Today, March 14th, is Registered Dietitian (RD) Day in the US.  The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) commemorates the RD day to promote the Registered Dietitian as the food and nutrition expert that can help people to live better lives through good nutrition.  The first RD day was celebrated in March 2008, while the National Nutrition Month ® (NNM) started in 1973 as a nutrition week and then became a month long in 1980. This year the theme for the NNM was “Get your Plate in Shape”. You can find educational materials (both in English and Spanish) from the NNM here  .

The Academy developed these RD Day key messages directed to the public and the media:

• Registered Dietitians are the food and nutrition experts who can translate the science of nutrition into practical solutions for healthy living.
• Registered Dietitians have degrees in nutrition, dietetics, public health or a related field from well-respected, accredited colleges and universities, completed an internship and passed an examination.
• Registered Dietitians use their nutrition expertise to help individuals make unique, positive lifestyle changes.
• Registered Dietitians work throughout the community in hospitals, schools, public health clinics, nursing homes, fitness centers, food management, food industry, universities, research and private practice.
• Registered Dietitians are advocates for advancing the nutritional status of Americans and people around the world.

 As I posted before, in Argentina the dietitian day is celebrated on August 11th. When is dietitian/nutritionist day in your country?

-          Romina

Effective this January, formerly American Dietetic Association changed its name to the Academy of Nutrition and Dietetics. It was announced on the Food and Nutrition Conference and Expo (FNCE) on September 24, 2011.
Why ADA changed its name? Basically to better represent who we are and what we do. Academy President Sylvia Escott-Stump said that "An academy is a society of learned persons organized to advance science.' This term describes our organization and immediately emphasizes the educational strength of our advice and expertise."
This name change has to do with the evolving role of dietitians focusing more on protecting public nutrition and health. It was felt that the word NUTRITION should be included. "By adding nutrition to our name, we communicate our capacity for translating nutrition science into healthier lifestyles for everyone. Keeping dietetics supports our history as a food and science-based profession" Escott-Stump said.
You may noticed that the word American is gone. It is said that the reasons were:
- Many of the proposed names with the word "American" were already in use (for example: American Nutrition Association, American College of Nutrition, American Society for Nutrition, etc. )
- Going global: Dietetics is a growing global discipline and the Academy has members in more than 70 countries. The Academy is committed to impact on the nutritional health of people all over the world for years and decades to come.
Also, the name of the Journal (JADA) changed to Journal of the Academy of Nutrition and Dietetics and the ADA Foundation is now the Academy of Nutrition and Dietetics Foundation. The logo EatRight remains the same.

In my opinion the new name is more accurate, I like it more and better represent us (specially us that are international members). But is going to take time to get used to...
What do you think about the new name? Share your thoughts!

- Romina

The Argentinean Asociacion of Dietitians and Nutritionist Dietitians (in Spanish: AADYND - Asociacion Argentina de Dietistas y Nutricionistas Dietistas) is a new member of the International Confederation of Dietetic Associations (ICDA). Congratulations AADYND!!
ICDA nucleates dietetic associations of all over the world and supports them (an their members) to develop international standards of education and practice and to improve our professional image around the globe. Don't miss ICDA website for useful info on international opportunities and get to know the profile of Argentinean dietitians: click here

“Our profession is our bond. Our diversity is our strength. Our needs are our opportunity to work together” (Doris Delerian, RD, President of the ADA - 1996)

- Romina

I am very excited to introduce you to Eat Well Global and Eat Well Argentina. What’s it all about? Eat Well Global, Inc is a nutritionist-led travel media to help people to eat well not only at home but also when traveling around the globe. It was founded by Julie Meyer, RD, who is a great entrepreneur dietitian, nutrition writer and an awesome person to work with!

So, Eat Well guides are written by local nutritionists and provide travelers (and why not locals) with exclusive information about typical foods, nutrition trends, food labeling, tips for people with food allergies or special dietary needs, markets, restaurants, and even recipes developed by local chefs. As most travelers today make use of electronic devices these guides are presented as applications (apps) for smart phones and tablets. (IPod touch, IPhone and IPad). Much easier to carry than a book!

Like I said, I have the great pleasure to work with Julie in developing Eat Well Argentina. This is an example of how dietitians can work together, even when we are located in opposite hemispheres, to improve people’s health. We worked hard to put together all the contents...but what a wonderful learning experience! Guides from other countries are coming up (like China, Greece, Mexico), so check out www.eatwellglobal.com for your next travel, where you will also find ongoing info on how to eat well across the globe.

I’m happy to announce that Eat Well Argentina is now available at Apple Store: click here. If you know foreign students or business people coming to Argentina or expats living here...pass the voice! They would love to hear where to order healthier delivery foods, how to eat vegetarian in the “beef country”, how to read food labels, how to ask for gluten-free (audio is included in the app), where to shop for food and much more! Also, many Argentineans will benefit from this easy-to-use and truthful information developed by dietitians.

Eat Well and be well!

 - Romina

Some of the new food products are:

Are your patients/clients tired of the same old liquid supplements? Blue Bunny® presented an ice cream called NUTRI-plus™, a real ice cream loaded with nutrients ideal for those that are not eating well. It comes in orange, vanilla and cherry chocolate flavors. A 4oz. cup contains 240 calories, 9 grams of protein and 10-20% of the daily value of most vitamins and minerals.

Nutritionally balanced meals ready to eat. Go Picnic™ makes boxed lunches that need no refrigeration, heating or preparation. They are easy to carry and are meant to be enjoyed anywhere. Also made with clean ingredients, with no trans fat, no added monosodium glutamate (MSG), no high fructose corn syrup (HFCS) and no artificial flavors or colorings. My favorites were salmon + crackers and hummus + crackers, but in my opinion they are more like snacks than a “meal” as they lack in many components of My Plate....

No excuse not to eat fruit. Crispy Green® presented its new snack fruit: Crispy Cantaloupe, which is another of their freeze-dried fruits available in convenient single-serving (15-gram) bags or a "Grab and Go" 6-pack. It’s 100% fruit and nothing else!

Medical Nutrition going organic. PediaSmart® SOY is a complete formula designed to be used as a supplemental beverage or to be delivery through tube feedings for children 1 through 13 years. It has no corn, gluten, GMO ingredients.

Finally, I want to highlight the closing session which was very inspiring and motivating. Jack Canfield, author of Chicken Soup for the Soul among other books, presented the Success Principles. My favorite quote was "If you want to be really successful, and I know you do, then you will have to give up blaming and complaining and take total responsibility for your life -- that means all your results, both your successes and your failures. That is the prerequisite for creating a life of success."

I hope you enjoyed these FNCE highlights and please share comments or other news. Thanks!
- Romina

Hey all! In this post I will continue sharing the best of FNCE 2011. I hope you enjoyed the first part of this FNCE highlight series. As I said before, FNCE is a conference that gives content to talk about for a while. It’s impossible to cover all topics, thought. So, I just selected some of the topics that are in my opinion more interesting. Otherwise you can access to speakers presentations on the FNCE website. 

§    The Skeleton’s Out: A Standardized Approach to the Recognition and Documentation of Malnutrition. The ADA Malnutrition Workgroup and the ASPEN Malnutrition Task Force have worked together to get a consensus on how to diagnose and document malnutrition. Several characteristics of malnutrition were acknowledged and any 2 or more of these 6 characteristics can be used to diagnose malnutrition:

o       Evidence of reduced intake: for instance > 5 days with intake of < 50% of total estimated energy requirement (acute illness/injury category or suboptimal intake like > 1 month with a nutrient intake of <75% of total estimated energy requirements (chronic illness/condition category)

o       Unintended weight loss: > 2% weight loss in 1 week or > 7.5% in 3 months

o       Changes in body composition: loss of subcutaneous fat

o       Changes in body composition: loss of muscle mass

o       Changes in body composition: fluid accumulation

o       Measures of physical function/performance: hand grip strength, stair climbing

The speakers (Dr. Jane White and Dr. Annalynn Skipper, both dietitians) mentioned that these characteristics to identify malnutrition represent a work in progress and that they may change overtime as evidence is collected to support their appropriateness. If you are interested in learning more, here is the handout.

§    The War on Obesity: A Battle Worth Fighting? This was a provocative debate between an antiobesity researcher, John Foreyt, PhD, and Linda Bacon, PhD, a nutrition researcher, author of Health at Every Size (HAES), where she proposes an approach were people don’t have to lose weight to live longer and encourages “Accepting and respecting the natural diversity of body sizes and shapes”. Bacon presented research that shows that obese people live as longer as normal weight people. But, how can she ignore the quality of life of the obese? Or the cost of their health care? I don’t agree with Bacon statement “the best way to win the war against fat is to give up the fight”and neither have I agreed with Foreyt when he dismissed mindful or intuitive eating. One thing, where the two speakers have agreed is that restrictive diets don’t work. But, we can’t just say that “diets don’t work”. We need to help people to incorporate life lasting healthy eating habits. Don’t you think?

§    The Skinny on Bariatric Surgery: Illuminating the Evidence from Early Stage CKD through Transplant. Dr. Maria Collazo-Clavel from Mayo Clinic highlighted how post bariatric surgery patients started to show up at the Stone clinic as renal stone formation (specially calcium oxalate stones) became a common condition after bariatric surgery, mainly due to dehydration, diet composition (low in protein/calcium),  fat malabsorption with hyperoxaluria. The next speaker, dietitian Judith Beto, PhD pointed out how bariatric surgery can be useful in reducing BMI to decrease surgical risks prior to renal transplantation. Nutrition therapy for renal patients after bariatric surgery is well addressed by Rachael Majorowicz (moderator of this session) in “Nutrition Management of Gastric Bypass In Patients With Chronic Renal Disease” (Nephrology Nursing Journal March-April 2010:37:171)

§    How Risky is Our Food? Clarifying the Controversies of Chemical Risks. In this session, Julie Miller Jones, PhD, LN, CNS, board member of ILSI, showed that despite acrylamide is considered a carcinogen in the laboratory, studies have reported that everyday exposure to acrylamide in food is too low to be of concern.  Acrylamide in food forms from sugars and an amino acid when foods are cooked, specially at high temperatures. There are some ways to reduce acrylamide in your food, like: toast lightly (scrape off very dark areas), allow long yeast fermentation, bake and fry at right temperature (don’t over-brown), store potatoes properly (not in the fridge) and cook them with skin on.

The next speaker, Carl Winter, PhD, a fellow of the Institute of Food Technologists and a Board member of the FDA, showed his research about organic foods and challenged all their claims. He questioned the methodology used by the EWG on the “dirty dozen list” and showed data where organic foods are not healthier than conventional ones.
Great piece of the audience criticized this session for the lack of balance. Would have been nice to hear from researchers that supports organic foods as well. Take a look at the handouts here.

That’s all by now. Don’t miss the next post, with info about new products presented at the Expo and closing session remarks!

- Romina

I was so fortunate to attend -for the first time- to the largest nutrition and dietetics conference in the world. I had to travel to the other hemisphere but it totally worth it. Wow… The American Dietetic Association really knows how to put together a conference! It was held last week in the beautiful sunny city of San Diego. The Convention Center was so huge that I actually did my daily workout by walking around it. Also, the energy felt in the air …with thousands of dietitians under one roof …was amazing and inspiring (there were around 9000 attendees). FNCE is not only a place to learn and get updated on the changing field of nutrition, it is also a true opportunity to network with peers and grow personally and professionally.

So, I would like to share with you some of the FNCE 2011 repercussions. There is so much to share that I will post it in three parts.

-          I was surprised, at the Opening Session on Saturday 24th, when ADA President Sylvia Escott-Stump announced that the ADA changes its name to Academy of Nutrition and Dietetics, effective January 2012. The reason was to better communicate our identity. The term academy better represents the aim to advance science and "by adding nutrition to our name, we communicate our capacity for translating nutrition science into healthier lifestyles for everyone”, Escott-Stump said. Do you think the name change was a good idea?


-          The Wimpfheimer-Guggenheim International Lecture: “Opportunities for International Nutrition Work” held on Sunday 25th showed three different professionals paths in international nutrition. All of the speakers shared tips and resources especially for those students looking for the dream of working/volunteering overseas. One of the most important ones I took from them is to be international before going abroad. For instance: learn a second language; participate in local internationally focused activities and if you travel, go beyond the touristic spots. See my previous post about Dietitians learning a foreign language. Also a person from the audience added that AODA is a great resource.

-          The member showcase on Monday 26th was a very interest live debate between two leading experts. The session was titled “Sweet Scrutiny: Debating the Research on Nutritive and Non-Nutritive Sweeteners”, but the really issue discussed was whether sugary drinks can be blamed for the growing obesity. Dr. Theresa Nicklas pointed out that consumption of added sugar in the U.S. is decreasing but –paradoxically- obesity rate keeps growing. Also, she stated that the evidence is inconclusive when we link carbonated beverage consumption with prevalence of overweight. On the other hand, Dr. Barry Popkins, is convinced that sugary drinks promotes the obesity epidemic and believes that sodas should be taxed in the similar way as tobacco because it’s deleterious to our health. He argued that one should be carefull when analyzing studies, as many of them were funded by beverage companies with results more likely to be “industry-friendly”. He also pointed out that liquid calories are not the same as solid ones, saying that “if we take in 200 calories in liquid, we won’t eat 200 fewer calories from food” (to compensate). To this, Dr. Nicklas replied back saying that “a calorie is a calorie” and that “If we’re going to tax soft drinks, why not tax pizza or donuts? We’re fighting the wrong battle here. We need a total diet approach”, prompting a round applause from the audience. What do you think? Share your opinion, and I will share mine.

Stay tuned for more. Next post I will talk about the organic controversy, standardized approach and documentation of malnutrition, bariatric surgery and more. The third part of these highlights will be based on new products from the Expo. Don’t miss it!

- Romina

Exactly 134 years ago, Argentinean physician Dr. Pedro Escudero was born (1877-1963). He is the founder of the nutrition profession in Latin America and in order to evocate his contribution, every August 11th (the day he was born) the Nutritionist’s Day is celebrated in most Latin-American countries. He made the first move in nutrition and dietetics in the region!

Escudero visited diverse institutions in the United States of America and in Europe (especially those dedicated to the study and treatment of diabetes and other metabolic diseases) and selected from them what suited the needs of the Argentineans.  After fighting arduously to surmount the indifference and opposition, he founded the National Institute of Nutrition in 1928 and the School of Dietetics in Buenos Aires in 1933, the first in Latin America. Then, in 1938 it was upgraded to the National School of Dietetics and gave scholarships for each country of the region, in such a way that the first dietitians of Bolivia, Brazil, Colombia, Costa Rica, Chile, Ecuador, Guatemala, Honduras, Mexico, Nicaragua, Paraguay, Panama, Peru and Uruguay, had graduated  in the Argentinean school. Afterward, each country created its own school according with their individual needs.

In Argentina, the term dietitian (“dietista”). The health professional expert in food and nutrition comparable to the RD is the Licentiate in Nutrition (“Licenciado en Nutrición”). In Latin America, “nutritionist” is considered a broader term that accurately covers the wide scope of practice: clinical nutrition, food service management, community nutrition, education and research.

So, today is a special day to remember Dr. Escudero and to reflect about our past, present and future to make the most of the upcoming opportunities. Very proud of being Licenciada en Nutrición,  ¡Feliz día del Nutricionista!

Romina
Source: BARRITTA DE DEFRANCHI, Romina L y NELSON, Jennifer K. Evolución y tendencias del profesional nutricionista en los Estados Unidos de America y en Argentina: Norte y Sur unidos por desafíos similares. ALAN, jun. 2009, vol.59, no.2, p.113-119. ISSN 0004-0622.

Recently a comentary published on the Journal of the American Dietetic Association adressed the issue of transitional care and opportunities for dietitians. Transitional care is a very popular term nowadays and -according to the American Geriatrics Society- transitional care is defined “as a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care within the same location. Representative locations include (but are not limited to) hospitals, sub-acute and post-acute nursing facilities, the patient's home, primary and specialty care offices, and long-term care facilities.”

Most places have physician-led programs to coordinate transitional care. Nurses or social workers also have a role. But…what about dietitians? Is nutrition in the transitional care not that important?

Dietitians, the nutrition experts, have a role (and opportunity) here to be an active participant of the discharging-planning process. What I want to highlight from this article is the importance of the systematic screening that should be done at discharge. Yes, nutrition screening not only done at admission but also at discharge. Especially older adults may have lots of barriers to eat well at discharge. Who is going to prepare meals? Can he or she eat alone or assistance is needed? Does the patient understand the role of nutrition in recovery? Nutrition screening at discharge is a new concept that can improve recovery, provide timely nutrition services and prevent complications and readmission. This, will ultimately save money with little effort.

This is one way to show how nutrition is an essential part of health promotion and disease prevention with a potential health care cost reduction. Don't you think?

How much are you willing to pay for organic produce? Can you be sure that it is worthwhile? These are worldwide questions with no straight answer. In Argentina, certified organic production is relatively new as it started about 20 years ago. The extension and richness of the Argentinean soil and the use of little agrochemicals made it easy for conventional farmers to transition to certified organic production. The certification of organics in my country is made by third party organizations. This means that a private agency controls and verifies that the producer is in compliance with the standards and provides them with the organic certification seal that you find in the food label. There are a dozen of certifiers and all of them must be approved and controlled by a national organism called SENASA (Servicio Nacional de Sanidad y Calidad Agroalimentaria).

Argentina is third organic producer country in the world, complying with the strictest standards (European Union, USDA, etc.). Unfortunately, only 5% of the organic production stays in Argentina. I ask myself, what’s the point of using ecological techniques to grow organic apples if you then spend lots of resources (and contribute to pollution) to ship them to Europe? In my opinion it is more important to buy local and seasonal produce. It is likely that they have less pesticides than the ones that need to shipped.

Even though the interest for buying organics has been growing, the internal market is still small. Mainly because their high cost and the lack of massive distribution. Also, many people don’t even think about buying organic because Argentinean regular foods are though to be “natural”.

If you are going to spend in organic produce, I would start with foods from the dirty dozen list. These are foods that -when conventionally produced- are likely to have higher levels of pesticides’ residues (According to the Environmental Working Group).

How is the organic production in your area? Please share your thoughts!

The dirty dozen
·                 celery
·                 peaches
·                 strawberries
·                 apples
·                 domestic blueberries
·                 nectarines
·                 sweet bell peppers
·                 spinach, kale and collard greens
·                 cherries
·                 potatoes
·                 grapes
·                 lettuce