I thought I’d take a step out of my comfort zone and talk about what I’ve been doing lately in my Dietetic Internship because pretty much all I talk about on this blog is delish food. I’m currently interning with The Breathing Association and The Inflammatory Bowel Disease Center at the medical center on campus.
The Breathing Association is a free lung health clinic that offers medical and nursing services to income-eligible people with a variety of breathing disorders ranging from chronic obstructive pulmonary disease (COPD) to asthma. The Breathing Association received a grant to fund a program called “Every Step Leads to Success,” a nutrition education program that allows the patients to learn about healthy behaviors and eating habits through personalized nutrition care plans and modified behaviors. The hope is that these patients will have improved overall health along with fewer hospital visits and emergency care.
As nutrition interns, we meet with patients interested in the program and perform an initial nutrition assessment in order to gather more information regarding their dietary patterns, food intake and nutrition habits. We help the patients set realistic goals such as increasing fruit and vegetable intake to three times a day instead of once a day or walking for thirty minutes five times a week instead of twenty minutes twice a week. We also establish weekly exercise plans, set objectives for healthier eating, establish personalized goal weights and schedule follow-up visits. All of the counseling is aimed at establishing the relationship between lung health, diet and weight, which are all inherently related. We also help assess neighborhoods, looking for resources like safe parks for walking , food pantries for grocery shopping and affordable places to purchase fresh produce.
The next portion of the grant includes conducting grocery tours with the patients, arranging visits to local food pantries and offering cooking classes that introduce new and affordable foods and meal planning tips. We’ll also teach the patients simple ways to set up a more nutritious kitchen. Diabetes patients will have the option to attend a diabetes education class though the Central Ohio Diabetes Association. Additionally, there will be patient perks or incentives such as gas or grocery cards, one month gym membership cards, and even food apps for free phones provided by social services. All the while, we will be tracking the patients’ progress on goals.
We hope that in the end the patients will have improved dietary habits, a better understanding of the benefits of healthier eating habits and physical activity, how to eat well on a budget and increased knowledge of food and exercise resources in the community.
This is an extremely rewarding experience. I can already tell that I love counseling. These patients have problems way beyond the scope of what they’re eating for lunch, and sometimes all they need is some one to talk to. My trivial problems are really put in perspective when I talk to a patient who doesn’t have a stove to cook with or a refrigerator to store the vegetables I’m advising them to eat three times a day. Though I’ve only counseled a few patients so far, I’ve already learned so much. It can be difficult to consume enough fruits and vegetables when they only get two cans of vegetables a month at the Food Pantry. Even though most patients are on food stamps, struggling to get by and living with a chronic lung disease, they enter the office excited to see me and enthusiastic about my suggestions. It helps the patients to know that losing that extra weight could make their disease much easier to manage. Our mental health is connected to our physical health and diet has a tremendous impact on both.
When I’m not at the Breathing Association, I’m at the Center for Inflammatory Bowel Disease in the Division of Gastroenterology, Hepatology and Nutrition. The center specializes in diagnosing and treating disorders of the digestive tract, liver, pancreas and gallblader. On Wednesdays I shadow an amazing doctor and watch surgeries like upper endoscopies and colonoscopies. The patients have a variety of disorders, including Crohn’s disease, ulcerative colitis, fatty liver disease, reflux , celiac and IBS.
This opportunity is close to the heart for me because last year my 25-year-old brother was diagnosed with severe Crohn’s disease. He went through months of no appetite, serious weight loss, constant vomiting, diarrhea and pain. I was worried that he wouldn’t live. We had absolutely had no idea what was wrong with him. Doctors kept misdiagnosing him until he had a proper colonoscopy that showed his severely ulcerated colon. He has only had a couple of flare ups, so we’ve been pretty lucky. He has eliminated alcohol from his diet and has learned to pay much closer attention to the effect that various foods have on his GI tract.
I’ll be in the nutrition clinic on Fridays counseling patients dealing with Crohn’s in addition to a host of other diseases ranging from diabetes, metabolic syndrome, and obesity. Diets for these patients must be individualized since everyone’s GI tract handles food differently. In order to decrease inflammation, low-fat diets are typically recommended. FODMAP diets in addition to low-glycemic index foods are often recommended as well.
These diseases can severely affect quality of life and proper nutrition is vital to maximize the patient’s well-being. The doctor I follow stresses a holistic approach to inflammatory bowel diseases, which I really admire. The molecules that cause depression and anxiety are the same ones that cause Crohn’s and UC; hence the doctor stresses the importance of patients’ seeing behavioral psychologists if necessary. As I mentioned before, physical and mental health are closely intertwined. I believe in a holistic approach to nutrition as well, so I can’t wait to learn more.
Three words I continuously misspell:
recommended, exercise, diarrhea
Anyone with me on that?