FDA Announces Changes to the Nutrition Facts Label

LabelAmericans are faced with a smorgasbord of foods, eating venues, and endless “advice” from television, the Internet, and (sometimes questionable) “experts” so it can be difficult for a person to determine which foods are the healthiest to eat. Many consumers, especially those looking to lose weight, have looked on the packages of foods in the grocery store to find the calorie, fat content, carbohydrate grams, sodium content, etc. as they make their purchasing decisions — but these labels have often been confusing and list nutrients with smaller serving sizes than people normally eat. With the link between Americans’ dietary habits and chronic disease becoming clearer, the Food and Drug Administration (FDA) has responded to stakeholder input, including that of the Academy of Nutrition and Dietetics, to update the requirements for the food label.

The iconic look of the food label that has been in use for over 20 years will remain the same, but there will be several changes in response to Americans’ dietary needs and eating habits. Expect to see the new food labels within the next few years: large manufacturers have until July 26, 2018 to make the changes, while small manufacturers get an extra year to make the changes. Here is a brief look at some of the changes, and you can learn more on the EatrightPro website here.

What is newly required?

  • Actual amounts of the nutrients have to be included in addition to the % daily value (%DV).
    • For example, Calcium would be listed as 260 mg and 20% DV.
  • Vitamin D and Potassium must be listed on the new labels. Calcium and iron continue to be required.
  • Added sugars must be included and expressed in grams and %DV.
    • The Dietary Guidelines for Americans recommends limiting added sugars to less than 10% of overall calories.
  • Serving size must be more realistic with what people are actually eating, not what they should be eating.
    • For example, a 12 oz can of soda is now considered 1 serving instead of 1.5 servings, since most people drink the whole can at one time.
    • A serving of ice cream is now 2/3 cups, not ½ cup.
    • Some packages will have dual columns, with the amount per container or package, and the amount per serving.

What is no longer required?

  • Calories from fat is no longer required since the type of fat is more important than the quantity when decreasing the risk for chronic disease.
    • Trans fat, saturated fat, and total fat must still be listed.
  • Vitamin A and C can still be listed, but are no longer required on the label.

The explanation of % Daily Value is also changing.

  • Old wording for % DV:
    “Percent Daily Values are based on a 2,000 calorie diet. Your daily value may be higher or lower depending on your calorie needs.”
  • New wording for %DV:
    “The % Daily Value tells you how much a nutrient in a serving of food contributes to a daily diet. 2,000 calories a day is used for general nutrition advice.”

The NutritiPoweradeon Facts label of the beverage shown here will be different in many ways when the new regulations take effect. Since most people will drink the entire bottle at one time, the nutrient information will need to be listed per 32 fluid ounce container size, rather than the current listing of nutrients per 12 fluid oz serving (2.5 servings per bottle). This will make it easier for consumers to realize they are drinking 200 calories, not 80 as some may currently think. Out of the 21 grams of sugars listed, it will have to indicate how many of those are Added Sugars (versus naturally occurring sugars such as in fruits or dairy).

Although we won’t know for several years if these changes will make a difference on Americans’ eating habits, the updated label will certainly make nutrition information easier and quicker to understand. Future educational campaigns can help consumers understand the Nutrition Facts Panel and make healthful choices when shopping. This is one more “tool in the toolbox” to help Americans decrease our risk for chronic disease through good nutrition and lifestyle habits.

Janelle and Wendy
Wendy Phillips, MS, RD, CNSC, CLE, FAND is a Division Director of Nutrition Support for Morrison Healthcare. She is the Policy & Advocacy Leader for the Clinical Nutrition Management Dietetic Practice Group for the Academy of Nutrition and Dietetics, and helps the public understand the impact of nutrition-related legislation on their health.

Janelle Walker, MBA, CLE, is a lifestyle educator for Kaiser Permanente. Janelle works with Kaiser members, families and consumers to help them adopt healthy lifestyle habits.

VAND Honors 3 RDNs at the Annual Meeting in April 2016

Each year VAND honors 3 Registered Dietitian Nutritionists (RDNs) with Academy awards at the Annual Meeting:  Recognized Young Dietitian of the Year, Emerging Dietetic Leader, and Outstanding Dietitian of the Year.  Here you can read more about each award and this year’s honorees from the annual meeting in Fairfax, VA in April.IMG_0236

The purpose of the Recognized Young Dietitian of the Year program is to recognize the competence and activities of younger dietitians in the Academy of Nutrition and Dietetics and to encourage their continued participation in Academy affairs.  Recipients of this award must have demonstrated concern for the promotion of optimal health and nutrition status of the population, as well as demonstrated leadership in legislation, research, education, management, etc in either the Academy or employment.

IMG_0246Lisa Conway, MS, RD, CNSC, is VAND’s Recognized Young Dietitian of the Year for 2016!  Lisa has on the board for the Tidewater district (TAND) for 4.5 years in several different roles, including secretary, newsletter editor, membership chair, and other positions.  Her “day job” finds her working for Aramark at Chesapeake Regional Medical Center as a nutrition support clinician in the ICU and PCU.   Lisa shares her passion with others through mentoring students in TAND and with dietetic students from Norfolk State University shadowing her at work. She was instrumental in making the 2015 VAND annual meeting in Virginia Beach a success through her marketing and media efforts, including promoting the event and designing the cover art for the brochure.

 

The Emerging Dietetics Leader Award recognizes the competence and activities of members, regardless of their age, who are at the beginning of their dietetics careers. Members who receive this honor support the promotion of optimal health and nutritional status of the public through demonstrating leadership in legislation, research, education, management and other areas related to the profession.Kelly 2016

Kelly Leonard, RD is VAND’s Emerging Dietetics Leader for 2016! 

Kelly has been a Feeding Program Dietitian at Children’s Hospital of Richmond at VCU, Brook Road Campus for 5 years.  She also sees children for overweight, obesity, failure to thrive and food allergies.

Immediately following her internship, Kelly worked for Martin’s as a Supermarket Dietitian and practiced privately in adult weight management.  Even though she is working in pediatrics now she feels it’s the best of both worlds.  The children are her patients, but she works directly with parents to make changes that benefit the whole family.

Kelly graduated from Virginia State University with her BS in Nutrition and completed her internship at Virginia Commonwealth University Health Systems.  She’s been involved with the Greater Richmond Academy of Nutrition and Dietetics since before her internship and has been on the Board for 5 years as Sustainable Agriculture Rep, President-elect and President.  She loves to learn and appreciates the continuing education and networking opportunities that conferences offer.  She has attended several state and national Academy conferences as well as Pediatric conferences hosted by Johns Hopkins in Baltimore and Children’s Hospital of Philadelphia.  She is a member of the Pediatric Nutrition and the Hunger and Environmental Nutrition Dietetic Practice Groups.

Kelly has been married for 30 years and has 2 daughters.  During her husband’s military career she lived in 7 states within 10 years.  She feels this experience allowed her to meet many people and to value diversity which better equipped her to return to school and to work with patients today.

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Wendy Phillips is pictured here with fellow UVAHS managers Angie Hasemann, Cynthia Moore, and Lesley McPhatter.

 

The Outstanding Dietitian of the Year award is the highest honor a state affiliate can award, and recognizes members who have made distinguished contributions to advancing the profession. The winner of this award is an individual who has demonstrated outstanding leadership and service.

Wendy Phillips, MS, RD, CNSC, CLE, FAND is VAND’s 2016 Outstanding Dietitian of the Year!

As a Division Director of Clinical Support at Morrison Healthcare, Wendy Phillips directs the development, implementation, and maintenance of clinical nutrition programs and services according to regulatory requirements, current trends, and market place demand. In her role, she provides regulatory oversight for the clinical nutrition services at ~160 hospitals from California to.  Wendy has worked with Morrison’s corporate operations and wellness/nutrition teams to lead a productivity analysis program for registered dietitians to ensure efficient and effective use of resources.

2016_04_11_4638Wendy is also the Immediate Past President of VAND.  Wendy has held various positions on their executive board’s public policy panel in addition to her presidency and enjoyed her time on the Blue Ridge district board as the Newsletter Editor and Constituent Liaison.  She recently championed the legislative update to Virginia regulations to allow greater flexibility for order writing privileges for dietitians in Virginia hospitals.  She continues her public policy and advocacy work on the Consumer Protection and Licensure Subcommittee for the Academy and leadership positions in several dietetic practice groups.

While she has worked for Morrison Healthcare in Clinical and Patient Service Manager roles in California and recently accepted a corporate position with Morrison, her most recent position was the Clinical Nutrition Director at the University of Virginia Health System, where she managed 48 RDs in inpatient, ambulatory, and dialysis settings.

She received her B.A. degree in Dietetics from Point Loma Nazarene University in San Diego, CA and her Master’s Degree in Clinical Nutrition from Rosalind Franklin University School of Medicine and Science.  She is a Certified Nutrition Support Clinician, a Certified Lactation Educator, and a Fellow of the Academy of Nutrition and Dietetics.

 

 

Making Food Dollars Stretch: A Family Affair!

Last week I went grocery shopping at my favorite “big box” market, and once again I winced as I watched the total click higher and the printed receipt get longer. The printed tape makes it even more difficult to deny that the cost of food has skyrocketed over the past few years. My family of four, including two athletic teenage (hence HUNGRY!) boys, started to notice the price creep higher first on the foods that we regularly bought in the stores that we shopped at the most frequently, and it became a game to try to guess the final total price while we waited in line to pay. We certainly took notice of an increase of fifty cents per pound of meat, one pound of strawberries that used to cost two dollars now costing three dollars, and one pounds of grapes all of a sudden costing almost four dollars, even in the summer time! Feeding two growing adolescent boys was getting more expensive by the week. Now, we can’t get out of a grocery store for less than $300 for one week’s worth of groceries, and it seems the shopping basket is a little lighter each time.

Hard economic times can force families to consider their grocery budget a little more carefully, cutting out “extras” and skipping restaurants; the good thing is, this can often lead us to eating a healthier diet with smaller portions. Shopping with less food dollars requires more planning, including budgeting and deciding on a menu for the week, but this usually keeps the “extras” such as chips, cookies, candies, sodas, and other sweetened beverages from finding their way into the cart. As family members start to eat healthier, portion sizes may decrease, saving money on the grocery or dining out bill, and maybe even leading to weight loss.

If you need to make your food dollars stretch, involve your whole family in the process.

  • Take the cookbRed Dress Day 2014 008ooks off the kitchen shelf, look through smartphone apps such as Food.com or the Food Network app, or browse through magazines and TV shows to get recipes and meal ideas. Invite your children to pick a new recipe to help avoid the monotony that can happen at dinnertime.
  • Create a monthly calendar that is printed and pinned to the refrigerator or kitchen bulletin board. Plan breakfast, lunch, and dinner for each family member a week at a time. Knowing what foods you will need for the week minimizes the number of trips to the grocery store (where it’s always tempting to buy more than you need!) and prevents after-work trips through the fast food drive through because “there’s nothing to eat at home.”
  • “Eat down the pantry and the refrigerator.” We often have several different ingredients already in stock at home; have your spouse help you create a meal using only the ingredients that you have already. Be sure to check the expiration dates on the foods; use the First-in First-out method when putting your groceries away in the pantry (foods already in the pantry move to the front of the shelf and the newer foods are placed behind.)
  • Have your school age children make a shopping list from recipes they want to try or meals they know they will like, double-checking the pantry and refrigerator for items already on-hand. Wasted food is decreased when everyone likes what’s served!
  • Avoid being a “short order cook.” Cooking the same meals for the whole family generates less leftovers, encourages each family member to possibly try new foods, and saves time and energy in the kitchen by the “chef.”
  • Choose healthy, low-cost foods that can be used in more than one dish in the same week.
  • “Base” ingredients include foods like whole grain bread, skim or 1% milk, chicken breasts, romaine lettuce or spinach, and frozen vegetables. These foods can be used in a variety of recipes, are generally cheaper than other foods, and don’t spoil as quickly.
  • At the grocery store, shop the perimeter of the store first, stocking up on fresh produce and meats while avoiding the more expensive processed items that are most often found on the interior shelves of the store. Invite the kids or your spouse to go grocery shopping with you; it might at first seem like a difficult distraction, but family members who are more engaged with the selection of groceries will likely be more willing and adventurous eaters.
  • Making food dollars stretch can be a learning opportunity for the kids. Kids can use their math skills to determine the price per serving of various food items to determine which package is the best value. Remember, buying in bulk is not always the best investment if some of the package goes to waste.
  • Copy the children when taking your lunch to work: buy yourself a cute reusable lunch box or container that makes you want to take your foods to the office refrigerator.
  • Have the center of focus during meals be family time, not the quantity of food. Pleasant conversation can help you eat slowly and let your body be satisfied naturally by smaller portions.
  • Start a conversation at work about healthy shopping or food budgets, or even just eating smaller portions. You might be able to glean a tip or two from your co-workers on how they make their own food dollars stretch!

Other tips:

  • Shop the supermarket weekly ads for special sales or coupon items, and build your week’s meals around what’s on sale. If you are unsure of how to cook these foods or incorporate them into your meal plan, check the Internet or cookbooks for recipes or ask the grocery store manager for hints.
  • Look in the “markdown” bin of your grocery store; each section of the store seems to have foods on sale that are nearing the expiration date or are on overstock clearance. Ask the store manager what day of the week these “markdowns” are usually taken. Just be sure that you will use it quickly before it expires!
  • Buy frozen foods on sale, as these usually keep longer and still retain their nutritional value.
    When making large meals, freeze the leftovers to enjoy later in the week. Prioritize using the leftovers within a few days.
  • Try re-purposing leftovers: use extra meat and rice from dinner in breakfast burritos the next morning or send left over salad in your family’s lunch the next afternoon.

Remember, these are YOUR healthier habits, so make them work for you!

Janelle and Wendy

Janelle Walker, MBA, CLE is a lifestyle educator for Kaiser Permanente, with a special interest in helping families learn to live healthy together through nutrition, exercise, and other healthy habits.

Wendy Phillips, MS, RD, CNSC, CLE, FAND is a Division Director of Clinical Nutrition for Morrison Healthcare, with a background in pediatric nutrition and desire to help kids grow up healthy!

Order Writing Privileges Resources

Thanks to Wendy Phillips for creating the resources for order writing privileges in Virginia! 

Order Writing Privilege Resources are now available on the Downloads section of our website:

As a complimentary resource for members, we have posted guidance materials to help you implement order writing privileges for RDNs in acute care hospitals.  As always, we must mention the caveat that these are not intended to replace legal advice or the guidance from your hospital’s administration.

Materials that are now posted:

  • Sample protocol for MNT orders
  • Sample protocol for delegated nutrition orders
  • Handouts from VAND’s 2015 Annual Meeting workshop on order writing privileges
  • Guidance on the Drug Control Act of VA (Thank you to the clinical nutrition manager at Virginia Commonwealth University Medical Center, Regine Dallosta, for bringing the relevant regulations affecting parenteral nutrition ordering in Virginia to our attention)

VAND will continue to post resources on the website as they come available. We encourage you to share your resources with us so that we can post for others to customize (pay it forward!).  Be sure to check the Members Section under Downloads of www.eatrightvirginia.org for these resources.

Thank you for your ongoing work and support!

nicole_brown2Nicole V. Brown, MS, RDN, LD, ACSM EP-C

President, VAND

Nutrition Strategies for Children with ADHD – Part 2

Austin CookingThis week I introduced you to my son, Austin, and some nutrition interventions that do and do not work to help children with Attention Deficit Hyperactivity Disorder (ADHD). While it’s true that impulsivity, inattentiveness, and hyperactivity are each hallmarks of ADHD, so are creativity, innovation, imagination, and usually intelligence! Children with ADHD are often the best little chefs if this imagination and creativity are fostered correctly. You see, while most of us can shut out the multiple distractions that come at us each day to focus on the task at hand, individuals with ADHD are not able to shut out that stimuli. Another child tapping a pencil, someone humming a tune, or a butterfly outside the school window are each enough to pull the attention of a child with ADHD in many different directions.

This inability to maintain focus is thought to be related to a disorder of the dopamine receptors in the brain and a decrease in serotonin activity (both of these chemicals are known as neurotransmitters that help control brain activity). Therefore, it’s believed that a child with ADHD has difficulty or the inability to shut down the right brain in favor of the left brain as many of us normally do. So while this can lead the child to be impulsive and inattentive, these children are also usually the builders, creators, engineers, inventors, and chefs.

Austin underwent 6 weeks of psychological testing a few years ago to determine the cause of his nervous tics and impulsive behavior. He was diagnosed as a genius with ADHD. We weren’t surprised – at the age of 2 he was building 500 piece puzzles and massive Lego structures. We originally thought he would be an engineer when he grows up, and we still think that is a possibility. But now we’re thinking he may become a chef – he has decided he loves cooking and baking if he gets to cook from scratch rather than from a box. The science of food intrigues him; he wants to know the role that each individual ingredient plays to make the final product. Even as a Registered Dietitian who studied food science in college he sometimes stumps me with his questions!

Working with my son in the kitchen has taught me several things that are helpful for all children, and not just those with ADHD:

  • Children are known to ask (sometimes repeatedly) “when will dinner be done?” For children with ADHD and other behavioral diseases characterized by impulsivity, it is especially difficult for them to wait for the meal (or really anything else). But when they are helping make the food, they don’t need to ask – they will know. Preparing the ingredients, assembling the meal, and placing it in the oven while setting the timer for cook time will give them something active to do while waiting and give them control and knowledge over the time to completion.
  • All children are more likely to eat new foods if they help prepare them. Developmentally and age appropriate tasks should be assigned to children to help with some aspect of meal preparation, even if it is simply setting the table.
  • Creativity and imagination should be encouraged, even in the cooking process! I let Austin experiment with new or substituted ingredients, just so he can see what will happen. Some of these are tried and true things, like substituting applesauce for the fat source in muffins to reduce the overall calories. While it’s a well-known cooking “trick” for those of us who have been cooking for years, it is still a fun novelty for my son while sneaking some “stealth health” into our food. Other times, I let him try things that will have unexpected results (like using baking soda instead of baking powder to see for himself the difference between the two, or using different spices and seasonings). If the meal doesn’t turn out right, we always have a back-up soup or crock-pot meal that can stand in its place. But the memories created, knowledge gained, and creativity fostered are priceless in comparison.

My husband fears that my cooking career is on hiatus for the next 6 years until Austin leaves for college! In the meantime, I’m loving having a partner in the kitchen to expand my own skills and spend quality time with my son all while harnessing his ADHD in a positive manner. If you have a child with ADHD, I hope you will consider some of these tips and guidelines as a way to utilize their ADHD to their benefit while becoming more engaged in nutrition in the kitchen!

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Wendy Phillips, MS, RD, CNSC, CLE, FAND is the Immediate Past President of VAND and a Division Director of Nutrition for Morrison Healthcare. She is the mom of 2 boys, ages 12 and 15.