In honor of National Nutrition Month, we sat down with our three fantastic Registered Dietician Nutritionists (RDNs), Candace, Brandy, and Sara, to share more about their work at Moveable Feast. Whether they are working one-on-one with clients in Medical Nutrition Therapy sessions or developing Medically Tailored Meals with our chefs to expand menu options, our RDNs play a pivotal role in carrying out our mission.

Why did you choose to work for Moveable Feast?

Candace: I learned about Moveable Feast when moving to Baltimore for a dietitian role at Johns Hopkins, I was very excited about this organization and referred some of my patients to Moveable Feast. What I love about being a dietitian at Moveable Feast is that nutrition, education, and food access goes hand in hand. If someone is not able to procure or prepare food, then providing nutrition education is not as impactful. Here at Moveable Feast, we are able to address the root causes of food access while addressing individual nutrition needs.

Brandy: I chose Moveable Feast because I knew early on as a dietitian that my heart belonged to serving the community. By working here, I get to spend time getting to know my clients, setting goals, and offering encouragement throughout their personal health journeys. As a bonus, I’m working with our talented chefs to help update and expand our menu. At Moveable Feast, I get to combine both of my passions into one career!

Sara: Like Moveable Feast, I value prevention in the community setting. A lot of the time healthcare is focused on treatment instead of prevention. Providing healthy meals to individuals in need, as well as Medical Nutrition Therapy can help people get ahead of their conditions and increase their quality of life.

What has been the most rewarding part of your job so far?

Candace: Working with others! Collaborating with my team to provide the best care for our clients.

Brandy: Since I’ve been a dietitian here for almost 3 years now, I’ve had some clients that have been with me since I’ve started. It’s been extremely rewarding to see their progress and remind them of how far they’ve come with accomplishing their goals when they feel discouraged.

Sara: The people. Clients are so grateful for the services we provide and getting to see, firsthand, that we are increasing individuals’ access to healthy food is very rewarding. Additionally, the people I get to work with. Everyone at this organization truly cares about the work they do and the people they serve.

What is your favorite Moveable Feast meal?

Candace: I have not had a chance to try all the meals so this may change, but I would say the Turkey Chili is fantastic!

Brandy: The Potato Crusted Whiting with Florentine Sauce, Quinoa, and Peas!

Sarah: I am new to the organization, so I have not been able to try them all yet, but my favorite so far is the Chicken, Bean and Cheese Burrito!

What is a common nutrition myth you hear?

Candace: Honey is better than sugar. Many people switch from sugar to honey and think that it will be better for their blood sugar, but honey and white sugar have very similar amounts of sugar. 1 tsp honey has approximately 6g of sugar, 1 tsp white sugar has approximately 4g of sugar. What is important is to not overconsume honey or sugar especially if a person has diabetes. If you like honey or sugar in your tea, try to limit to 1 tsp.

Brandy: People seem to think that once you have diabetes, you can’t have fruit or pasta, which is false! By working with a Registered Dietitian, you can learn how these foods can still fit into your diet even if you have diabetes.

Sara: A common nutrition misconception is that food is “good” or “bad.” A good dietitian knows that food has no morality, and a great dietitian understands that all foods fit. On the flip side, there is no single “super food” that will cure disease or make you instantly lose weight. Being healthy means including a variety of foods to fuel your body.

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When Moveable Feast began in 1989 in response to the HIV/AIDS epidemic, treatment options were limited, not terribly effective and often costly. As such, it was not uncommon for a person who was diagnosed with HIV to have the disease go unchecked. As the virus replicates, in addition to weakening one’s immune system, it puts a greater demand on the body for calories, protein and other nutrients.

When this happens, individuals often suffer from muscle and fat wasting and malnutrition. Thus, historically, registered dietitians often focused on  prescribing these individuals with a high calorie, high protein diet.

While there is still not a cure for HIV, the treatment options have come a long way in the past 30 years. HAART (highly active antiretroviral therapy), a customized combination of different medications, has changed what was once a fatal diagnosis into a chronically managed disease, which means those with HIV are living longer lives and are subject to the same comorbidities as the general population. Although the nutrition intervention that is provided has changed, the Academy of Nutrition and Dietetics recommends that asymptomatic HIV positive individuals meet with a registered dietitian (RD) at least twice a year to help them manage side effects of their medications, maintain a healthy weight and reduce the risk of comorbidities.

 

 

 

 

 

 

 

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When Kayla* started on service with Moveable Feast, she knew she needed to make some changes. She acknowledged that she wasn’t making herself or her health a priority, and that she needed to make better choices to help her lose some weight. Kayla had struggled with weight loss previously. Her previous attempts were with the use of fad diets, and she was looking for something more sustainable.

When she first met with the dietitian, in April, shortly after starting service, she reported that she really enjoyed the  Moveable Feast meals and appreciated how they were split up. By the end of her session with Ilene (RD) they had set goals. One of them was make her other meals more balanced, like the Moveable Feast meals. Kayla’s other goal was centered on getting in daily physical activity.

She met with Ilene again about six months after her first visit, and Kayla had lost 70 pounds! She was very happy about her progress and reported that she feels differently; she has more energy and a very positive outlook on life. Kayla said that eating the Moveable Feast meals has not only taught her about balance, but that it has also helped her listen more to her  body about when she is actually hungry and full. She was excited about recertifying because she feels like they have made such a difference for her.

*Name has been changed for the privacy of the client.

(Client starting weight: 275 pounds, current weight 205 pounds)

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Current Moveable Feast client, Roger*, has numerous chronic disease diagnoses, and has struggled to manage his diabetes. Roger, like many of our clients, has limited access to healthy foods and has limited mobility. These barriers make it difficult to manage chronic diseases.

Roger is not alone, in Maryland, 12.6% of the adult population have diabetes, and an additional 36.9% have pre-diabetes. 1 Last year, more than a third of those served by Moveable Feast had a diagnosis of diabetes. Though diabetes can lead to severe consequences, including kidney failure, lower-limb amputations, blindness and even death; type 2 diabetes can be prevented and or managed.

Getting to and maintaining a healthy weight is important. This can be done by getting regular exercise and following a healthy eating plan. Following a healthy eating plan includes eating fruits, vegetables, and whole grains, limiting added sweets and highly processed foods, and watching portion sizes. Exercising 30 minutes, 5 days a week is recommended, though getting any kind of regular movement is a great start. Smoking cessation is also important in diabetes prevention. Consistency is key!

Roger started receiving Moveable Feast meals last fall and completed his nutrition assessment with Community Dietitian, Olivia Massa. He had already started his journey to healthier eating but was encountering some obstacles along the way. During his medical nutrition therapy sessions with Olivia,

Roger learned about the importance of managing portion size and how that affects his blood glucose readings. They talked about small changes that would lead to better diabetes control now and in the future. For our clients who have diabetes, “It is so important to meet the client where they are; some have been diagnosed with diabetes for many years and some have a new diagnosis; some have had previous education on how to manage their diabetes with the foods they eat and some have not,” states Olivia. Armed with new knowledge and with achievable but ambitious goals in place, Roger was ready and willing to make some changes.

A few months went by, and Roger and Olivia were able to talk again. Roger was excited to share his progress! By incorporating the Moveable Feast meals into his daily eating plan and with Olivia’s guidance and advice, Roger was able control his blood sugars and his meal portion size. He reports he is even washing out the Moveable Feast meal containers and saving them to portion out food he makes on his own. Although it was tough at first to make changes like limiting sweets and soda, Roger was able to stick with it and instead of these changes being drastic and overwhelming, it became his normal routine. Consistency truly is key, and Roger is a great example of how small changes helped to manage his diabetes and overall health.

*Name has been changed

1) http://main.diabetes.org/dorg/PDFs/Advocacy/burden-of-diabetes/maryland.pdf

https://www.cdc.gov/diabetes/library/features/diabetes-stat-
report.html#:~:text=34.2%20million%20Americans%E2%80%94just%20over,Asians%20and%20non%2D
Hispanic%20whites.

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At Moveable Feast, we aim to foster a positive relationship with food, one that underscores moderation, balance, and mindfulness. For this reason, we want to highlight recommendations on what to “add” in your diet versus what to eliminate or avoid.  However, keep in mind that research has found that a “Western diet” high in refined sugars, saturated fats, processed meats, and alcohol, as well as physical inactivity and smoking, have all been strongly associated with an increased risk for breast cancer. 

Phytoestrogens, lignans, isoflavones and Omega-3s: 

Breast cancer is estrogen-sensitive, meaning that it depends on estrogen to grow.  Certain foods have “phytoestrogens” which are chemical compounds that look similar to the estrogen we make in our bodies.  The latest research shows that moderate intake of foods high in phytoestrogens like lignans and isoflavonoids can actually protect us from breast cancer! It appears that when a “weak” estrogen-like compound like phytoestrogens takes the place of our body’s natural estrogen, then the weak substance can act as a relative anti-estrogen, decreasing the risk of estrogen-sensitive cancers like breast cancer. 

So how do I get more phytoestrogens in my diet? 

The most popular food high in phytoestrogens is soy or soy-based foods like tofu and tempeh. Foods high in Omega-3 fatty acids tend to be a good source of lignans, with flax seeds being a prime example; others include sardines, salmon, tuna, cod, mackerel, walnuts and some white and red beans. Other foods typically higher in phytoestrogens include most nuts, minimally processed whole grains, legumes like mung beans, and some vegetables like yams, garlic and cabbage.  

Like most other nutrients, phytonutrients are lost when foods are processed extensively. Look for the most wholesome version of the foods to maximize your phytoestrogen intake! For example, eating whole soy beans instead of drinking soy milk.

Fiber 

Some research studies have shown that dietary fiber has multiple protective effects, including inhibiting intestinal estrogen reabsorption, lowering cholesterol levels and assisting with glucose control, thereby reducing the risk of breast cancer from multiple fronts. It’s important to note that this recommendation is based primarily on whole foods, specifically fruits and vegetables,and not on fiber supplements. Additional considerations for potential protective effects were seen for mushrooms and citrus fruits.  Keep in mind the daily recommended amount of fiber is between 20-38 grams. 

Exercise

According to the National Cancer Institute and the CDC, women who exercise four or more hours a week have a lower risk of breast cancer.  Exercise can help you maintain a healthy weight, keep blood sugars in a healthy range and support your immune system. Although EVERYONE should exercise regularly, the protective effect of exercise on breast cancer risk may be greatest for premenopausal women who have normal or low-body weight. 

Mediterranean Diet

Research has continued to point to the numerous benefits of a Mediterranean diet, including breast cancer prevention.  The Mediterranean diet constitutes a regular intake of fruits and vegetables, whole grains, moderate in protein (including fish!) and low-fat dairy.  Naturally, this is a diet very high in antioxidants, phytoestrogens, omega-3s and fiber. 

The Mediterranean diet was found to be most effective when alcohol was excluded all together (the correlation between alcohol consumption and breast cancer is fairly well established in research). This eating pattern also seems to have a protectiveinfluence against the risk of breast cancer, regardless of body weight and BMI, and it seems to be most beneficial for post-menopausal women. 

Click here for more information on the “Mediterranean Diet” from the AHA. 

Here are some key takeaways: 

• Meet your daily fiber recommendations! 20-38 grams per day. Make sure most of your fiber is coming from whole fruits and vegetables. 
• Limit meats high in saturated fats and avoid processed, cured, charred or smoked meats. (E.g., hot dogs, bologna, lunch meats, bacon, salami, etc.)
• Limit your alcohol intake. If you are a female, limit to no more than one serving of alcohol per day. (A serving of alcohol is considered 1½ fluid ounces of hard liquor, 5 fluid ounces of wine or 12 fluid ounces of beer.)
• Include some foods high in phytoestrogens! Like soy, tofu, flax seeds, legumes, seeds, nuts, etc. 
• Exercise! The more active you are, the better off you’ll be. The CDC recommends 150 minutes of physical activity every day, which comes down to 30 minutes, 5 days a week. 

Interested in learning more? Here are some great additional resources to read or view: 

• https://www.eatright.org/health/diseases-and-conditions/cancer/reduce-breast-cancer-risk
• https://www.cancer.gov/types/breast/patient/breast-prevention-pdq#_12
• https://www.cdc.gov/cancer/breast/basic_info/prevention.htm
• Buja, A.; Pierbon, M.; Lago, L.; Grotto, G.; Baldo, V. Breast Cancer Primary Prevention and Diet: An Umbrella Review. Int. J. Environ. Res. Public Health 2020, 17, 4731. https://doi.org/10.3390/ijerph17134731
• Breast cancer and alcohol: https://www.youtube.com/watch?v=JAVV-Hmp9o8
• Breast cancer prevention https://www.youtube.com/watch?v=nYM2CcuhS4E

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