Dietitian's Journal

Thursday
Aug232007

Food allergies and intolerances

On this blog I like to share what I've discovered while working on projects in case you are working on something similar and might benefit from what I've learned. Today I completed a task I started way back in July: updating the list of specific food allergens in our hospital's menu items. I previously posted some relevant links but now want to tell you about an indispensible resource I consulted during every stage of the project:
Dietary Management of Food Allergies & Intolerances: A Comprehensive Guide by Janice M. Vickerstaff Joneja, Ph.D.

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This book, published in 1998, appears to be out-of-print, but sellers on amazon.ca and amazon.com are offering used editions starting at $115.00 USD! (Ouch. I paid about $25.00 for my new, signed copy 8 years ago at one of Janice's conferences.)

Dr. Joneja's latest book, much more reasonably priced, is Dealing with Food Allergies: A Practical Guide to Detecting Culprit Foods and Eating a Healthy Enjoyable Diet. I haven't read it but if it's like Dr. Joneja's other writings, it's sure to be an authoritative, clearly written resource.

I've also added a Food Allergy & Intolerance category to my Practice Resources page.

Wednesday
Aug222007

Welcome to the new home of Dietitian Online

Welcome to my new blog site. I decluttered, repaired and then packed up and moved* the old site's contents to my new Squarespace home.  In my first official blog post here, I'd like to tell you about the site's features because they're my main reasons for moving.

  1. Pages - Now you will find my Journal, Archives, Practice Resources and Links on separate pages. Just click under Navigation. Each of these pages will be formatted to enhance quick info-finding.
  2. Power search - You can also look for items by entering a key term or phrase such as "stroke.", "sustainability", "practice guidelines", "Marion Nestle".  The search feature field is at the top right of the page.
  3. Writer-friendly -  I find posting easier and faster using Squarespace's tools.
  4. Artist-designed templates -- Now I can have an attractive site even though I'm not a designer. There is also some flexilibility with formatting so I'm going to tweak the font and spacing to achieve maximum readability. (Please let me know if you have trouble reading anything.)

That's it. I'd love to know what you think. I can change the name of this site to Dietitian-to-Dietitian or Dietitian Online. Or I can make it look like the old site by changing the design template. Or.....? I'm open to suggestions on how to better share information and build our community of practice.

(*I'm still editing, updating and moving old posts here and should be done by the end of November. It's taking a bit longer than I thought. You can read my early 2007 posts at Dietitian Online.)

Tuesday
Aug212007

Admin note

 A lot of work.   This site is going to grow quickly in the next couple of days but not because I'm a prolific writer. (Actually, the opposite.)  I'm simply transferring the January to August archives from my old blog to this new site. 

Sunday
Aug192007

Blackberry season

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Photo credit: blackerberries for breakfast posted on Flickr by jek in the box. Reproduced here under this Creative Commons license. 

Friday
Aug172007

Education on secondary stroke prevention

Earlier today I provided some last-minute nutrition counseling to a stroke patient and wife just before the patient's discharge -- it was an ideal opportunity to test some new education checklists and resources to see if they'd be suitable for our unit's stroke program.

First, I needed to determine if the the patient and his wife were competent Internet-users. After confirming they were, I compiled the resources listed below and wrote a brief covering page explaining how to use them and listing all the web links.

1. Preventing another stroke: Lifestyle changes (Section 7 in the Heart & Stroke Foundation's information guide Let's Talk About Stroke).

I am going to reproduce the excerpt on eating so we know what the Heart & Stroke Foundation is recommending in one of their widely-used publications [I have bolded words for emphasis]:

The basic rule of eating a healthy diet is to follow Canada's Food Guide to Healthy Eating. The Food Guide recommends that you:
- Enjoy a variety of foods
- Emphasize cereals, breads, other grain products, vegetables and fruit
- Choose lower fat dairy products, leaner meats, and foods prepared with little or no fat
- Limit the amount of fat and trans fats in your diet
- Limit your use of salt, alcohol and caffeine

No more than 20% to 35% of your total daily calories should come from fat. This is about 45 to 75 grams of fat per day for a woman, and about 60 to 105 grams per day for a man. Whenever possible, eat polyunsaturated fat, especially omega-3 fatty acids and monounsaturated fats. Reduce the amount of saturated and trans fat in your diet.

Homocysteine is a substance that is produced naturally in the body as the body breaks down protein for fuel. In some studies, a high level of homocysteine in the blood was associated with a higher risk of stroke. Folic acid (a B vitamin) can help to keep homocysteine levels in the blood low. However, doctors still do not know if taking folic acid or redcuing homocysteine levels also reduces the risk of stroke (pages 24-5).

 

You may already know why I highlighted selected words in this excerpt. These are key concepts, perhaps not even all of them, that needed to be explained and illustrated with practical examples of real food and simple, visual rules-of-thumb for portion sizes. As good as it is, Let's Talk About Stroke needs to be supplemented with more how-to advice. And this is where resources #2 - 5 are so valuable in providing practical, up-to-date tips and more detailed explanations.

2. Heart & Stroke Foundation home page (this page changes monthly and always contains nutrition tips and links to other nutrition content on the site)

3. Health Check (Heart & Stroke Foundation's food information program)

4. EATracker

5. Dial-A-Dietitian

I must also state that in a ten-minute, bed-side counseling session with a patient and family member eager to go home I obviously was not able to cover everything in-depth. I also provided information on how they could access nutrition counseling through their local hospital, particularly because the patient is hypercholesterolemic, had a mild stroke that left him with minimal or no deficits and is hightly motivated to make lifestyle changes to prevent a second stroke.