West Virginia Diabetes Symposium – 2013

These past three days I have my time at the West Virginia Diabetes Symposium that was held in Morgantown, WV at the Waterfront Place Hotel.  This is an annual event that has been in existence for the past 13 years.  This year the conference was entitled “Bridging the Gap with Education.” This conference is attended by physicians, physician assistants, dietitians, nurses, and various other health professionals alike.

On the first day of the conference I attended two sessions:

  • “Diabetes Prevention in the Real World: The Group Lifestyle Balance Program” – Kaye Kramer, RN, DrPH, CCRC
  • “Role of Physical Activity in Diabetes” – Andrea Kriska, PhD

West Virginia has a fairly poor standing when it comes to national health measures. Below are a few statistics to give you a mental representation of the issues this state is facing:

  • 32.4% of the WV adults are obese = 3rd highest in the nation
  • 35.1% of WV adults participate in no leisure-time physical activity or exercise
  • 12% of WV adults have diabetes = 4th highest in the nation
  • 12.3% of WV adults have cardiovascular (heart) disease = 1st highest in the nation

As you can see, West Virginia has a multitude of issues that stem from the high obesity rates in the state.

Are familiar with diabetes? If not, here are few things you should know about diabetes:

  • There are a two main types of diabetes; Type 1 and Type 2.
  • Type 1 Diabetes only accounts for about 5% of all diabetes cases. It is typically diagnosed in childhood or early adulthood.  With Type 1, your body does not produce any insulin.
  • Type 2 Diabetes accounts for the remaining 95% of all diabetes cases.  It can be diagnosed at any time in life. With Type 2, your body produces insulin but your body does not respond to it like it should – this is called insulin resistance.

The lab criteria is the same for any type of diabetes in order to be diagnosed you must meet one of the following criteria:

  • Symptoms of diabetes AND casual plasma glucose of 200mg/dl or above
  • Fasting plasma glucose of 126mg/dl or above
  • 2-hr plasma glucose of 200mg/dl or above during an oral glucose tolerance test
  • Hemoglobin A1c greater than or equal to 6.5%

Exercise can be a huge contributor to overall health!  Remember exercise can be any form of physical activity that gets your body moving.  Exercise has been proven to have a positive impact on:

  • Coronary heart disease (CVD)
  • Cancer (certain types…e.g. colon and breast cancer)
  • Gallbladder disease
  • Bone health
  • Mental health
  • Osteoarthritis
  • Quality of Life/Independence
  • Weight management
  • DIABETES!

While diet will contribute more directly and quicker to one’s weight – it has been stated that one of the greatest predictors of who will keep the weight they lost from coming back is… EXERCISE!

One the second and third day of the conference, I attended the following sessions:

Thursday:

  • “Diabetic Retinopathy” – Muge Kesen, MD
  • “Type 2 Diabetes: A Cardiovascular Disease” – Joel Zonszein, MD, CDE, FACE, FACP
  • “Roles and Strategies of Diabetes Support Group Facilitators” – Joanne Costello, PhD, MPH, RN

Friday:

  • “How to Identify Type 1 versus Type 2 Diabetes, and is There Such a Thing as Type 1.5?” – Brian Ely, MD
  • “Pharmacological Management of Type 2 Diabetes Mellitus: Highlighting the Benefits and Limitations of Each Treatment” – Angel Kimble, PharmD, BCPS
  • “Developing Cultural Competence in Health Care Providers” – Pedro (Joe) Greer, Jr., MD, FACP, FACG

Diabetes wordcloud

References:

– American Diabetes Association, http://www.diabetes.org

– West Virginia Diabetes Symposium & Workshop, http://dsw.ext.wvu.edu/

iCook 4H Nutrition Assessments

For my current rotation I will be dedicating my time to working on the iCook 4H Nutrition Research Study. This study is being conducted in 5 different states: West Virginia, Maine, Tennessee, Nebraska, and South Dakota. This is an awesome opportunity for children between the ages of 8-10 and a caregiver/parent to be able to attend nutrition and cooking related classes while focusing on physical activity to improve their overall well-being.

For more information about iCook click here – and make sure to “like us” on Facebook!

This past weekend we packed up our research lab and traveled to Martinsburg, WV to conduct assessments for the families we have enrolled there. This process involved collecting data such as blood pressure, height, weight, waist circumference, tanner stages (to assess biological maturity), and surveys to assess dietary and physical activity habits. At this time the children/parent pair were also randomly assigned into a control or an intervention group. Each child was given an accelerometer to wear for 7 days; this will assess their physical activity and monitor it continuously for an entire week. This next week we will be recruiting more in Morgantown and conducting assessments starting on Thursday! Stay tune for more posts about iCook – Don’t forget to like us on Facebook!

iCook Logo

Childhood Obesity Awareness Month: A Look at the Big Picture

In lieu of September being Childhood Obesity Awareness Month I wanted to look at the big picture of childhood obesity, as well as the entirety of obesity as a National epidemic.

Shocking New Trends for Obesity

A recent report released new findings that if changes are NOT made and the current trend continues, 39 states will have obesity rates soaring above 50% by 2030. Keep in mind that is only the number of adults who are obese (BMI >30) and does not include those who are only considered overweight (BMI between 25-30). This is a HUGE problem for America. Think back to 20 years ago. No state had obesity levels above 15%, yet in 20 years all 50 states could have obesity rates above 44%. 13 states would have obesity rates above 60% with Mississippi tipping the scales with 66%. Colorado would reign of being the “skinniest state” but it’s obesity rates would increase from today rate of 20.7% to 45%. Although they would still have their “bragging rights,” 45% is nothing to be proud of. Since my recent move from Colorado to West Virginia where the obesity rate is currently 32.4%, earning them the title of the 3rd most obese state, the difference was beyond obvious. I cannot imagine seeing those rates more than double in the next 20 years — something needs to change! Click here to view an interactive map with state-by-state data on the current and projected obesity rates for 2030. Currently, roughly 2/3 (66%) of all adults are overweight or obese, which translates to only 33% of adults in America being at a healthy weight. Nation-wide obesity levels total 35.7% of the US population. Obesity is now a nation-wide epidemic and not just concentrated in the South.

2010 Map of State Obesity Rates

2010 Map of State Obesity Rates
Source: http://www.cdc.gov/obesity/data/adult.html

Want to see how obesity has dramatically increased over the years? Click here to see the obesity map change from 1985 to today!

Obesity: An Unnecessary Expense

Not only is obesity a huge health concern, it also could lead to an economic crisis. The amount of money spent towards health-care cost will skyrocket from the increased prevalence in diabetes, heart disease, and other comorbidites of obesity. This report projected that by 2030 America will see an additional 6 million cases of type 2 diabetes, 5 million cases of coronary heart disease and stroke, and over 400,000 new incidences of cancer that is directly related to obesity. These levels are already extremely high with 25 million Americans with type 2 diabetes, 27 million with chronic heart disease, 68 million with hypertension (high blood pressure), and 50 million with arthritis today. If obesity continues on the current trend we can easily expect to see an increase of 18 billion dollars each year, which does not account for a decrease in productivity!

View the full report, F as in Fat: How Obesity Threatens America’s Future 2012 at the Trust for America’s Health.

“Reversing” the Trend

Obesity is considered to be “one of the most challenging health crisis that this country has ever faced.” When we look at starting to “correct” this trend and being able to reduce obesity rates we need to be implementing and promoting small changes for adults. In America, weight loss is promoted as something that should be quick and easy and can be bought; in fact, permanent weight loss should be close to the opposite and should be looked at as a steady loss of 1-2 pounds a week. Increasing exercise, decreasing portion sizes, increasing fruit and vegetable intake, and decreasing high-calorie, low-nutrient foods could lead to the change in the trend of obesity that America needs.

When looking at future trends, our focus also needs to be towards preventing children from becoming obese and ultimately eliminated childhood obesity. Since 2010, the month of September has been dedicated to looking at childhood obesity and raising awareness. Today, nearly one-third of children and teens are either overweight or obese. Since 1980, the rate of childhood obesity has tripled! It has been suggested that this is the first time that children may have a shorter life span their parents. Think about how this can really impact America.

What caused the increase in childhood obesity?

Think back to when you where a kid or to what your parents told you about their childhood. Compare your activity levels and those of your parents with children today and you will most likely see a significant difference in activity levels and habits of children today. Thirty years ago, children walked to school, participated in daily physical education, spent recess being active, and ran around the neighborhood until dinner. Now-a-days children ride buses to school and are replacing their time that was once spent actively playing with playing video games, watching TV and chatting online. The average 8 to 18 year-old spends 7.5 hours each day using TV, computers, video games, cell phones, and movies. Physical education programs and after-school sports are being decreased and even eliminated in some schools to the point that only 1/3 of children are meeting the recommended daily activity levels of just one hour. Back in the day, more meals were home-cooked, less processed, and portion sizes were reasonable. Today, parents tend to be busier resulting in less home-cooked meals. Snacks were once consumed only once or twice a day and now one in five school-aged children consume up to six snacks a day! Portion sizes have increased up to five times larger than they were in the 1970’s.  As Americans, we are now consuming 31% more calories than we were in the 1970’s, yet our activity levels have plummeted. Combine the lack of physical activity with the “fast food nation” our children are exposed to and the result is childhood obesity. It is shocking to find out that many children are unaware of where their food is even coming from and cannot identify the names of common fruits and vegetables. We are setting our children up for obesity, diabetes, heart disease, a shorten life span, decreased productivity, and decreased success rates. This needs to end! Children establish their habits and eating behaviors early on and need to have the proper education and resources to do so.

Childhood Hunger and Obesity 

In America we tend to be fighting a double-edged sword when it comes to children and nutrition; obesity and hunger. Although, we tend to associate obesity with having more than enough access to food that is not always the case. One in seven low-income preschool aged children are now obese. One way to fight this epidemic is to look at the source. Most children are receiving meals through the schools and making those meals healthier, more nutritious, and more available can work to fight both ends of the spectrum. I will focus directly on school lunches and legislation involved childhood nutrition in a future blog post during National School Lunch Week, which is October 15-19th. If you would like to get more involved in helping fight against childhood obesity or learn more about it please check out the COAM at http://www.healthierkidsbrighterfutures.org and the Let’s Move initiative at http://www.letsmove.gov/learn-facts/epidemic-childhood-obesity. Are a student at West Virginia University or a resident of Morgantown? Check out what WVU and local programs in the area are doing to help fight against by clicking here.

Sources:

http://www.cdc.gov/obesity/data/adult.html

F as in Fat: How Obesity Threatens America’s Future 2012

http://www.healthyamericans.org/report/100/

http://www.healthierkidsbrighterfutures.org

http://www.letsmove.gov/learn-facts/epidemic-childhood-obesity

GDI Bootcamp

It’s official. My experience as a graduate dietetic intern and a graduate teaching assistant is officially in full swing! Let me step back for a moment and explain what exactly that means and why I am here in at WVU. In order to become a registered dietitian one must complete an accredited dietetic internship. The accredited dietetic internships come in a variety of formats. The main requirement is that interns must complete, at least, 1,200 hours of supervised practice rotations with registered dietitians in the areas of clinical, community, and food service. Internship programs may be combined with a Master’s degree, or any number of graduate courses, or just rotations. The application for an internship is done through a matching system, which means that each applicant will receive either one match or no matches at all, no matter how many programs one applies to. Internships are extremely competitive! Only 50% of applicants who apply receive an appointment to a dietetic internship! I was lucky enough to receive my first choice internship with West Virginia University. I chose this program because it allowed me to further my education with a master’s degree by combining it with the internship amongst many other reasons including the program’s quality, the rotations offered, the well-rounded emphasis, location, cost, etc.

The entire internship experience started with a two-week boot camp orientation. It is a fairly new concept to this program and has really proven beneficial. I am one out of a class of six interns this year and have been lucky enough to get to know them, as well as the second year interns extensively the past two weeks. Boot camp is designed to introduce us to WVU, the department, the division, and most of all, our program specifically. Boot camp was held over the course of the two-weeks prior to the beginning of the fall semester, which was August 6th – August 17th. Here is a brief overview of my experience at boot camp including some of the interesting facts I learned along the way.

Week One!

Day 1: August 6th, 2012

The first day was spent getting to know the other first-year interns and Dr. Melissa Olfert, the program director. We also took time going over the logistics of the program and important details that we needed to know. Today we were directed to think over a few very important decisions:

  • Choose between thesis and non-thesis (problem statement)
  • Who we wanted to be our advisor
  • Who we wanted to serve on our committee
  • What courses we wanted to take
  • What area we wanted to focus our research towards

Day 2: August 7th, 2012

On the second day we had a chance to meet with the second-year interns. They each shared their own “pearls of wisdom” and talked about their experiences. This really helped us answer the questions we had and help us get more of an idea of what to expect the next two years. We also took the Jung Typology personality test and were separated into groups according to our results. Interestingly enough, we were all fairly similar! I guess that just proves that it takes a certain type of person to become a dietitian. The Jung Typology test is based on 4 main characteristic trait options:

  • Extraverted vs. Introverted
  • Sensing vs. Intuition
  • Thinking vs. Feeling
  • Judging vs. Perceiving

With the combination of 4 letters labeling a personality type, there are a total of 16 different personality types that can be identified using this method. My scores came out to be ENTJ, aka the Executive, which stands for extraverted, intuitive, thinking and judging. Find out what type of personality you have here! 

We finished up the day by going on a tour of the campus and set up our Mountaineer Cards and Pay Roll. We learned about social media from a guest lecture from Mary Rodavich, a second year intern. This presentation was extremely informative and helped us navigate through the Internet world and taught us how to set up our blog, ePortfolio, LinkedIn, and others.

First and Second Year Interns
Top Row (left to right): Kaitlin Mock, Emily Todhunter, Erin Smith, Jessie Popelka
Bottom Row (left to right): Remi Famodu, Shannon Ackerman, Mary Risch, Wendy Thompson, Mary Rodavich, Roanna Martin

Meet the Interns:

1st Year Interns – Class of 2014

Shannon Ackerman

  • Hometown: Morgantown, WV
  • Undergrad: Indiana University of Pennsylvania

Remi Famodu

  • Hometown: Bloomington, MN
  • Undergrad: Ohio University

Jessie Popelka

  • Hometown: Lincoln, NE
  • Undergrad: University of Nebraska – Lincoln

Mary Risch

  • Hometown: Baton Rouge, LA
  • Undergrad: Nicholls State University

Erin Smith

  • Hometown: Union, WV
  • Undergrad: West Virginia University

Wendy Thompson

  • Hometown: Grand Junction, CO
  • Undergrad: University of Northern Colorado

2nd Year Interns – Class of 2013

Leah Gecheo (Doctoral Student)

  • Hometown: Kenya, Africa
  • Master’s: West Virginia University

Roanna Martin

  • Hometown: Mount Joy, PA
  • Undergrad: Messiah College

Kaitlin Mock

  • Hometown: Pittsburgh, PA
  • Undergrad: West Virginia University

Mary Rodavich

  • Hometown: Pittsburgh, PA
  • Undergrad: Pennsylvania State University

Emily Todhunter

  • Hometown: Grand Forks, ND
  • Undergrad: University of Nebraska – Lincoln

Day 3: August 8th, 2012

Today, we met the new Dean of the Davis College of Agriculture, Natural Resources and Design, Dr. Dan Robision, and the Division Chair, Dr. Matt Wilson. It was so interesting to hear from these two and learn about their backgrounds. They also took time to explain this history of West Virginia University and it’s title as a “land-grant university.”

Dr. Dan Robison (left-side), The Dean of Davis College & Dr. Matt Wilson (right-side), The Chair of the ANS Division Presenting at Boot Camp for the GDI Interns

So, what exactly is a land grant university?

In 1862 (the same year as the Emancipation Proclamation and the Homestead Act) the government, with the help of Abraham Lincoln signed the Morrill Act into law. The Morrill Act supplied each state thousands of acres of land that could either be used to house the university or to make money in order to build an institution elsewhere in the state. The following year, in 1863, West Virginia officially became a state and by 1876 they had officially opened their own land grant university – Agricultural College of West Virginia, know known as West Virginia University. Today, there are over one hundred land-grant schools and they are located in every single state and US Territory!

This decision was based on the need for accessibility to higher education for the working class. There was an increased demand for practical education regarding agricultural, mechanics, and military tactics to supplement the sophisticated universities that existed for the affluent populations. The working class needed access to more education in order to develop the land and infrastructure necessary to maximize the use of our nation. The Morrill Act can be considered, in some ways, one of the most transformative events that arose from the Industrial Revolution.

As a land-grant university, institutions are required to have a mission statement that involves education, research, and extension (community outreach). Most land-grant universities began as “agricultural institutions,” which is true for WVU, and in fact Davis College of Agriculture is the oldest college at WVU. It is very cool to say, that “I am apart of Davis College” knowing that it has been around for over 136 years – now that’s a lot of history! 2012 also happens to mark the 150th anniversary of the Morrill Act. West Virginia University began with only six students and is now home to approximately 35,000 students, 14 colleges, and over 193 different degree programs.

Woodburn Hall was originally build in 1874 – this is how it looked it 1890.

WVU Downtown Campus as it Looks Today

Sources:

http://wvuhistory.wvu.edu 

After hearing from the Dean and the Division Chair we were lucky enough to hear from Roanna Martin (a second year intern) regarding the topic of local foods, food systems, farmers markets, and various programs including, Grow Your Own, Farm2Table, and Know Your Famer Know Your Food. Roanna Martin has an extensive background in farming because her family has been farming same land for over 15 generations! Take a look at her blog here!

One interesting thing I learned about was pepperoni rolls. Since moving to West Virginia I had seen signs and outside stands for pepperoni rolls all over and repeatedly been told to try one. Well, I finally got the chance and the best part was that they were even homemade – and they were fantastic! One of the best things about moving and traveling around is seeing all the wonderful regional foods that are out there! Click on the picture for a link to a healthier pepperoni roll recipe!

The Classic West Virginia Pepperoni Roll

Day 4: August 9th, 2012

Today was we heard from Emily Todhunter and Dr. Liz Quintana regarding diabetes, cardiovascular disease and the Ornish program.

Day 5: August 10th, 2012

Today was a fairly easy day that was spent on finalizing our schedules, working through classes, and creating and assembling the bulletin boards according to the topics that we chose. Emily Todhunter and I decided to create a board that showcased the interns and bootcamp. We chose to do a map tracing the interns from their hometown to WVU in Morgantown, WV.

Bulletin Board Created By Emily Todhunter and Wendy Thompson

The end of the day was spent relaxing at Cheat Lake with the other first and second year interns, Dr. Olfert, her husband and their daughter. We enjoyed swimming, tubing, and of course, snack time! It was great to be able to see other areas of Morgantown and all the outdoor activities it has to offer.

Cheat Lake

Week 2: August 13th – August 17th

Throughout the week we attended the Graduate Teaching Assistantship Orientation for all GTA’s at WVU as well as a Graduate Student Orientation for all graduate students just within the Division of Animal and Nutritional Sciences. We also attended presentations on sports nutrition, childhood obesity, associations and meetings regarding nutrition, and learned how to use the library resources through WVU.

Additional Pictures From Boot Camp

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My Experience Coming to West Virginia from Colorado.

Having lived in the state of Colorado for almost all of my life (with the exception of the first three years that I spent in the neighboring state of Utah) I was ready to see new scenery. A friend of mine once said, “I think you’re foolish if you spend your whole life in one place…the world is gigantic – it’s a waste of time if you don’t try to see it.” I couldn’t agree more! Colorado is a wonderful place – and could possible the best state, in my opinion, but how will I ever know where I want to end up if I haven’t seen other places.

West Virginia and Colorado are very, very different! While Colorado is constantly being ranked the state with the lowest prevalence of obesity, diabetes, heart disease, etc. West Virginia is continually ranked as having one of the highest. Notably Colorado and West Virginia are both known for their mountainous scenery, but I have to admit, when I first arrived in West Virginia I found myself asking, “so… where are the mountains?” not realizing that the ‘hills’ I was surrounded by were indeed the Appalachian Mountains. Colorado is very flat, with the exception of the MASSIVE MOUNTAINS, which separate the Eastern and Western parts of the states. West Virginia is much different. Here, you are constantly going up and down these huge hills. The tree density in Morgantown is completely incomparable to that in Colorado, it is so green here! Climate is another huge difference! Just in the two months that I have been in Morgantown I feel like I have seen more rain than I saw throughout my entire undergrad experience in Colorado. The lightening and thunderstorms here are intense, to say the least. It was a shocker to me to not see irrigation and sprinklers systems in anyone’s yard. In Colorado it is hard enough to keep your lawn green with sprinkler systems because of water regulations, and here it is completely cared for by the rain. Another huge difference is the culture, which I learn more about each and every day. The final eye-opening experience that I have had since moving here would be the size of West Virginia University and the pride seen with the students, faculty, and just about every single West Virginia resident. I came from the University of Northern Colorado, a smaller Division 1 school comprised of about 12,000 students total. It lacked school spirit and good athletic programs (with the exception of boys basketball, who made it to the NCAA tournament in 2011). I absolutely loved my school and wouldn’t change anything about my time spent at UNC, but it is nice to be a part of a big school with tons of spirit and good sports teams. Figuring out parking and maneuvering my way through traffic has proven to be a struggle in itself!

Now, for the actual move across the states! From our starting point in Greeley, Colorado to Morgantown, West Virginia we covered nearly 1,500 miles and crossed through 8 different states! My boyfriend and I packed up our belongings into my car, his small truck (Toyota Tacoma), and a 5 X 8 foot U-haul trailer that we rented. Both of our moms met us in Greeley to join us on the trek across the country and as a final send-off. We ended up driving about 15 hours each day and made it here in two very long days. The first night we stayed in Iowa City, Iowa and the second night we stayed at the Hampton Inn in Morgantown. We made it a point to stop in South Bend, Indiana to tour the beautiful campus of Notre Dame! After countless stops at gas stations, fast food restaurants, and sleeping in hotel beds we finally arrived. We had our apartment lease signed prior to making the move, so the next day was our official move-in day. Although the drive wasn’t miserable I can honestly say I will not be driving home for holidays or breaks. Flying will be my premier travel source!

We have now been in Morgantown for a little over two months and have really enjoyed exploring a new city and state that is so different that what we are used to! I am looking forward to continuing my journey as a graduate dietetic intern at West Virginia University.

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