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Efficient and highly educated Registered Dietitians who focus on continuous quality improvement and program development.

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An invaluable resource of nutrition consultants that follow the trends in healthcare and changes in regulatory requirements.

Claxton Dietetic Solutions Articles

Micronutrient Deficiencies in the Elderly
“Macros” has become an almost commonplace phrase in the health and wellness community lately.  Anyone on a weight loss journey who has visited you as a Registered Dietitian, has probably asked you to assess his or her macro intake. Although “macros” or macronutrients have a large impact on energy availability, muscle structure and lipid levels; micronutrients play an equally important role in sustaining human life. More often than not though, it’s the micronutrients that are ignored and forgotten about. A population of individuals that is particularly at risk of micronutrient deficiencies is the elderly.  Some of the leading causes of micronutrient deficiencies include 1) age related physiological changes such as forgetfulness, and loss of appetite, resulting in poor dietary intake, 2) financial factors that limit food purchasing and 3) medications that decrease the body’s ability to absorb nutrients. Common micronutrient deficiencies you will see in this population include calcium, vitamin D, magnesium, vitamin C, vitamin E, and vitamin B6. These micronutrients play a powerful role in the human body. Calcium is needed for strong bone density. Low calcium levels can lead to osteoporosis and subsequent bone fractures from lowered mobility and falling. Vitamin D is calcium’s best friend and helps calcium to be absorbed. Magnesium is the jack of all trades mineral that plays a part in blood pressure regulation, muscle contraction, making DNA and participating in hundreds of cellular reactions. Deficiency in this mineral can manifest as fatigue, muscle weakness/twitching and even depression. Vitamin C helps with the absorption of proteins, increases immunity and is an antioxidant helping to prevent cellular damage. Deficiency in this micronutrient can lead to delayed wound healing. Vitamin E is also an antioxidant that supports immune function. Vitamin B6 is largely involved in promoting adequate cognitive function, but also play a part in protein absorption like our friends, Vitamin C and E. Where are good sources of these micronutrients? Well, I’m glad you asked!Calcium: dairy products, dark leafy greensVitamin D: absorbed by the body through sunlight but can also be found fortified foods like orange juice or milkMagnesium: dark leafy greens, nuts, seeds, whole grainsVitamin C: citrus fruits, bell peppers, tomatoesVitamin E: nuts, seeds, vegetable oilsVitamin B6: organ meats, fish, starchy vegetables (like potatoes)If you are an RD working in a LTC facility, make sure your menus contain a variety of these foods to ensure adequate nutrition for this age group. Community RDs can focus on education, or better yet, host a grocery store tour for this age group and show them where to find these foods! There are many ways to get the word out there and help our fellow neighbors. Check out the most recent recipe page for an example of a calcium rich meal/snack!
Farmer's Market Finds
Summertime has arrived! School’s out, temperatures are hot and…the farmer’s market is open! The perfect Saturday morning outing comes equipped with local vendors, fresh produce and maybe even fresh coffee. It’s no secret that eating seasonally is beneficial not only for your health but for your finances as well. Somehow though, the summer farmer’s market brings this year round truth back into focus.  The main health benefit of buying seasonal produce is that you get exposure to a wide variety of fruits and vegetables therefore increasing your intake of vitamins and minerals. Financially, seasonal produce is cheaper. And who doesn’t want that? Let’s look at what foods are popular in which season and then discuss how we can implement this into our dietetics practice! Spring - artichokes, asparagus, chives, fava beans, green onions, leeks, lettuce, parsnips, peas, radishes, rhubarb, Swiss chard Summer- berries, corn, cucumbers, eggplant, figs, grapes, green beans, melons, peppers, stone fruit (apricots, cherries, nectarines, peaches, plums), summer squash, tomatoes, zucchin Fall- apples, Brussels sprouts, dates, hard squash (acorn, butternut, spaghetti), pears, pumpkin, sweet potatoes Winter- bok choy, broccoli, cauliflower, celery, citrus fruit (clementines, grapefruit, lemons, limes, oranges, tangerines), collard greens, endive, leafy greens (collard, kale, mustard, spinach), root vegetables (beets, turnips) Now, how can we as dietitians put this knowledge into practice in new and interesting ways? Here are a few ideas I have.  ·     Community Education- Ask your local Parks and Recreation Department if you can set up a table or booth at your local farmer’s market advocating for seasonal eating. This would be a great way to get good face to face contact with your community and give them an immediate opportunity to put their newfound knowledge into practice.·     Clinical Education- Highlight seasonal eating through a “Recipe of the Week.” This would involve getting preauthorization from your FSM and/or CDM but would be a great way to educate both staff and patients on what is in season.·     Home Education- If you are an RD and a parent, exploring seasonal eating is a great way for you to boost your child’s exposure to fruits and vegetables. Allow them to get involved and pick a particular fruit or vegetable to try each week. Find a kid free recipe and let them help prepare it to get them even more involved!I hope this week’s blog post has been helpful! Get out in the community and shop your local market this weekend. And check out the recipe page for a great summertime recipe!
Slow and Steady Wins the Race
I have a vivid childhood memory of reading an old copy of Aesop’s fables at my grandmother’s house when I was a little girl and one of my favorite fables to read was “The Tortoise and the Hare.” The well-known fable tells of rabbit and tortoise that set out on a race to prove who is faster. The hare quickly leaves the tortoise behind and, confident of winning, takes a nap halfway through the race. When the Hare awakes though, he finds that the Tortoise, crawling slowly but steadily, has beaten him to the finish line.This story is a lot like ones we hear daily from clients, neighbors, family members, coworkers…really anyone who has set out on a weight loss journey. People nowadays are intrigued by fast results, making extreme lifestyle changes like cutting out entire food groups and restricting intake beyond necessity all in the name of better health and weight loss.  As dietitians we are taught to help our clients make “SMART” goals = Small, measureable, attainable, realistic and time oriented goals. This concept is on the complete opposite end of the dieting spectrum. Telling a hare to embrace the attitudes and pace of a tortoise is no easy task, but I believe we are up to the challenge and our clients will thank us in the end.  Here are some examples of SMART goals:  S: Small: Address making healthier choices at one meal (either breakfast, lunch or dinner) instead of addressing all meals at one time M: Measurable: If a client is wanting to decrease their fruit juice intake, help him/her to specify the amount of juice. “Decrease juice intake” becomes “drink 4 oz of juice at breakfast.” Then make sure the client has the necessary equipment to measure this out.  A: Attainable: Set goals that are actually achievable. 1-2 lbs of weight loss per week is something that can actually be done. Setting out to lose 5-10 lbs is, scientifically, not attainable. You as the counselor will need to help the client understand what is attainable and what is not based on particular time frames. R: Realistic: Again, this will involve you helping and counseling your client to understand that the goal of better health, weight loss, etc. are lifelong goals. Changes need to be realistic in their everyday lives.  For example, it would not be realistic for a client who loves grains to cut out all grains to lower carbohydrate intake. Portion control would be a better option for this client. T: Time Oriented: This aspect helps specify goals even further giving them an endpoint. “Lose up 1-2 lbs of weight in 1 week,” “Drink 4 oz of juice with breakfast for 1 week” and “increase physical activity to 30 minutes of cardio 3 times a week” are examples of time oriented goals.  SMART goals not only help your clients achieve what they have set out to accomplish, but they also help you serve your client better. So lets preach it loud and clear-- Slow and steady wins the race!