Are You Health Literate?

Teresa 2013

Do you “Talk the Talk”?

This Friday, I will have the privilege of speaking at the North Texas Dietitian Spring Seminar on Health Literacy. Additionally, I am coordinating the Health Literacy Conference sponsored by the United Way of Tarrant County, UNT Health Science Center and Texas Health Resources to be held in April for health professionals. This emerging topic impacting health outcomes is of utmost importance to all health professionals. For registered dietitians, translating our language into understandable, actionable terms not only from the medical but also the culinary world can mean help our clients and patients succeed when it comes to optimizing their health and wellness.

Quality health care depends on effective patient communication. The effectiveness of health care communication has received increased focus with the advent of the Affordable Care Act (ACA) requiring that consumers receive clear, consistent and comparable health information from health plans and insurers. At the same time, the ACA emphasizes patient-centered care using methods to improve patient understanding of complex medical issues.

Do you hear what I hear?

Do you hear what I hear?

Health literacy is the ability of the public to obtain, process and act on health information to optimize and maintain their health. A growing body of research indicates that limited health literacy can lead to adverse health outcomes due to patients’ inability to follow instructions on medications, labels and health messages. This is especially important in preventative care such as nutrition and physical activity.

Research estimates indicate that between one-third and one-half of all adults struggle with health literacy. This may lead to limited overall health and wellness, increased and longer hospitalizations, trouble managing chronic conditions, increased use of emergency care and higher mortality rates especially among the elderly, ethnic minorities and people of lower socioeconomic status. Limited health literacy costs the U.S. between $106 and $236 billion annually.

Health literacy issues have been traditionally viewed as individual patient deficits in knowledge and skills affecting their ability to manage health issues. Recently, adverse outcomes have been recognized as a health care system issue involving the complexity of navigating technical health information and exceedingly complicated health care systems. In this emerging view, much more of the responsibility for patient knowledge is borne by the health care system rather than by the patient. For many people, food procurement, preparation and nutrition are a foreign country with their own language, customs and mores. Registered dietitian’s translate for our patients to help them navigate food and nutrition and become successful in protecting their health.

Fort Worth, Texas…A Travel Destination?

Recently, I made a new cyber friend as kindred spirits in travel and media. Kendra asked me to fill her in on things to do in Fort Worth, the city in which I live. Kendra Thornton who lives in Chicago, a city I love to visit, appears as a travel expert on television stations across the country to offer travel tips and deals.

Fort Worth Stockyards

Fort Worth Stockyards

As I started thinking about why someone would want to visit Fort Worth, I considered the newly revamped downtown area which offers many restaurants as well as a variety of things to do from Pete’s Piano Bar to Four Day Weekend comedy club to the Bass Performance Hall, hotels and shopping. My recent post on Taverna highlighted just one of the restaurants and who could forget Reata, the cornerstone of Fort Worth’s downtown cuisine?

Another fun area is the up and coming West 7th development. Including not only restaurants such as Terra and Tillman’s but also the club Studio Eighty for some eighties music dancing, a variety of other clubs and bars, the West 7th Movie Tavern, Sweet Sammies Ice Cream and of course, more shopping! West 7th is located not too far from the Museum district including the Children’s Museum, Cowgirl Museum, Museum of Modern Art and the Kimbell Art Museum.

The University Park Shopping Village features more great restaurants and an offering of nice retail shops including Banana Republic, Talbots and the like. A great place to grab a sandwich or pastry in that area is McKinley’s Bakery. Hoffbrau is another beloved restaurant in that area and who could forget Silver Fox? Located just north of TCU on University, the area has the feel of a college town set in the middle of the city. Depending on the time of year, a Horned Frog football game is a great option for family fun or just tour the newly remodeled campus and stadium.

Half Marathon Teresa River

Trinity Trails

Both the West 7th and University Park areas are just adjacent to the expanding plethora of bike trails in and around Fort Worth. These trails are home to a number of Marathons, Bike Rides and Triathlons as well as winding next to the Fort Worth Zoo and the Botanic Gardens. The new bike rental system allows for a choice of biking or walking through or around these areas and venues. As a registered dietitian, I think it is important when vacationing to find ways to get out with the family, spouse or friends and be active.

Last but not least, I have to mention the Stockyards. This area gave rise to the slogan, “Where the West Begins” or another Fort Worth nickname, “Cowtown”. Visiting the stockyards gives privy to many specialty western shops, the world renowned Billy Bob’s Texas and Cattleman’s Steakhouse. There are additionally a smattering of smaller venues for dancing and the ever popular, Joe T. Garcia’s Mexican restaurant.

Throw in a couple of outliers, Salsa Fuego, Ellerbe Fine Foods and The Keg and some seasonal events such as Mayfest, the Stockshow and Rodeo and the Cowtown Marathon and I realized Fort Worth has become a travel destination. You will want to experience all that Fort Worth has to offer for your next vacation or business convention. Give me a shout if you need a tour guide!

Conjugates and Carbohydrates

Everyone remembers the line in Eat, Pray, Love where Julia Roberts in her role states that every word in Italian is like a truffle. She goes on to say that she is going to Italy to write a book and call it Conjugates and Carbohydrates.

The definition of conjugate means the bringing along of basics into the more complex. This fall’s important lesson is that embracing the basics in constructing one’s life can help us get back to those things that are important in leading a healthy lifestyle.

While my semester challenged me with the basics of Biostatistics and Epidemiology, I did manage to attend the Texas Academy of Nutrition and Dietetics media representative training. During our training, we made a new friend who taught us the basics of fashion for not only our media appearances and but also everyday.

Me with Victoria Snee

Me with Victoria Snee

Victoria Snee, author of The Beauty Buzz showed us the key to avoiding cosmetic and fashion catastrophes by sticking with tried-and-true products. By abiding by this rule, one can feel good about their appearance and project a positive image.

October went on to include attending the Academy of Nutrition and Dietetics Food and Nutrition Conference in Houston where I caught up with many friends from all over the country while refreshing my basic knowledge of nutrition in 2013. Another adventure took me to Lubbock, Texas where I spoke at Texas Tech and Lubbock Academy of Nutrition and Dietetics on the “New Basics,” emerging trends in public health nutrition.

When it comes to nutrition, the basics to fueling for life is choosing nutrient-rich foods. Nutrient-rich foods contain health-building nutrients while limiting calorie dense simple sugars and excess fats. Similarly to fat as one of my students pointed out in a recent blog post, people tend to have a bad connotation when hearing the word Carbohydrate.

The most recent dietary guidelines encourage us to make half our grains whole and at the same time increase our intake of fruits and vegetables. These are all complex carbohydrates that provide fiber, vitamins and minerals currently lacking in the American diet. Getting back to the basics means choosing those whole, unprocessed foods that provide healthy amounts of fat, carbohydrate and protein, the energy-yielding nutrients.

Armed with all of our new appreciation for the basics, my colleagues and I headed out for our end-of-semester dinner gladly embracing the complex carbohydrates at Taverna. Despite all of the parodies that have been played on the book title, I think we must venture inside the book to learn from Julia…embracing each nuance of life can bring us to a place of health and contentment. So, I say Conjugate away!

Own Your Outcomes

Exercise Your Options!

Exercise Your Options!

Despite the debate over the Affordable Health Care Act, one important facet asks people to take responsibility for their own health. Over time, our country has undergone a shift in health threats from communicable disease to chronic disease. In fact, many Americans are now living daily with a chronic disease such as high blood pressure, diabetes or cardiovascular disease. These chronic diseases not only burden our quality of life they additionally burden the health care expenditures in our country. The question becomes how do people lead a healthy lifestyle to prevent chronic disease or prevent disease from worsening and optimize outcomes?

The World Health Organization (WHO) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Good nutrition and adequate physical activity are among the most important influencers of health. Given the WHO definition lets look at optimizing outcomes?

Know Your Numbers

When looking at the current rates of chronic disease, nutritional intake and decreasing physical demands have played a major role in their development. As food available for consumption has increased in all major categories, the availability of energy dense foods that lack nutritive value has coincided. At the same time, increased portion sizes and sedentary lifestyles have further tipped the scales leaving a gap between energy in vs. energy out.

Do you know your BMI? Your Cholesterol level? HDL’s? Bone-Density or your Blood Pressure? And if you do, what are you doing to get them or maintain them in normal ranges? A Registered Dietitian can help you create a lifestyle that incorporates nutrient-rich foods to promote well-being. Registered Dietitian’s are the experts in food and nutrition who can translate current recommendations for good health into real life food to help keep your numbers in check.

Exercise Your Options

Is walk to you a four letter word? When is the last time you moved your body? The USDA Dietary Guidelines for Americans recommend that we pick activities that we like and start small. Even 10 minute increments over time can add up, as you spend more time being active the health benefits increase.

Many registered dietitians are additionally certified in physical fitness or work closely with fitness experts.They may additionally work at community centers or local fitness facilities where they can be accessed at reasonable or nominal fees. Combined they can help find ways to achieve at least 30 minutes of movement in your day or more optimally 60 minutes. Make an appointment today and find out: What moves you?

Stay Social

Stay Social!

Stay Social!

Numerous studies have suggested that strong social ties are associated with better health and longevity, a sweeping review of the research in 2010 showed that people who have strong ties to family, friends or co-workers have a 50 percent lower risk of dying over a given period than those with fewer social connections.

Good friends help increase the sense of belonging and purpose, boost happiness, reduce stress, improve self-worth, help cope with traumas, such as divorce, serious illness, job loss or the death of a loved one and may even encourage changing and following healthy lifestyle habits, such as drinking only in moderation or getting a minimum amount of exercise.

Embracing the WHO definition of health can help people develop a lifestyle that supports health and well-being. Eating well to keep your numbers in check, moving more to increase physical fitness and staying social can optimize health outcomes. In turn, we can all contribute to reversing the trend towards chronic disease in our country. So do your part, own your outcomes!

 

Ode to Rusty

Rusty PillowRusty could light up a room when he entered. In fact, the whole house seemed brighter with him around. Rusty came into our lives 8 years ago and grew up with my girls. He was a part of every holiday, milestone, success and failure lovingly giving plenty of hugs or consoling whichever was needed.

Rusty was Ryan’s cheerleading coach as she held him in various holds to practice and never even flinched. He was Megan’s soul mate lying amongst her various books, movies or studies. Whatever she happened to be doing that day was fine with him.Ryan and Rusty 2

Rusty loved his dad too. When I would take him to his house in the mornings, he would run back to the bathroom to find David and repeat the ritual of heading to the kitchen together to greet his brother dogs.

Rusty was my faithful walking companion. We must have walked hundreds of miles together at duck ponds, parks and around our neighborhood. He loved to go with me on errands and would happily ride “shotgun” as he knew there would be a stop along the way for a walk.

Rusty ShotgunOn September 2, 2013, Rusty was taken from us with the vengeance of a terroristic attack. Someone stole Rusty from David’s backyard as we all slept and the rain poured down. This day will forever be our September 11th.

Similarly to those who lost their loved ones on September 11th and those who lost their limbs at the Boston bombing, I now know the depth of sorrow and pain that can be caused by such an attack. We are no longer safe at work, nor at play and now not even in our own backyards. What is happening to this country that someone could be so callous as to blow a hole in my family’s heart that feels like ground zero?

I have so many regrets about the last few hours with him and songs like “One More Day” by Diamond Rio and “I’ll Never Get Over You” by Miranda Lambert have new meaning. Those of you reading this may think I am overdramatizing the loss of a dog. Rusty was not just a dog, he was a member of our family.

A good friend of mine tweeted this scripture today, “Trust in the Lord with all your heart and lean not on your own understanding.” – Proverbs 3:5Rusty

That is what I’ll have to do because I will never understand. And God, I know you are with me while I write this…please watch over Rusty and thank you for the time we had with that magical little guy. Maybe, there was another family that needed some of his magic.

Should Women be in Politics?

Me and Megan at Annie's List Candidate Training

Me and Megan at Annie’s List Candidate Training

This past weekend, I attended Annie’s List Candidate Training 101 with my daughter. According to their website, “Annie’s List is a diverse coalition of political professionals, non-profit executives, policy experts, former candidates and elected officials, major donors, attorneys and more, all dedicated to changing the face of power in Texas politics – and thereby combating the assault on issues of most importance to women and their families – by recruiting, training and supporting women candidates across the state.” Annie’s List staff posed the question to us, should women be in politics?

My daughter, Megan, majored in political science and history at Southwestern University in Georgetown, TX. She recently interned at Emily’s List, a national organization similar to Annie’s List. Currently, Megan works for the Democratic Senatorial Campaign Committee in Washington, D.C. Before Megan, I rarely paid attention to politics. Between Megan and studying public health in my doctoral program and learning the impact of politics on health care, I have suddenly become very interested in politics.

After Senator Wendy Davis’ historic filibuster regarding H.R. 1797, I wrote a paper in my Ethics course on the impact of that bill now signed into law during special session. Despite the focus of the law on abortion, the law stands poised to consequently shut down numerous women’s clinics throughout the state that perform not only abortions but additional women’s health services.

At the same time the new legislation is claiming to benefit women’s health, consequences of the legislation appear to limit access to essential reproductive care and screenings. This ultimately will cause more harm to the uninsured population of women who desperately depend on these services.

Having grown up in the demographic standing to be impacted and been a victim of sexual assault at an early age, my interest in politics has deepened. Education played a key role in my escape from these circumstances. Yet, education is another pivotal subject when one talks about politics and women. Funding cuts in education have increased the difficulty for women to rise out of low-income and receive the health care they deserve.

Limiting access to health care and education concerns me both as a woman and a registered dietitian. Doing so may limit the only access for low-income women to nutrition and fitness education and divert what little disposable income available from feeding themselves and their children healthy foods to prevent future health problems.

My answer to the question is yes. Women should be in politics to defend and further their rights while protecting those who cannot speak for themselves. Will I run for office? After I finish my degree, I just might.

 

Life-Long Learning

KidsDr5-ag

Texas Academy Media Representative

Those who know me personally know that I am a doctoral student. This summer, I had the opportunity to take two thought provoking courses, Leadership and Ethics.

In leadership, we took a battery of leadership assessment tools including the Myer’s Briggs and the Firo-B among many others. The point of the exercise was to examine oneself as a leader and person then use the learning to enhance leadership skills. Everyone should self-assess and grow from time-to-time. As a registered and licensed dietitian, my profession requires pursuit of continuing education and growth since our foundation is evidence-based science and practice.

In Ethics, we read an amazing book, “The Immortal Life of Henrietta Lacks.” The book details the use of Henrietta’s cells in medical research and gives not only a detail of how the research affected her family but also a good history of medical advancement. The book was wonderfully written and engaging. I highly recommend reading although make sure you have plenty of time as you won’t be able to put the book down.

Another learning opportunity I experienced came from attending the annual Leadership Conference hosted by the Texas Academy of Nutrition and Dietetics. Having recently been selected as a media representative by the Texas Academy, I attended the conference to learn more about my role.IMG_0137

The Texas Academy serves Registered and Licensed Dietitians in the state of Texas helping to ensure they receive support, networking opportunities and education to meet the criteria of registration and licensure. Registered Dietitian Nutritionists (RD or RDN’s) are food and nutrition experts who have met academic and professional requirements to qualify for the credentials. In the state of Texas, licensure is also required to protect the health of the public.

Interestingly, in order to become registered and licensed RD/RDN’s must:

1)   Complete a minimum of a bachelor’s degree in science from an accredited university or college.

2)   Complete a supervised practice or internship.

3)   Pass a national examination based on their education and experiences.

4)   Complete continuing professional education requirements to maintain both registration and licensure to ensure current understanding of emerging science.

Many Registered and Licensed Dietitians go on to complete further credentialing in specialized areas of practice such as diabetes, pediatrics or sports nutrition. In any scenario, registered dietitians are educated professionals prepared to assist people in meeting their nutrition goals.

Now entering my second year in my journey of life-long learning as a doctoral student in public health, I am thankful for the opportunity to seek further expertise. At the conference, I discovered that many of my colleagues are pursuing advanced degrees as well. This allows registered and licensed dietitians to engage and impact food and nutrition policies to benefit the lay public.

Assisting the public in their education and proactive efforts to utilize healthy food as well as an active lifestyle for health prevention defines the role of the dietitian in working collaboratively with local and state food and nutrition communities. Through these communities, life long learning can help to prevent degenerative diseases and empower the generations of our future to live long, productive and healthy lives.

Finals, Friends and Fine Food

April was another busy month leading into May wherein I am delinquent on my blogging. The end of my April was consumed with Final Exams and Final Projects to wrap up my first year of classes as a doctoral student at the University of North Texas Health Science Center.

As a result, several of my new friends and I ventured to Ellerbe Fine Foods for an evening of camaraderie over an elegant meal. That outing is detailed on my examiner.com posting “Fort Worth, Friends and Fine Food”. However, other friendships yielded other opportunities to share and experience outside my norm.Ellerbee's Outing

First, I had the opportunity to host an intern from Guatemala at my hospital-based workplace, HealthSouth Cityview. Her visit with me provided an opportunity for her to learn about Medical Nutrition Therapy for patients recovering from longer-term injuries rather than acute illnesses. At the same time, her presence afforded me the opportunity to learn about another country.

Yet another friendship provided me the opportunity to experience The Chef’s Gallery at the Art Institute in Dallas. This venue provides the opportunity for the culinary students to practice restaurant management, serving and food preparation while completing their studies. My Guatemalan intern, Pilar, and I met there to discuss her project for the hospital internship while we experienced the food and fanfare of the culinary school. We also discussed her upcoming half-marathon and I cheered her on having run my own recently.

The menus created by the instructors focus on seasonal ingredients. Pilar and I spilt the steak that was flavorful and tender and accompanied by tender asparagus and lightly seasoned French fries. The desserts were amazing and included homemade ice cream, mine was rum raisin and Pilar’s pistachio featured here with mini key lime pie both of which quite literally and figuratively melted in your mouth!Key Lime Pie

Take opportunities such as new dining venues to try new foods, doing so only adds to the array of nutrients one can obtain from food as every food has a unique nutrient profile.

Located in the business development zone close to North Park Mall, The Chef’s Gallery at the Art Institute’s International Culinary School is a wonderful food experience highlighting food prepared by future chefs. Check it out for lunch or dinner and support their endeavors!

Although my travels have become more limited of late, cultivating multi-cultural friendships continues to afford me new experiences  in my own little corner of the universe. By stretching boundaries, one only adds to the depth and substance of existence. Understanding and learning about other cultures and foods does not require a trip around the world. So, take the time to get out and challenge yourself to experience something new!

 

Visiting My Roots

Teresa Olympic VillageIn January, I had the opportunity to revisit my TravelingRD roots, traveling to Atlanta for the Collegiate and Professional Sports Dietitian Association (CPSDA) Boot Camp. The workshop provided a great opportunity for me to hone my sports nutrition skills but at the same time visit the city where I began my Dairy Council career.

Landing in Atlanta, my well-respected original supervisor from Southeast United Dairy Industry (SUDIA), Cheryl Hayn, picked me up. We ventured to the popular Atlantic Station shopping area for dinner at Strip. Strip claims to be Atlanta’s place for those craving both style and substance. They market the multilevel steak house with lively bars and patios on each level as having new meaning in the world of steak houses. This unique venue allows diners the experience of enjoying a great steak in a super hip environment. After a long, heart-felt visit dining on a wonderful filet with caprese salad and three-cheese macaroni and cheese, she dropped me off at my hotel near Georgia Tech where my conference took place the next day in the Wardlaw Center.

The conference day was beautiful and sunny as I walked down through the Olympic Village built to accommodate the 1996 Summer Olympics to Georgia Tech. After the conference, a local, hard-working dairy farmer took me to dinner. We dined at an Atlanta icon, Pitty Pat’s Porch. The restaurant is known for the down-home southern fare. We enjoyed fried chicken, greens, black-eyed peas and biscuits followed by a large slab of chocolate cake with ice cream. I love the country décor complete with unique dinnerware. We split the entrée and dessert. Later, we walked off our indulgences wandering through the Olympic Park viewing the Coca-Cola Museum and watching ice-skaters on the temporary rink.

Olympic PlazaAll in all, I had an enjoyable and educational trip. Visiting Atlanta brought back many fond memories of my early years with the Dairy Council. Most of all, the trip emphasized the importance of cherishing good food and good friendships no matter where you roam!

 

Of Monuments, Monumentos and Monumental Movies

 

2013 Me and MegThis past weekend, I got to get back on the road and headed down to Georgetown to see my daughter, Megan, who was visiting her sorority and boyfriend at Southwestern University. Megan graduated in December and quickly whisked off to Washington, DC for an internship at Emily’s List. The organization assists women throughout the country with political aspirations build the skills and tools to obtain political office.

As always, Megan and I had a great time together pursuing our favorite pastimes; dining, shopping and movies. We started our adventure at a new restaurant in Georgetown, El Monumento. The upscale southern style Mexican restaurant with an elegant but casual feel is located on the banks of the San Gabriel River showcasing a beautiful glimpse of the hill country landscape of Texas. Owned by the same family who has owned The Monument restaurant also in Georgetown for years, the new restaurant we found just as delightful.

The portions are fairly large and since we ordered a cup of their Queso Blanco made from Oaxacan Cheese, to enthusiastically scoop with their thick, yummy chips, we split the El Mon Sunday Brunch Casserole which was served with cubed, roasted potatoes and fresh fruit. Oaxaca cheese is a mild tasting, gently salty, stringy white cheese with a deliciously chewy, full and filling bite.The casserole combined eggs, chorizo sausage, pablano peppers, corn tortillas and cheese into a light but satisfying blend of breakfast heaven. Eggs are a great source of protein and help provide a feeling of fullness and satiety while providing a number of important nutrients which play a role in good health. Each egg provides 6 grams of protein which is important to me as a runner trying to preserve lean body mass or a mom’s hard day playing and shopping. Pablano peppers are high in vitamin C and fiber also good for the antioxidant properties and digestive health. We enjoyed every nutritious and delicious bite and left satisfied and content.

After lunch, we headed down to Austin for some shopping at The Domain. The Domain is an upscale shopping and dining complex off the Mopac at Braker Lane that features a pedestrian friendly, open-air style experience true to the Austin spirit. We specifically visited Macy’s, H&M, Brighton and Forever 21 but there were many more shops we did not get to as we headed next to the movie theater to see Silver Linings Playbook, a must see movie in my opinion. All in all, our experiences and food were much enjoyed and would recommend them all on your next girls’ weekend, mother daughter trip or romantic getaway!