been a MCH Nutrition trainee since August 2018.
My earliest experience working with the MCH population dates back to my volunteer work as an undergraduate. I worked as a research assistant with Dr. Marsha Spence (UTK) for the Cardiac Club Program, which is an afterschool nutrition and physical activity intervention program for elementary school-age children in fourth and fifth grades. Additionally, I worked as a nutrition educator for the Healthy Kid’s Club program ran by East Tennessee Children’s Hospital. For this program, I helped plan and teach weekly nutrition lessons and games that focused on movement and physical activity. My interest in working with this population grew throughout my dietetic internship, both in my community and clinical rotations, where I chose a concentration in pediatrics/pediatric oncology. My experience in public health nutrition further developed with my work as an RD for the WIC program.
So far, as a trainee, one of the projects I am leading is the diversity recruitment and retention committee. The committee is comprised of faculty members from both the Departments of Nutrition and Public Health at UTK. Currently, the committee is planning strategies to increase recruitment efforts of racially/ethnically diverse students into the dietetics profession. One of these strategies includes visiting historically black colleges and universities (HBCUs) in the surrounding states. Another strategy is to create an infographic to disseminate to Hispanic-serving institutions and tribal colleges/universities that are further away. I am excited about the many opportunities the traineeship offers, and am looking forward to increasing my knowledge, refining my leadership skills, and better serving the MCH population.
Somadee is a first year MPH Nutrition student in coordinated masters program at the University of Minnesota Twin Cities where she also received her undergraduate degree in nutrition and dietetics in 2018. She began her MCH traineeship in September 2018 and has been working on the development of the University of Minnesota’s Public Health Nutrition newsletter. Somadee is passionate about increasing healthy food access through transformation of the agricultural system to prioritize investments in healthy foods and farms and through the creation of a more transparent supply chain.
For the first semester of my program, I had the privilege of interning at St. Paul Ramsey County Public Health in the Healthy Communities division. During my time spent there, I primarily worked with the Food and Nutrition Commission which is funded and supported by the Statewide Healthy Initiative Partnership grant. I was introduced to the Good Food Purchasing Program and have been working on expanding the partnership between the Twin Cities coalition and the Commission. The Good Food Purchasing Program is a national program with local coalitions working to build relationships with institutions and encouraging them to direct their buying power to source their foods with the consideration of their five core values of nutrition, animal welfare, local economies, valued workforce, and sustainable agriculture.
Public institutions across the country spend billions of dollars on food purchases and have the opportunity to lead the movement for food system change and influence supply chains. Local food procurement through large institutions has been shown to positively impact the food system as it increases transparency throughout the supply chain. Currently the Twin Cities coalition is working with Minneapolis Public Schools and just finished a full assessment of food procurement of the district. With nutrition being one of the core values of the program, it is emphasized within procurement practices. With strategic planning, schools can leverage their purchasing power to provide nutritious food to their students without exceeding their limited budgets. It is very exciting to get involved in this program just as it is starting to gain national momentum. I look forward to continuing to strengthen local and regional food systems through fostering these relationships between producers and consumers and ultimately increasing access to healthy food to communities who need it most.
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
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
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!
Amber 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!
Noelle 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):
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 like 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.