WIC Resources


By: Nikki Nies

I recently completely my last dietetic internship rotation at Will County WIC! During my time, I was able to create several handouts and provide resources that would be distributed to future mothers and families.

Today, I’ve provided a copy of the handout I made to gather more information on maternal nutrition and early childhood nutrition. Make sure to check out these resources today!

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Cooking Matters


logoBy: Nikki Nies

With the holiday season just around the corner, it seems fitting to talk about a giving activity–Cooking Matters, that is.  Cooking Matters strives to make sure children have access to the healthy foods they need daily. Participants include mothers, fathers and whole families that want to make healthier meals on a budget, learn sound nutrition advice and how to cook delicious dishes!

As part of the No Kid Hungry campaign, for the past 20 years, Cooking Matters has made tremendous contributions with the help of volunteer instructors.  More than 120,000 low income families have had greater access to the necessary tools and resources to eat healthier! In addition, Cooking Matters has been features on the Let’s Move campaign and recognized by the USDA for its excellence in nutrition education.

Want access to Cooking Matters while on the go? Make sure to download their free healthy app, that offers more than 90 recipes for you to make today! What’re you waiting for?!?

Photo Credit:Cooking Matters

Sources: http://cookingmatters.org/

http://www.ilmaternal.org/cookingmatters/index.html

http://www.nokidhungry.org/blog/cooking-matters

http://www.extension.umn.edu/family/health-and-nutrition/partner-with-us/cooking-matters-mn/

https://www.grymca.org/community-programs/community-based-programs/cooking-matters-program/

http://daretocare.org/about_us/programs/cooking-matters

Sprinkles Fortified Supplement


packages_sprinklesBy: Nikki Nies

Nearly 300 million children are impacted anemia, with parents finding their children listless and prone to illness.   With damage in the first 1000 days of life to a badly malnourished child is irreversible. In the late 1990s, UNICEF introduced Sprinkles, which were created by Dr. Stanley Zlotkin. Dr. Zlotkin is a professor of pediatrics, nutritional sciences and public health.  Sprinkles is an innovative treatment for the treatment of anemia in children under the age of five, formed of zinc.

Prior to the creation of Sprinkles, the normal treatment was the unpleasant, unflavorful iron supplements via pill or syrup.  Sprinkles is a specially coated, powdered supplement in the form of rice or corn porridge without the untasty flavor.

Regulation of iron absorption is two fold: dietary and store regulator.  There is a short term increase in dietary iron that’s not avidly absorbed and while iron stores increase in liver, hepicidin is released.  Hepcidin is a hepatic peptide that diminishes intestinal mucosal iron ferroportin release.  As body iron stores fall, hepcidin decreases and intestinal mucosa’s signaled to release absorbed iron into circulation.  Dietary citrate and ascorbate from citrus foods can also impact absorption, by forming complexes with iron that increase abruption while tannins found in tea decrease absorption.

The supplements are provided through UNICEF and the Centers for Disease Control and Prevention. The Sprinkles fortified food supplement is provided to those between the ages of six months to two years old and to all pregnant and lactating women.  Those younger than six months are encouraged t be exclusively breast fed in accordance with WHO guidelines for breast feeding. In the past, Sprinkles was delivered in the form of drops, but due to complains of stain to teeth and inability for many parents to “know” how many drops to use due to illiteracy, these supplements are provided in the form of a pap for infant and in drink form for women This is supplement is designed to treat and prevent anemia.  In addition, the amount of vitamin D in Sprinkles is meant to meet the RDI for vitamin D, which in turn is able to prevent rickets.

Additionally, stool color in infants that use Sprinkles are known to change to a dark or black color as iron itself is dark in color.  Sometimes some quantities are left unabsorbed and the iron is excreted in the stool, causing the change in color.

Therefore, due to the positive impact of the Sprinkles implementation into children’s nutrition profile, iron is my favorite micronutrient as it can mean the difference between life or death.  Iron’s mainly absorbed in the duodenum and upper jejunum, with divalent metal transporter 1 (DMT1) facilitating the transfer of iron across epithelial cells.  With the help of ferroportin in the bloodstream, this is released within the enterocyte and is bound in bloodstream by transferrin, a transport glycoprotein.  There is an equal balance of storage and use of iron, with half of absorbed iron put into storage pool in cells, while other half is recycled into erythropoiesis.

Photo Credit: SGHI

1. Worldwide programs. Sprinkles Global Health Initiiative Web site. http://www.sghi.org/worldwide_program/mexico_pg1.html. Accessed 10/24/14, 2014

2. Loewenberg S. Easier than taking vitamins. NYTimes Web site. http://opinionator.blogs.nytimes.com/2012/09/05/easier-than-taking-vitamins/?_php=true&_type=blogs&_r=0. Published 9/5/12. Updated 2012. Accessed 10/21, 2014

3. O’Brien TX. Iron metabolism, anemia, and heart failure. J Am Coll Cardiol. 2011;58(12):1252-1253.

4. Rambousková J, Krsková A, Slavíková M, et al. Trace elements in the blood of institutionalized elderly in the czech republic. Arch Gerontol Geriatr. 2013;56(2):389-394.

Kids LiveWell


KLW_homepage_spot_ad_webBy: Nikki Nies

Dining out is meant to be filled with fun, however, a little planning ahead of time can make it healthy too! Thanks to the National Restaurant Association’s partnership with the Healthy Dining Finder on the Kids LiveWell Program, parents have more access to list of healthier restaurants options.

Restaurants that participate in the Kids LiveWell program promise to offer menu options that focus on increased fruit and vegetable intake, lean protein, whole grains and low fat dairy.  These provisions are on top of the limitation of unhealthy fats, sugars and sodium.  Do these menu options sound familiar? Perhaps, it reminds you of the Dietary Guidelines?

Criteria to be considered Kids LiveWell full meal including entree, side and drink

  • 600 calories or less
  • ≤ 35% of calories from total fat
  • ≤ 10% of calories from saturated fat
  • < 0.5 grams trans fat
  • ≤ 35% of calories from total sugars (added and naturally occurring)
  • ≤ 770 mg of sodium
  • 2 or more food groups

Criteria to be considered a nutritious side item:

  • 200 calories or less
  • ≤ 35% of calories from total fat
  • ≤ 10% of calories from saturated fat
  • < 0.5 grams trans fat
  • ≤ 35% of calories from total sugars (added and naturally occurring)
  • ≤ 250 mg of sodium
  • 1 food group

With more than 42,000 restaurants participating in this health initiative, your family should not have too much trouble finding healthy options that meet your taste preference. Restaurant  establishments include: Au Bon Pain, Bonefish Grill, Burger King, Burgerville, Carrabba’s Italian Grill, Chevys Fresh Mex, Chili’s Grill & Bar, Corner Bakery Cafe, Cracker Barrel, Denny’s, El Pollo Loco, Friendly’s, IHOP, Joe’s Crab Shack, Outback Steakhouse, Silver Diner, Sizzler, T-Bones Great American Eatery and zpizza.

Due to Kids LiveWell three year anniversary, make sure to check out promotional offers that can be used as supported restaurants!  With all these great offers, you can dine out guilt free! What menu option are you going to try next?

Photo Credit:National Restaurant Association

Sources: http://www.restaurant.org/Industry-Impact/Food-Healthy-Living/Kids-LiveWell-Program

Sensory Science Focus Groups


By: Nikki Nies

When people talk, listen completely.  Most people never listen.” -Ernest Hemingway

Yes, one of the great American authors, Ernest Hemingway stated thecfans_asset_089259 above words that are as relevant today as when said in 20th century.   There is room for interpretation of the quote, but for today, Hemingway’s words resonate as a reminder of health professionals’ ongoing priority: to listen to clients, customers and colleagues needs.  In particular, Registered Dietitians (RDs) can better “listen” to clients and patients’ needs through the administration of focus groups.

To elaborate, the use of a focus group that consists of 6-12 participants using qualitative, quantitative methods of questionnaires and/or observations helps to understand consumer’s intrinsic characteristics (i.e. preferences of taste, aroma or color).  Consumers may not be able to articulate product preference, but with the use of focus groups, it allows researchers to take the guess work out of the equation and focus on the “what” differences. The goal is to recognize the perceptions, preferences, opinions and beliefs of a particular audience.

Not sure how to best incorporate focus groups into your daily work? Past research and examples of focus groups are a great reference and starting point for budding sensory scientists.   Again, focus groups can be used in a myriad of situations and populations.1

Use of Focus Groups by RDs:  

·         Making Tortillas without Lard: Latino Parents’ Perspectives on Healthy Eating, Physical Activity, and Weight-Management Strategies for Overweight Latino Children1

  • With Latinos among the most overweight racial/ethnic groups of US children, a study aimed to identify parents’ perspectives on healthy eating, physical activity, and weight-management strategies for overweight Latino children. Four focus groups were conducted of Mexican immigrant, Mexican-American, Puerto Rican, and other Latino families with overweight children. Parents were open to integrating healthy substitutes into traditional Latino meals/snacks, and found them palatable
  • Quinoa Flour as a Replacement for All Purpose Flour in a Peanut Butter Cookie2
    • As a high quality protein, fiber rich content and lack of gluten, quinoa flour is a great health substitute for celiac patients and for the health conscious. Objective tests and subjective evaluations were administered to university students, with no significant difference in preference found using a nine point likert scale. Although, the quinoa flour was described as significantly sweeter and chewier than the control group, the wheat flour
  • Research continues to show consumption of whole grains reduces one’s risk of diabetes. However, due to a lack of acceptability of brown rice for white rice, a study led by Zhang et al., 2010 looked at the feasability of introducing brown rice into the Chinese diet. Prior to tasting, most considered brown rice inferior to white rice in regards to unpalatable taste, rough texture and quality.  After tasting the brown rice, the majority of participated stated a willingness to try brown rice in the future.
  • Obtain baseline data on employee and/or customer preferences4
    • Using a focus group allows anonymity of opinions that may not be obtained otherwise. This allows employees and customers to feel more comfortable sharing the “whole truth.”  People are often more open with suggestions and concerns if there is less of a worry of repercussions with shared comments
    • Through the use of focus groups surveys, information obtained can be used to develop marketing surveys to assess customer perceptions of foodservice operation from employees that have direct contact4
  • Increase participation in community events, such as congregate meals5
    • The administration of focus groups, RDs can better understand what foods older adults are more receptive to at congregate meals. 5
    • In a study led by Lee et al., 2008, they inquired why there was an 18% decline in participation of congregate meals from 1980 to 2002. Researchers valued the senior’s beliefs about participation is fundamental to implement a successful program.  With four different meal sites, they learned what seniors valued in the congregate meals (social interaction, cost/savings on grocery bill, access to nutritious meals), but there were concerns for bland tasting breakfast and the lack of meals provided on the weekend. 5
  • Response to a “Better-For-You” peanut butter by three consumer population segments: A focus group Study6
    • It can’t be ignored that health claims and food labels influence consumer purchases. By using focus groups, one can assess consumer responsiveness to health claims, detect themes in consumer perception of peanut butter and determine potential impact of identifying peanut butter as an antioxidant or high rich fiber food.6
    • A study led by Harrison et al., examined the taste perception of peanut butter based on food label and health claims. It was found, while the health claims don’t necessarily impact purchasing decisions, but “taste” , appearance and price were the leading factors of purchasing power.6
  • Improve store and/or company brand quality through sensory evaluation methods7
    • Using sensory evaluation to determine acceptability and likeability of products can help companies brand their generic products to compete with national brands. By inquiring consumer’s perception of nutrition quality and packaging can provide dietitians with the ability to provide more “acceptable” visually pleasing company products.7
  • How to meet children’s taste and palate preferences more effectively8
    • It’s not realistic or effective to generalize children’s food preferences.  In a study led by Donadini et al., a hierarchical cluster analysis was used to better identify cheese preferences among preschoolers. 8  Among the clusters formed, it was evident some children focused on flavors and textures while others exclusively fixated on flavors.5  Such information could not be as easily obtained without the controlled setting administered and in addition with obtaining parental consent was required.

Sensory-Science-Course6As you can see, sensory science is its own platform of evaluative tools.9  Furthermore, sensory science is used for research purposes and not necessarily to manipulate people’s choices, but to provide choices that they don’t even recognize they want.10  The point is, while health professionals are given numerous opportunities to learn what consumers, clients and/or patients want, often times it’s easier to anticipate the wrong assumption or not really “hearing what’s said.”  Don’t squash the opportunity to use focus groups in your field of dietetics.  Better yet, I challenge you to find a way to incorporate at least one focus group study into your field of practice!

  1. Flores, Glenn et al. Making Tortillas without Lard: Latino Parents’ Perspectives on Healthy Eating, Physical Activity, and Weight-Management Strategies for Overweight Latino Children Journal of the American Dietetic Association , Volume 112 , Issue 1 , 81 – 89
  2. Harra, N.M. et al.Quinoa Flour Is an Acceptable Replacement for All Purpose Flour in a Peanut Butter Cookie Journal of the American Dietetic Association , Volume 111 , Issue 9 , A45
  3. Zhang, Geng et al. Substituting Brown Rice for White Rice to Lower Diabetes Risk: A Focus-Group Study in Chinese Adults Journal of the American Dietetic Association , Volume 110 , Issue 8 , 1216 – 1221
  4. Perlmutter C, Gregoire M, Canter D. Use of focus groups to improve nutrition services in a worksite cafeteria. Journal of the American Dietetic Association. 1994;94(9):A76.
  5. Lee K, Gould R. Using focus groups to access beliefs of seniors about participating in congregate meal programs. Journal of the American Dietetic Association. 2008;108(9):A110.
  6. Harrison J, Hargrove J, Kerr W, Pegg R, Swanson R. Response to a “Better-for-you” peanut butter by three consumer population segments: A focus group Study. Journal of the Academy of Nutrition and Dietetics. 2014;114(9):A61.
  7. Way L, Paris K, Poynor S. Sensory evaluation methods to select, maintain and improve store brand products and quality. Journal of the American Dietetic Association. 2011;111(9):A18.
  8. Grenci A, Brill M, Kinsey J, Hughes L, Cirignano S, Morgan K. Parent focus groups spotlight opportunities for nutrition professionals to collaborate on school wellness Initiatives. Journal of the Academy of Nutrition and Dietetics. 2012;112(9):A81.
  9. Rohall S, Ballintine J, Vowels J, Wexler L, Simeral S, Goto K. Who’s your patty: Sensory evaluation of burger patties made with different types of meat or plant-based Products. Journal of the American Dietetic Association. 2009;109(9):A68.

Photo Credit: University of Minnesota and Nottingham

Discovering Healthy Choices


dhcBy: Nikki Nies

Who likes free? If you’re like the rest of the global society, you answered with an emphatic “I DO!!!”  Today you’re in luck, I’m sharing some the free curriculum that was shared with me at FNCE 2014. Discovering Healthy Choices os a garden enhanced nutrition curriculum as part of the Shaping Healthy Choices Program.

The goal with this curriculum is to provide better understanding of nutrition concepts and development o problem solving skills so children and teens can make wise, evidence based decisions about the foods they eat.  The curriculum covers everything from the roles of specific nutrients to MyPlate and physical activity recommendations to explanations on how food companies market their products.

Whether you’re an elementary teacher that wants to incorporate more sustainable practices in your classroom or you’re a dad that wants to teach your kids how to read food labels, this curriculum is friendly to all!

Photo Credit:UC Davis

Sources: http://cns.ucdavis.edu/resources/shcp/curriculum.html

Food Revolution


By: Nikki Nies Jamie-Oliver

While obesity is a preventable disease, we’re currently on the losing end of the war.  It’s not only an American, first world problem.  As a global epidemic, Jamie Oliver has once again, thankfully, taken it upon himself to lead a Food Revolution!  While we’re by no means deprived of food, with so many options, more children than ever are malnourished due to the number of empty calories they consume on a regular basis.

Jamie Oliver explains the premise behind said Revolution!

“Since I’ve been working in America, I’ve been overwhelmed by the number of people who have come out to support the Food Revolution. More than 630,000 people have signed the petition, over 300,000 of you subscribe to our newsletter and thousands of you have written to me. The only message I keep hearing is that you believe your kids need better food, and that you want help to keep cooking skills alive. That’s why this Food Revolution matters.” -Jamie Oliver

It’s great to hear others acknowledge and understand the issue at large.  The Food Revolution is a great platform to help inspire all to get back into the kitchen to cook real food from scratch and get away from the pre packaged, processed products that are ubiquitously calling our names!  This movement has already made great strides toward health awareness and changing how we eat. Still not convinced change is needed?

Global obesity alarming #s:

  • More than 43 million children under 5 years old are overweight or obese
  • More than 1.5 billion adults are overweight or obese
  • With obesity, one’s life can be cut by 10 years
  • In the U.S., obesity costs $10,273,973/hr!

While the above numbers are scary stats, Jamie’s got a 6 point plan moving forward:images

  1. Cook more with the availability of community kitchens (i.e. church halls, healthcare centers and/or schools) that will help you learn the basics of home kitchen! By getting in the kitchen you can control portion sizes, ensure the use of fresh ingredients and it’s a great way to get the family together!
  2. An activist program is supporting parents that want to ensure better quality of food for their children.  There is a community website that encourages grass roots change nationwide in the U.S.
  3. With the Food Revolution truck, this mobile food classroom offers cooking classes
  4. Inspiring parents, caregivers, teachers and students to cook fresh meals and snacks on campus and throughout school district
  5. Within corporations, promoting a culture change: helping healthcare sectors to recognize the “investments” needed for better health in the future.  Also, providing employees the opportunity to learn essential cooking skills and fresher foods at canteens

What are you waiting for?!? There’s so many ways you can contribute to this revolution and be part of the change! Sign the global petition today! Learn more about this Revolution and how you can get involved today!

Photo Credit:Mazwo and Indiana Public Media

Sources: http://www.jamieoliver.com/foundation/jamies-food-revolution/

http://www.theguardian.com/lifeandstyle/2014/jun/22/jamie-oliver-food-revolution-online-video

http://foodrevolution.org/