WRDA Student Blog

Neighbors in Need:  Food Insecurity in Westchester and Rockland

Angela Iovine, WRDA Student Liaison

PACE Graduate Student, MS 2021

September 1, 2020

Many Americans face food-access problems that limit their ability to keep themselves active and  healthy.¹  This is broadly referred to as food insecurity.  Prior to the COVID-19 pandemic, food insecurity was at its lowest since the Great Recession.²  Data from 2018 estimated that 7.8% of the population of Westchester county (75,730 people) and 9% of the population of Rockland county (28,980 people) were food insecure.  The majority of these households met SNAP eligibility requirements; however, up to a third did not qualify.³  Projections for 2020 increase these numbers to 12.5% and 13.7% for Westchester and Rockland respectively.⁴  According to the Feeding Westchester website, 1 in 5 Westchester residents will be food insecure this year, including about 60,000  are children.⁵

            Food insecurity denotes an inability to dedicate the necessary resources to purchase food.  People who are food insecure may have food to eat, but the food may not nutritionally adequate.  Households may prioritize value over quality, desirability, or variety.  This is known as having “low food security”, one of the two categories the USDA uses to quantify food insecurity.  The other category is “very low food security”.  These are people who, in addition to the above sacrifices, don’t always have enough food to eat, and have gone hungry due to a lack of resources.⁶  Some groups of people, including children, the elderly, Latinos, and African Americans, have higher rates of food insecurity than the general population.⁷ 

The lack of food security in our community is concerning.  This is one of several social determinants of health, as is poverty.⁸  Poverty and food insecurity have a direct relationship, as do poverty and chronic disease.  The poorest Americans tend to have the least resources to acquire nutritious food and the worst health outcomes.⁹  The coronavirus pandemic has potentially exacerbated these issues, disproportionally affecting people with chronic diseases, seniors, Latinos and African Americans.  These vulnerable populations are at a higher risk for serious infection and for economic hardship related to layoffs and business closures. ¹⁰  These are many of the same groups that are more likely to be food insecure.  Since the pandemic began, the need for food assistance has grown, and researchers anticipate that demand will continue to grow.¹¹

The many challenges that face those who are food insecure are complex and not easily solved.  As nutrition professionals we can advocate for change by supporting community-based programming, policy change, and research.  The vision of the Academy of Nutrition and Dietetics is: “A world where all people thrive through the transformative power of food and nutrition.”¹²  This is a message we can all get behind.  There are many local advocacy organizations, food banks, and charities in our area addressing this cause.  If there’s one you find particularly valuable, please share a couple sentences about it on our Facebook page to spread awareness.

References

1.         U.S. Department of Agriculture. Food Security in the U.S. U.S. Department of Agriculture Economic Research Service, Web site. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/. Updated September 4, 2019. Accessed June 19, 2020.

2.         Coleman-Jensen A, Rabbitt MP, Gregory CA, Singh A. Household Food Security in the United States in 2018. U.S. Department of Agriculture Economic Research Service. https://www.ers.usda.gov/webdocs/publications/94849/err-270.pdf?v=2493.9.  Published September 2019. Accessed June 19, 2020.

3.         Feeding America. Food Insecurity in New York. Feeding America Web site. http://map.feedingamerica.org/county/2018/overall/new-york. Accessed June 19, 2020.

4.         Feeding America. The Impact of Coronavirus on Food Insecurity. Feeding America Web site. https://www.feedingamericaaction.org/the-impact-of-coronavirus-on-food-insecurity/. Published June 3, 2020. Accessed June 19, 2020.

5.         Feeding Westchester. Hunger in Westchester. https://feedingwestchester.org/hunger-in-westchester/. Accessed June 19, 2020.

6.         U.S. Department of Agriculture. Definitions of Food Security. United States Department of Agriculture, Economic Research Service, Web site. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/definitions-of-food-security/. Updated September 04, 2019. Accessed June 19, 2020.

7.         Feeding America. What is Food Insecurity? Feeding America Web site. https://hungerandhealth.feedingamerica.org/understand-food-insecurity/#_ftn3. Accessed June 19, 2020.

8.         American Academy of Family Physicians. Advancing Health Equity by Addressing the Social Determinants of Health in Family Medicine (Position Paper). AAFP.org Web site. https://www.aafp.org/about/policies/all/socialdeterminantofhealth-positionpaper.html. Published April 2019. Accessed June 19, 2020.

9.         Shaw K, Theis K, Self-Brown S, Roblin D, Barker L. Chronic Disease Disparities by County Economic Status and Metropolitan Classification, Behavioral Risk Factor Surveillance System, 2013. Prev Chronic Dis. September 1, 2016;13. doi:http://dx.doi.org/10.5888/pcd13.160088. Accessed June 19, 2020.

10.       Hake M, Dewey A, Engelhard E, et al. The Impact of Coronavirus on Local Food Insecurity. America F. https://www.feedingamerica.org/sites/default/files/2020-05/Brief_Local%20Impact_5.19.2020.pdf.  Published May 19, 2020. Accessed June 19, 2020.

11.       Feeding America. The Impact of the Coronavirus on Food Insecurity. Feeding America. https://www.feedingamerica.org/sites/default/files/2020-04/Brief_Impact%20of%20Covid%20on%20Food%20Insecurity%204.22%20%28002%29.pdf.  Published March 30, 2020. Updated April 22, 2020. Accessed June 19, 2020.

12.       Academy of Nutrition and Dietetics. Academy Mission, Vision and Principles. eatrightPRO Web site. https://www.eatrightpro.org/about-us/academy-vision-and-mission/mission-and-vision-statements. Accessed June 19, 2020.

• August is National Breastfeeding Month

  WRDA Celebrates Lactation Professionals

   

  By Kristen Nicolai, WRDA Student Volunteer

  Hunter College Graduate Student, MS 2022

  August 14, 2020

  August is National Breastfeeding Awareness Month and is celebrated to promote the benefits and importance of breastfeeding. The Academy of Nutrition and Dietetics’ position on breastfeeding is that exclusive breastfeeding offers optimal nutrition and health protection for the first six months of life, and that breastfeeding with complementary foods from six months until at least 12 months of age is the ideal feeding pattern for infants.

  
  Breastfeeding offers the following benefits for mothers and babies:

• • Protects babies against a variety of diseases and conditions such as respiratory tract infections, onset of diabetes, childhood obesity, and other infections
  • Provides all necessary nutrients, vitamins, and minerals, and antibodies from the mother that can help babies fight disease and infection
  • Promotes earlier return to pre-pregnancy weight for mothers
  • Lowers mothers’ risk of breast and ovarian cancers and post-natal depression
  • Helps uterus return to its pre-pregnancy size and decreased postpartum bleeding
  • Creates a special bond between mother and baby

•  

  Andrea Ventura, MS, RD, CDN, IBCLC, is a clinical nutritionist at New York-Presbyterian Hospital. She became certified as a lactation consultant after becoming a mother and breastfeeding her own children. Andrea found it difficult to find reliable nutrition information to help her successfully continue her lactation journey after one of her children had a dairy protein allergy. After this she knew she wanted to use her nutrition knowledge to work with breastfeeding moms. 

  The lactation consultant profession is accessible to anyone interested in the field. The credentials require a 90-hour lactation specific course, a clinical internship, and 14 health science classes. Medical professionals are also able to use past experience or credits to apply to clinical internship hours and coursework. Some IBCLC students must also compete a 300-500-hour internship working under an IBCLC.

  Elaine Carlevaro, RDN, CLC, is a Certified Lactation Counselor with the Department of Prenatal Services at the Montefiore Nyack Prenatal Center. To become a Lactation Counselor Elaine participated in a one-week program through the Academy of Lactation Policy and Practice to receive a CLC certification. While IBCLCs work one-on-one with moms, as a CLC Elaine works more broadly to make sure that breastfeeding is being supported. What she particularly loves about her job is the many hats she can wear as a nutritionist, and the work she does with many organizations and committees in her community such as Child Care Resources in Rockland and the Department of Health to bring training to childcare providers. As a CLC she works breastfeeding education into the overall health resources she provides moms, specifically higher risk moms, including education on the benefits of breastfeeding.

              Like many professionals in the field, during the current COVID-19 pandemic lactation consultants are working virtually to assist nursing mothers. While virtual appointments can allow mothers to work with a lactation consultant from the comfort of their own home, it can also be difficult for consultants to use all the senses used when helping mothers in-person. This can make it harder to fully assess mothers’ breasts or see how a baby is latching or listening to sucking and swallowing. Elaine has also encountered that mothers with the least amount of resources are a population harder to support during the pandemic, as they have less access to virtual visits. Both Andrea and Elaine agree that peer support groups are one of the most helpful tools for new mothers. These programs are able to give women the opportunity to connect with other mothers experiencing the same challenges, giving them the support needed after many prenatal services end postpartum.

              When it comes to the roles that hospitals, pediatricians, and OB/GYNs can play in successful breastfeeding, Andrea and Elaine both emphasize the importance of promoting the benefits of breastfeeding and recognizing when to refer a mother to an IBCLC. Through her work as a lactation counselor in Rockland County, Elaine works to improve support for breastfeeding through the Breastfeeding Coalition and has worked to have hospitals become a part of the Breastfeeding Friendly initiative. Elaine also works with early childhood educators, WIC, and many other community organizations to help mothers breastfeed well and support initiatives to lower infant and maternal morbidity and mortality.

              Andrea recommends that every RDN who works with mothers and babies can help normalize breastfeeding and educating themselves on a mother’s nutrition needs while lactating. Elaine also encourages RDNs to focus on the benefits of breastmilk when working with clients and knowing how best to inform moms. It is also important to know what is recommended by the Academy of Pediatrics, ACOG, NIH, WIC so consistent communication is shared.

              When it comes to choosing a career as a lactation consultant, Andrea advises that many hospitals will not hire an IBLCL that is also not a Registered Nurse, so working as a Registered Dietician in that capacity is not always possible. Andrea works with some breastfeeding mothers through her work at an inpatient psychiatric hospital but does home visits for mothers on the side. She is also bilingual, speaking both English and Spanish, which is an asset that helps her to communicate with many different people and helps the mothers she works with feel validated and understood in their native language.

  As a lactation counselor, Elaine expressed she is better able to meet the needs of her clients, and it has opened up avenues to be able to promote breastfeeding in ways she didn’t realize were possible. She also notes that RDNs that have a bilingual education can have more opportunity for direct communication with clients, rather than having to converse through a translator, as this can be challenging as almost 80% of her patients didn’t speak English. For RDNs or nutrition students interested in working in lactation consulting, Elaine recommends starting to research the different avenues within the lactation profession. While breastfeeding mothers are a specific population, it is an important time to invest in women, as breastfeeding can play a role in their overall health after pregnancy, as well as the health of their future generations. She concluded that an RDN with a lactation background is a perfect position to not only impact that individual mother, but many lives from generation to generation.

  Sources:

·      https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Breastfeeding/Pages/Benefits-of-Breastfeeding.aspx
·      https://www.eatrightpro.org/-/media/eatrightpro-files/practice/position-and-practice-papers/practice-papers/practicepaperpromotingandsupportingbreastfeeding.pdf?la=en&hash=39B07DA0E25D1703828C1AAF3ADEC410A8E8141F
·      https://www.unicef.org/nutrition/index_24763.html

WRDA Clinical Update 2017- “An Ounce of Prevention…Food for Healthy Living”

 By Co-President Elects Kathleen Ryan MS, RD, CSO, CDN  and Melissa Keeney MS, RDN, CDN, CDE

The Westchester Rockland Dietetic Association’s (WRDA) annual clinical update was on December 7, 2017. Around 100 nutrition professionals attended this year, including Registered Dietitian Nutritionists (RDN), Dietetic Technicians, Registered (DTR), and nutrition students. This year, the clinical update focused on disease prevention “An Ounce of Prevention…Food for Healthy Living”.

To start the event off, Niharika Jaiswal, WRDA’s President gave the opening remarks. Next, Diana Monaco, NYSAND’s Immediate Past President spoke about getting involved in the Academy of Nutrition and Dietetics and the New York chapter, NYSAND. It was then time to begin the presentations. Kathleen Ryan and Melissa Keeney, WRDA’s Co-Presidents Elect provided the biographies and introductions for each speaker. A mid-morning highlight to this year’s update was a Public Policy Update by Ann Darcy.

The presentation topics and the speakers for the Clinical Update were:

Presentation:  Sustainability and Culinary Nutrition Trends, Q&A
 Presenter:  Andrea Canada, MPH, RD from SPE Certified     

Presentation: Improving Patient Engagement Using Culinary Nutrition Tools and Programming, Q & A
Presenter:  Jeanne Petrucci, MS, RDN and Julie Harrington RDN, CPC from Living Plate

Presentation:  Treating Heart Disease with a Plant-Based Diet, Q & A
Presenter: Lauren Graf MS, RD from Montefiore Einstein Cardiac Wellness Program

Each speaker this year presented innovative ways that nutrition professionals can assist their clients to live healthfully. Andrea Canada discussed current food trends and how an RDN can add value and a health sustainability focus to a foodservice operation. Mary Beth Augustine discussed the microbiome, including the evidence for medical nutrition therapy and a risk characterization framework for clinical decision making. She also discussed emerging research topics regarding nutrition, healthcare, and the microbiome. Jeanne Petrucci and Julie Harrington discussed ways to engage clients with culinary nutrition, and how to grow your business by offering culinary nutrition program. They then provided us with a food demo and samples while discussing how the audience can incorporate this concept into their own practice. Lauren Graf discussed the role of plant- based diets in managing cardiovascular disease, diabetes, and chronic kidney disease.  She  shared some remarkable patient stories.

A huge thank you to our raffle sponsors. The WRDA raised $340 at the meeting through the raffle. Diana Monaco won the Capri Beauty gift certificate, Abby Walker won the cookbooks and Field Goods coupon, Roberta Gershner won attendance to next year’s Clinical Update, Terry Schlanger won next year’s WRDA Membership, Niharika Jaiswal won the gift certificate to Rouge Tomate, Jennifer Sukhdeo won the 2^nd Century Initiative basket, and Ellen Pospishil won the PAC basket. Thank you to all those who participated in the raffle!

A big thank you to our generous product sponsors this year, including Peanut Butter & Co, Harvest Snaps, Purely Elizabeth, Biena Snacks,  JCC of Rockland, Celebrate Vitamins, KIND, Manitoba Harvest, Shoprite, Once Again, and Kite Hill.

Top 3 Ways to Stay Informed about WRDA Events

1.     Like and Follow us on Facebook: WRDA – Westchester Rockland Dietetic Association

2.     Follow us on Instagram: @eatrightwrda

 3.     Visit our Website: www.eatrightwrda.org

Like us on Facebook and check us on Instagram to follow our page for photos, recipes, and information regarding events!

Over 50% of colorectal cancers are preventable through a healthy lifestyle (including diet choices).  Elisa Bremner, WRDA President, Janice Shaw, NYSAND AME Chairperson, and Melissa Keeney, WRDA Nominating Chair took time out of their Sunday morning to help cheer on the runners at CCCF's fun run/walk at Manhattanville College.  WRDA provided nutritional guidance and a delicious colon-cancer-busting snack of hummus & veggie wraps (that pink thing in the background is a giant inflatable colon).  We hope this will be the start of many more event where WRDA members can get out our message to the public. 

There was a wide array of presentations focusing on the continuum of the aging process, management of Alzheimer's disease, usefulness of meditation therapy, nutrition therapy in the Aging process. 

The opening speech was given by WRDA President Elisa Bremner, followed by the information on NYSAND Centennial AME by Janice Shaw. Niharika Jaiswal, President-elect, provided an overview of the Clinical Update.

The presentation topics and the speakers for the Clinical Update were:

 Nutrition Across the Aging Continuum... Including End of Life:  Bindhu Thomas MD, CMD
Columbia University College of Physicians and Surgeon, Department of Medicine/ Division of Geriatric Medicine and Aging.

Advances in the Management of Alzheimer’s Treatment and Prevention: Hollie Webb, MSN, FNP-C
New York-Presbyterian Hospital/Weill Cornell Medical Center, Alzheimer’s Prevention Clinic

Meditation for Healthy Mind: Supriya Reddy Certified Meditation Trainer, Heartfulness Institute

Maximizing Nutrition in Aging: Miriam Pappo MS, RD, CDN Director of Clinical Nutrition Montefiore Medical Center
Jennifer Flood-Sukhdeo MS, RD, CDN  Director of Nutrition Hebrew Home at Riverdale

Dr. Thomas provided an excellent overview and in depth of understanding of the human physiology on the complex topics of aging, end of life, palliative and hospice care, which are clinically relevant to members of the healthcare team providing nutritional care to their patients.   Speaker, Hollie Webb, provided cutting edge information on the different treatments utilized for the management of Alzheimer’s disease. In addition, participants were given an opportunity to partake in a meditation session under the guidance of Supriya Reddy. The final segment of the Clinical Update comprised of a presentation by Miriam Pappo, on understanding the nutritional aspect of the aging process followed by a panel session along with Jennifer Flood-Sukhdeo. There was a Q&A session where the participants were able to ask nutrition questions to the panelists.

During the Clinical Update, a session by Ms. Ann Darcy and Ms. Catherine Foley provided an update on public policy on nutrition related topics.  The Clinical Update finished with drawing of two raffle prize winners Sylvia Hawkins, and Antonella Caggiano receiving the WRDA membership for the year 2017.

Niharika Jaiswal MS, RD, CDN
WRDA President Elect

We look forward to seeing you at our October event on "Fearless eating for children" with Jill Castle at Phelps!

Thank you to our speakers. Please visit their websites and consider becoming a member of their Community Supported Agriculture (CSA)- Farm Share Program!

Stone Barns Center in Pocantico Hills: http://www.stonebarnscenter.org/visit/explore/stone-barns-csa.html

John McDowell, Rockland Farm Alliance in New City:   http://cropseycommunityfarm.csasignup.com/members/types

Steffen Schneider, Hawthorne Valley Farm in Ghent (Columbia Co.): http://hawthornevalleyfarm.org/where-to-buy/community-supported-agriculture-csa/

Mike Fedison, Hilltop Hanover Farm in Yorktown Heights : http://www.hilltophanoverfarm.org/wp-content/uploads/2013/12/CSA2014App1.pdf

Doug DeCandia, Food Bank of Westchester

Joan Dye Gussow, Teacher, Author, Organic Producer