Nutrition and Food Service includes both the food service operations and clinical dietitian services. We aim to provide optimal customer service in all areas. Our food service employees take pride in preparing and serving nutritious meals to Veterans during their hospital stay. Our dietitians are skilled in medical nutrition therapy that helps Veterans while in the hospital and at home to best take care of their nutrition needs.
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Strive Nutrition leverages Perfect Day animal-free whey for 'sustainable' milk DairyReporter.com
The food justice work being done by local nonprofit Healthy Day Partners started by looking at a hyperlocal version of the issue — other kids who went to school with the founder’s son didn’t have the same access to healthy snacks.
“I noticed a lot of kids didn’t have food during recess, and I realized very quickly that they couldn’t afford it, so my co-founder and I … very quietly, supplied organic, healthy snacks in the classroom. It grew into really diving deep into school gardens and creating a 1-acre educational farm at the school,” says Mim Michelove, founder of Healthy Day Partners, an Encinitas-based nonprofit providing education and resources on starting and sustaining home and school gardens, and reducing food insecurity.
The program continued to grow. It gained state and national recognition for improving health and wellness in schools and providing environmental education. In addition to growing food for the school district and local food pantries, it expanded to 10 acres, with Michelove serving as director of the Encinitas Union School District’s Farm Lab, educating students and the surrounding community, working on environmental issues, and designing school gardens. That eventually led to the formation of Healthy Day Partners as it functions today.
“After three years, I realized that I really loved what I was doing, but I wanted to focus on less affluent communities,” she says. “That’s when we relaunched Healthy Day Partners with a very personal focus for me, which was to try to reduce food insecurity and increase education and physical health in underserved communities.”
Michelove, who lives in Encinitas, took some time to talk about the organization’s food justice work and the passion she has for increasing equity in our food system. (This interview has been edited for length and clarity. For a longer version of this conversation, visit sandiegouniontribune.com/sdut-lisa-deaderick-staff.html.)
Q: What’s informed the way you approach the kind of food equity work you’re doing through Healthy Day Partners?
A: My philosophical perspective is that, particularly with the pandemic and Black Lives Matter, we noticed and talked about a broken food system, but it’s more than a broken food system. It is a classist system, it’s a racist system, and when I go to the grocery store in my neighborhood, it is completely wrapped in White privilege. For me, knowing that I have this ability to feed my family and my child healthy food whenever I want (and I also grow my own food, so it makes it really easy to do that), I think: “Well, everybody should be able to do this for their families. Everybody should have the same access.” When you look just around the corner, though, there are all of these pockets around us that don’t have the same access, and you can clearly see that people are hungry and that there’s food insecurity. There’s also this food system that has plenty of food and wastes it, throws it away, and doesn’t have the distribution system that is needed to feed everyone equally. It upsets me so much that I need to do something about it.
Q: There are numerous reports and studies about food insecurity and hunger — in San Diego County, as well as the state and the nation — including reporting from the San Diego Hunger Coalition that estimates one in three San Diegans are unable to provide enough nutritious meals for themselves/their families, as of March 2021 (which is up from one in four San Diegans in 2019). Can you talk a bit about your Homegrown Hunger Relief program and what kind of role it plays in addressing this issue of local food insecurity?
A: Those are unacceptable numbers, especially knowing that we’re in San Diego, and we have year-round growing. We have the ability, I believe, to change a lot of these local food systems. Our Homegrown Hunger Relief program really started with our Grab & Grow Garden program. As soon as (the COVID-19 pandemic) lockdown was announced, that was a time when a lot of grocery store shelves were empty and a lot of people were nervous about the food system and whether there was going to be access to food. My friend, Nan Sterman, and I were talking about what we could do. We both have expertise in gardening and growing food, so within three weeks, we put together the Grab & Grow Gardens program. We put together that program to help food insecure folks learn how to grow their own food. It’s more than just giving out emergency food, which is obviously critical, but it’s also empowering people with a life skill to grow their own healthy food, even if they don’t have land. They can grow it in a bucket, they can grow it in another container, and they are able to access seasonal and healthy food without relying on charities.
We were able to immediately get our garden kits into hunger relief agencies throughout San Diego County and at affordable housing units. We were getting feedback that it was an intergenerational activity, it gave people something to do during COVID, but I thought the food pantry lines were still too long and people were still having a hard time getting fresh food. What about empowering the home gardener who’s already growing food to take their excess bounty and donate it? We came up with a way for them to donate it and for us to collect it and get it directly to local food pantries, which is our Homegrown Hunger Relief program. We have donation stations around Encinitas and Carlsbad, and we really want to expand beyond that. I hope it’s helping people see that there’s a way for them to donate their excess bounty, and it’s a way for us to think about the health of our communities one garden at a time, one community at a time. It sounds so small, but it can add up to something that is truly life-changing.
We want to empower more people, whatever their ZIP code or income level, to grow their own food. We want to encourage to take that excess zucchini this season, or extra citrus in the winter, and really think about others and where it can be most impactful and powerful in changing our communities. It’s a neighbor-helping-neighbor situation where we have enough food; what we don’t have right now is the right distribution system. If everybody were to participate in a system like this, we could end hunger in our communities. Looking at that is a powerful way of looking at growing a home garden and being able to nourish your neighbors.
Q: In the report titled “The State of Nutrition Security in San Diego County: Before, during and beyond the COVID-19 crisis,” released by the San Diego Hunger Coalition in October 2021, a map illustrating the ZIP codes with the greatest numbers of food insecure people in the county shows areas including Otay Mesa, Chula Vista, National City, Lemon Grove and El Cajon. With the understanding that people of color and those with lower incomes are disproportionately food insecure, can you talk about what Healthy Day Partners is doing in service to those communities, specifically?
A: With Grab & Grow Gardens, we were very careful to partner with hunger agencies that are targeting those with the lowest income, the most food insecure, the hardest hit by COVID. Those who are the most disproportionately affected by every level of inequality. I really hope to get Homegrown Hunger Relief further south than where we are currently piloting the program.
We were very lucky to receive a (U.S. Department of Agriculture) Farm to School grant for working with National School District in National City. We were able to revitalize all of their school gardens. Before the grant, we donated a couple of gardens and helped build a couple of gardens to be sure that every student has equal access to garden education. Once we received the grant, we partnered with Olivewood Gardens & Learning Center because they’re in National City and they are also garden and nutrition experts with a great working relationship with National School District. A new program being piloted at all of the schools is staffing garden educators and garden maintenance as separate, paid positions as a result of the grant. With Olivewood, we were able to model what we think is an ideal garden, outdoor, science-based education program. We could talk about National City as a food desert and say, “Here you go, here’s some fresh zucchini, green beans and fennel,” but we need to educate people on how to make these changes to be healthier and how to use different foods to make healthier versions of traditional, cultural meals. Olivewood is great at doing that in National City, so they’re perfect partners for us.
My philosophy is that education and food are two of the ways that we show our children how much we value them, so we’re really happy to support National School District. Having high-quality garden education and growing healthy food is really important. The kids get to see that and whatever is in the cafeteria, we want to have that growing in their school garden so they can really see where their food comes from.
Q: Why is this kind of food justice work — closing this gap in access to healthier foods — important to you?
A: This whole career of mine was inspired by having a child. I just can’t help it that, if my child has access to healthy food that I’m providing for him, I think that every one of his peers should have access to that same quality of food. When I think about it, I get very emotional about that area of inequality because it was relatively new for me to realize that, when my son went into public school, that not everybody has the same access to healthy food. I know that sounds really ignorant, but it just didn’t have the same impact. I’m a big believer in the understanding that if I have access to something, everyone should have access to it.
I think, for a lot of us, it’s time for some self-reflection and taking responsibility to fix what’s broken that our society and country needs to address. For me, this is something I can help with because I have an area of expertise in growing food and I see the impact of growing food, having and increasing local food supplies, and having private and public spaces offering access to healthy food in order to eliminate food insecurity. I think we shouldn’t just be looking at our backyards to grow food, but our front lawns, side lawns, balconies and public parks. We have a lot of answers, they’re kind of simple, and they add up to having a real impact, so I hope that more people will adopt growing food as close to their plates as possible.
A South Side chef is on a mission to make classic comfort foods healthy.
David Fuller is founder and president of Eating to Live, a vegan line of dishes that can be found in Chicago-area Whole Foods and Jewel Osco stores.
His specialty is collard greens and dishes like braised collard greens and kale, collard greens and cabbage, and even a collard greens grilled cheese.
Fuller recently debuted his creations at the National Restaurant Association Show, a dream 25 years in the making.
“I think that comfort food appeals to everyone, but also we have health conditions like diabetes, heart, high blood pressure, hypertension. All those things come from diet,” said Fuller. “It’s not radical. This is a slowdown process, you gotta feed the baby milk as I was taught. So gradually if you get people to thinking that way, and give them an offering like this that is health conscious that still has the flavor of what great grandmama and our ancestors produced, I think we’re spot on.”
Fuller is also a culinary arts and hospitality teacher at Chicago Vocational High School. His next goal is to take his collard greens nationwide.
Due to its distinctive flavor and creamy texture, coconut milk can add a nice twist to coffees, protein shakes and desserts. Although it’s nowhere near as popular as other plant-based milk alternatives in the US, it retains a loyal fan base.But how nutritious is this drink? And can it bring about any tangible health benefits?
Coconuts are well-known for their high saturated fat content. For decades, this nutrient has been linked to the obesity epidemic and a host of chronic diseases. However, recent years have seen a steep increase in studies (opens in new tab) challenging these findings, and even contradicting them.
If you feel confused, don’t worry. In this article, we’ll discuss the nutritional value and potential health benefits of coconut milk to help you decide whether it is the right plant-based alternative for you.
| Nutrient | Amount per serving (1 cup) | % Daily Value |
|---|---|---|
| Fat | 5g | |
| Carbohydrates | 2g | |
| Protein | 0g | |
| Dietary fiber | 1.9g | 7% |
| Sugar | 0g | |
| Calcium | 360 mg | 28% |
| Phosphorus | 0 mg | 0% |
| Vitamin D | 3.6 mcg | 18% |
| Potassium | 0 mg | 0% |
| Riboflavin (vitamin B2) | 0 mg | 0% |
| Cobalamin (vitamin B12) | 2.16 µg | 90% |
There are two types of coconut milk – canned and cartoned. Whilst they’re made out of the same ingredient, they differ in terms of consistency, nutritional value, storage ability and culinary uses.
Canned coconut milk is a thick, white liquid extracted from coconut ‘flesh’. Because it’s canned and sealed in a sterile container, it’s shelf-stable and comes with a longer expiration date than coconut milk in a carton. It also doesn’t need to be refrigerated. Canned coconut milk is much higher in fat than other types of milk, and as such, is primarily used as a cooking ingredient. It is a common staple in many South Asian cuisines and is frequently used to make curries.
Coconut milk from a carton is a watery, white liquid extracted from coconut ‘flesh’ and typically enriched with vitamins, minerals and added sugars. It’s used primarily as a milk alternative in coffees, smoothies, shakes and cereals. As opposed to canned coconut milk, the cartoned version contains significantly less fat and more water, and in most cases, it has to be refrigerated before and after opening.
Just like dairy milk, coconut milk from a carton can be divided into two categories: UHT (ultra-high temperature)/shelf-stable and fresh/refrigerated. The UHT drinks undergo extensive heat processing to increase their shelf-life, whereas the refrigerated ones don’t. As a result, they come with different use-by dates and storage guidelines.
Shelf-stable coconut milk typically has a shelf life of six to 12 months. The refrigerated ones tend to have much shorter use-by dates – usually a couple of weeks from when they were produced – and stay fresh for about a week after being opened.
When not accounting for water, saturated fat is the main ingredient in coconut milk. For several decades, saturated fat has been considered to be one of the biggest contributors to obesity, cardiovascular diseases and degenerative conditions. However, more studies (opens in new tab) are beginning to contradict this, pointing to the fact that the correlation between cardiometabolic conditions and saturated fat consumption remains weak.
There is also growing evidence suggesting that fatty acids found in coconut oil – lauric acid and medium-chain fatty acids in particular – may actually be beneficial for our health. According to a review published in the Journal of the Science of Food and Agriculture (opens in new tab), lauric acid has been shown to exhibit significant antibacterial and antiviral properties, whilst medium-chain fatty acids, which resemble the fats found in human breast milk, may play an important role in regulating blood lipids, improving cognitive function, fighting free radicals and reducing inflammation, as well as decreasing the risk of developing type 2 diabetes and several types of cancer.
When compared to animal fats, regular consumption of coconut oil may lead to lower levels of ‘bad’ low-density lipoprotein cholesterol and higher levels of ‘good’ high-density lipoprotein cholesterol, as indicated by the results of a meta-analysis published in Nutrition Reviews (opens in new tab). However, it’s worth noting that another meta-analysis published in Diabetes & Metabolic Syndrome (opens in new tab) points to more adverse effects of coconut oil on cardiometabolic health.
What’s more, according to a review published in the International Journal of Food Science (opens in new tab), coconut milk contains several compounds that may provide protection against damage to lipids, proteins and DNA strands. This drink also tends to be enriched with calcium, vitamin B12 and vitamin D, which can help vegans to top up the intake of these nutrients without resorting to additional supplementation. Unsweetened coconut milk is largely devoid of carbohydrates and sugars too, making it a good choice for people on low-carb diets.
According to Statista (opens in new tab), almond milk is the most popular plant-based milk alternative in the US. Unsweetened almond milks tend to have far fewer calories as well as much lower fat and protein contents than coconut milk. When it comes to nutrient values, they’re roughly comparable in both drinks, although this obviously varies between brands. As such, almond milk may be a better option for people whose primary goal is weight loss, whereas coconut milk would suit individuals who are after a more substantial drink.
Both almond and coconut milk perform well in a variety of meals and drinks. However, coconut milk tends to have a stronger taste and more overwhelming aroma that may overpower other ingredients, so it may need to be used more sparingly in cooking.
From an environmental perspective, the impact of growing coconuts and almonds is fairly similar in terms of their water and land use, according to a review published in the Global Food Security (opens in new tab) journal. So it really comes down to your health goals and personal preference.
By KIM JARRETT
THE CENTER SQUARE
(The Center Square) – The Hawaii State Department of Education is paying tens of millions of dollars to feed Hawaiian school children due to a flaw in the funding method used by the federal government, according to a report.
The authors of a report from Hawaii Appleseed, Hawaii Children’s Action Network, the Hawaii Afterschool Alliance, and Ulupono Initiative said the U.S. Department of Agriculture had not updated its funding formula since 1979.
“Because of this lack of federal funding, Hawaii’s state government has to pay between $20 and $30 million annually to keep feeding kids,” said Nicole Woo, director of research & economic policy at Hawaii Children’s Action Network. “Other school districts across the nation pay much less. This means that in Hawaii, less funding is available to cover other important education costs, like pre-K programs, afterschool programs, and better pay for teachers.”
The USDA is currently undergoing an updated analysis of its funding formula, but that will not be completed until 2025.
Hawaii’s congressional delegation sent a letter last week to the USDA calling for emergency funding.
“While we support the study’s objective to provide a comprehensive, accurate accounting of the real costs associated with producing and supplying school meals, we are concerned that the current school meal reimbursement rate for Hawaii is not reflective of these costs, and that the state and its students are currently being negatively impacted,” they said in the letter.
The state’s farmers, who compete with commodity prices, are also affected, according to the authors of the report.
“Leaving federal dollars on the table short-changes our entire community because a portion of those funds would go to Hawaii’s food producers, with that percentage growing each year as the DOE makes progress toward its goal of 30% locally sourced meals by 2030,” said Jesse Cooke, vice president of investments and analytics with Ulupono Initiative.
Food insecurity is a significant problem in the state, according to the report’s authors. Earlier this week, Gov. David Ige agreed to extend the emergency Supplemental Nutrition Assistance Program.
As of April 2022, 92,903 families representing 172,464 individuals were receiving the emergency allotments, according to Ige’s emergency proclamation. The benefits amount to $18.4 million.
“Many Hawaii families continue to suffer from food insecurity as they struggle to provide food for themselves and their families because of the effects of the pandemic. This is compounded by the continued increase in the cost of living,” Gov. Ige said in a statement. “Without additional support from SNAP, families may not be able to adequately feed their families.”
The proclamation is effective until July 22.
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Walmart's Cheryl Pegus: Everybody deserves healthy food CNN
In response to a recent column where I mentioned how genetic research is beginning to show us how our DNA may influence our dietary needs, reader Ann F sent me a slew of questions:
"Could race, hair color, eye color, ancestry help you choose the best diet? What about your gender? If you do have DNA information, how much would you be able to learn about your optimal nutrition?
And I wonder if food preferences are DNA-related, in some way. I try to have a healthy diet, but if I learned that I'd be better off with peanut butter sandwiches and not much else, day in, day out, that would sound great to me. (If I remember correctly, you might feel much that way about some New Mexico specialties.) Thanks."
Dear Ann,
Pretty much everything about you—including your susceptibility to some diseases—is determined by what you inherited from your parents. Even your preference for peanut butter sandwiches, and mine for New Mexican food, are at least partially influenced by our genetics, researchers say.
And yes, because males and females have differing body types and functions, our nutritional needs do vary. Men generally require more protein and women of childbearing age need more iron, for example.
There are two areas of study on this topic. One is called nutrigenomics, which looks at how diet affects the "expression" of our individual genetic code. For example, my dad developed Type 2 diabetes late in his life. Since we know the condition is linked to family history, there's a good chance I inherited a tendency for diabetes as well.
What is fascinating, say scientists, is my lifestyle, including how I eat, can influence if that gene may turn on to diabetes or stay off. (So far, it's off.)
On the flip side is an emerging field of research called nutrigenetics, which delves into how one's individual genetic code affects how we respond to certain components in food. These discoveries have spawned personalized nutrition programs based on DNA results.
And while there are companies that will map your nutritional needs based on your genetics, please note this area of nutrition is still in its infancy and not standardized by any means.
That said, I was offered to submit my saliva for evaluation by Genopalate, one such company with a great resume of nutrition professionals and researchers. And I must say I was intrigued with the results.
Among other details, my report found that my "genotype" is best suited to a diet high in carbohydrate foods and a moderate intake of dietary fiber. I also need a high normal amount of zinc, vitamin D and omega-3 fats in my diet. And apparently my body breaks down caffeine fast but alcohol slow—a reminder that "genetics loads the gun, but lifestyle pulls the trigger."
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That said, while certain foods may be generally categorized as "gut-healthy foods," you also have to consider any potential food intolerances that may be unique to you. Such intolerances can contribute to a "loose" or permeable gut wall—a phenomenon also referred to as "intestinal permeability" or "leaky gut" by many functional health experts.
"When the permeability of the gut lining has been altered, this allows toxins, bacteria, and foreign substances like undigested food particles to enter the bloodstream along with the nutrients," family medicine physician Bindiya Gandhi, M.D., previously told mbg. This may also ladder up to digestive issues, hormone imbalances, autoimmune issues, food allergies, and joint pain.
And while your diet is important, it's not the only thing that can promote imbalance. "There are so many factors—both societal and structural, environmental, and behavioral, that can impact gut health," says Pasquariello, adding that she likes to refer to the "social determinants of health model" to get a more holistic view. Proximity to and access to nutritious foods, education level, food quality/agriculture in the region you live, pollution, and water quality can all contribute to gut issues, she says.
On an individual level, some other things that can negatively affect your gut include:
EASTON, Pa. - Easton's West Ward has been longing for a community gathering space and access to fresh health food for years. The Greater Easton Development Partnership is hoping to deliver both with its new West Ward Market.
A citrus kale salad is one of the many healthy, prepared meals that will be available at the West Ward Market.
"We have awesome local kale from LaFarm right down the road," said Amanda Pietrobono, the executive chef and director of operations at the Kellyn Foundation, as she prepared the salad. "We also have arugula from Crooked Row Farm. The red onions that we get from Terra Fauna Farm here are amazing."
Starting next Wednesday, the market will be open from 3 p.m. to 7 p.m. every Wednesday throughout the summer.
"It'll be on 12th Street, right next to Paxinosa Elementary School," said Jared Mast, the executive director of the Greater Easton Development Partnership.
"There's going to be a lot of different options," said Pietrobono.
The need has been longstanding.
"There aren't full-service grocery options in the West Ward," said Mast.
"Some people do not have a car, so they have to take a bus to grocery stores," said Pietrobono.
"West Ward is a food desert, so if we can bring fresh produce and vegetables into the West Ward, that's great," said Easton Mayor Sal Panto.
One of the vendors, the Kellyn Foundation, is all about making the healthy choice the easy choice.
"To have farmers coming in say, 'hey this is available, it's affordable and it's delicious' will make shifts in all of our lives," said Pietrobono.
Part of the recipe for success is collaboration.
"We have a lot of partners teed up from Community Bike Works, the YMCA to Kellyn Foundation, that will be hosting different types of programming," said Mast.
"There will be a lot of different community partners doing fun activities for kids, parents, as well as anyone just stopping by to come and really make it a true event, not just a stopping and a grocery store experience," said Pietrobono.
The launch lands on the 270th year anniversary of the Easton Farmers Market.
"We've had two years of limited social interaction, so I think markets and special events and community gathering events continue to play a key role as we emerge from the pandemic," said Mast.
"There's a lot of good restaurants in the West Ward," said Panto. "They can now have a venue to go out and actually have outdoor dining."
The Brito Food Program provides healthy food and education to patients in the Piedmont Triad.
Greensboro – In just 12 hours, the community donated thousands of pounds of food – and thousands of dollars – to support the women Cone Health serves.
On Wednesday, May 25, community members donated 4,400 pounds of food and nearly $7,000 in cash donations during the second food drive for the Cone Health Brito Food Program. The event took place at the Renaissance Shops at Phillips Avenue in Greensboro.
The Brito Food Program provides healthy food options to patients at the Cone Health MedCenter for Women and facilities across the health system.
Part of the program is the Dr. Miguel and Denese Brito Nutrition and Education Center at MedCenter for Women. The medical food market provides healthy and nutritious food to women and their families experiencing food insecurity, hardship or chronic disease. The center also teaches women how to make better food choices and connects them with community resources.
During the program’s first drive in November 2021, the community donated 3,222 pounds of food and more than $2,800 in cash donations.
EASTON, Pa. - Easton's West Ward has been longing for a community gathering space and access to fresh health food for years. The Greater Easton Development Partnership is hoping to deliver both with its new West Ward Market.
A citrus kale salad is one of the many healthy, prepared meals that will be available at the West Ward Market.
"We have awesome local kale from LaFarm right down the road," said Amanda Pietrobono, the executive chef and director of operations at the Kellyn Foundation, as she prepared the salad. "We also have arugula from Crooked Row Farm. The red onions that we get from Terra Fauna Farm here are amazing."
Starting next Wednesday, the market will be open from 3 p.m. to 7 p.m. every Wednesday throughout the summer.
"It'll be on 12th Street, right next to Paxinosa Elementary School," said Jared Mast, the executive director of the Greater Easton Development Partnership.
"There's going to be a lot of different options," said Pietrobono.
The need has been longstanding.
"There aren't full-service grocery options in the West Ward," said Mast.
"Some people do not have a car, so they have to take a bus to grocery stores," said Pietrobono.
"West Ward is a food desert, so if we can bring fresh produce and vegetables into the West Ward, that's great," said Easton Mayor Sal Panto.
One of the vendors, the Kellyn Foundation, is all about making the healthy choice the easy choice.
"To have farmers coming in say, 'hey this is available, it's affordable and it's delicious' will make shifts in all of our lives," said Pietrobono.
Part of the recipe for success is collaboration.
"We have a lot of partners teed up from Community Bike Works, the YMCA to Kellyn Foundation, that will be hosting different types of programming," said Mast.
"There will be a lot of different community partners doing fun activities for kids, parents, as well as anyone just stopping by to come and really make it a true event, not just a stopping and a grocery store experience," said Pietrobono.
The launch lands on the 270th year anniversary of the Easton Farmers Market.
"We've had two years of limited social interaction, so I think markets and special events and community gathering events continue to play a key role as we emerge from the pandemic," said Mast.
"There's a lot of good restaurants in the West Ward," said Panto. "They can now have a venue to go out and actually have outdoor dining."
Nutrition is an important part of a healthy lifestyle. Nutrition and Food Services programs offered by VA can help with weight management and focus on health conditions related to nutrition, such as diabetes, heart disease, high cholesterol and renal disease.
Accessing those programs is easier than ever due to telehealth technology, such as VA Video Connect, VA’s secure videoconferencing app.
Kari Mularcik, chief of Nutrition Services at Central Ohio VA, has seen the positive impact of virtual nutrition care. Many Veterans have joined these specialized nutrition programs because they’re convenient. They may not have joined if they had to visit a VA facility, but the virtual aspect makes them accessible.
Today, every VA facility offers virtual appointments. At Central Ohio VA, only 10% of nutrition appointments are in person. This has opened the door to Veterans who value the accessibility and convenience of a video appointment.
“Instead of taking three or four hours off work to come and see us, they can take a break at work and use 30 minutes for a virtual appointment,” said Mularcik.
It’s also a benefit for many facilities that might not have the physical space for so many in-person appointments during the day.
Central Ohio VA in Columbus offered VA Video Connect visits before the COVID-19 pandemic. It is especially helpful to Veterans who live in rural areas far from the VA facility. But Mularcik said the number of Veterans who use VA telehealth has increased greatly since 2020.
Aside from video visits, VA offers telehealth programs to help Veterans with nutrition care:
Learn more about virtual care options for Veterans.
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Schools still in need of nutrition, janitorial and transportation staff This Is RenoSome studies have shown that dietary pattern has a significant effect on fertility. Of particular importance are certain vitamins and fats. However, much remains to be elucidated, and further research on the most promising results is needed to establish or debunk these findings.
Pregnancy nutrition. Image Credit: Dasha Petrenko/Shutterstock.com
Having a baby is often a great desire of human couples. As such, every factor that could potentially alter the chances of fertility assumes importance, especially as up to a quarter of couples in Western nations do not conceive within 12 months of unprotected intercourse at regular intervals. If miscarriages and other disruptions of pregnancy are considered, this figure doubles.
The modern medical answer to this issue is the use of assisted reproductive technologies (ART), in developed nations. These have risen almost fourfold in two decades, but the results in terms of live births have not been commensurate.
This has given urgency to the quest to find modifiable fertility factors. Since nutrition is related to weight problems as well as abnormal metabolism, it is an important topic in preconceptional care.
Folic acid and vitamin B12 play a positive role in conception and live birth rates following ART. In addition to reducing the risk of neural tube defects in the fetus at a dose of 1500 mcg per day, folic acid shows even more of a benefit in live birth rates at higher doses, especially when coupled with B12.
Folates are coenzymes that take part in the synthesis and methylation of DNA as well as protein synthesis. In its deficiency, homocysteine may build up, causing epigenetic changes via methylation. These changes alter embryonic development, X chromosome inactivation and chromosome stability, as well as genomic imprinting, and are heritable, without altering the DNA sequence.
Vitamin D has not been found to affect fertility at the levels of supplementation usually employed.
Food rich in folic acid. Image Credit: Yulia Furman/Shutterstock.com
Trans fatty acids are part of many baked and fried goods, but at current levels of intake, they are associated with lower fertility levels. Conversely, long-chain omega-3 fatty acids favor fertility. Trans fatty acids are being banned in the USA, though they may still be an issue in other countries.
Though fats are present in some dairy products, the role of such foods is unknown, as is that of meat.
Carbohydrate consumption has been linked in some cases to ovulatory ill-health, and conversely, correcting glucose metabolism in women with PCOS has caused ovulatory function to be restored, with the return of fertility.
Earlier, soy and isoflavones were considered to hinder conception, but recently it has been demonstrated that fertility rates do not decline in couples with a higher soy intake. In fact, isoflavone may boost live birth rates after ART.
More animal and less vegetable protein intake were linked to lower or higher pregnancy rates due to ovulatory factors, respectively, in women aged 32 years or more.
Overall, diets usually considered healthy are linked to higher fertility and live birth rates after ART, with the opposite effects being seen with poor-quality diets. Too much carbohydrate, fats, proteins or vitamins may delay or inhibit ovulation, perhaps by affecting oocyte maturation as well as embryo quality and implantation.
Women on Mediterranean-type diets show a shorter time to conception and higher conception rates with ART. Nutrition is thus key to conception, and more fish, legumes, and vegetables, olive oil, unprocessed grains and red wine, with fewer carbohydrates, showed red cell folate and blood vitamin B6 levels to be higher.
Some scientists found that this was linked to a 40% increase in pregnancy rates using intracytoplasmic sperm injection (ICSI), as was ingesting more omega-3 polyunsaturated fatty acids, like docosahexaenoic acid (DHA),
The intake of large amounts of caffeine or alcohol is not consistently associated with decreased fertility, but it is difficult to study these effects since these substances should not be administered in a randomized controlled trial, for obvious ethical reasons.
Women on Mediterranean-type diets show a shorter time to conception and higher conception rates with ART. Image Credit: Foxys Forest Manufacture/Shutterstock.com
Bodyweight affects fertility in women, and women with a non-ideal body mass appear to prolong the time to conception. Both over- and underweight women have a lower pregnancy rate, higher gonadotropin levels and a greater miscarriage risk. This is linked to poor ovulatory function.
Further support is provided by the observation that eating disorders are known to be associated with amenorrhea, infertility and miscarriage. On the other hand, overweight women are at risk for insulin resistance, with hyperinsulinemia and hyperandrogenemia. This leads to abnormal metabolism in adipose tissue.
With excessive body weight, androgens are over-produced in the ovarian theca cells, while fat metabolism is hyperactive. This causes central deposition of fat, or visceral adiposity, along with an abnormal blood lipid pattern. This triggers a vicious cycle of more central adiposity and resulting hyperinsulinism, causing further deteriorations in the metabolic pathways.
This could also be implicated in polycystic ovarian syndrome (PCOS), found in up to one in five women of reproductive age. Both high insulin levels and insulin resistance are found here, and gonadotropins are also often altered.
Fatty tissue is also key to cytokine production since many of them are derived from molecules like arachidonic acid. Cytokines are required for cell proliferation and differentiation of follicular cells, as well as for oocyte survival and atresia.
Leptin is another hormone involved in the development and function of the corpus luteum, inducing further estrogen synthesis from luteinized granulosa cells, and damping progesterone synthesis in the insulin-activated theca cells. High leptin levels are found in infertile obese women, reflecting the disordered metabolic state.
The resulting aberrations in hormonal and cytokine levels may cause ovulatory dysfunction and anovulation, leading to miscarriages and infertility. Even when there is no evidence of ovulatory disorders, overweight women typically show a poorer response to ART and take more time to conceive.
Scientists agree that a healthy diet, with adequate antioxidant levels, control of body weight, and moderate regular physical exercise, could reduce the risk of ovulatory infertility by almost 70%, according to some estimates. Some idiopathic infertility could also be alleviated by dietary antioxidant intake. Folate supplementation at levels beyond that recommended today also appears to be helpful.
The mechanism by which this works includes mitigating the adverse effects of insulin resistance, thus supporting ovulatory function; supplying antioxidants at adequate levels; and limiting fat intake, while promoting adequate monounsaturated fatty acid intake.
“In this context, the association of MedDiet [Mediterranean Diet] with antioxidants compounds and 1-CC support appears suitable to improve women's fertility.”
Silvestris et al. 2019
The diet which promotes female fertility could thus be described as including plant vegetable protein, whole milk and its products, folate, iron, and monounsaturated fats. When this is the preconceptional norm, the risk of ovulatory infertility was 66% lower, and other infertility 27% lower, compared to women who had the lowest adherence to this pattern of eating, even after compensating for smoking, caffeine, body mass index, alcohol intake, and oral contraceptive use.
Panth et al. (2018) indicated that “Population attributable risk calculations based on this sample suggest that not following the “fertility diet” was the attributable factor in 46% of cases of infertility, which was higher than all other independent risk factors.“ There is evidence to show that correcting dietary patterns provides as much benefit, if not more, as reducing weight and taking exercise, as far as fertility is concerned.
Antioxidant supplements are prescribed in abundance and see high sales, but again, a healthy diet, with more poultry and fish intake, unprocessed grains, fruits and vegetables, or the Mediterranean diet, is associated with better semen quality. Again, low saturated and trans fat intake, and less red and processed meat, along with low intake of potatoes and other high-carb foods, sweetened foods and beverages, improve semen quality.
However, more research is required to establish whether this correlates with increased fertility, as so far, semen quality has not been found to be a good fertility predictor.
“While a complete picture of the role of nutrition on fertility is far from complete, much progress has been made. Future efforts should concentrate on solidifying emerging evidence and jointly considering female and male diets.”
Gaskins et al. 2018
The Special Supplemental Nutrition Program for Women, Infants and Children, or WIC, is available through the Carter County Health Department and can help provide nutritious food for those who are eligible. Pregnant women, new mothers, breastfeeding mothers, infants, and children up to five years old who are at nutritional risk, have TennCare, or receive SNAP benefits, or meet income guidelines are eligible for the program.
“Each month thousands of Tennesseans receive WIC benefits provided through the Tennessee Department of Health,” said Caroline Chinouth, Carter County Health Department Director. “We encourage families to apply for these important benefits even if they think they might not be eligible.”
WIC food benefits are issued to an electronic benefit transfer card making it easier for families when they go through the checkout line. The Tennessee WIC card can be used at any store that participates in the WIC program. WIC participants can also download the WICShopper app onto their smartphones by searching for WICShopper. The app allows participants to access information on benefit balance, eligible food lists, recipes, and much more. Participants can visit www.tn.gov/wicshopper for instructions to download the app to their smartphone. The WICShopper app is available to all and free to download.
In addition to providing healthy supplemental foods, nutrition education, and breastfeeding support, the program also provides referrals to other health, welfare, and community-based services.
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Food is big business, especially in Michigan. With farmers growing over 300 commodities, Michigan has the second most diverse agriculture industry in the nation after California. However, getting from seed to table is complicated. From labor and transportation to government policies and climate, many factors inform and influence the growth, harvest, and distribution of food, and those factors define global, national, regional, and local food systems. Food systems encompass all the pieces that influence nutrition, food, health, community development, and agriculture along the food chain. The many components of a food system create opportunities to make changes and improvements — or create barriers.
“In food policy council work, the council looks at a food system to understand what parts of it are working well and what parts of it could change to make it better,” says Jane Whitacre, Michigan Fitness Foundation (MFF) project manager.
Food policy councils are made up of many different community stakeholders such as residents, farmers, food distributors, retailers, government agencies, and community organizations like food pantries, nonprofits, and education organizations including organizations that deliver Supplemental Nutrition Assistance Program Education (SNAP-Ed). SNAP-Ed is an education program of the U.S. Department of Agriculture that teaches people eligible for SNAP how to live healthier lives. MFF is a State Implementing Agency of the Michigan Department of Health and Human Services for SNAP-Ed. MFF offers grants to conduct SNAP-Ed programming throughout the state of Michigan.
“At MFF, our SNAP-Ed work inspires people to eat healthy and move more,” shares Whitacre. “On the nutrition side, our SNAP-Ed partners work with people in their communities in areas like how to access healthy foods in their neighborhoods, how to navigate the local food pantry, and where they can find recipes for healthy foods that may be new to them."
“In their PSE work, our SNAP-Ed partners engage with people and listen to their situations to gain a better understanding of the barriers they face,” explains Whitacre. “Then, they bring those voices into their food policy council work to address barriers that help further policies and systems changes. For example, addressing access to affordable, fresh fruits and vegetables by looking at things like transportation issues, the types of food available nearby, and if those retailers accept SNAP."
"Across Michigan, we envision and support a thriving, fair, equitable, and affordable food system. Our SNAP-Ed partners understand that it's really about partnerships and collaborations. One organization can't do it all by themselves. The issue is so big that it's going to take a lot of people doing their little bit for a long time,” explains Whitacre. "It's a really good time for organizations delivering SNAP-Ed to get involved with other like-minded people that are focused on local food systems work."
St. Vincent Charity Medical Center and the Greater Cleveland Food Bank are teaming up this summer to provide fresh produce and lunches to people in Cleveland's Central neighborhood.
The area is a food desert, which is why bringing fresh, healthy food to residents is important, said Leslie Andrews, a diabetes coordinator with St. Vincent Charity Medical Center.
"Central does not currently have a grocery store, so residents are using corner stores for most of their food," Andrews said.
Healthy food is part of a healthy community, and the event will try to improve the neighborhood's health in other ways as well, like through health screenings, she said.
"Things like unsafe neighborhoods, poor housing conditions, chronic stress, lack of transportation, access to nutritious foods, really all contribute to their well-being," Andrews said.
A person's income has an impact on how healthy they are, and poverty is one of the greatest indicators, Andrews said.
"80 percent of the factors that influence a person's health really happens outside the walls of a hospital," she said.
Doctors will be available at the event to answer health-related questions. There will also be cooking demonstrations and people who can connect residents to resources.
The ReFresh Pantry events will take place from noon to 2 pm. on the fourth Tuesday of the month through September.
The organizers also plan to offer COVID-19 vaccinations at future events.
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Milk for Health on the Niagara Frontier has had the same mission for more than 80 years.
Incorporated in 1941, Milk for Health is one of the oldest dairy promotion organizations in the United States. Its goal since day one has been to support dairy farmers of Western New York, promote dairy products and educate the public about the goodness of milk.
“We’ve earned people’s trust over the years because we’ve been an established part of the community for so long,” MFH Executive Director Bethany Hobin says. “We’re trusted by dairy farmers to continue putting out their bright message, and the community trusts us as well to give them the facts.”
Hobin grew up in and around dairy farms in Wyoming County. Since taking over as executive director in 2018, she has continued to promote the message that milk is good for consumers as well as the planet.
“Dairy is in my heart,” Hobin says. “I grew up with it in my heart, and I have a passion to protect my friends and family and their livelihoods. It comes with the understanding of how ingrained that lifestyle is when you’re a dairy farmer.”
The dairy industry is the largest single sector of New York’s agricultural industry. With about 3,400 dairy farms that produce 15 billion pounds of milk annually, the state is the fifth largest producer of dairy in the nation.
In New York, 98% of milk products come from local farmers. Milk for Health works with family-owned co-ops and milk producers of all shapes and sizes in Erie, Niagara, Chautauqua, Cattaraugus, Wyoming and Allegany counties and part of Genesee County.
Decades of research confirms that dairy plays an essential role in a healthy lifestyle. Just three daily servings of dairy products – which often go from farm to table in less than 48 hours – contribute to healthy eating styles and well-being.
“When you have dairy products, it's the most natural source of nutrition you can possibly get,” Hobin says. “With my kids, I teach them just like I’d teach anyone else about the importance of milk and how to incorporate it into your diet in so many different ways.”
Milk is also vital for a healthy immune system. It has a unique nutrient package and contains 13 essential nutrients, which is everything you need for heart health, strong bones, diabetes prevention, weight management, sports recovery and more.
Those three servings of low-fat or fat-free dairy foods, when combined with adequate physical activity, help children ages 9 years and older achieve peak bone mass, helping reduce the risk of osteoporosis later in life.
Milk – both white and chocolate – is also a powerful nutrient package that has several benefits to sports recovery. Drinking after exercise helps the body refuel, recover and rehydrate.
Here is a closer look at why each essential nutrient is important for growth and development:
Calcium: helps build and maintain strong bones and teeth
Iodine: crucial for bone and brain development in pregnancy and infancy
Niacin: used in energy metabolism in the body
Pantothenic Acid: helps the body use carbohydrates, fats and protein for fuel
Phosphorus: supports strong bones and teeth; helps tissue growth
Potassium: supports healthy heart, blood pressure, body fluid balance and muscle function
Protein: helps build and repair tissue; supports immunity
Riboflavin: helps the body use carbohydrates, fats and protein for fuel
Selenium: supports healthy immune system and metabolism; helps protect healthy cells from damage
Vitamin A: supports healthy skin, eyes and immune system; promotes growth
Vitamin B12: supports normal blood function and nervous system
Vitamin D: supports strong bones, teeth and immune system
Zinc: supports immune system, development and skin
“If you look at the ingredients in milk and then compare it to any other sports beverage, milk is the most pure recovery drink that you can have,” Hobin says. “Milk is 98% water. The rest is protein and vitamins that benefit all the systems in your body, but especially muscles and bones. You can’t get that anywhere else.”