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Malnutrition and Professional Licensure

4/15/2019

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Post contributed by Katia Zogg, SNDA Public Policy Committee Leader

The role of dietitians in health care is incredibly important, especially when it comes to malnutrition in hospitals and how intervention by a registered dietitian nutritionist can improve the outcomes for malnourished patients. On Monday, March 11th over 200 registered dietitian nutritionists (RDN), nutrition and dietetic technicians, registered (NDTR), and dietetic interns gathered at the state capitol for the annual California Academy of Nutrition and Dietetics Public Policy Workshop to advocate for the profession. This year, dietitians spoke to lawmakers about the benefits of RDN intervention for malnutrition and the importance of professional licensure.
 
Clinical malnutrition is becoming an increasingly worrisome concern and it is vital that malnutrition be diagnosed and addressed in a timely manner. Malnutrition can decrease quality of life, lead to longer hospital stays, increase costs to the patient, hospital, and insurance companies, impact recovery time, and increase the risk of death. RDNs work together with the health care team to ensure that patients receive the nutrition they need. Weight history, dietary intake, a nutrition-focused physical examination, and lab values are evaluated by RDNs to assess for malnutrition. A nutrition-focused physical exam involves checking hand grip strength, fluid accumulation, and loss of muscle and body fat.
 
RDNs are educated and trained to address the issue of malnutrition, but in order to make it more effective, licensure protection is needed. Currently in California, RDNs have title protection with no formal state regulation. Title protection provides very little protection to consumers, while licensure would provide much better consumer protection and allow consumers to find and access qualified professionals who can provide ethical and safe nutrition therapy. Additionally, licensure would also ensure that standards of professional competencies are met in order to be reimbursed for the provision of nutrition care services. Basically, licensure would provide assurance to government and health insurance companies so that the nutrition services provided by RDNs can be reimbursed.
 
The California Academy of Nutrition and Dietetics is working on proposing a consumer safety bill in 2020-2021 for RDN licensure in California.
 
For more information about professional licensure from the Academy of Nutrition and Dietetics, click here. You can also view an interactive map of other state’s RDN licensure protection. And you can click here to learn more about the CA legislative steps to licensing.
 
Resources:
https://www.eatright.org/food/nutrition/healthy-eating/what-is-malnutrition
https://www.eatrightpro.org/advocacy/licensure/professional-regulation-of-dietitians#importance


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SFSU Health Promotion & Wellness Center & Interview with Danielle Lundstrom, MPH, RD

3/17/2019

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Danielle Lundstrom, MPH, RD
Post contributed by Katia Zogg, SNDA Public Policy Committee Leader

The SFSU Health Promotion and Wellness Center is offering up some exciting nutrition related resources! Through campus health initiatives and programming, the Health Promotion and Wellness Center (HPWC) provides health education for the SF State community. In addition to nutrition, the HPWC offers other health resources that focus on alcohol, tobacco, and other drugs, sexual health, men’s health, sexual violence prevention, and mental health.

The HPWC nutrition resources include:
  • Nutrition Clinic: Free one-on-one nutrition counseling sessions with the campus Registered Dietitian Nutritionist, Danielle Lundstrom, which focuses on a holistic approach and strategies to help students meet their nutrition related goals.
  • Cooking Classes: Free hands-on cooking classes that teach cooking and preparation skills to create healthy, quick, and nutritious meals and snacks with a college student’s budget in mind.
  • Nutrition Workshop: You can request an interactive nutrition workshop for your organization, class, or student group. Nutrition workshop topics include healthy eating 101, eating healthy on a budget, and decoding nutrition labels.
  • CalFresh Help Clinic: If you need help paying for groceries, visit the CalFresh Help Clinic to see if you qualify for CalFresh. CalFresh is a part of SNAP (Supplemental Food Assistance Program), which is a federally funded program that helps low-income individuals buy healthy food.
​
I had the opportunity to ask questions of Danielle Lundstrom, the new Nutrition Health Educator/Registered Dietitian Nutritionist at SF State, to learn more about her journey and to see how she is utilizing her background as a Registered Dietitian to help promote wellness for the students on campus. See below!
  1. How did you become interested in nutrition and dietetics? When I was still in high school, I visited my brother who was in college at the time. I tagged along to one of his classes, which happened to be an introductory nutrition class, and I found it really interesting. However, I ended up not deciding to major in Dietetics until the end of my sophomore year after taking a public health class that taught concepts of preventive health related to a variety of topics, including nutrition.
  2. Where did you do your dietetic internship?​ I completed a two-year coordinated master’s program at the University of Minnesota School of Public Health, which included a dietetic internship alongside coursework to obtain a Master of Public Health degree with a concentration in nutrition.
  3. Do you have any advice for dietetics/community nutrition students about to embark on their career or an internship? First, don’t be afraid to ask questions! No one expects you to know everything. If you go on to do a dietetic internship, the RDs you will work with are there to help you learn and grow. Take advantage of their knowledge and expertise by asking questions and learning as much as you can from them. And second, say yes to opportunities, but don’t be afraid to say no sometimes. Say yes to things that excite you, help you to develop new skills, increase your knowledge, and/or connect you to others in the field. But realize that you can’t do everything, and that is okay. Learn how to gracefully decline opportunities when needed and know that new ones will always come your way.
  4. Do you have any literature recommendations for future dietetic professionals? There are a lot of great options depending on the field of nutrition you are most interested in. The two that I would recommend are The Broken Ladder by Keith Payne and The Health Gap by Michael Marmot. Both of these books discuss social determinants of health and health inequity, which are important concepts for anyone who plans to work in the field of dietetics. Understanding these concepts allows dietetic professionals to better support the health of the individuals and populations they work with.
  5. Do you recommend joining any dietetic practice groups through the Academy of Nutrition and Dietetics (AND)? From speaking with nutrition colleagues, the DPGs vary widely in terms of what they provide and how active their members are. Since there is a fee associated with joining, I would recommend reaching out to the leaders of the DPG(s) that you are interested in to learn more about what they offer to members.
  6. What are your short-term goals as the Nutrition Health Educator/RD at SF State? My short-term goals are to increase student's nutrition knowledge, skills and self-efficacy, as well as to work toward improving the campus nutrition environment to make healthy eating the easy choice.
  7. What are your long-term goals? The thing that I enjoy most about the nutrition/dietetics field is that we have so many career opportunities, and RDs are continually creating new paths by demonstrating the importance of nutrition outside of the typical healthcare setting. My heart is in public health, so I know that long-term I will continue to work within the public health sector in some capacity, but I plan to follow along as the dietetics field continues to evolve!
Resources:
http://wellness.sfsu.edu/home
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What is Action for Healthy Kids?

1/29/2019

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Post contributed by Katia Zogg, SNDA Public Policy Committee Leader

As I was meal prepping over the weekend to get ready for my final semester at San Francisco State University, I started to think about what I used to eat in grade school and the food and physical activity environment I was provided. I attended public school in the 1990’s and have very fond memories of my grade school years; I remember eating lunches from home and always having plenty of recess breaks. Today, however, it seems the focus on kids’ health in schools has shifted significantly, but I was happy to read recently about Action for Healthy Kids.
 
Action for Health Kids (AFHK) is an awesome initiative and it gave me hope for the future health of our youth. Created in 2002, AFHK is a national and state integrated initiative and their focus is centered around making changes in the school environment to address childhood obesity, physical inactivity, and undernourishment. Their mission is “To mobilize school professionals, families and communities to take actions that lead to healthy eating, physical activity and healthier schools where kids thrive”. Decreases in funding have limited the United States Department of Agriculture (USDA), local sponsors, and state agencies to deliver nutrition education adequately to children. Additionally, funding for nutrition education through child nutrition programs is narrow and limited, even though the number of participants in these programs continues to grow. With AFHK, however, changes in the school environment can be made in order to combat obesity and undernourishment and promote active and healthy behaviors in kids. Through donations, volunteers, partnerships, and fundraising, AFHK has brought grants, programs, and physical activity and nutrition lessons to over 29,000 schools. The number of volunteers has grown from 700 in 2002 to over 120,000 in 2017 - and that number is still growing! They have partnered with over 75 national organizations and associations that focus on serving and caring for the needs of youths. And they are continuing to develop their programs to meet the needs of school nutrition programs, physical activity programs, and developing, implementing and/or evaluating action plans or policies for school wellness.
 
A short-term goal of AFHK is to increase the amount of health promoting schools. Long-term, AFHK wants to be strongly involved and a leading player in preventing childhood obesity nationwide. AFHK has three main objectives to achieve these goals:
  • Increasing access to nutritious food and beverages in schools while decreasing access to high-calorie, low-nutrient items while at the same time incorporating nutrition education into curriculum
  • Increasing physical activity through recess, implementing physical activity in academic lessons, physical education courses, and fitness programs that are after-school and co-curricular
  • Educating parents, educators, administrators, and students on the important role good nutrition and physical activity have on academic achievement
 
There are many grassroots efforts being made all over the country to promote proper nutrition and physical activity in schools through AFHK teams. Some examples include installing more drinking fountains to increase water intake, creating a school garden with garden education as part of the curriculum, and creating culinary arts electives that focus on cooking, nutrition, gardening, and math. There are many, many more examples that you can read about here. Additionally, AFHK provides tools and resources to schools to help with implementation of health and wellness programs.
 
If you’re interested in getting involved, you can donate, volunteer, and/or fundraise and you can read more about taking action here. I hope this information will inspire and excite you about how small steps and people coming together to meet a common goal can create significant change.
 
Resources:
http://www.actionforhealthykids.org/index.php
Boyle, M.A. (2017). Community nutrition in action: an entrepreneurial approach (7th ed.). Boston, MA: Cengage Learning
Action for Healthy Kids (n.d.). Action for Healthy Kids logo [graphic]. http://www.actionforhealthykids.org/index.php​
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