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What Is a Nutrition and Dietetic Technician, Registered?

A Nutrition and Dietetic Technician, Registered (NDTR) is a food and nutrition practitioner, often working in conjunction with a Registered Dietitian Nutritionist, who has met the minimum academic and professional requirements to qualify for the credential “NDTR.” Like RDNs, NDTRs must complete professional educational requirements to maintain their registration.

In recognition for all they do to support Registered Dietitian Nutritionists and the field of dietetics, the Connecticut Academy of Nutrition and Dietetics has proclaimed June 22, 2015 as “NDTR Appreciation Day,” and called upon its members to recognize their NDTR colleagues through social media using the hashtag @EatRightCT #NDTRAppreciationDay, holding in-office celebrations or doing other special activities to express gratitude.

Here are some testimonials from CT Academy members and NDTR employers about why they value their NDTR:

  • “It is the unity of the RD and NDTR that complete the nutrition team, to provide optimal patient care. They excel at nutrition educations. They assist workflow by independently managing the lower risk patients on the units. They have a strong understanding of the workflow in the foodservice setting/kitchen and throughout the Food and Nutrition Department. The clinical NDTRs at Hartford Hospital are leaders in the field and they excel every day. They pick right up where the RD leaves off. I feel strongly that NDTRs receive increased recognition. These are hard-working, intelligent nutrition professionals that improve nutritional status of the population and community every day.” — Diane Avino, MS, RDN, CD-N, Food and Nutrition Services at Hartford Hospital
  • “My NDTR is key player and a tremendous asset to the nutrition team. Her responsibilities’ are to oversee the daily operations of the Dietary office and assigned Performance Improvement projects. With her knowledge of computers and her great organization skills she has no difficulty managing the Diet office. She has gone above and beyond her assigned job duties and has taken the initiative to audit all diet entries to ensure they are entered correctly in our computer system by the diet clerks, and also reviews production sheets and breakdown menus for any discrepancies to help with resident in receiving appropriated menu items and promote patient satisfaction.” — Joe Russo RD,CD-N Clinical Manager, Dining Services
  • “Our NDTR is fantastic! She is the glue that keeps our practice running smoothly! She is such an integral part of our team and always willing to do whatever necessary to assist in our nutrition practice mission,” — Renee Bordeaux RD, CDN, CPT
  • “Having a DTR in our private practice has added a lot of value to the business. Our NDTR helps the business flow by supporting the RDN’s and eliminating the need for an administrative person because she can do both admin and nutrition related tasks. I think she especially excels at patient interaction and playing an overall supportive roll in the nutrition practice.” — Jacqui Campbell MS, RD, CDN
  • “I am a Speech Language Pathologist who works closely with NDTRs to provide optimal care to our many residents with dysphagia here at the Hebrew Home and Hospital. Residents in need of my services are frequently identified by the NDTR. They often are the first professional to identify poor intake, weight loss and/or nutritional deficits that commonly are due to or coexist with dysphagia. Early identification and treatment is important in achieving positive nutritional outcomes and reducing risk of developing aspiration pneumonia. NDTRs play a very valuable role in the care of our residents with dysphagia improving their nutritional status and quality of life. I am glad that they are part of our team of professionals.” — Lisa Mowry, M.A., CCC/SLP Speech-Language Pathologist

    Why do you value your NDTR? Show your appreciation in the comments section below, and be sure to recognize them on Facebook, Twitter or InstaNDTRcommitteegram on Monday, June 22!

CT Academy’s NDTR Committee


This is a guest post from CT Academy Member Amy Baertschi, MS,RDN – Green Eyed Nutrition

Happy Summer_picFor most of us with children, we have a few weeks left of school.  When I was growing up in California, this meant days spent at the beach, riding my bike, and running around until dark.  Things are a little different now, with most kids spending too much time in front of a screen, whether it’s wasting the day away watching TV, playing video games, or tapping away on their smartphone. Instead of summer being an opportunity to get moving, it has turned into a time for added weight gain for many kids and teens. According to a recent survey done by the YMCA and the American Academy of Pediatrics, two thirds of kids ages 5 to 12 years of age spend at least three hours a day watching TV or online during the summer.

Here are some ways to help your family stay on track during these lazy days of summer…

  1. Maintain your family’s regular mealtime, activity and bedtime schedules as much as possible.  Keeping a regular bedtime schedule may be trickier with the longer days, but adequate sleep lends to better energy levels during the day for the whole family.
  2. Take advantage of the longer day.  Have dinner a little earlier, and then head out for an evening walk with the kids after you’ve finished the meal. It will be cooler then and it’s a nice way to sneak in a little activity at the end of the day.
  3. Make a trip to the farmers market a weekly activity. Let your kids pick a fruit or vegetable that will be served with dinner that evening.
  4. Remember that sugar sweetened beverages like lemonade, fruit punch and juices can have as much sugar as an ice cream cone. Push water and low calorie beverages to stay hydrated.
  5. Set the example. Staying active yourself and joining in on the fun shows your kids that you want be healthy, too.

Helping individuals and families stay healthy through exercise and healthy eating is the focus of my nutrition business. No gimmicks or wacky diets…just healthy “everyday” foods that nourish the body and help improve their health. For more information go to www.greeneyednutrition.com.

A big thank you goes out to Sarah Bourque, President Elect & Teresa Dotson, Fundraising Chair and their committee for organizing the conference on the “Ethical Implications of Direct-to-Consumer Genetic Testing” that took place on May 21st. Not only did the participants learn the latest information on this topic, but it was followed by a great panel discussion and networking session.

For our members and other health professionals that were unable to attend, here are a few highlights and resources:

  • Ahmed El-Sohemy, PhD , the keynote speaker reviewed the state of the science of nutrigenomics and described the strengths and limitations of the genetic testing.  He encourages RDNs to embrace the science.  Dr. Ahmed El-Sohemy is an Associate Professor and Canada Research Chair in Nutrigenomics , Dept. of Nutritional Sciences, University of Toronto and President and Chief Science Officer of Nutrigenomix Inc.    (http://www.nutrigenomix.com)
  • Derek Dube, PhD, Assistant Professor, Dept. of Biology, University of Saint Joseph presented background information on the evolution of genomics and sequencing.  It was surprising to learn that there are over 1000 genetic tests available for human diseases and conditions but not surprising on the long road ahead in continued research.
  • Beverly Burke, MSW, Coordinator, CT Dept. of Health, Genomics Office.  Many participants became aware that the CT Dept. of Health had an office dedicated to this area.  Ms. Burke emphasized the  importance of family health history and provided a Family Health History Workbook – “Knowing Your Past Can Influence Your Future”.  More information can be found by visiting http://www.ct.gov/dph and type in ‘family health history’.
  • Kate Reed, MPH, ScM, CGC, Director, Clinical & Continuing Education Program, The Jackson Laboratory.  Ms. Reed explored the implications of genetic testing for individuals and the issues that arise in the clinical setting.

A valuable tool to explore was shared from the National Coalition for Health Professionals Education in Genetics provides clinical scenarios for Genetics and Nutrition – http://www.nchpeg.org/nutrition

In addition, the University of St. Joseph’s School of Pharmacy provided a great venue with state of the art technology which allowed Dr. Ahmed El-Sohemy to present from Canada.   A special thank you also goes out to Sandra G. Affenito, PhD, RD, FAND, Associate Provost and Dean of the School of Health and Natural Sciences, University of Saint Joseph for welcoming the participants to this important conference.

This is a guest post from CT Academy member Jacqui Campbell MS, RD, CDN, a consulting dietitian at Bordeaux Nutrition, who writes the blog “All in Moderation”: allinmod.wordpress.com.  Reprinted with permission.

May is Celiac Disease Awareness Month. Celiac disease is a genetic autoimmune disordered triggered by eating gluten, the protein found in wheat, rye and barley. When someone has celiac, ingesting gluten causes the immune system to respond and damage the villi of the small intestine. Villi are responsible for absorbing nutrients from food through the walls of the small intestine into the bloodstream. When villi are damaged and not working properly, a person becomes malnourished, no matter how much food one eats.normal-celiac-villi

Celiac disease is genetic, meaning it runs in families. Sometimes the disease is triggered—or becomes active for the first time—after surgery, pregnancy, childbirth, viral infection, or severe emotional stress.

In the past few years, celiac disease has gotten a lot more attention and the gluten free industry has exploded. Many people, including health care professionals, have brushed the gluten free diet off as a fad, but it should be taken much more seriously. It is estimated that 1 in 133 Americans, or about 1% of the population, has celiac disease. In individuals who have a first-degree relative—a parent, sibling, or child—diagnosed with celiac disease, the occurrence rate may be as high as 1 in 22. 83% of Americans who have celiac disease are undiagnosed or misdiagnosed with other conditions. Celiac disease goes undiagnosed or is misdiagnosed often because there are at least 300 documented symptoms and some people have no symptoms at all.

Symptoms of Celiac Disease

celiac-disease-symptoms-500Great infographic from the Gluten Dude.com
The most common symptoms include:
◾bloating, gas and/or abdominal pain, IBS
◾hard to flush, bulky or loose stools
◾diarrhea or constipation
◾pale, foul-smelling, or fatty stools
◾fatigue
◾anemia
◾itchy skin rash
◾Dermatitis herpetiformis
◾tingling or numbness in hands and feet
◾discolored teeth or loss of enamel
◾canker sores
◾bone or joint pain
◾irritability or behavior changes
◾anxiety or depression
◾significant unexplained weight loss
◾poor weight gain
◾delayed growth/failure to thrive in children
◾missed menstrual periods
◾infertility or frequent miscarriages
◾fractures or thin bones, osteoporosis
◾migraines
◾seizures

Symptoms vary depending on a person’s age and the degree of damage to the small intestine. Celiac disease can also have no symptoms at all, leading many adults to have the disease for a decade or more before they are diagnosed. The longer a person goes undiagnosed and untreated, the greater the chance of developing long-term complications.

If you think you might have celiac, you can use this interactive checklist to identify your symptoms and check a print off to discuss with your doctor. http://www.celiaccentral.org/disease-symptoms-checklist/

Related Conditions

In addition to having several symptoms, celiac disease is also closely related to a number of other health conditions and autoimmune disorders. The following is a list of related disorders and the estimated percentage of patients with the disorder that have celiac.
◾Type 1 diabetes – 3-8%
◾Autoimmune thyroid disease — It has been shown in studies that the prevalence of celiac disease in patients with autoimmune thyroid disease is 4-15 times greater than that in the general population. 3.3-4.8% with Hashimotos thyroiditis and 4.5% with Grave’s disease. Stay tuned for an upcoming blog post dedicated to this connection alone.
◾Autoimmune liver disease. Celiac disease has been found in 5-10% of patients with liver diseases including autoimmune hepatitis, primary biliary cirrhosis, autoimmune cholangitis and primary sclerosing cholangitis.
◾Sjögren’s syndrome – 4.5-15%
◾Turner syndrome – 2-8%
◾Williams syndrome – 9.6%
◾Down syndrome – 5-10%
◾Juvenille idiopathic arthritis – 1.5% – 6.6%
◾Rheumatoid arthritis
◾Addison’s disease

Testing and Diagnosis

Blood Test

The first step is blood testing. Your doctor can order tests to measure you body’s response to gluten. Individuals with celiac with have higher than normal levels of specific autoantibodies—proteins that react against the body’s own cells or tissues—in their blood. These specific antibodies are anti-tissue transglutaminase antibodies (tTGA) and anti-endomysium antibodies (EMA). The blood tests will measure total IgA, IgA-tTg and IgA-EMA, high levels will indicate a positive celiac test. A person needs to be consuming gluten regularly at the time of testing for the results to be accurate.

Intestinal Biopsy

Blood tests are simple and helpful in diagnosing celiac disease, but they are not always accurate. False negatives and false positives are possible, so an endoscopy is needed to take a biopsy of the small intestine. The doctor will take several small samples, which are studied under a microscope to look for damage and inflammation due to celiac disease. It is recommended that the doctor take at least 4 duodenal samples, including at least 1 from the duodenal bulb, in order to obtain an accurate diagnosis.

Read more at http://celiac.org/celiac-disease/diagnosing-celiac-disease/diagnosis/#fgXrWafjbrzspu2l.99

Treatment

The only treatment for celiac disease is a completely gluten-free diet. Eating just a small amount of gluten can damage the intestine. A gluten-free diet means avoiding all foods that contain wheat (including spelt, triticale and khorasan), rye, and barley. This means eliminating or finding substitutions for things like breads, pastas, and baked goods. There are many good substitutions like brown rice pasta, and baked goods made with flours from other grains, beans and nuts. I like to encouraged by patients to focus mostly on naturally gluten free foods like rice, potatoes, starchy vegetables, quinoa and other grains to replace the gluten-containing foods in their diets. Plain meats, fish, eggs, fruit and vegetables are all naturally gluten free. Working with a Registered Dietitian is the best way to ensure you are following a well-balanced, completely gluten free diet.

For more on celiac disease go to:

Celiac Central

National Institute of Diabetes and Digestive and Kidney Diseases – Celiac Disease

Celiac Disease Foundation

Celiac.com

grill

Memorial Day marks open season on backyard barbeques, picnics and potlucks, and with it comes many opportunities to indulge in foods we normally wouldn’t eat (at least not every weekend!) – think hotdogs, potato salad, coleslaw, dips and chips. Whether you are hosting a BBQ, or attending one as a guest, it’s time to broaden your repertoire of summertime party staples. The Connecticut Academy of Nutrition and Dietetics has put together the following dietitian-approved barbeque fare for your next soiree.

CHIPS AND DIP
• Bake a batch of seasoned kale chips (or buy store-bought).
• In lieu of potato chips, bring a bag of lentil chips and serve with hummus or guacamole.
• Create a colorful crudité plate and serve with a greek-yogurt dip .
• Do-over deviled eggs by replacing the mayonnaise with Greek-yogurt or avocado.

SALAD
• Quinoa stars in a salad – just toss with any combination of chopped vegetables, dried fruit (apricots or cranberries), nuts (pistachios, almonds, walnuts), a little crumbled cheese (such as reduced fat feta) and toss with a drizzle of olive oil.
• Showcase summer’s seasonal fruits in a colorful fruit salad with watermelon, berries, cut up peaches and plums. Toss in some fresh mint from the garden, and voila!
• Bring on the beans! Whip up some Cowboy Caviar and replace full-fat dressing with a reduced fat Italian dressing.

MAIN COURSE
• There are many lean proteins that are perfect for the grill. Think lamb (leg, loin and rack), pork (tenderloin, loin chop), fish (salmon, halibut, scallops), or chicken.
• Go veggie! Bring your favorite frozen veggie burger brand to throw on the grill, or make veggie kabobs with tofu or tempeh .
• Pizza party! Start with whole wheat dough, grill both sides, top with sauce, fresh mozzarella and veggies and grill for another two-to-three minutes.

DESSERT
• Make a better-for-you version of traditional BBQ desserts, like these flourless black bean brownies.
• Try this twist on a lemon bar featuring peak of the season raspberries with this recipe from Eating Well.
• Grill up some fruit – pineapple, stone fruits like peaches or plums, mangoes – drizzle with raspberry sauce and serve with lowfat frozen yogurt.

DRINKS
• Fruit-infused water is a refreshing alternative to sweet tea and lemonade.
• Calories from alcohol can quickly add up on a hot summer day. Alternate with water in-between, or splash some soda water into white wine for a spritzer.
• Search for fun and festive mocktails and lower-calorie cocktail recipes like these from Prevention.

What’s your favorite go-to summer time dish? Post in the comments below!

 CT Academy Member:                      Dana Angelo White,  MS,RD,ATC 

                                                             www.DanaWhiteNutrition.com

I prefer certain grocery stores for meat and fish and others for things like snacks and produce, but who has time to go to three stores each week?  In the summer months I also like to get out to the farmers’ market to take advantage of all the locally grown offerings.  You can make it easier.  Use these strategies to help get it all done.

  1. Use a grocery delivery program for weekly staples like bananas, milk, and paper towels.  Most have a delivery fee,  but you can actually save money by paying attention to per-unit pricing and reducing impulse purchases.
  2. Pick one local farmers’ market to visit a week (and bring the kids).  If you can’t find one near you, look into joining a CSA where you can get a weekly delivery of local foods.
  3. Take the kids shopping! No one should shop hungry so five them a meal or snack before you head out.  Use the time together to teach them about food and allow them to take some ownership over what you are buying.
  4. Alternate weeks at other stores.  I usually swap between Whole Foods and Trader Joe’s.  Stock up when you can to save money and time.

With your extra time and money get the kids in the kitchen and whip up some of these family friendly recipes —

Charlie’s Double Pumpkin Muffins and Maddy’s Creamy Dreamy Banana Shake.

Excerpted from First Bites: Superfoods for Babies and Toddlers by Dana Angelo White.

Copyright 2015 by Dana Angelo White.  A Perigee Book, Penguin Group USA, A Penguin Random House Company.

Connecticut Academy of Nutrition and Dietetics

Heart disease remains the leading cause of death in the United States. Eighty percent of these cardiac events can be prevented with education, diet and lifestyle changes.   Rather than focusing on foods we can’t eat, emphasize all of the delicious foods we should be adding to our diets. Since February is American Heart Month, here is the CT Academy’s top 10 foods to add to your diet to reduce heart disease risk, along with some delicious recipes that incorporate these foods. What other foods would you add to this list? Feel free to add your comments!

  • FISH: Aim for two servings of fish high in omega-3 fatty acids like salmon, tuna, or mackerel. The “fatty”-fish can reduce risk of developing heart disease by decreasing inflammation and lowering triglyceride levels, and can even help boost your HDL levels.
  • SOY: 25 grams of soy protein a day, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease, by helping to lower levels of LDL (or ‘bad’) cholesterol. Find soy protein in tofu, soy milk, soy nuts, vegetarian meat alternatives as well as certain protein bars and powders
  • WHOLE GRAINS: Replacing refined grains (white bread, pasta, etc.) with high-fiber, antioxidant rich whole grains including oatmeal, brown rice, whole wheat breads and pastas, can help reduce heart disease risk by lowering cholesterol, triglycerides, blood pressure and insulin levels.
  • NUTS: Adding four servings of unsalted nuts a week (a serving is a small handful of whole nuts or two tablespoons of nut butter), is good for your heart. Be sure to buy raw or dry-roasted nuts rather than those cooked in oil. Toss chopped walnuts or pecans into your morning oatmeal or on a salad, snack on some almonds or peanuts, or spread some almond butter onto whole grain toast.
  • HEALTHY FATS: Avocado, olive oil and olives all contain heart-healthy monounsaturated fat, which helps reduce total cholesterol while raising the ‘good’ high-density lipoprotein, or HDL, cholesterol. High levels of HDL cholesterol protects the heart from heart disease, and adding these healthy fats to the diet also helps reduce total body inflammation.
  • BEANS: Beans, beans are good for your heart — in one study, people who ate legumes, including beans and lentils, at least four times a week had a 22% lower risk of heart disease than people who ate them less than once a week.
  • BERRIES: High in antioxidants and polyphenols, berries can help improve blood flow and prevent plaque build-up in the arteries.
  • GREEN VEGGIES: The antioxidant compounds in broccoli, asparagus and spinach, combined with being a good source of potassium and folate, make these veggies heart-health standouts, but adding more fruits and vegetables of any kind is heart smart.
  • GARLIC: Garlic contains a high amount of the antioxidant allicin, a powerful anti-inflammatory agent that can help lower blood pressure and LDL-cholesterol in the body. Other naturally-occurring compounds in fresh garlic have been shown to reduce inflammation and improve blood flow.
  • SPICES: An emerging area of research into the medicinal properties of spices has shown that spices such as turmeric and cinnamon have powerful antioxidant and anti-inflammatory properties that can help reduce many of the risk factors for heart disease by improving blood flow and cholesterol levels.

Heart-Healthy Recipes by CT Academy Member Evelyn H. Gezo, MS,RD,CDN

Salmon with Spicy Black Beans & Cilantro Sauce Dinner

*Heart healthy salmon combined with beans, garlic, and avocado.

  • 4 – 4 oz. salmon
  • 1 small minced onion
  • 1 small diced red bell pepper
  • 4 medium minced garlic cloves
  • ½ cup chicken or vegetable broth
  • 15 oz can black beans, drained
  • ½ tsp chili powder

Sauce:

  • 1 clove garlic
  • 1 cup cilantro leaves
  • 4 Tbsp. olive oil
  • Juice of one lime
  • Ground pepper
  • Large tomato, chopped and seeded

Garnish:

  • Lettuce greens
  • Sliced avocado
  1. Prepare cilantro sauce by combining ingredients except tomatoes in small food processor or blender.
  2. In large skillet, sauté onion, pepper, garlic in broth over medium heat for approximately 5 minutes, stir.
  3. Add broth, beans and chili powder.   Continue cooking at least ten minutes. Add more broth if needed.
  4. Brush baking pan with oil, place salmon pieces (skin side down) in pan and spread with cilantro sauce.
  5. Add chopped tomatoes on top and bake uncovered at 350 F for 20 minutes.
  6. Serve with lettuce greens topped with sliced avocado and spicy beans on the side on one plate.

Avocado and Hearts of Palm Salad

*Refreshing salad to serve with heart healthy seafood.

  • 1 cup cherry tomatoes, cut in half
  • ½ small sweet onion (cut into thin slivers)
  • 2 – 14 oz cans hearts of palm, drained and cut into ½ inch pieces
  • ¼ cup chopped cilantro
  • 2 avocados, peeled and cut into small cubes
  • ½ tsp finely grated lime zest
  • 2 Tbsp fresh squeezed lime juice
  • 2 Tbsp mayonnaise (can substitute light mayo)
  • 2 Tbsp canola oil
  • Salt and fresh ground pepper
  1. Toss together tomatoes, onion, hearts of palm, avocado and cilantro.
  2. Whisk together in separate bowl dressing ingredients: mayo, lime zest,

lime juice and oil.   Season with salt and pepper.

  1. Add dressing to salad and gently toss.
  2. Can serve over greens and add chopped walnuts if desired.

Oriental Spread

*Here is a recipe that substitutes tofu (soy) for cream cheese and has nuts, garlic, and spices for a great spread!   Good on crackers and whole wheat bagels.

  • 12 oz. cream cheese or soft tofu
  • 2/3 cup shredded carrots
  • ½ cup chopped dry roasted peanuts
  • ¼ cup chopped water chestnuts
  • ¼ cup sliced green onions
  • 4 tsp. low sodium soy sauce
  • 1 Tbsp. chopped fresh cilantro
  • 1 small clove minced garlic
  • 1/8 tsp. ground ginger

Combine all ingredients in food processor and blend well.

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