Monday, March 24, 2008

Cows Grazing in the Rumpus Room

Click on the post title to read a GREAT opinion piece in yesterday's New York Times about gardens-not lawns, urban agriculture, Victory gardens, Edible Estates, community gardens, etc, etc, etc. This article give an overview of the need for and the benefits from growing some of our own food, no matter if you live on an acre or only have a window while living in a college dormitory. You can grow something to eat that will be beautiful and delicious.

I didn't take the time to read through all the comments (129 at last count), but here is one that caught my eye and heart. I haven't seen the movie The Future of Food yet, but it is on my list of things to do. However, it is the last sentence that brought a leap to my heart and a tear to my eye.
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please see the film The Future of Food
www.futureoffood.com
It’s the most powerful film I’ve seen on this subject.
Remember, don’t go through life, Grow through life!
— Posted by josh
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As a cancer survivor for a long long time, I realized one year that I love, and in fact need, having things to look forward to. Planning and planting gardens every year while looking forward to the harvesting, eating, and "putting up" fits that bill for me. The effort invested in bringing beauty and delicious tastes to my table clearly meets Josh's mantra to "grow through life"!

One of my favorite graces (I seem to have a lot of "favorites"!)

Be a gardener.
Dig a ditch,
toil and sweat,
and turn the earth upside down
and seek the deepness
and water the plants in time.
Continue this labor
and make sweet floods to run
and noble and abundant fruits to spring.
Take this food and drink
and carry it to God
as your true worship.

~~Prayer by Julian of Norwich

Grow through life and be a gardener this year! Please let me know what you are planning to plant!

Diana Dyer, MS, RD

Sunday, March 23, 2008

Finally, Singing Robins!

Saturday morning my husband and I went to our local seed exchange organized by Project Grow at The Leslie Science Center in Ann Arbor. Snow, snow, snow, all 7.5 inches of it, was everywhere, and so were robins! We saw dozens at The Leslie Science Center, hopping, flying, and fluttering from ground to shrubs to trees. It was a sight to see on the glorious sunny day. However, not one was singing. Not one! When were they going to announce to the world that winter was done (snow or no snow) and spring has truly begun?

Flash forward to this evening. As my husband and I stepped outside to say good-bye to my mother before she drove home after spending Easter day with us, we finally heard our first robin of the year just singing his heart out from the tippy top of the tree across the street. It was a lovely and beautiful way to end the day, knowing that spring was finally ready to surge forward.

Now that Ann Arbor has set a record for the most snow during the season (and for the month of March!), maybe the snow gods will pay attention to the second memo sent by my husband that says "We've had enough. No more snow! We're not going to take it anymore until November!

There is nothing more fun to watch than a robin splashing away with vigor in a birdbath. Although there will be plenty of puddles of melting snow everywhere for a while, I hope they find the birdbath in my backyard soon, all nicely cleaned and heated for them (so much more inviting than a puddle of melted snow - at least to my way of thinking!)

Ending with a very apropo blessing:

Thank you for the flowers so sweet,
Thank you for the food we eat,
Thank you for the birds that sing,
Thank you, Earth, for everything.
~~Author unknown

Diana Dyer, MS, RD

Saturday, March 22, 2008

Best-laid Plans - Our Spring ?? Chicken Celebration

We ate our oven-roasted whole pastured chicken raised on Polyface Farms in Virginia with only 3 of our guests as one family could not come due to last minute flu and another family started the drive across town but could not get out of their own neighborhood because of the poorly timed snow and hazardous roads. Here is the chicken coming out of the oven after 20 minutes to do "the flip".


The second photo is the final dish, all cooked, browned nicely, juices running clear, with tender veggies all ready to eat. Needless to say, our friends who could not make it were incredibly sad to miss out on this special treat. I know these photos will not do it justice for either the taste or smell, but this chicken was scrumptious and the company was delightful.

We also had a beautiful salad made with locally grown greens from Brines Farm, whole grain bread with both caponeta (made last fall with locally grown organic vegetables, frozen, and then thawed) and a bean spread made from some beans I grew and dried last summer (North Carolina white pole beans - very prolific!) plus some fresh herbs growing in my window garden and plenty of garlic from my husband's garlic patch. We also served homemade applesauce, both plain using some Lura Red apples we purchased at a farm stand in Minnesota on our way home from a wedding in September and a special concoction my husband made called "Fire in the Belly" applesauce that combined some locally grown organic Grimes apples with jalapeno peppers and chili powder ("spicy" says our 2-year-old guest Grace - she was right about that!)

For dessert, I made a cobbler from rhubarb, apples, and blueberries, all put up and frozen from last summer or fall. Oh, yum, yum, yum, with a little vanilla ice cream on top of hot cobbler fresh from the oven, oh I repeat, yum, yum, yum, and yum! I am going to have to put what we did not eat under lock and key to make sure there is enough to serve for dessert tomorrow on Easter Sunday. No one left the table hungry! (Recipes for the bean spread and fruit cobbler will follow in a separate posting. I'll ask my husband if he is willing to share his "Fire-in-the-belly" applesauce!)

Some final (hopefully) photos of spring snow in the upper Midwest and one last (hopefully) enjoyable romp in the snow until next winter for our dog Kaya. However, admittedly I prefer her tracking snow into the house versus mud!

A blessing for our food:
Bless this food we are about to receive.
Give bread to those who hunger,
And hunger for justice to us who have bread.
Amen.
~~Traditional American Grace


Diana Dyer, MS, RD

Friday, March 21, 2008

Someone's thinking!

I just love how clever people can be with words! While searching the internet to find a recipe for roasting a whole chicken with cut up vegetables (just to make sure of the timing so those veggies will be done, since this dinner is for company, not just family), I found a web site with a newsletter called the ComPost. What a GREAT name - I do wish I had thought of that, and I am most surprised that my husband had not found that great play on words.

We're starting to cook the "pasture-raised" whole chicken that we bought in Virginia from Polyface Farms. My husband (our chicken cooker) has already said that it is evident the chicken was butchered manually, not mechanically, with a flap left to retain the legs. He is excited!!

This is our "spring chick" celebration to welcome Spring to Michigan.

Yes, it is snowing! Hopefully this is the last gasp for what has been a very long and cold winter in the upper Midwest during 2007-2008.

More to follow. :-)

Diana Dyer, MS, RD

Thursday, March 20, 2008

Another Spring Ritual - March Madness Begins - Go Badgers!

From the center of Wolverine country, I have proudly flown either our "Bucky Badger" flag or our "Action W" flag for 20 years. Without the University of Michigan being at the dance (again), I would have been happy to cheer for Michigan State. However, it's no contest this year as I'll be cheering for my alma mater The University of Wisconsin-Madison all the way, even if they end up playing Michigan State University or Purdue (another alma mater for both me and my husband) in the finals.

Just to show you I am not kidding, here is one of my favorite "photo ops", in fact, I use this photo of me with Bucky Badger (taken at the UW-Michigan State football game in 2004) as my screensaver.

May there be plenty of excitement and may your team do well unless they play Wisconsin. :-) Enjoy a great tasting locally produced beer or two during the game(s). My favorite is the Old Number 22 German Alt from Arbor Brewing Co. in Ann Arbor, a great pub and eatery in Ann Arbor, MI that is beginning to change its menu to incorporate as many locally sourced foods as possible! I already loved their beer, they already had more choices than most brewpubs for my style of eating, but I look forward to enjoying the upcoming shift as they provide new menus items from food grown as locally as possible. What fun that will be! If they can do it, so can others.

Celebrate Spring! (even if more snow is forecast for my area of Michigan on Friday and Saturday - arghhh!)

Diana Dyer, MS, RD

Wednesday, March 19, 2008

Pediatric cancer survivors need long-term follow-up

I thought about making the title of this posting be something like the positive statement "My oncologist 'signs off'..." or the, hmmm, less than positive statement "the problems of success" (one of my husband's favorite phrases).

It's been ~13 years since my annual mammogram in 1995 showed highly suspicious areas not seen the year before. I was overbooked into the breast care clinic at the University of Michigan a few days later for a biopsy and subsequent evaluation where the consensus was that I was starting another hard year.

Fast forward 13 years. Yesterday, during my now once-a-year visit to my oncologist, which has been a mostly "social and/or advocacy visit" during the past several years, he and I discussed appropriate follow-up care from this point forward. He congratulated me on my success :-), and we talked about how my medical care could be handled most appropriately by my primary care physician and other health care professionals on my team of docs.

It was a special day, and I tried to focus on the success. However, I was very aware of the need for my extensive "team of docs" because my oncologist strongly recommended that I contact my cardiologist immediately to discuss the dosing of one of my medications.

I won't go into "boring details" but suffice it to say that I am at the leading edge of full understanding how childhood cancer therapies impact long-term health and functioning. I do have cardiac problems related to the radiation used to treatment my childhood cancer, which are likely compounded by the two rounds of chemotherapy I have received also.

The link to the title of this posting will take you to an article written in the recent NCI Cancer Bulletin describing the importance of full follow-up care of pediatric and adolescent cancer survivors, not just immediately for important educational, employment, and/or other social concerns, but long-term, meaning very long-term, for the appearance of medical concerns that may take decades to show up. Data being gathered on long-term childhood cancer survivors have shown that ~70% of survivors have at least one chronic health condition related to their cancer treatments such as premature heart disease, with women having higher risk than men, particularly for breast cancer (like me, twice).

Actions:
(1) If your child is currently receiving cancer therapy, ask how long-term follow-up will be provided. Ask for copies of the clinical guidelines available for appropriate monitoring and/or screening depending on the type of cancer and the type(s) of treatments.
(2) If you are an adult survivor of a childhood/adolescent cancer, I urge you to make sure you have a primary care physician that you see for annual physicals and discussions of your health concerns with whom who feel comfortable and confident having in-depth discussions about your health. Gather as much information as you can about your cancer history to share with your PCP.

I highly recommend reading the book Childhood Cancer Survivors: A Practical Guide to Your Future (Childhood Cancer Guides), 2006, by Nancy Keene, Wendy Hobbie, and Kathy Ruccione as an excellent source to start gathering an understanding of your medical needs with up-to-date and accurate information to help guide your doctors with appropriate follow-up care. You may get lucky and find a PCP who has a special interest in following cancer patients long-term and thus may already be aware of some of their unique health concerns, but chances are you will need to become your own advocate and help educate your PCP about appropriate follow-up. Keene's highly regarded book will help you do this.

*****************
Our snow is almost gone yet I still have not heard any robins singing in my neighborhood. However, I do hear them "chirping" and "chortling" constantly, so I know they are here. Friends and I are going to welcome spring with a celebration on Friday night that will feature some "spring chicks". I'll take lots of photos and let you know how we celebrated, even if the robins are not yet singing!

Welcoming spring with good wishes to all for another year of good health, healing, and hope!

Diana Dyer, MS, RD

Monday, March 17, 2008

Eat your berries

I was recently asked my opinion about the use of a product currently being promoted via multi-level marketing to cancer patients called Mona Vie, a juice with a proprietary blend of several varieties of berries, including the acai berry. Interestingly, the question came from a cancer center administrator whose husband is selling the product. Here is my response to her.

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Thank you for visiting my web site and your thoughtful comments about my presentation and book.

My web site's Contact page does kindly request that people not send me inquiries related to products such as you have described. However, I appreciate the position you are in as a cancer center administrator and your professionalism. I am highly supportive of your caution about promoting this product and have decided to share my thoughts with you. For full disclosure, as I believe my thoughts may be of interest to a wider readership, I will also post this Q&A on my blog, most assuredly without identifying you or your cancer center in any way .

I truly understand the power of hope, and although I feel like I may be treading on eggshells with the tone of my response, I do not recommend that people "put their hope" into the product for which you have sought my opinion. It is certainly fine to drink this product occasionally as one part of an overall healthy diet. I checked PubMed today and saw there is still next to nothing published in peer-reviewed journals that shows the product your husband is selling (or acai fruit, juice, or extract) has anti-cancer activity that would make it truly unique for a cancer patient to consume to optimize cancer fighting/prevention compared to the consumption of the thousands of cancer-fighting phytochemicals that are present in berries commonly grown in this country and a plant-based diet containing a wide variety of other plant foods that are both readily available and also considerably more affordable.

Changing the way one eats each and every day is more difficult than adding any type of dietary supplement and/or functional food to a typical diet that is high in fat, sweets, meat-based, plus low in fruits, vegetables, whole grains, legumes/beans, nuts/seeds, and foods rich with omega-3 fatty acids. However, a plant-based diet such I eat and promote offers far more cancer-fighting molecules on a daily basis than can ever be contained in one product with its proprietary formula. In addition, a plant-based diet such as I consume and promote has extensive and solid research behind it to show decreased risk of heart disease, diabetes, and hypertension, too, all of which can contribute to a poor quality of life and premature death for cancer patients. I have recommended to my own family members that they put their money into purchasing more foods of higher quality versus single products such as the one your husband sells.

Here are some other thoughts from people whose opinions I respect, who do thorough research, promote "cutting edge" science-based information regarding nutrition to help fight a cancer diagnosis, and also provide extensive information on their web sites to help people with a cancer diagnosis separate information that offers hope from hype or from potential harm:
http://www.cancerdecisions.com/012906_page.html
http://www.cancerdecisions.com/020506_page.html
http://www.caring4cancer.com/go/community/forums/t/6976.aspx

In addition, here is a web site from a "competitor" of this product. I do not vouch for the accuracy of anything on this web site, but I do find the information it contains "curious", and this web site sends up many red flags in my brain about both products. http://www.powersupplements.com/acai/monavie-compare.html

I am sorry if my response seems blunt and/or if this is not the answer for which you were hoping. It is the very same answer I would have given if asked about this product in a Q&A session after a presentation. In fact, at one presentation a few years ago, I did recommend that cancer patients NOT get their nutritional advice from the "18 year old" working the supplement aisle in a health food store nor from anyone selling a product for which they received financial gain from its sale. To my great surprise the audience of hundreds of cancer patients burst into spontaneous applause and jumped to their feet to give me a standing ovation in the middle of my talk.

In contrast, I always recommend that cancer patients seek out the professional expertise of a Registered Dietitian (RD) as a component of truly comprehensive and individualized cancer care, as early after diagnosis as possible and ideally at their own cancer treatment facility to optimize discussion and coordinated care among all of the patient's health care team members. As a cancer center administrator, I know you will be very interested to hear that RDs can now sit for a specialty certification in oncology nutrition, a rigorous written examination offered through the Commission on Dietetic Registration. Many RDs are currently taking the inaugural exam, the result of a long, thoughtful, and passionate process initiated by The Oncology Nutrition Dietetic Practice Group (ON DPG) of The American Dietetic Association (ADA). Here are the websites for the certification exam and also the practice group:
http://www.cdrnet.org/certifications/spec/oncology.htm
http://www.oncologynutrition.org/index.php

Thank you again for your kind comments. I send my best wishes to you and all the patients at your cancer treatment center.

Diana Dyer, MS, RD

Tuesday, March 11, 2008

Good questions that made me think!

I was recently contacted by a medical writer seeking information for an article about the importance of nutrition for breast cancer survivors. She asked me some very good questions for which I needed to think before I responded; I was not able to just fire off answers in a knee-jerk manner. She did tell me that the article would be short, so I expect most of my answers to her questions to end up "on the cutting room floor." Thus I want to share them with my blog readers. When her article is published, I will let you know on my blog, with a link to her full article, which I am sure will gather input from other good sources, too.

Here are her questions and my answers:

Can nutrition make a difference for breast cancer patients? Why?
Yes. The most recent data reported from the Women's Intervention Nutrition Study (WINS), which evaluated breast cancer recurrence in women who followed a low-fat (~20%) diet has shown an overall recurrence risk reduction of 24% with a 42% recurrence decrease in the subgroup of women who had ER-negative breast cancers after 5 years of follow-up. The overall reduction of 24% in all the women was not considered statistically significant at the 5-year point, however the 42% decrease in the ER- women is considered very significant statistically. Data are still being collected in this study with the goal of final evaluation at 8 years of follow-up. The group of women following the low-fat diet lost ~6# during the course of the study, an unintended and unexpected result, compared to the control group. An unanswered question at this point is whether the lower recurrence rates in the diet group are related to the lower fat content of the diet or the weight loss experienced by the women in the diet group. Stay tuned for further results still to come from the WINS trial.

The Women's Healthy Eating and Living (WHEL) study results were released in 2007 after 10 years of follow-up comparing breast cancer recurrence rates between a group of breast cancer survivors who ate a low-fat (15-20%), high fiber and vegetable intake diet to a control group of survivors who were only given general advice and support to consume a "healthy diet". Although results of this study were disappointing because no significant difference was observed in the recurrence rate between the two groups, there has been useful information for breast cancer survivors from this study.

Data from within the control group in the WHEL have shown that the combination of eating 5 or more daily servings of fruits and vegetables plus walking an average of 30 minutes/day on 6 days/week reduced the risk of breast cancer recurrence nearly 50%. The good news is these remarkable and hopeful data were true even in women who were obese. Everyone wants to know "how much is enough". Perhaps this study has shown that 5 daily servings of fruit and vegetables combined with brisk walking for 30 minutes daily for 6 days/week "is enough" to significantly (even dramatically) reduce the risk of breast cancer recurrence. Is there a pill or treatment that gives one such "bang for the buck", especially at such a low cost, without undesirable side effects, reduces risk of other chronic diseases such as heart disease and diabetes that also kill breast cancer survivors, and may enhance many aspects of quality of life? The important point though is that only the combination of eating 5 servings/day of fruits and vegetables combined with walking 6 days/week gave these desired results. These recommendations are easy to remember and easy to achieve!


What are the biggest nutritional concerns for breast cancer patients and why? (The article is fairly short, so if you want to list the top 4 that would be great.)
(1) Data continue to accumulate showing that weight gain after a breast cancer diagnosis increases the risk for breast cancer recurrence and death. As one example, data from the Nurses Health Study have documented a 35% increased risk of recurrence or death with a weight gain of 6# and a 64% increase in recurrence or death associated with a 17# gain. I believe all breast cancer patients should be made aware of the tendency to gain weight before breast cancer treatment begins, particularly chemotherapy, along with the elevated risk of recurrence and death from breast cancer associated with the weight gain.
Action - Seek out healthy eating and lifestyle guidance from a Registered Dietitian early after diagnosis for individualized information during and after treatments to minimize the risk of gaining weight or for slow, gradual weight loss.

(2) Along with the tendency to gain weight during treatment, studies are showing that there is a shift of weight with a loss of lean body mass and an increase in fat mass. Yikes! Who wants or needs that? No one wants or needs to lose lean body mass, which is critical to providing strength to participate in all our daily activities, exercise, fun activities, to prevent falling and breaking bones, and increases our caloric expenditure. In addition, very few women need or want to increase the fat content of their body for a whole variety of reasons, including the fact that adipose tissue (fat cells) produces a significant amount of estrogen in post-menopausal women, which can fuel those breast tumors that are ER+, potentially leading to increased risk of recurrence, metastasis, and death.
Action - participate in strength-building exercise(s) that maintain and/or increase your lean body mass and decrease body fat. Start during treatment, doing as much as possible, and then continue to build up your strength and muscle mass during recovery from treatment and as a part of a life-long healthy habit.

(3) Begin to eat a "plant-based diet" incorporating the thousands of cancer-fighting phytochemicals that are only just beginning to be identified and studied. A plant-based diet includes a wide variety of fruits and vegetables, whole grains, beans and legumes (along with small amounts of food that provide lean animal protein, if desired), nuts, seeds, and plant-based oils. An overall healthy diet of this type may reduce your risk of cancer returning and will also reduce your risk or improve the management of chronic diseases that breast cancer patients also have or are at risk for developing, particularly if overweight, such as heart disease, hypertension, and diabetes, all of which can cause decreased quality of life and death, even if you are fortunate enough to beat breast cancer.
Action: Find some helpful recipes and menus to show you how to make the switch from a meat-centered diet to a plant-centered diet. The American Institute for Cancer Research (AICR) has many recipes on their web site (www.aicr.org) and many helpful brochures to send for. My web site www.CancerRD.com also has many delicious, family-tested recipes that increase your intake of cancer-fighting plants.

(4) Incorporate more "healthy fats" into your diet, such as the (a) omega-3 fatty acids that come from the deep cold water fish salmon, tuna, trout, herring, sardines and some plants such as flaxseeds, walnuts, soybeans, and purslane (a common weed here in the US) and (b) monounsaturated fatty acids that are common in olives and olive oil, canola oil, many nuts and seeds, and avocados. These types of fats have overall health-promoting properties via many mechanisms in our body, but particularly by the molecules made from them that help to reduce inflammation in our body, the on-going process now thought to underlie many of our chronic diseases, including cancer, which is exacerbated by the overabundance of omega-6 fatty acids we consume that are used in our processed foods (vegetable oil, soybean oil, cottonseed oil, as examples).
Actions: Purchase canola oil or olive oil to use in food preparation at home. Reduce your intake of processed foods such as cookies, cakes, pies, donuts, crackers that are made with vegetable oils high in omega-6 fatty acids. Your neighbors (and family) may think you've gone "over the edge" a bit, but learn to identify purslane in your yard or garden and add the tender and tasty leaves to your spring and summer salads. I do!, plus my family eats this in their salads without complaints. :-)

What is your feeling about supplements for breast cancer patients?
Where to start? Where to end? :-) Here are a few thoughts focused on breast cancer patients recovering after treatment is completed:
(1) Avoid any dietary supplements or soy powders that contain isolated or added phytoestrogens, also called isoflavones or genistein, until more information is known regarding their safety for breast cancer patients with ER+ tumors. Some herbal supplements may also have estrogen-like activity and should be avoided or used with caution.

(2) Have a Registered Dietitian help assess if your diet is adequate in calcium, particularly if you avoid or limit dairy products, are post-menopausal already, or will become so from cancer treatment. Calcium supplements may be needed to optimize bone health (recommended intake of 1000 mg if pre-menopausal and 1200 mg if post-menopausal), especially since many women are pushed into premature menopause by breast cancer treatments and thus are at increased risk of developing osteoporosis at an earlier age than would have been expected.

(3) Suggest that your doctor measure your serum vitamin D levels. The vast majority of women already diagnosed with osteoporosis or those at risk of developing it will benefit from a vitamin D supplement. Vitamin D3 (cholecalciferol) is the form that is better absorbed and found in most multi-vitamins and calcium supplements. Although the range of adequate intake is officially set at 200-600 IU/day, with the larger level recommended for older age groups, the optimal intake is not known and may be higher than current recommendations for overall good health. A supplemental amount of 1,000-2,000 units/day of vitamin D3 is not unreasonable, is relatively inexpensive, and may be beneficial for preventing and treating osteoporosis and also reducing the risk of cancer recurrence, as just a few conditions. Stay tuned to this "hot" topic.

(4) If you do not include in your diet at least 2 servings/week of fish that are high in omega-3 fatty acids, consider consuming a dietary supplement of fish oil with the omega-3 fatty acids EPA and DHA. Again, optimal levels are not known, but a daily intake of 1-2 grams of EPA and DHA from a combination of fish and supplements is reasonable and may be beneficial for both heart health and reducing the risk of cancer recurrence.

(5) Always discuss all dietary supplements consumed with your physicians and health care team members.

(6) Consider requesting the professional expertise of a Registered Dietitian who can review your food intake and then make recommendations for foods and dietary supplements using the latest research results to develop an individualized plan that will meet your goals and needs.

So much more information is in my book and on my web site that it was actually challenging for me to pare it down to these important recommendations. I might learn something from others' perspective, too. I look forward to reading her article!

Diana Dyer, MS, RD

Monday, March 10, 2008

Family Tradition gets an update

Every year for the holidays, my husband and I enjoy going to our local Farmers' Market to purchase 2 big beautiful wreaths that we hang outside from our front windows. I love looking at them so much that we leave them up for some time after the holidays. I always felt a bit of sadness at taking them down and in a bit of a quandry about just when to do it anyway. At some point I remember reading that a Scottish tradition involved making sure all holiday decorations were finally put away by March 1, supposedly to ensure that winter's evil spirits were really put to rest. I'm not sure if that is a true tradition, but the idea of it gave me a target date to take down my wreaths.

Then a couple of years ago I heard a robin singing away from a tree in my yard during the middle of February. I decided that I would listen each year for the early singing robins and take down my wreaths on the day I heard the first robin sing or on March 1, whichever came first. That tradition has worked well for the past several years with many robins singing during February. Alas, this year, March 1 came and went without my hearing a single robin sing. I was so discouraged (winter has been so long this year!) that I just didn't remind my husband to take the wreaths down on March 1. In fact, as of today, I have seen plenty of robins in my neighborhood (even with all the continuous snow and ice), but not one has been singing yet.

However, late last week, I heard something else singing (calling is more like it) overhead, and my heart just leaped with joy, knowing that spring really is coming. Although I could not see them, I heard a flock of sandhill cranes flying overhead, calling to each other with their bugling, even croaking, type of call. That ancient sound is music to my ears and heart! Clicking on the link will take you to the web site for the International Crane Foundation in Baraboo, Wisconsin (one of my favorite places) and then scrolling down will take you to a link where you can hear their many types of calls. You may see also hear their calling while viewing videos of the sandhill cranes on the Platte River in the Rowe Audubon Sanctuary near Kearney, Nebraska, another of my favorite places.

My husband took this photo of sandhill cranes flying in at sunset to the Platte River last March. Traveling to that area of the country to view (and hear!) the northward migration of hundreds of thousands of cranes has been on my "life list" of things to do forever, but especially since my last cancer diagnosis.

Hearing the cranes reminded me of my favorite line from the book The Sand County Alamanac by Aldo Leopold in which he begins the chapter for the month of March with this line:

"One swallow does not make a summer, but one skein of geese, cleaving the murk of a March thaw, is the spring. "

I have loved this line from Aldo Leopold's classic book for at least 30 years, as I look forward to spring during our long winters in the upper Midwest. However, since even in Michigan we now have geese that stay in our area all year long, this line and image seems to have lost its luster for me over the years. So, I will very happily trade geese for cranes as I look to the skies to both see and hear the cranes finally migrating back to our area in March and have that joyful event be my target date for taking down our wreaths next year.

My other favorite image and line from this book comes after Aldo Leopold describes how the geese land in the marsh with their accompanying raucous honking and splashing.

"It is at this moment of each year that I wish I were a muskrat, eye-deep in the marsh."

I have often wanted to be that muskrat. Being completely surrounded by the cranes at sunset in the blind at the Rowe Audubon Sanctuary near Kearney, NE gave me the closest experience I expect I will ever get to being that muskrat, surrounded by cranes instead of geese, an experience of a lifetime!

Ending with a grace from the native people of Mexico that speaks of spring, gardens, and friends.

And now, O friends,
hear the dream of a word:
Each spring gives us life,
the golden ear of corn refreshes us,
the tender ear of corn becomes a necklace for us.
We know that the hearts of our friends are true.

~~ Nahuatl prayer (16th century)

Yes, each spring gives us life. Who could ask for anything more? :-)

Diana Dyer, MS, RD

Sunday, March 9, 2008

Celebrate National Dietitian's Day!








To all my friends, mentors, and teachers who are Registered Dietitians, I salute you! Thank you for guiding my career and enriching my life.

I first heard the word dietitian from a fellow grad student (Joann Simon, now Joann Simon Carson, PhD, RD) sitting next to me in my statistics class at The University of Wisconsin during the fall of 1973. It took me a few years to change tack from my original graduate school plans to fulfill the necessary undergraduate class requirements to be accepted by a dietetic internship, which I began in June, 1975. I finally completed my internship and MS in Nutritional Sciences from The University of Wisconsin-Madison in December, 1977, a month after the birth of my first son Eric. A few months later in April 1978 I took the national registration exam, and only within the past few weeks did I realize that I have now been a Registered Dietitian for 30 years!

I have loved every job I have had, every place I have worked, and all the professional volunteer opportunities I have had throughout the past 30 years. I consider myself fortunate to have enjoyed my work, my colleagues, and my patients. I hope that I have made a difference in patient care. I know that my guiding mantra has always been to "keep the care in health care".

I still enjoy my profession, and even though I consider myself "somewhat retired", there will always be more to learn, more to share, and more new friends to meet.

Diana Dyer, MS, RD

Friday, March 7, 2008

In Defense of Food - and Dietitians!

Ellen Goodman of the Boston Globe has been my favorite newspaper columnist since I first read one of her columns during the late 70's.

However, Ellen's favored spot is fast being taken over by Melinda Hemmelgarn who writes a weekly column called Food Sleuth for the Columbia, MO newspaper, The Columbia Tribune. Food Sleuth is filled with information that helps a reader understand the connections between our farmers, food, good eating, health, environment, social justice, economics, and politics. This is no small task that Melinda has undertaken! Not yet nationally syndicated and carried by my local newspaper, I sleuth out (ha ha) her column myself every week by going to the web site for the Columbia Tribune and simply doing a search using the term "food sleuth".

This week, in honor of the first National Registered Dietitian Day to be celebrated on Monday March 10, Melinda wrote a column that sings high praise for Registered Dietitians who have long been advocates of food, real food, for both enjoyment and good health. I urge you all to read it (click on the title of this post to go right to the full article) and then ask your local newspaper to include Food Sleuth on a regular basis. In my opinion, it belongs front and center on both the editorial page and the food and recipe section.

Melinda recently gave the keynote address at the 19th Annual Organic Farmers Conference in LaCrosse, Wisconsin. Her memorable "sound bite" from that speech rang true with me, and I hope it will with you, too. Here it is:

“We should all be growing some of our food, we should be cooking most of it and we should know all of it,” she said. “I tell my husband that growing food together is second only to having children together.”

Speaking of growing one's own food, here is a scene of the gardens at Thomas Jefferson's home Monticello during their winter resting period, in the beautiful mountains near Charlottesville, VA, where I visited last month. Jefferson's garden was 1000 feet in length, and he grew over 300 varieties of vegetables there. Monticello is where I first purchased the seeds for Early Curled Siberian Kale in the spring of 2006. The sweetness and tenderness of this variety of kale changed my view of how kale can taste and frankly, has made me a true, even devoted, kale fan. In fact, like Thomas Jefferson, I enjoy eating my vegetables enough to concur with his famous quotation: “[I eat meat] “as a condiment to the vegetables which constitute my principal diet.” I think my husband is envious of both this beautiful spot and space for a vegetable garden but wisely confessed that he would need a lot of help (more than me!) to manage one this large. :-)

In celebration of Registered Dietitians and the connections they help us find between food and all that is good in universe, I'll end with one of my favorite blessings:

May the food we are eating make us aware of
the interconnections between the universe
and us, the earth and us, and all other living
species and us. Because each bite contains
in itself the life of the sun and the earth,
may we see the meaning and value of life
from these precious morsels of food.

~~ Adapted from Thich Nhat Hanh
(Vietnamese Zen Buddhist monk, born in 1926)

Diana Dyer, MS, RD

Thursday, March 6, 2008

Keep this book in your purse or backpack!

I recently read an updated edition of a very popular book entitled Eat Out, Eat Right by Hope Warshaw a registered dietitian, diabetes educator and professionally trained chef. It's a VERY helpful book for those who are eating away from home several times each week (and aren't most of us in that category now?)

Here is a copy of the review I just posted on Amazon.com:
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This book is filled with information that will help you navigate menus and food preparation techniques when you are eating away from home while achieving both great health and great tasting food. Those two goals are not mutually exclusive, and Hope gives you the keys to achieving both outcomes.

I found the specific requests and questions she lists in order to help you pleasantly and assertively communicate your food desires to the servers to be especially helpful. No one wants "to make a scene" while ordering food, so Hope's background as a registered dietitian and educator plus being a professionally trained chef gives one confidence that her recommendations are easy for you to say, easy for the waiter to understand, and easy for the kitchen to execute.

The book's small size is a plus for keeping this wealth of information handy in your purse or book bag. However, the small size does mean that those of us over age 40 will need to have our reading glasses handy, too.
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Here's to great taste and great health!
Diana Dyer, MS, RD