Rotation: Health Promotion Disease Prevention

The VA has a program called Health Promotion Disease Prevention (HPDP) and we dietetic interns each spent three weeks with the program.

HPDP is very different than the clinical rotations.  With clinical rotations, the focus is fixing the immediate health problem the patient is facing.  With HPDP, the focus is to prevent the health problem in the first place.  This is a concept I think a lot of health professionals can get behind.  Heck, not just health professionals – everyone!  It’s no secret that health promotion and disease prevention will save money and lives in the long run.

But I digress!  With HPDP, I got to participate in a variety of wellness projects, not just nutrition projects.  I wrote newsletter articles on safe driving that will be used in the winter newsletters. I helped out with a Cooking Matters class that was just for Veterans and had a lot of fun working with the Veterans in the class.  A lot of them had never cooked before being in the class, so it was nice to coach them along so that they did all the real cooking work.  During the class, one Veteran asked me if I thought that foods with chemicals in them were bad and he went on to tell me about an email he had gotten that told him lard and butter were better for him than the “so-called heart healthy stuff” or supplements.  Apparently the email told him that anything with a chemical sounding ingredient was automatically bad for his health.  I pointed out that it all packaging can be misleading unless you’re really paying attention to the label, pointing out that one food might have a lot of sugar in it but the sugar could be listed in three different forms so it doesn’t get listed as the first ingredient.  He pressed the issue, so I finally asked him if he’d drink a glass of dihydrogen monoxide.  His immediate answer was “Of course not!”  He was kind of taken aback when I told him it was another name for water.  The RD I was working with was amused by that conversation.  (If you ever want to chuckle, check out http://www.dhmo.org/ – I find it quite hilarious.)

I also observed and led nutrition portions of MOVE! classes.  MOVE! is a great weight loss program run by the VA.  I’ve helped out with MOVE! classes now in two different VA systems and it’s always amazing to help out with the classes.  The in-person weight loss classes are taught by a three-person team – a dietitian, a physical therapist, and a psychologist.  The dietitian goes over the nutrition topic for the day, the physical therapist teaches exercises and ways to modify the exercises so everyone can do them, and the psychologist goes over behavior change strategies to help make the weight loss a lasting change.  MOVE! is truly a lifestyle change class and it’s amazing to see the progress of the Veterans who participate.

While I had fun with everything I’ve mentioned so far, my favorite part of HPDP ended up being something I wasn’t originally scheduled to do.  On my last day, I went with one of the HPDP dietitians to Camp Hope, a non-profit lodge specifically for the use of combat Veterans, to help teach a cooking class.  The Veterans were there for a multi-day retreat just for Veterans who had suffered TBI and they were working with social workers, physical therapists, psychologists, and a whole host of other health professionals.  We were there to help them learn healthy cooking habits by having them make their own lunch for the day.  I think a lot of the Veterans were a little nervous when the RD told them, “This is your lunch, so you guys better follow the recipes because you guys are going to have to eat it.  There is no backup meal.”  They all ended up doing great and a few of them who claimed they never cooked seemed proud of themselves for cooking, and deservedly so.  We were also there to encourage them to break out of the “meat and potatoes” mindset and a few were surprised to learn that vegan chocolate cake tastes just as good as regular chocolate cake.  Camp Hope is a truly wonderful place and I highly encourage anyone who can volunteer or help out with it to do so.

HPDP definitely ranks up there as one of the highlights of the internship.  The Veterans I worked with were all great, as was everyone who was an HPDP employee.  I can easily envision myself working in a health promotion field now.

Week two of Operation Food Search/Cooking Matters

Eek!  Nearly two weeks since my last post and over two weeks since my last post about the internship!  Kind of gives you an idea of how busy I’ve been!

A little backtracking for this post, because I want to finish writing about my time with Operation Food Search/Cooking Matters, even though I’ve had a short rotation since then.  To start, I ended up with two posts going up on their blog!  The first, “Children and Cooking,” is about my experience assisting with one of the in-classroom presentations and getting children to help in the kitchen.  Originally, the draft for that became a lot longer than we originally planned, so I split it into a second entry, “Eat seasonally and save money, too!”  Go check ’em out!

The first chili

My three classes/demos that I led my last week of that rotation… Well, I didn’t set anything on fire!  The first demo went well.  The recipes (a sweet-potato chili and a chile sweet potato dip) were well-received and there was a good discussion afterwards.  The little bit of left over chili that I brought back was enjoyed by a couple of people in the office.  The second demonstration didn’t go quite as well.  I made two different dips and “pancakes” (really more like hashbrowns) and only one of the dips was a hit.  Why the difference in receptivity?  Different audiences.  I made a really basic mistake and forgot to take into account the fact that the second demonstration was for children.  So!  Big lesson learned there: Don’t forget to pick your recipes for your audience.  While the food wasn’t a huge hit, the children did seem to have fun helping me and were all eagerly volunteering and competing to yell the answers first, so at least that part went well.

The pretty popular dip

Now, the third demonstration.  Heh.  Overall, this one went well.  It was in a group rehab home that also provided counseling services for those that didn’t live there and we had a pretty decent crowd attend.  No one really wanted to volunteer, though, so I and the RD overseeing me did most of the cooking.  Again, we made a chili and a dip, figuring the chili was perfect for the cold, rainy weather that day, and the dip would be good to talk up for serving at football or hockey watching parties.  The dip was the same as the first demonstration, but the chili was a different recipe.  We started with the Cooking Matters recipe Turkey Chili With Vegetables, but then doubled it, used one can of black beans, one can of kidney beans, only one pound of turkey, and added one large cubed sweet potato.  So far, so good…the mistake happened with the chili powder.  If you check out the original recipe, you’ll see that it calls for “chili powder.”  Well, I used what I saw was the chili powder, but it came out on the spicy side!  While a few people liked it that spicy, it was too spicy for some.  This recipe had been made many times before and wasn’t that spicy, so we looked at everything a little closer.  Turned out, what I had used for “chili powder” was actually “ancho chili powder.”  D’oh!  See, “chili powder” is a combination of spices (ancho or jalapeno chilis with cumin, garlic, oregano, and salt) so it’s not as spicy as “ancho chili powder” which is only dried, ground ancho chilis.  Whoops!  So, lesson learned? Always, ALWAYS double check your ingredients– not just that you have them, but also that they are exactly what the recipe calls for.  The original plan for the discussion was to discuss portion sizes, but we also ended up adding a bit on how to save a recipe.  (For example, if your chili ends up too spicy, add extra tomatoes and beans, bulking up the chili and spreading out the spiciness.)

The rest of my time with OFS/CM was spent working on papers and having debates such as “Should people on food stamps be restricted from purchasing things like soda?”  Something I forgot to mention in my last post about this rotation was that prior to the start of the rotation, I had to partake in the Food Stamp Challenge.  The rules for our set-up are slightly different than the $4.80/day most challenges use.  For one week, all you have to do is write down everything you eat and about how much it cost.  Then, for the second week, you are limited to $21 for the entire week (or $3 a day.)  I highly suggest anyone who wants to work with those who are food insecure try the challenge.    Actually do it and no fudging!  I know of one person who just gave up right away when she realized it meant she couldn’t have her favorite organic lettuce mixes.  The Challenge isn’t doable for everyone and some people don’t need the Challenge because they’ve already lived it.

For me, the Food Stamp Challenge was doable because as a poor intern and after years as a poor student, I don’t spend a whole lot on food- just the occasional splurge.  But participating in the challenge meant absolutely no splurging.  For example, the first week where I was just tracking what I spent?  I had an expensive glass of wine.  Couldn’t do that my second week or I would’ve blown my budget for days.  It is possible to spend less than $3/day/person on food and still meet your nutritional needs, but it takes a lot of planning and self-control.  I ended up going to the library and looking through cookbooks that were all about cheap recipes.  I also ended up coming across Budget Bytes, which is now one of my favorite blogs.

I have read some of the criticisms of the Food Stamp Challenge and I understand the limitations of it.  For a brief look at some of the problems with the Food Stamp Challenge and similar challenges, please read this post.  In the essay I had to write about my experience, I pointed out that it wasn’t realistic because unlike those who are using SNAP funding to survive, I didn’t have to figure in time to travel for acquiring food, cooking food, overhead costs such as electricity, and a whole slew of other other things that go into feeding oneself.

I had a blast working with the Cooking Matters team at Operation Food Search.  My time with them has me re-considering the possibility of going into community nutrition.  At the very least, I’ll want to somehow be involved with public health advocacy.  And isn’t this what the internship is supposed to be about?  Finding out what field of nutrition you’re best suited for?  We’ll see what the rest of the rotations hold for me.

Related articles

• Operation Food Search/Cooking Matters (didispatch.wordpress.com)
• Traverse City students learn healthy cooking (record-eagle.com)
• Cooking Matters Class (uropcbrp.com)
• Healthy, affordable cooking with a big dose of fun (siouxcityjournal.com)
• Why use cooking in the classroom? (bakingforteachers.wordpress.com)

Operation Food Search/Cooking Matters

This last week I’ve been in my first community rotation, working with Operation Food Search.  More specifically, I’ve been working with their Cooking Matters instructors.

Check out this video from KETC9’s Living in St. Louis about Operation Food Search’s Cooking Matters.

The materials I’ll be using while I’m at OFS/CM

So what have I been doing with them?  Well, after familiarizing myself with what the organization does, what materials they use, and getting a tour of their facilities, I spent some time first observing one of the classes they teach, then assisting with some of the classes and a grocery tour.  I’ve helped out with classes for children, adults, and elderly adults.  I’ve been taking pictures the entire time, too.  (Except for two classes where I didn’t even have a second of down time, but there were official photographers from the host sites there, so hopefully I’ll get those pictures.)   I  won’t be posting any pictures of the students in the classes because I don’t have signed waivers, but Cooking Matters does, so my pictures might be used for their website.  In fact,  one of my photos was used for a blog post over at the Cooking Matters St. Louis blog.  (Not one of my best, but it was an action shot with a small pocket camera, so oh well.)  I’ve offered to write a blog entry for them, so I’ll be sure to share when I do.  The pictures will also be shared with the schools and sites that hosted the classes for their use.

Chili and Chocolate Cake

However, I do have some pictures of food for you to enjoy!  In one of the classes, we made Turkey Chili with Vegetables and Chocolate Cake (which was vegan!)  It was a cold day so the chili was greatly enjoyed by everyone and of course, everyone loved the cake.  While the chili was simmering and the cake was baking, I led everyone in some easy chair and soup can exercises.  I’ve linked to the chili and cake recipes if you’re interested in trying them yourself.

In one of the classes where I couldn’t take pictures, we made Sweet Potato Quesadillas.   We were working with first through third graders at one of the local schools.  The children have been working in a school garden and had just harvested sweet potatoes, so we wanted to make sure we used sweet potatoes in our recipe.  We had the children help us out by doing things like stirring, pouring, peeling, and measuring.  Remember, getting your children involved in meal prep is an excellent way to instill good eating habits.  While the quesadillas were cooking, I led the children in activities focusing on MyPlate and eating a variety of colors when it comes to fruits and vegetables.

Flaky chicken with two sauces

The peppery pasta

In the post at the Cooking Matters St. Louis blog that used the picture I took, you can read about the Baked Flaked Chicken and the Chicken Broccoli Fettucine that the students made.  There was a little mishap with the pasta, which amused the instructors.  You can read about it at the Cooking Matters St. Louis blog.

Next week, I’ll actually be leading three classes and demos with some of the Cooking Matters instructors as my assistants.  I’ve had to pick the recipes already and come up with outlines for two of the presentations, just to make sure I’ll be good on time and to list out key points I’ll need to touch on during each presentation.  Normally, I get nervous before presentations, but right now I feel pretty good.  Here’s hoping I don’t set anything on fire during my presentations!