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  • 01 Nov 2020 1:14 PM | Amy Habeck (Administrator)

    November is National Diabetes Month

    By Donna Varamo, WRDA Student Volunteer

    Hunter College Graduate Student, MS 2021

    November 1, 2020

    November is National Diabetes Month, which intends to increase the public’s awareness of the risk factors, symptoms, and types of diabetes.1  This year, National Diabetes Month is raising awareness for the diabetic youth population.1

    Diabetes is one of the major health epidemics in America, and the prevalence is continuing to increase.  The 2020 National Diabetes Statistics Report states that there are roughly 34 million Americans that are currently living with diabetes and roughly 88 million adults that are living with prediabetes.2  As of 2018, approximately 210,000 children and youth under the age of 20 years old had diagnosed diabetes, including 187,000 diagnosed with type 1 diabetes .2  In children ages 10-19, the incidence of type 2 diabetes has significantly increased in Non-Hispanic black, non-Hispanic Asian Pacific Islander, and Hispanic youth populatons compared to non-Hispanic whites. 2 Variations in diet and lifestyle factors, genetics, and access to healthcare can contribute to the rise of diabetes diagnoses among these populations and increase the risk of developing diabetes-related complications in the future.

    What is Diabetes?

    Diabetes can be differentiated into two types: type 1 and type 2. 

          Type 1 diabetes is typically diagnosed in children and young adults.  It is an autoimmune condition that develops when the body’s immune system begins attacking and destroying pancreatic beta cells, resulting in the decreased production of insulin.3  If there is a lack of insulin production, sugar cannot be transported into cells and converted to energy, resulting in elevated blood sugar levels.  Type 1 diabetes is managed with synthetic insulin injections that allow cells to utilize glucose and create energy.

          Type 2 diabetes is attributed to lifestyle and genetic factors including low levels of exercise, dietary habits, age, history of prediabetes, and family history of diabetes.3 Type 2 diabetes was once commonly referred to as “adult-onset diabetes” due to its high prevalence in the adult population, although this type is increasingly being diagnosed in children.  In people with type 2 diabetes, pancreatic beta cells make insulin, however the body’s cells are unable to respond to the insulin and cannot take up glucose, resulting in hyperglycemia.  Type 2 diabetes is typically managed using a combination of medications, diet, exercise, and insulin.3

    The increased blood sugar levels associated with both types of diabetes can lead to long term complications, such as neuropathy, retinopathy, nephropathy and cardiovascular complications.3  Blood circulation to extremities may become impaired, leading to nerve damage, poor wound healing, and possibly to amputations.3

    Controlling Diabetes with Diet

    Diabetic diets are intended to maintain stable blood glucose levels and prevent complications from diabetes.4  Meals should be consistently spread throughout the day and include healthy carbohydrates, fiber-rich foods, and heart healthy fats.  Foods high in saturated fats, trans fats, and sodium should be avoided. There are different approaches clients can use to creating well balanced meals that keep blood sugar levels within an optimal range, including the plate method, carb counting, and tracking the glycemic index of foods. 

    An Interview with a Dietitian who Specializes in Diabetes:

    I was fortunate to have the opportunity to interview Dr. Diana Malkin-Washeim, PhD, MPH, RDN, CDCES, CD-N.  Dr. Malkin-Washeim has been working with youth and adults diagnosed with diabetes for roughly 25 years.  She is currently the director of the Nutrition and Diabetes Program at the BronxCare System’s Health and Wellness Program.  She continues to find tremendous joy, passion and endurance working with patients with diabetes because the scope of practice is so broad.

    As an RDN and CDCES, she believes that encouraging dietary changes in patients can be very challenging.  In her program, she frequently utilizes a multidisciplinary approach that includes the RDN/CDCES, pharmacists, social workers, primary care physicians, adult and pediatric endocrinologists, and OB/GYNs.  This team approach optimizes patient care and allows the patient to receive education from each of these disciplines.

    Behavior modification can also be more successful when the practitioner meets the patient where they are and understands their point of view.  Asking questions regarding access to food and cooking equipment, literacy, and physical ability ensure that the practitioner and their patient are on the same page.  It also serves to establish realistic goals that are achievable for the patient.  She believes that fulfilling patient expectations, being transparent, and being sincere are keys to successful sessions for both the patient and dietitian.

    Dr. Malkin-Washeim frequently works with individuals who are illiterate, impoverished, and food insecure.  Attempting to secure necessary medications and equipment for these patients can be a frustrating process that sometimes ends in failure.  Access to technology, such as continuous glucose monitoring systems, insulin pumps, and blood sugar test strips, is necessary for monitoring and controlling both type 1 and type 2 diabetes.  Some patients have difficulty accessing these materials. 

    During the COVID-19 pandemic, services and programs that are available to patients with DM include one-on-one counseling, shared medical visits (PCP and RDN/CDCES), and telephone/telehealth visits.  Patients have also demonstrated decreased food security and increased need for services due to the pandemic.  Demand for telehealth has increased dramatically, but its use is limited by the amount of time available for training and staffing of the platform.  It is also more difficult to perform a thorough physical examination remotely, as the practitioner is limited to only sight.  Still, Dr. Malkin-Washeim expertly manages her resources to ensure that her patients will always receive quality care, which includes making telehealth and in-office patients both a priority.

    She finds that working with each patient individually, being present and actively listening during their sessions, and having empathy are some of the most beneficial approaches when educating and collaborating with her patients.  It is also important to be understanding and supportive of cultural diversity within her population.  Her advice for dietitians is to expand their breadth of knowledge to include more diverse technology and medications.  Also, dietitians should not be afraid to ask each other questions.

    References

    1.   NATIONAL DIABETES MONTH - November 2020. National Today. Accessed October 20, 2020. https://nationaltoday.com/national-diabetes-month/

    2.   CDC. National Diabetes Statistics Report, 2020. Centers for Disease Control and Prevention. Published February 11, 2020. Accessed October 20, 2020. https://www.cdc.gov/diabetes/library/features/diabetes-stat-report.html

    3.   Differences Between Type 1 and Type 2 Diabetes. Diabetes Research Connection. Published July 11, 2016. Accessed October 20, 2020. https://diabetesresearchconnection.org/differences-type-1-type-2-diabetes/

    4.   Diabetes diet: Create your healthy-eating plan. Mayo Clinic. Accessed October 20, 2020. https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-diet/art-20044295


  • 17 Oct 2020 3:01 PM | Amy Habeck (Administrator)
    • October is Breast Cancer Awareness Month

      Chat with an RDN Breast Cancer Specialist

      By Marissa Lau, WRDA Student Volunteer

      PACE University Graduate Student, MS 2022

      October 9, 2020

      October is Breast Cancer Awareness Month and is recognized internationally to spread awareness of breast cancer.1 Many foundations, organizations, and charities worldwide, use this month to educate people about this disease as well as to gain support and funds for research associated with breast cancer.1  

      What Is Breast Cancer?

      Breast cancer is a disease where atypical cells in the breasts are unable to stop multiplying and can spread to other nearby tissues.2,3 There are different types of breast cancer including ductal carcinoma, lobular carcinoma, and Paget’s disease which form in the milk ducts, the breast’s milk-producing lobules, and the skin of the nipple, respectively.4 Symptoms of breast cancer include:

    • ·              Changes in the size, shape, or appearance of the breast4,5
    • ·              Development of a lump or thickening in the breast that feel different (lumps can form in the underarm as well)4
    • ·              Nipple discharge other than breast milk, such as blood4
    • ·              Irregular skin texture around the pigmented area of the nipple, such as peeling or flaking5
    • As one of the most common cancers in women, there are approximately 1.38 million new cases diagnosed globally every year and 458,000 breast-cancer related deaths. Research continues its struggle in ascertaining the cause of the disease.1

      Causes, Risk Factors, And Risk Reduction in Breast Cancer

      Researchers speculate that rather than being caused by a single trigger, breast cancer development is caused by multiple interactions between a person’s genetic makeup, environment, and lifestyle.1,2 Prioritizing early detection is the primary recommendation for improving disease outcomes since the early stages of breast cancer are easier to treat, and these patients are more likely to be cured.1 As of now, mammography, taking an X-ray picture of the breast, is the best method to screen for breast cancer.6 Routine screening is especially important for people who have certain risk factors including, being female, being over the age of 50, being obese, and having genetic changes to BRCA1 or BRCA2 genes.3,5 Individuals aged 75 or older should consider refraining from routine breast cancer screenings since the screenings themselves can be harmful to an older individual’s health.7

      Breast Cancer: A Clinical Dietitian Nutritionist’s Point of View

      Cara Anselmo, MS, RDN, CDN, is a clinical dietitian nutritionist and breast cancer specialist at Memorial Sloan Kettering Cancer Center (MSKKCC). I was fortunate enough to ask her a few questions about her input on breast cancer and her role as an RDN at MSKKCC.

      Cara treats her patients on an individual basis to ensure that they are well-nourished and have a good nutritional status after receiving surgery or treatments. Such treatments include chemotherapy, radiation therapy, endocrine therapy, and biologic therapy. These treatments kill off cancer cells, but they also may cause a variety of side effects which vary, depending on the type of treatment and cancer. Cara helps breast cancer patients manage weight gain, which is a common treatment side effect. This is unique to breast cancer treatment because most cancer patients tend to lose weight. Cara helps patients lose and maintain an appropriate weight after treatments.

      Some research has suggested the use of ketogenic diets for breast cancer patients receiving chemotherapy, and these diets are gaining popularity among those in the general public who wish to lose weight.8,9 Cara feels there is not enough research to recommend ketogenic diets to her patients. She also referred to pre-clinical studies that suggest that high fat diets may increase the risk of breast cancer. Upon further research, I found a study which speculated that increased consumption of saturated fats can increase the risk of breast cancer.10 Therefore, ketogenic diets which mainly rely on proteins and fats, may be harmful for those who have breast cancer or who are at risk for the disease.11

      Cara stays informed of emerging research on weight management and breast cancer in post-menopausal women. She recommended the work of Jennifer Ligibel, M.D., a Harvard researcher specializing in this area. According to Cara, appropriate weight management is key to reducing risk, and that body compositions consisting of high proportions of fat can also increase risk. She provided some tips that can lower one’s risk for breast cancer:

    • ·      Eat whole-food diets that include more plant-based foods, limit added sugars, and limit processed/red meats
    • ·      Maintain a healthy body weight and body composition
    • ·      Stay physically active
    • ·      Limit alcohol
    • Diets To Reduce The Risk of Breast Cancer

      Below are some eating plans that include more plant-based food components, which research suggests may help reduce the risk of breast cancer:

      DASH Diet12,13

      The DASH acronym stands for Dietary Approaches to Stop Hypertension. This diet was designed to lower blood pressure without the use of medication. The Nurses’ Health Study followed 86,621 women for over 25 years and found an association between the DASH diet and a lower risk of developing breast cancer. Below are the DASH diet recommendations:

    • ·      Grains, 6 to 8 servings, daily
    • ·      Vegetables, 4 to 5 servings, daily
    • ·      Fruits, 4 to 5 servings, daily
    • ·      Dairy, 2 to 3 servings, daily
    • ·      Lean meat, poultry, and fish, 6 one-ounce servings or fewer, daily
    • ·      Nuts, seeds, and legumes, 4 to 5 servings, weekly
    • ·      Fats and oils, 2 to 3 servings, daily
    • ·      Sweets, 5 servings or fewer, weekly
    • ·      Limit intake of alcohol and caffeine
    • Mediterranean Diet14,15,16

      Several studies have found an association between adherence to the Mediterranean diet and reduced risk of breast cancer in both pre- and post- menopausal women. The Mediterranean diet consists of:

    • ·      Vegetables, fruits, whole grains, and healthy fats, daily
    • ·      Fish, poultry, beans, and eggs, weekly
    • ·      Moderate intake of dairy and dairy products
    • ·      Limited intake of processed and red meat
    • The New American Plate17

      The American Institute for Cancer Research has new recommendations for healthy meals, called “The New American Plate,” that focus on cancer prevention. These guidelines consist of:

    • ·      3 ounce serving of meat (such as fish, poultry, or red meat)
    • ·      Two types of vegetables
    • ·      An appropriate serving of a whole grain (such as brown rice, barley, or quinoa)
    • References

    • 1.     Breast Cancer Awareness Month in October. who.int. https://www.who.int/cancer/events/breast_cancer_month/en/. Accessed October 1, 2020. 
    • 2.     Nelms M, Sucher KP. Nutrition Therapy and Pathophysiology. 4th ed. Boston, MA: Cengage; 2020.​
    • 3.     Breast Cancer. mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470. Published November 9, 2019. Accessed October 4, 2020.
    • 4.     Breast Cancer. mskcc.org. https://www.mskcc.org/cancer-care/types/breast#what-is-breast-cancer-. Accessed October 4, 2020.
    • 5.     Breast Cancer Awareness. cdc.org. https://www.cdc.gov/cancer/dcpc/resources/features/breastcancerawareness/index.htm. Accessed October 1, 2020.
    • 6.     What Is a Mammogram?. cdc.org. https://www.cdc.gov/cancer/breast/basic_info/mammograms.htm. Accessed October 6, 2020.
    • 7.     Older Americans receive cancer screenings past recommended age. news.psu.edu. https://news.psu.edu/story/627134/2020/07/29/research/older-americans-receive-cancer-screenings-past-recommended-age#:~:text=%E2%80%94%20Older%20Americans%20may%20be%20receiving,colorectal%2C%20cervical%20and%20breast%20cancers. Published July 29, 2020. Accessed October 1, 2020.
    • 8.     Khodabakhshi A, Akbari ME, Mirzaei HR, Mehrad-Majd H, Kalamian M, Davoodi SH. Feasibility, Safety, and Beneficial Effects of MCT-Based Ketogenic Diet for Breast Cancer Treatment: A Randomized Controlled Trial Study. Nutr Cancer. 2020;72(4):627-634. doi:10.1080/01635581.2019.1650942
    • 9.     Khodabakhshi A, Seyfried TN, Kalamian M, Beheshti, Davoodi SH. Does a ketogenic diet have beneficial effects on quality of life, physical activity or biomarkers in patients with breast cancer: a randomized controlled clinical trial. Nutri J. 2020;19(87):2020. https://doi.org/10.1186/s12937-020-00596-y
    • 10.  Zhu Y, Aupperlee MD, Haslam SZ. Schwartz RC. Pubertally Initiated High-Fat Diet Promotes Mammary Tumorigenesis in Obesity-Prone FVB Mice Similarly to Obesity-Resistant BALB/c Mice. Transl Oncol. 2017;10(6):928-935.
    • doi: 10.1016/j.tranon.2017.09.004
    • 11.  Ketogenic diet: Is the ultimate low-carb diet good for you?. health.harvard.edu. https://www.health.harvard.edu/blog/ketogenic-diet-is-the-ultimate-low-carb-diet-good-for-you-2017072712089. Published July 27, 2017. Accessed October 6, 2020.
    • 12.  Fung TT, Hu FB, Hankinson SE, Willett WC, Holmes MD. Low-carbohydrate diets, dietary approaches to stop hypertension-style diets, and the risk of postmenopausal breast cancer. Am J Epidemiol. 2011;174(6):652-660. doi:10.1093/aje/kwr148
    • 13.  DASH diet: Healthy eating to lower your blood pressure. mayoclinic.org. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456. Accessed October 8, 2020.
    • 14.  Mourouti N., Kontogianni M.D., Papavagelis C., Plytzanopoulou P., Vassilakou T., Malamos N., Linos A., Panagiotakos D.B. Adherence to the Mediterranean diet is associated with lower likelihood of breast cancer: A case-control study. Nutr. Cancer. 2014;66:810–817. doi: 10.1080/01635581.2014.916319.
    • 15.  Turati F, Carioli G, Bravi F, et al. Mediterranean Diet and Breast Cancer Risk. Nutrients. 2018;10(3):326. 2018. doi:10.3390/nu10030326.
    • 16.  Mediterranean diet: A heart-healthy eating plan. mayoclinic.org. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801. Accessed October 8, 2020.
    • 17.  New American Plate Setting Your Table to Prevent Cancer. aicr.org. https://www.aicr.org/cancer-prevention/healthy-eating/new-american-plate/. Accessed October 1, 2020.


  • 27 Sep 2020 9:41 PM | Anonymous

    WRDA Fall 2020 Kickoff and Networking Event

    Kristen Nicolai, WRDA Student Volunteer

    Hunter College Graduate Student, MS 2022

    The Westchester Rockland Dietetic Association’s (WRDA) kickoff and networking event was held virtually on September 23, 2020. The event focused on food insecurity, highlighting the response of local community agencies during the current COVID-19 pandemic.

    To start off the event, Amy Habeck, WRDA’s president, spoke about food insecurity in Westchester and Rockland, and the impact the current pandemic has had on access to food. The potential nutrition and health related risks that could impact our communities were also discussed.

    The presenting community organizations and speakers for the event included:

    Agency: NourishAll

    Presenter: Julie Konvisser, Director of Community Engagement, City of New Rochelle

    Agency: Proyecto Faro

    Presenter: Charo Ureña, Director/Lead Organizer

    Agency: Second Chance Foods

    Presenter: Martha Elder, Executive Director

    Agency: Centro de Amigos

    Presenter: Doris Karpeh-Diaz, Director

    Each speaker presented how they are providing inventive programming for their communities, along with food assistance during COVID-19. Julie Konvisser discussed how NourishAll works to purchase gift cards from local restaurants and distribute to community and city agencies, serving vulnerable residents of New Rochelle. In total, this program was able to help sustain local businesses, while serving 9,429 total recipients, and distributed $471,450 gift cards. Proyecto Faro spoke of the work to support the needs of the undocumented community in Rockland County, and the pandemic food program that was implemented to deliver healthy food packages to immigrant families on a weekly basis through the help of local organizations. Martha Elder discussed the ways Second Chance Foods works to reduce food waste and expanded their distribution of recovered food to families in the area by starting their own Summer Meals Program. Finally, Doris Karpeh-Diaz of Centro de Amigos, an adult social day center dedicated to the Latino and Hispanic community of Rockland and Haverstraw, discussed the ways senior citizens have been impacted during the pandemic due to the lack of community support, and the work of the organization to provide this population with the care they need.

    After the presentations, members were able to move to break out rooms and discussed ways to support the efforts of these community outreach organizations and how to integrate this information into professional practice.

    For more information on how to volunteer, donate, or learn more about these local community organizations, please visit their websites:

    NourishAll

    Proyecto Faro

    Second Chance Foods

    Centro de Amigos


  • 01 Sep 2020 5:00 AM | Amy Habeck (Administrator)

    Neighbors in Need:  Food Insecurity in Westchester and Rockland

    Angela Iovine, WRDA Student Liaison

    PACE Graduate Student, MS 2021

    September 1, 2020

    Many Americans face food-access problems that limit their ability to keep themselves active and  healthy.1  This is broadly referred to as food insecurity.  Prior to the COVID-19 pandemic, food insecurity was at its lowest since the Great Recession.2  Data from 2018 estimated that 7.8% of the population of Westchester county (75,730 people) and 9% of the population of Rockland county (28,980 people) were food insecure.  The majority of these households met SNAP eligibility requirements; however, up to a third did not qualify.3  Projections for 2020 increase these numbers to 12.5% and 13.7% for Westchester and Rockland respectively.4  According to the Feeding Westchester website, 1 in 5 Westchester residents will be food insecure this year, including about 60,000  are children.5

                Food insecurity denotes an inability to dedicate the necessary resources to purchase food.  People who are food insecure may have food to eat, but the food may not nutritionally adequate.  Households may prioritize value over quality, desirability, or variety.  This is known as having “low food security”, one of the two categories the USDA uses to quantify food insecurity.  The other category is “very low food security”.  These are people who, in addition to the above sacrifices, don’t always have enough food to eat, and have gone hungry due to a lack of resources.6  Some groups of people, including children, the elderly, Latinos, and African Americans, have higher rates of food insecurity than the general population.7 

    The lack of food security in our community is concerning.  This is one of several social determinants of health, as is poverty.8  Poverty and food insecurity have a direct relationship, as do poverty and chronic disease.  The poorest Americans tend to have the least resources to acquire nutritious food and the worst health outcomes.9  The coronavirus pandemic has potentially exacerbated these issues, disproportionally affecting people with chronic diseases, seniors, Latinos and African Americans.  These vulnerable populations are at a higher risk for serious infection and for economic hardship related to layoffs and business closures. 10  These are many of the same groups that are more likely to be food insecure.  Since the pandemic began, the need for food assistance has grown, and researchers anticipate that demand will continue to grow.11

    The many challenges that face those who are food insecure are complex and not easily solved.  As nutrition professionals we can advocate for change by supporting community-based programming, policy change, and research.  The vision of the Academy of Nutrition and Dietetics is: “A world where all people thrive through the transformative power of food and nutrition.”12  This is a message we can all get behind.  There are many local advocacy organizations, food banks, and charities in our area addressing this cause.  If there’s one you find particularly valuable, please share a couple sentences about it on our Facebook page to spread awareness.

    References

    1.         U.S. Department of Agriculture. Food Security in the U.S. U.S. Department of Agriculture Economic Research Service, Web site. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/. Updated September 4, 2019. Accessed June 19, 2020.

    2.         Coleman-Jensen A, Rabbitt MP, Gregory CA, Singh A. Household Food Security in the United States in 2018. U.S. Department of Agriculture Economic Research Service. https://www.ers.usda.gov/webdocs/publications/94849/err-270.pdf?v=2493.9.  Published September 2019. Accessed June 19, 2020.

    3.         Feeding America. Food Insecurity in New York. Feeding America Web site. http://map.feedingamerica.org/county/2018/overall/new-york. Accessed June 19, 2020.

    4.         Feeding America. The Impact of Coronavirus on Food Insecurity. Feeding America Web site. https://www.feedingamericaaction.org/the-impact-of-coronavirus-on-food-insecurity/. Published June 3, 2020. Accessed June 19, 2020.

    5.         Feeding Westchester. Hunger in Westchester. https://feedingwestchester.org/hunger-in-westchester/. Accessed June 19, 2020.

    6.         U.S. Department of Agriculture. Definitions of Food Security. United States Department of Agriculture, Economic Research Service, Web site. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/definitions-of-food-security/. Updated September 04, 2019. Accessed June 19, 2020.

    7.         Feeding America. What is Food Insecurity? Feeding America Web site. https://hungerandhealth.feedingamerica.org/understand-food-insecurity/#_ftn3. Accessed June 19, 2020.

    8.         American Academy of Family Physicians. Advancing Health Equity by Addressing the Social Determinants of Health in Family Medicine (Position Paper). AAFP.org Web site. https://www.aafp.org/about/policies/all/socialdeterminantofhealth-positionpaper.html. Published April 2019. Accessed June 19, 2020.

    9.         Shaw K, Theis K, Self-Brown S, Roblin D, Barker L. Chronic Disease Disparities by County Economic Status and Metropolitan Classification, Behavioral Risk Factor Surveillance System, 2013. Prev Chronic Dis. September 1, 2016;13. doi:http://dx.doi.org/10.5888/pcd13.160088. Accessed June 19, 2020.

    10.       Hake M, Dewey A, Engelhard E, et al. The Impact of Coronavirus on Local Food Insecurity. America F. https://www.feedingamerica.org/sites/default/files/2020-05/Brief_Local%20Impact_5.19.2020.pdf.  Published May 19, 2020. Accessed June 19, 2020.

    11.       Feeding America. The Impact of the Coronavirus on Food Insecurity. Feeding America. https://www.feedingamerica.org/sites/default/files/2020-04/Brief_Impact%20of%20Covid%20on%20Food%20Insecurity%204.22%20%28002%29.pdf.  Published March 30, 2020. Updated April 22, 2020. Accessed June 19, 2020.

    12.       Academy of Nutrition and Dietetics. Academy Mission, Vision and Principles. eatrightPRO Web site. https://www.eatrightpro.org/about-us/academy-vision-and-mission/mission-and-vision-statements. Accessed June 19, 2020.


  • 17 Aug 2020 5:00 AM | Amy Habeck (Administrator)
    • August is National Breastfeeding Month

      WRDA Celebrates Lactation Professionals

       

      By Kristen Nicolai, WRDA Student Volunteer

      Hunter College Graduate Student, MS 2022

      August 14, 2020

      August is National Breastfeeding Awareness Month and is celebrated to promote the benefits and importance of breastfeeding. The Academy of Nutrition and Dietetics’ position on breastfeeding is that exclusive breastfeeding offers optimal nutrition and health protection for the first six months of life, and that breastfeeding with complementary foods from six months until at least 12 months of age is the ideal feeding pattern for infants.


      Breastfeeding offers the following benefits for mothers and babies:

      • Protects babies against a variety of diseases and conditions such as respiratory tract infections, onset of diabetes, childhood obesity, and other infections
      • Provides all necessary nutrients, vitamins, and minerals, and antibodies from the mother that can help babies fight disease and infection
      • Promotes earlier return to pre-pregnancy weight for mothers
      • Lowers mothers’ risk of breast and ovarian cancers and post-natal depression
      • Helps uterus return to its pre-pregnancy size and decreased postpartum bleeding
      • Creates a special bond between mother and baby
    •  

      Andrea Ventura, MS, RD, CDN, IBCLC, is a clinical nutritionist at New York-Presbyterian Hospital. She became certified as a lactation consultant after becoming a mother and breastfeeding her own children. Andrea found it difficult to find reliable nutrition information to help her successfully continue her lactation journey after one of her children had a dairy protein allergy. After this she knew she wanted to use her nutrition knowledge to work with breastfeeding moms. 

      The lactation consultant profession is accessible to anyone interested in the field. The credentials require a 90-hour lactation specific course, a clinical internship, and 14 health science classes. Medical professionals are also able to use past experience or credits to apply to clinical internship hours and coursework. Some IBCLC students must also compete a 300-500-hour internship working under an IBCLC.

      Elaine Carlevaro, RDN, CLC, is a Certified Lactation Counselor with the Department of Prenatal Services at the Montefiore Nyack Prenatal Center. To become a Lactation Counselor Elaine participated in a one-week program through the Academy of Lactation Policy and Practice to receive a CLC certification. While IBCLCs work one-on-one with moms, as a CLC Elaine works more broadly to make sure that breastfeeding is being supported. What she particularly loves about her job is the many hats she can wear as a nutritionist, and the work she does with many organizations and committees in her community such as Child Care Resources in Rockland and the Department of Health to bring training to childcare providers. As a CLC she works breastfeeding education into the overall health resources she provides moms, specifically higher risk moms, including education on the benefits of breastfeeding.

                  Like many professionals in the field, during the current COVID-19 pandemic lactation consultants are working virtually to assist nursing mothers. While virtual appointments can allow mothers to work with a lactation consultant from the comfort of their own home, it can also be difficult for consultants to use all the senses used when helping mothers in-person. This can make it harder to fully assess mothers’ breasts or see how a baby is latching or listening to sucking and swallowing. Elaine has also encountered that mothers with the least amount of resources are a population harder to support during the pandemic, as they have less access to virtual visits. Both Andrea and Elaine agree that peer support groups are one of the most helpful tools for new mothers. These programs are able to give women the opportunity to connect with other mothers experiencing the same challenges, giving them the support needed after many prenatal services end postpartum.

                  When it comes to the roles that hospitals, pediatricians, and OB/GYNs can play in successful breastfeeding, Andrea and Elaine both emphasize the importance of promoting the benefits of breastfeeding and recognizing when to refer a mother to an IBCLC. Through her work as a lactation counselor in Rockland County, Elaine works to improve support for breastfeeding through the Breastfeeding Coalition and has worked to have hospitals become a part of the Breastfeeding Friendly initiative. Elaine also works with early childhood educators, WIC, and many other community organizations to help mothers breastfeed well and support initiatives to lower infant and maternal morbidity and mortality.

                  Andrea recommends that every RDN who works with mothers and babies can help normalize breastfeeding and educating themselves on a mother’s nutrition needs while lactating. Elaine also encourages RDNs to focus on the benefits of breastmilk when working with clients and knowing how best to inform moms. It is also important to know what is recommended by the Academy of Pediatrics, ACOG, NIH, WIC so consistent communication is shared.

                  When it comes to choosing a career as a lactation consultant, Andrea advises that many hospitals will not hire an IBLCL that is also not a Registered Nurse, so working as a Registered Dietician in that capacity is not always possible. Andrea works with some breastfeeding mothers through her work at an inpatient psychiatric hospital but does home visits for mothers on the side. She is also bilingual, speaking both English and Spanish, which is an asset that helps her to communicate with many different people and helps the mothers she works with feel validated and understood in their native language.

      As a lactation counselor, Elaine expressed she is better able to meet the needs of her clients, and it has opened up avenues to be able to promote breastfeeding in ways she didn’t realize were possible. She also notes that RDNs that have a bilingual education can have more opportunity for direct communication with clients, rather than having to converse through a translator, as this can be challenging as almost 80% of her patients didn’t speak English. For RDNs or nutrition students interested in working in lactation consulting, Elaine recommends starting to research the different avenues within the lactation profession. While breastfeeding mothers are a specific population, it is an important time to invest in women, as breastfeeding can play a role in their overall health after pregnancy, as well as the health of their future generations. She concluded that an RDN with a lactation background is a perfect position to not only impact that individual mother, but many lives from generation to generation.

      Sources:

    ·      https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Breastfeeding/Pages/Benefits-of-Breastfeeding.aspx
    ·      https://www.eatrightpro.org/-/media/eatrightpro-files/practice/position-and-practice-papers/practice-papers/practicepaperpromotingandsupportingbreastfeeding.pdf?la=en&hash=39B07DA0E25D1703828C1AAF3ADEC410A8E8141F
    ·      https://www.unicef.org/nutrition/index_24763.html


  • 12 Dec 2017 6:06 PM | Anonymous

    WRDA Clinical Update 2017- “An Ounce of Prevention…Food for Healthy Living”

     By Co-President Elects Kathleen Ryan MS, RD, CSO, CDN  and Melissa Keeney MS, RDN, CDN, CDE

    The Westchester Rockland Dietetic Association’s (WRDA) annual clinical update was on December 7, 2017. Around 100 nutrition professionals attended this year, including Registered Dietitian Nutritionists (RDN), Dietetic Technicians, Registered (DTR), and nutrition students. This year, the clinical update focused on disease prevention “An Ounce of Prevention…Food for Healthy Living”.

    To start the event off, Niharika Jaiswal, WRDA’s President gave the opening remarks. Next, Diana Monaco, NYSAND’s Immediate Past President spoke about getting involved in the Academy of Nutrition and Dietetics and the New York chapter, NYSAND. It was then time to begin the presentations. Kathleen Ryan and Melissa Keeney, WRDA’s Co-Presidents Elect provided the biographies and introductions for each speaker. A mid-morning highlight to this year’s update was a Public Policy Update by Ann Darcy.

    The presentation topics and the speakers for the Clinical Update were:

    Presentation:  Sustainability and Culinary Nutrition Trends, Q&A
     
    Presenter:  Andrea Canada, MPH, RD from SPE Certified     

    Presentation:  Microbiome Nutrition for the RDN
    Presenter: Mary Beth Augustine, RDN, CDN, FAND of Mary Beth Augustine (MBA)

    Presentation: Improving Patient Engagement Using Culinary Nutrition Tools and Programming, Q & A
    Presenter:  Jeanne Petrucci, MS, RDN and Julie Harrington RDN, CPC from Living Plate

    Presentation:  Treating Heart Disease with a Plant-Based Diet, Q & A
    Presenter: Lauren Graf MS, RD from Montefiore Einstein Cardiac Wellness Program


    Each speaker this year presented innovative ways that nutrition professionals can assist their clients to live healthfully. Andrea Canada discussed current food trends and how an RDN can add value and a health sustainability focus to a foodservice operation. Mary Beth Augustine discussed the microbiome, including the evidence for medical nutrition therapy and a risk characterization framework for clinical decision making. She also discussed emerging research topics regarding nutrition, healthcare, and the microbiome. Jeanne Petrucci and Julie Harrington discussed ways to engage clients with culinary nutrition, and how to grow your business by offering culinary nutrition program. They then provided us with a food demo and samples while discussing how the audience can incorporate this concept into their own practice. Lauren Graf discussed the role of plant- based diets in managing cardiovascular disease, diabetes, and chronic kidney disease.  She  shared some remarkable patient stories.

    A huge thank you to our raffle sponsors. The WRDA raised $340 at the meeting through the raffle. Diana Monaco won the Capri Beauty gift certificate, Abby Walker won the cookbooks and Field Goods coupon, Roberta Gershner won attendance to next year’s Clinical Update, Terry Schlanger won next year’s WRDA Membership, Niharika Jaiswal won the gift certificate to Rouge Tomate, Jennifer Sukhdeo won the 2nd Century Initiative basket, and Ellen Pospishil won the PAC basket. Thank you to all those who participated in the raffle!

    A big thank you to our generous product sponsors this year, including Peanut Butter & Co, Harvest Snaps, Purely Elizabeth, Biena Snacks,  JCC of Rockland, Celebrate Vitamins, KIND, Manitoba Harvest, Shoprite, Once Again, and Kite Hill.



    Top 3 Ways to Stay Informed about WRDA Events

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    Like us on Facebook and check us on Instagram to follow our page for photos, recipes, and information regarding events!

  • 30 Apr 2017 9:30 AM | Anonymous

    Over 50% of colorectal cancers are preventable through a healthy lifestyle (including diet choices).  Elisa Bremner, WRDA President, Janice Shaw, NYSAND AME Chairperson, and Melissa Keeney, WRDA Nominating Chair took time out of their Sunday morning to help cheer on the runners at CCCF's fun run/walk at Manhattanville College.  WRDA provided nutritional guidance and a delicious colon-cancer-busting snack of hummus & veggie wraps (that pink thing in the background is a giant inflatable colon).  We hope this will be the start of many more event where WRDA members can get out our message to the public. 

  • 06 Dec 2016 8:07 AM | Anonymous
    The WRDA Clinical Update occurred on December 1, 2016 at Palisades Center. Around 70 medical professionals including Registered Dietitians, Dietetic Interns, Diet Tech students attended the Clinical Update. This year the Clinical Update focused on "Mindful Perspectives on Nutrition & Aging".

    There was a wide array of presentations focusing on the continuum of the aging process, management of Alzheimer's disease, usefulness of meditation therapy, nutrition therapy in the Aging process. 

    The opening speech was given by WRDA President Elisa Bremner, followed by the information on NYSAND Centennial AME by Janice Shaw. Niharika Jaiswal, President-elect, provided an overview of the Clinical Update.

    The presentation topics and the speakers for the Clinical Update were:

     Nutrition Across the Aging Continuum... Including End of Life:  Bindhu Thomas MD, CMD
    Columbia University College of Physicians and Surgeon, Department of Medicine/ Division of Geriatric Medicine and Aging.

    Advances in the Management of Alzheimer’s Treatment and Prevention: Hollie Webb, MSN, FNP-C
    New York-Presbyterian Hospital/Weill Cornell Medical Center, Alzheimer’s Prevention Clinic

    Meditation for Healthy Mind: Supriya Reddy Certified Meditation Trainer, Heartfulness Institute

    Maximizing Nutrition in Aging: Miriam Pappo MS, RD, CDN Director of Clinical Nutrition Montefiore Medical Center
    Jennifer Flood-Sukhdeo MS, RD, CDN  Director of Nutrition Hebrew Home at Riverdale

    Dr. Thomas provided an excellent overview and in depth of understanding of the human physiology on the complex topics of aging, end of life, palliative and hospice care, which are clinically relevant to members of the healthcare team providing nutritional care to their patients.   Speaker, Hollie Webb, provided cutting edge information on the different treatments utilized for the management of Alzheimer’s disease. In addition, participants were given an opportunity to partake in a meditation session under the guidance of Supriya Reddy. The final segment of the Clinical Update comprised of a presentation by Miriam Pappo, on understanding the nutritional aspect of the aging process followed by a panel session along with Jennifer Flood-Sukhdeo. There was a Q&A session where the participants were able to ask nutrition questions to the panelists.

    During the Clinical Update, a session by Ms. Ann Darcy and Ms. Catherine Foley provided an update on public policy on nutrition related topics.  The Clinical Update finished with drawing of two raffle prize winners Sylvia Hawkins, and Antonella Caggiano receiving the WRDA membership for the year 2017.

    Niharika Jaiswal MS, RD, CDN
    WRDA President Elect


  • 23 Sep 2015 7:11 PM | Anonymous

    The WRDA kickoff dinner occurred at The Rye Bar and Grill on Wednesday September 16. Over 30 members attended with at least half of attendees being new members. Several people walked in so there was a great turn out! Attendees schmoozed and networked over appetizers, wine and beverages for about a half hour before the presentation. The speaker was Dr. Elizabeth Wind who led an interactive presentation on mindful eating. Participants were engrossed in a discussion and were given tools to add to their counseling toolbox. A delicious three course dinner followed where participants were seated in a lovely room with tables of about 6 people. Janice Shaw also gave a short plug for the AME which will take place at the Doubletree in Tarrytown in May.

    We look forward to seeing you at our October event on "Fearless eating for children" with Jill Castle at Phelps!

    Meredith Stanford, Co-President, WRDA
  • 02 Apr 2014 10:52 AM | Anonymous
    Our March 29th meeting was a tremendous success!  Thank you to all who attended the  meeting. The WRDA prouded over $700 as a donation to the Food Bank of Westchester!

    Thank you to our speakers. Please visit their websites and consider becoming a member of their Community Supported Agriculture (CSA)- Farm Share Program!

    Stone Barns Center in Pocantico Hills: http://www.stonebarnscenter.org/visit/explore/stone-barns-csa.html

    John McDowell, Rockland Farm Alliance in New City:   http://cropseycommunityfarm.csasignup.com/members/types

    Steffen Schneider, Hawthorne Valley Farm in Ghent (Columbia Co.): http://hawthornevalleyfarm.org/where-to-buy/community-supported-agriculture-csa/

    Mike Fedison, Hilltop Hanover Farm in Yorktown Heights : http://www.hilltophanoverfarm.org/wp-content/uploads/2013/12/CSA2014App1.pdf

    Doug DeCandia, Food Bank of Westchester

    Joan Dye Gussow, Teacher, Author, Organic Producer

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