Tuesday, March 31, 2009

What's New?

(1) Have you checked out my kale blog www.365DaysofKale.com yet? You'll find a combination of great recipes using kale or its "cousins", the many other Brassica vegetables, along with recent research and "What's in Kale?", all written to inspire you to include these healthy and delicious vegetables in your diet as often as possible (even daily!). In addition, I just posted the link to the radio show 101 Foods to Save Your Life where my friend Maggie Green, RD and I were interviewed about our passion for kale.

(2) I have also just started another blog called www.CancerVictoryGardens.blogspot.com, and made my initial post. What exactly is a Cancer Victory Garden? It is my personal fruit and vegetable gardens that I will fill with organically grown food to both nourish my body (and help keep me cancer-free) and also nourish my soul as I enjoy the connection with the circle of life by having my hands in the soil and my face in the sun and rain.

Do you have a Cancer Victory Garden?
As either a cancer patient or caregiver, have you planted one for yourself (even if you didn't call it that)? Is your cancer center growing food? Would you like to share your experiences? If so, I would love to post some photos and a short story of why you enjoy your "Cancer Victory Garden". Feel free to send me an email at cancervictorygarden (at) gmail (dot) com. Please put "Cancer Victory Gardens" in the subject line.

(3) Please feel free to print off the "Good Food Checklists" for which I have posted links on the left side of my blog. Earth Day is coming up this month, and one way to celebrate is to make a commitment to doing one more thing to help the earth by eating healthy food that nourishes and replenishes our earth's natural resources, particularly our food-growing soil.

(4) Those of you who take the time to "read the fine print" may have noticed that I added information about ordering my book directly from Nicola's Books in Ann Arbor. While any book store can order my book, and it is also available from AICR and Amazon.com, ordering from Nicola's helps to keep a locally-owned and independent bookstore thriving (instead of struggling or closing like so many have done throughout the country). In addition, I still donate proceeds from those books sold through Nicola's to nutrition and cancer survival research funded by AICR.

The added bonus for ordering from Nicola's is receiving a personally autographed copy of my book. You may request a simple signature or a personal inscription, using your own words of hope and support for a dear friend or relative. Just order the book from her web site or call the store at 734-662-0600. Nicola's friendly staff will take your order plus your message and call me to stop in to personally sign the book for you. Then the book is quickly shipped off to you or directly to the gift recipient. I know Nicola has mailed my autographed books to Australia, England, and Canada besides many of our 50 states. Doing so is a win-win-win (maybe more) relationship!

Spring is all about newness, but I think I will do short a "What's new?" update each season.

Diana Dyer, MS, RD

Monday, March 30, 2009

Early spring photos in Michigan

A rhubarb stalk just peeking through - I think you can see the leaf.

Chives - I cut some to add to some soup for lunch.

One primrose blooming. None of the others are so brave yet. I wish I had thought to dash outside this morning to take its picture in the snow.

My favorite photo this time. It was a misty,moisty day and those big rain drops hanging on my dogwood reminded me of Seattle, where our younger son now lives. Plus I could finally see our goldfinches starting to turn gold to show off their spring finery!

Our new garden beds, built for the back deck, the only place in our backyard that we get enough sunlight for vegetables. It's still snowing a little in Michigan, but not too much and it won't last long.

Strawberry seeds planted and ready to put under the grow lights - 2 seeds to a pot - these were a "bear" to plant because the seeds are so small - see following photo.

See how small these seeds are? They are really just like the seeds on the outside of a strawberry!

Even more of a close-up to show you how small they are - Jefferson seeds from Monticello compared to a Jefferson nickle.

(Watercress seeds planted, ready to water generously, then when sprouted will go into an upper pool of our little pond.

Kaya with her toy squirrel that she takes everywhere. She has already dismantled it to find the "squeaky" but has kindly left the head on so I am not grossed out!

What little things are you seeing as signs of spring in your neck of the woods?

Diana Dyer, MS, RD

Monday, March 23, 2009

Taking Back Our Food

In a previous post I wrote on February 11, 2009 entitled "Quote: Beware of what you eat, you are on your own", I ended with a call for people to "take back our food". An article published March 21, 2009 in the New York Times entitled "Is a Food Revolution Now in Season?" elaborates and updates what I posted last month, as has a recent opinion piece entitled "Where Obesity Grows: Corn as a Health Issue" written George Will in the Washington Post on March 8, 2009.

I urge you to read those two articles and my previous post (links provided above) if you have not already done so to get another sense of what the "food revolution" is about and why change in what we eat plus how we grow and distribute our food is urgent and will bring benefits to our personal healthfulness, our local communities, and our entire planet.

I am inspired by one of my colleagues, Angie Tagtow, MS, RD, LD a Registered Dietitian and past Food and Society Fellow from Iowa, who says "healthy soil grows healthy food and healthy food nourishes healthy people who create healthy communities." Angie also reminds us of the words of previous leaders and visionaries who understood the vital connection between the health of our soil and our own healthfulness.

“A nation that destroys it’s soil, destroys itself.”
~~Franklin Delano Roosevelt

“Proper soil fertility which builds appropriate levels of humus in the soil is the basis of the public health system of the future.”
~~Sir Albert Howard, The Soil and Health, 1947

Yes, the time is now. We cannot wait, nor can our children or their children, to "take back our food". One place to start is in your own back, side or front yard (or a roof, windowsill, balcony, or community garden) by putting your own hands in the soil and planting some seeds, like I did yesterday, to grow some of your own food. Yes, this is a call to action, indeed even an "action alert", for the new season is clearly emerging all around us.

"A journey of 1000 miles begins with a single step".
~~Lao Tzu

There are other beginning steps that may be taken also. I suggest printing out the helpful Good Food Checklist for Families that Angie developed. I'll bet that you find at least one step that you have already taken that you can check off plus many more actions that are achievable by you and your family. Step, step, step, inch by inch, row by row!

I'm right with you, both beside you and sometimes a few steps ahead of you, hopefully helping to smooth the path for change just a bit.

Diana Dyer, MS, RD

Sunday, March 22, 2009

A joyful day - the gardening season has begun!

(Song sparrow looking for love!)

These two pix do not do justice to the beautiful afternoon we had in Michigan today where many of the gardeners who have perennial plots in the community gardens of Project Grow in Ann Arbor were out doing some clean-up, planting, chatting and getting reacquainted, while greatly enjoying a gorgeous early spring day.

I was planting kohlrabi seeds (my husband planted peas yesterday), harvesting some overwintered turnips, taking the winter blanket (mulch) off the kale, enjoying seeing our 300+ cloves of garlic peeking up through its mulch, listening to the Song sparrow's beautiful song defining his territory only a few feet from our garden while looking for a mate (and such a fine territory his is!), while soaking up some vitamin D from the sunshine. I don't really know how long the days need to be in order for the UV rays to create vitamin D in our skin, but I gave it a good chance today.

Our 'Garden Dog' Kaya who enjoys all the sniffing, poking, dashing, barking, rolling, basking, and does such a valiant job protecting her territory from any potential intruder (even with her lame back leg) that she'll have less freedom after things really get planted because she is not at all 'discrete or delicate' about where she steps or rolls.

I put more "Scenes of Spring' (photos of our garden) on my other blog today www.365DaysofKale.com.

I want to end with the blessing my husband and I read tonight at supper as it perfectly captures the beauty of the day, the anticipation of the season, and the gratefulness I feel for all of the above.

I am the one whose praise echoes on high.
I adorn all the earth.
I am the breeze that nurtures all things green.
I encourage blossoms to flourish with ripening fruits.
I am led by the spirit to feed the purest streams.
I am the rain coming from the dew
that causes the grasses to laugh with the joy of life.
I am yearning for good.

~~Hildegard of Bingen (1098-1179)

A good and joyful day indeed! I hope you have a chance to put your hands in the earth to nourish both body and soul while you enjoy the sounds and smells of spring wherever you live!

Diana Dyer, MS, RD

Wednesday, March 18, 2009

Vitamin D - how much do we need?

My last two posts have indicated that higher levels of serum vitamin D may lead to improved prognosis after prostate cancer and improved quality of life for breast cancer patients who are taking aromotase inhibitors. So the logical question is just how much vitamin D does one have to consume to achieve these optimal serum levels (>75 nmol/L or >30ng/mL)?

A recent small study of 129 young women in Maine (average age 22.2 years) showed that an intake of 1000 IUs, which is 4 times the current recommended daily intake (RDI) of 200 International Units (IUs) or 5 micrograms (which is thought by many experts to be insufficient), was needed to achieve the accepted optimal serum levels cited in the above studies during the winter months. A daily level of 1000 IU’s was able to raise the levels of the study participants to optimal levels in 80% of those women participating in the study, which sounds like a large number, but even an intake of 1000 IU’s per day clearly was not high enough to achieve optimal levels in 100% of the participants.

Current recommended daily intakes (RDIs) of vitamin D are 200 IU for people up to 50 years of age, 400 IU for people between 51 and 70, and 600 IU for over the 70s years.

Vitamin D collectively refers to two biologically inactive precursors - D3, also known as cholecalciferol, and D2, also known as ergocalciferol. Vitamin D3, produced in the skin on exposure to sunshine, has a higher rate of absorption when consumed orally and is also thought to be more bioactive. However the sunshine levels above a latitude of 37 degrees (roughly a line from Richmond, VA to San Francisco, CA in the US) are so weak during the winter months that our body makes no vitamin D at all, meaning that dietary supplements and fortified foods are seen by many as the best way to boost intakes of vitamin D.

So many studies are now indicating a relationship between higher levels of vitamin D intake and reduced risk of various cancers (in addition to better prognosis and/or quality of life) and other costly and debilitating diseases such as diabetes, osteoporosis, heart disease, and several autoimmune diseases, that there have been repeated calls in scientific and public circles for an increase in the recommended consumption levels of the vitamin.

At the end of 2008, both US and Canadian governments announced they would be sponsoring a review of vitamin D that may lead to the establishment of higher recommended daily intakes plus higher levels of recommended upper limits for vitamin D intake.

Bottom line: it is reasonable to consume 1000 IU of vitamin D through foods and dietary supplements as a daily amount. I still suggest having your serum level tested (25-hydroxy vitamin D, which is the storage form) and developing a plan for achieving and monitoring optimal levels from foods, supplements, and sensible sun exposure with your physician.

Source: Journal of Nutrition 2009, Volume 139, Pages 540-546
"Supplements of 20 microgram/d Cholecalciferol Optimized Serum 25-Hydroxyvitamin D Concentrations in 80% of Premenopausal Women in Winter”
Authors: M.L. Nelson, J.M. Blum, B.W. Hollis, C. Rosen, S.S. Sullivan

Diana Dyer, MS, RD

Tuesday, March 17, 2009

Breast Cancer Patients: Have your vitamin D levels Checked

Hmmm, sound familiar?

A small pilot study published today showed an inverse relationship between serum vitamin D levels and the bone, muscle, and joint symptoms that breast cancer patients often experience when taking aromatase inhibitor (AI) medication. An inverse relationship means (in simple language) that the patients who had the higher the level of vitamin D had fewer of these symptoms that are not just 'annoying' but can also significantly reduce quality of life (muscle weakness, bone pain, muscle pain and joint pain and stiffness).

Vitamin D Insufficiency and Musculoskeletal Symptoms in Breast Cancer Survivors on Aromatase Inhibitor Therapy, Cancer Nursing Volume 32(2) March/April 2009, pp 143-150, Waltman, N et al.

In this small study of only 29 patients in Nebraska, a full 86% (25 of the 29 patients) had serum vitamin D levels (25-hydroxy) below normal (<30 style="font-weight: bold;">Special note: in my previous post about prostate cancer and vitamin D, readers may have noticed that the levels discussed in that post seemed different (higher) compared to the levels discussed in this article. I don't know why some levels are reported as ng/mL (this article) and nmol/L (the other article). However, 2.5 is the conversion factor to go from ng/mL to nmol/L. Thus a level of 30 ng/mL in this article is equivalent to 75 nmol/L in the previous article, which was noted in the previous post to be the level of serum vitamin D associated with the best prognosis after a prostate cancer diagnosis.

Bottom line: Breast cancer patients - same advice as for prostate cancer patients. Have your serum vitamin D level checked (25-hydroxy level), and then discuss with your oncologist or primary care physician if you would benefit from supplemental vitamin D, how much, what form, sensible sunshine, and how often to monitor your levels. Aim to achieve a level above 30 ng/mL or 75 nmol/L.

In addition to higher serum levels of vitamin D potentially increasing quality of life as this article suggests, research is starting to emerge that serum vitamin D levels may also play a role in prognosis of breast cancer (along with both prostate cancer as previously discussed and colon cancer). Much is still to be determined, but making an effort to have your serum vitamin D level checked and having a discussion with your doctor to plan ways to increase your level if appropriate is an easy action plan to potentially improve your quality of life and overall health, too.

Diana Dyer, MS, RD

Prostate Cancer Patients: Have your vitamin D levels checked

Higher Serum Vitamin D Levels May Be Associated With Improved Prognosis

A new study has been published showing that a higher serum level of vitamin D (25-hydroxy vitamin D) is associated with increased length of life after a diagnosis of prostate cancer.
Association between serum 25(OH)D and death from prostate cancer. Br J Cancer. 2009 Feb 10;100(3):450-4. Tretli S, et al.

Summary: In a study involving 160 patients with prostate cancer, serum 25(OH)D level was found to be associated with prognosis and cancer mortality. During a median 44 month follow-up, 61 deaths occurred, of which 52 were due to the prostate cancer. Subjects with serum 25(OH)D in the medium (50-80 nmol/L) or high (>80 nmol/L) range were found to have significantly better prognosis (RR=0.33 and RR=0.16, respectively), compared to those with low levels of 25(OH)D (<50>
This is small observational study and was not done in a prospective manner with intent to measure survival, based on month of diagnosis, initial vitamin D levels at diagnosis, vitamin D supplements taken, etc. Future studies should evaluate prognosis after diagnosis when comparing patients who receive vitamin D to those who receive a placebo.

Take home message: Prostate cancer patients - insist on having the level of vitamin D in your blood measured as soon as possible after a diagnosis. Be sure the 25-hydroxy form of vitamin D is what is measured (that is standard, but just double check). Then discuss with your doctor if supplemental vitamin D from either dietary supplements, sunshine, or prescription level vitamin D plus additional monitoring of blood levels may be appropriate for you to achieve a level above 50 nmol/liter, at the very least.

Note: It is nearly impossible to achieve an intake of vitamin D from food that is necessary to get blood levels above 50 nmol/liter, let alone above 75-80 nmol/liter, even with more foods being supplemented with additional vitamin D3. Vitamin D3 is available at your local pharmacy over the counter tablets, usually in doses of 1000 IU or 2000 IU, for very reasonable costs.

Increasing attention is being paid to optimal levels of vitamin D intake and blood levels to in relation to prevention and treatment of many types of cancer plus intake and levels that are necessary to promote overall good health in terms of prevention for many disease areas, thus I recommend having your vitamin D levels checked even if you do not have a cancer diagnosis.

Take Action: Don't wait on this simple way that you can potentially improve your odds for cancer prevention, cancer survival, and overall quality of life and health!

Diana Dyer, MS, RD

Monday, March 16, 2009

Last day of birding - a lucky day!

My last day of birding was along the San Pedro River, a birder's 'mecca' as it is a major riparian zone in dry, dry SE Arizona. I saw a lot of birds I could easily identify and many I could not. Birds have this habit of flying just when you get them in view through the binoculars - the nerve!

However, I was lucky to be in the right place at the right time when one bird popped up from the ground to perch on top of a tall piece of grass right in front of me and then hung around long enough (which is maybe a full minute!) for me to actually get a pretty good view. I knew I had not seen this bird before, and there is no time to simultaneously be looking in a bird book at the same time I am looking at the bird through my binoculars (or by eye alone). 

So my technique is to first look at the whole bird for an "overall look" (sparrow) and then to start at the front of the bird and work my way to the tail, talking to myself out loud telling myself what distinguishing features I am seeing (i.e., size, color, shapes of the bill, eyes, head, throat, chest, wings, back, tail, legs) or if I am lucky by what I also hear in terms of a song or a call. When I finally lose sight of the bird, I have a somewhat systematic way of remembering what I actually saw when I finally get to open a bird book to review the options for doing an ID of the bird I saw. 

So after doing all of this, and comparing my possibilities by looking at options in several different bird field guides, looking at photos on the internet, and consulting a birding expert from SE Arizona, I feel comfortable declaring that I saw a Baird's sparrow, which is considered a rarely sighted bird. This was another new bird for me, which is called a "life bird", worthy of a toast! 

Now I actually know some people (they will remain unnamed!) who have no interest in trying to figure out sparrows because 1) they do not have interesting colors, 2) they are 'just' sparrows and/or 3) they are hard to figure out! I'm here to tell you that the Baird's sparrow is beautiful! I was mesmerized by its beautiful streaking on its chest and facial patterns. Because this sparrow spends most of its time on the ground in tall grass, it is not often seen or appreciated. I hope I have the chance to see one again some day, perhaps in its breeding territory when it does spend more time being visible and singing while attracting a mate and defending its home turf. 

The second thing I saw that was new to me was a huge huge huge flock of blackbirds of various types that seemed to be composed primarily of females. It's typical for male blackbirds to arrive north in their nesting territory to "stake their claim" on the prime nesting spots before the female birds arrive. As male red-winged blackbirds have already started to arrive in Michigan, perhaps this flock of females was having their last "girls weekend" before they needed to make that long flight north and get down to the business of being a mom. 

To cap the week, my husband and I stopped to see the Casa Grande Ruins National Historical Monument and there running through the parking lot was a roadrunner, a classic way to end a trip to Arizona! However, I can't wait to come back. :-) 

We fly home tomorrow, pick up our dog and get re-organized on Tuesday, and then back to a routine on Wednesday very well refreshed. It should be 55 degrees tomorrow at home, so we are eager to get home to first give our dog a hug and smooch and then to pull back the mulch from the garlic and get our hands in the dirt. Let the gardening begin!

Diana Dyer, MS, RD

Friday, March 13, 2009

More new birds!

I added a few more new birds today to my "life list":
• Gilded flicker (I would love to find this one again and see it in full light)
• Red-naped sapsucker
• Hammond's flycatcher
• Phainopepla (I only saw the female so far)
• Gray-headed subspecies of the Dark-eyed junco
• Greater roadrunner (finally, finally on my 4th trip to Arizona!)

No, the roadrunner does not say "beep, beep"! The call, which we did hear on Wednesday, is actually more dove-like, although loud enough to be heard in a canyon when it cannot be found and in a tone that almost suggests moaning.

Yes, we did see a coyote today, too. I have actually seen one right in the neighborhood where I live, but I preferred seeing one where it really belonged.

I wonder what tomorrow will bring? That is the beauty of bird-watching. Every day is a new day. Birds fly (!!) so you truly never know what you will see when you keep your eyes open. :-)

I missed the Farmers' Market in the small town (it was yesterday instead of Saturday - darn). However, the owner of the B&B where I am staying has never eaten kale and did not really know what it was. She was sure surprised when I pulled some beautiful red-leaf kale out of the little refrigerator in my room. I purchased it at Whole Foods Market in Tucson before heading south into the mountains for my birding and have been eating it raw in sandwiches and salads. I gave her some to taste and I believe there is now one more "kale fan" in this country.

My bird list has been expanded and her food list has been expanded - how do you spell 'satisfaction'? :-)

Diana Dyer, MS, RD

Thursday, March 12, 2009

Birds and Birdies in Arizona

My husband is golfing (and hoping to get some birdies) and I am birding in southern Arizona this week. We are surrounded by others from the cold and snowy Midwest and Canada, i.e., other "snowbirds". However, I am hoping to spot a few new birds to add to my "life list", while enjoying ALL of them. In addition, I am warm (I love feeling warm) and soaking up the sun to recharge my vitamin D levels.

(Addendum: I first spelled birdies as birdees. My husband finally corrected my spelling, thus it should be very clear that I am the birder and he is the golfer!)

I have had many highlights, but I'll list my "new birds" so far this week:
• Harris' hawk
• Violet-crowned hummingbird
• Gila woodpecker
• Northern Beardless Tyrannulet
• Gray Flycatcher
• Ash-throated Flycatcher
• Plumbeous Vireo
• Chihauhaun Raven
• Black-throated Sparrow
• Elegant Trogan (the Pièce de résistance!)

Look up that last bird (just 'google' it) - its beauty will take your breath away. It is considered "a find". :-) However, the best part of "the find" was that another birder, a total stranger who had already seen it, gave up her "spot" in front of the bird to make sure that I didn't "just get a glance at it" but that I got a great "front-row" look at it for my first sighting. When my heart started beating again, when I started breathing again, when I finally took down my binoculars to wipe the tears of joy out of my eyes from appreciating the uniqueness of that moment, she grabbed my hand, gave me a high five, and then danced a jig of happiness and celebration for me. It was a beautiful moment, one I will treasure forever, the joy from the "hunt", the "find", the beauty of the bird itself, and the totally unexpected bonding with another birder.

Life's little pleasures are sources of happiness; I both look for them (the birds) and enjoy the unexpectedness of them (the woman's jig). :-)

Remember the little quotation I included in my blog just a short while ago? Well, I just have to use it again!

Let us be grateful to people who make us happy, they are the charming gardeners who make our souls blossom.
~~Marcel Proust

I was happy enough to find the Elegant Trogan. To have the additional memory of a new friend (even not knowing her name!) showing me such a kindness and then dancing a jig of shared happiness will make the experience of finding the Elegant Trogan even more happy, in fact truly 'elegant', for me!

Diana Dyer, MS, RD

Tuesday, March 10, 2009

There and Back Again: A Celebration of National Dietitian's Day 2009!

Welcome to my post celebrating the 2nd annual National Dietitian's Day on March 11, 2009, as a part of National Nutrition Month. You may also read my 2008 post, but please come back to read 2009!

This year I am participating in a BlogFest with other Registered Dietitian (RD) bloggers, where we are all writing about what we do as RDs. All of their blog links are at the end of this post so you can sample a wide array of savory 'tastings', 21 blogs that showcase the wide variety of roles, responsibilities, and rewards of being a Registered Dietitian today!

This is my 31st year to be a Registered Dietitian, and I have loved all the work I have done over those 31 years. Once I finally found my way to this profession and an internship (I would be what is now called a "non-traditional" student), I have never looked back or sideways to wonder why I did this or wish I had done something else. How do you like this photo of me (upper right) and the other dietetic interns in my class at The University of Wisconsin Hospitals and Medical Center in 1975? Can you see my short skirt and "earth shoes"? Thankfully, we were allowed to take our hairnets off for this photo. However, here is a classic photo for the caption "You've come a long way, Baby!" :-)

The advantage of a career in the field of nutrition and dietetics is the wide array of opportunities for you to find your passion. In other words, it is completely possible to love what you are doing for years and years and then segue (or even jump!) to another career under the wide umbrella of dietetics. I am the perfect example!

I trained back in the 1970's when a typical career for an RD was working in hospitals. Indeed, I spent the first 20 years of my career working as a clinical dietitian doing just that. I never worked on the food preparation and delivery part of that picture, but instead specialized in providing the nutritional care for critically ill patients who were typically in an ICU and needed highly technical nutrition through an IV or tube feeding directly into the stomach or small bowel. I loved my work. The specialized expertise I contributed to those patients' complex medical care helped them recover and was highly valued by the critical care medical teams at each hospital where I worked during the 70's, 80's, and 90's. I always found the work challenging, interesting, and meaningful (and uniforms for RDs are definitely a thing of the past, thank goodness).

However, after my second breast cancer diagnosis in 1995, I could feel a "pull" or tug in my heart to do something of service within the cancer survivorship community. I didn't know what that could be or would be. Could I do something as a dietitian? I didn't have a clue (certainly not a 'business plan'), but I could not deny the depth and strength of what I was feeling, so after much self-reflection, I took a deep breath, a big leap, and left the position I loved in the ICU in 1996 at peace with my decision, still not knowing exactly what was coming next for me.

I am not recommending "the leap" as the best route for everyone (especially in today's difficult economy), however, it was the best for me. It allowed me the time and space to evolve into my new role as a dietitian.

In a nutshell, after being almost "sequestered" in the ICU, I was now out in the real world with millions of other real people, millions being cancer survivors just like I was, many of whom were seeking answers to the same question that I was asking myself, i.e., "Now that my cancer therapy is completed, how can I help myself optimize the odds for my long-term cancer survival and an overall healthy life?" What foods should I be eating? What foods should I be avoiding? Should I eat only organic foods? Should I be taking vitamins or other supplements? What type of exercise, how much would be helpful? And so on and so on and so on! In one giant leap, I went from one end of the health care spectrum to the other, from critical care to prevention and wellness!

With lots of help from colleagues, friends, even strangers, plus lots of my own focused passion and yes, even courage, I used all my expertise and skills as a Registered Dietitian to learn new information and acquire additional skills to begin a new career focused on providing "information and inspiration" for cancer survivors.

How did I do this?
  • I wrote and self-published my book A Dietitian's Cancer Story in 1997 about my cancer recovery experience (the book still sells well and is updated and reprinted nearly every year),
  • developed the web site www.CancerRD.com in 1998 (one of the very web sites on the internet by an RD) focused on nutrition information for cancer survivors,
  • developed a private practice solely for cancer survivors,
  • had my book translated into Spanish
  • learned how to market self-published books,
  • was invited to speak throughout the country to both health care professionals and cancer survivors about the importance of diet and nutrition for people with a cancer diagnosis,
  • participated in hundreds of interviews for all kinds of media, including being interviewed for two PBS documentaries on breast cancer plus a DVD 'Food for the Fight' about nutrition after a cancer diagnosis produced by The American Institute for Cancer Research (AICR)
  • taught at several local universities about both nutrition and cancer plus CAM (complementary and alternative medicine) for RDs
  • created a research endowment at AICR in 1999 to promote nutrition and cancer survivorship research using proceeds from the sales of my books for funding of the endowment's research projects
  • consulted for several research projects related to nutrition for cancer survivors
  • invited to be a member of the Professional Advisory Board for several oncology non-profit organizations
  • elected to national board positions on ADA's Oncology Nutrition Dietetic Practice Group
  • Founded the Survivorship Subunit for the Oncology Nutrition Dietetic Practice Group and was instrumental in the development of both the Oncology Nutrition Standards of Practice and the Specialty Cerification exam
  • mentored hundreds of other RDs as they also spread their wings into new career paths.
As I read through this description of what I have been doing for the past 10+ years, I am more than a bit overwhelmed reflecting about the new information and skills I had to learn on this journey, all I have done with that information and those skills, what I have accomplished (still lots to do, of course), but most importantly, how being a Registered Dietitian was the key that opened so many doors for me to have these opportunities to help so many people.

And today? Am I still doing all this? No, not really. I "semi-retired" in June 2007, although I am not sure what that really means. While I still do some (but much less) speaking, consulting, advising, professional writing, and mentoring, what I have added now that I really enjoy is blogging! I just love writing for this blog plus my new blog 365DaysofKale.blogspot.com.

I can still reach the world with my messages of "inspiration and information" for healthy living through both blogs without the stress of travel while also being home to enjoy being home, spending time
with my husband, gardening, cooking, gardening, walking my dog, gardening, with new friends and old friends, birding, reading, gardening, finally joining book clubs, some travel (mostly to visit my grown sons), etc, etc, etc. Did you notice gardening more than once? Good, because organic vegetable gardening is going to be part of the next phase of my career as a Registered Dietitian, exactly how is still to be determined. Hmmm, does that sound familiar? :-)

I know that I will always have a heart-felt connection to oncology in general and all other cancer survivors in particular, but I find myself coming back to an early passion (funny how that often happens in life!) when I was inspired by the first Earth Day to use my college degree in biology to become an environmental biologist. For a variety of reasons I didn't do that, going on to graduate school to study nutrition and become an RD instead. However, the thought keeps percolating through my mind that perhaps the very best way I can continue to serve the cancer survivorship community at this point is by enlarging my focus on cancer survivors to include the other end of the cancer spectrum, i.e., more wellness = more cancer prevention = fewer cancer survivors!

How? By going back to my original passion for environmental biology (the relationship between human society and the earth's natural resources) and re-focusing on environmental nutrition (the relationship between sustainable ecosystems and maintaining optimal nutrition and well-being for all people).

While continuing to blog about my thoughts and experiences from the perspective of a cancer survivor, I hope my writing can also help people understand the direct links between how our food is grown (in addition to what food we eat) with:
  1. Our personal internal biological environment plus
  2. Our planet's multiple environments or ecosystems.
In other words, our personal food choices not only profoundly impact our individual health (i.e., cancer prevention and survivorship plus overall health) but the environment and health of our planet, too. Yes, they are all connected.

I am convinced that we need to back up several steps before "we what we eat" to embrace an understanding that we are also "what we grow" plus"how we grow" and raise our foods.

There is plenty of room under the wide umbrella of the nutrition and dietetics profession for RDs who have a passion for connecting the dots between our food, our health, our environment (including climate change), and the sustainability of our planet's natural resources. In fact, RDs with these interests are urgently needed now more than ever in every area of dietetics practice. Thus one of the fastest growing Dietetic Practice Groups (DPGs) within The American Dietetic Association is the Hunger and Environmental Nutrition (HEN) DPG, whose vision is focused on promoting access to nutritious food and clean water from a secure and sustainable environment. In many ways, I feel as if I have both come home and found a new home within the HEN-DPG and its many passionate and dynamic members.

By reading this post, I hope you are inspired, or at least curious, to:
  1. Consider a career as a Registered Dietitian (it's not too late - really!),
  2. Make an appointment with an RD as a beneficial member of your personal health care team,
  3. Hire an RD as part of your professional staff, whether you are a cancer center administrator or wellness coordinator for a business as just two examples, where RDs will improve the health of your organization by helping to both cut health care costs and optimize the wellness of your patients or employees.
I also hope you are inspired to read at least some of these additional RD blog posts at the end of this post. I'll just bet that they will help you act on at least one of the above three possibilities.

It's been a great 31 years as an RD. I have no plans to fully retire and give up the credentials I worked so hard to achieve at any point in the foreseeable future. There is still lots to share and lots to learn, plus countless ways for me to grow, both personally and professionally. As the tag line for my blog says,

"Cultivate your life - you are what you grow - inch by inch, row by row"

I have every intention of doing just that and hope you will, too!
Diana Dyer, MS, RD
• Beyond Prenatals - Food vs. Supplements and Real Advice vs. Fake Advice
• Annette Colby - No More Diets! A Registered Dietitian Shares 9 Secrets to Real and Lasting Weight Loss
• Ashley Colpaart - Dietitians working in food policy, a new frontier
• Marjorie Geiser - RD Showcase for National Registered Dietitian Day - What we do
• Cheryl Harris - Me, a Gluten Free RD!
• Marilyn Jess - National Registered Dietitian Day--RD Blogfest
• Julie Lanford - Antioxidants for Cancer Prevention
• Renata Mangrum - What I'm doing as I grow up...
• Liz Marr - Fruits and Veggies for Registered Dietian Day: Two Poems
• Meal Makeover Moms' Kitchen - Family Nutrition ... It's our "Beat"
• Jill Nussinow - The Registered Dietitian Lens I Look Through
• Wendy Jo Petersen - March 11 is our day to shine!
• Diane Preves - Registered Dietitians and the White House Forum on Health Reform
• Andy Sarjahani - Dr. Seuss Tribute continued: Green Eggs and Ham and a Sustainable Food System
• Rebecca Scritchfield - Big Tips from a "Big Loser"
• Anthony Sepe - RD Showcase: Registered Dietitian Day, March 11, 2009
• Kathy Shattler - RD Showcase for Nutri-Care Consultation
• UNL-Extension, Douglas/Sarpy County - Nutrition Know How - Making Your Life Easier
• Monika Woolsey - Dietitians--Can't Do PCOS Without Them!
• Monika Woolsey - In Honor of National Dietitian Day
• Jen Zingaro - My life as a Registered Dietitian

Wednesday, March 4, 2009

When cancer sparks a new beginning

I received an email from a colleague last fall, asking if I could share some time to talk with her at a conference we were both attending. I was happy to do so. What she told me was astonishing, both her frankness at sharing her own cancer story with me but also how her very very difficult situation had inspired her to help other people with cancer.

For those of us who have had a cancer diagnosis of our own, we can all relate to both the challenges and the frequent desire to help others overcome those challenges. However, my colleague overcame difficulties most of us have not had to face, such as making the decision to come to another country for her cancer treatments. Fortunately, she had the financial resources to have this choice, which may have led to the depth of her desire to help others in her home country who are not so fortunate.

I urge you to read my friend's story published in her home country's (Tanzania) newspaper and send her a cyber-hug of support. Her desire and efforts bring tears to my eyes, even only having a glimpse of understanding of all her struggles and all she is trying to accomplish for her fellow citizens in Tanzania.

I'd like to close with the quotation I actually used to close my very first blog post in June 2007.

"No one could make a greater mistake than he who
did nothing because he could do only a little."
~~ Edmund Burke (1729 - 1797)

Mary, I commend you from the depths of my heart for the service you are giving to your fellow travelers. Please don't ever ever ever think that what you are doing is "little". Know that the opposite is true; your local efforts are needed, appreciated, and huge for every person you touch.

I send all my best wishes to you for many more decades of health, healing, and hope, so you may continue sharing your knowledge and your love with your country's citizens.

Diana Dyer, MS, RD

Sunday, March 1, 2009

Spring is coming - yes it is!

How do I know? While visiting a friend this afternoon, I walked up to her front door along her brick sidewalk. I noticed that the snow was all gone on her 'south-ish' facing front yard and the sidewalk was bordered on each side by a narrow strip of bare dirt. As I looked and wondered what type of plants she used these beds to grow (flowers or vegetables or herbs or all three), I suddenly realized that I could smell DIRT - oh it was delicious, a true smell of spring, I breathed and breathed deep life-renewing breaths, feeling that smell just shoot through every cell of my body with a true wake-up call.

It won't be long now. We'll be starting our seeds in two weeks, after we get home from a trip to the sunny and warmer Southwest. No way do we want to burden a neighbor with the responsibility of checking on, watering, and keeping so many babies alive. Because we have a perennial plot in our community garden, we'll be able to get in early to finish any clean-up, see what is peeking up (like our garlic, maybe some rhubarb), see what is coming back to life (hopefully some of our kale plants were hardy enough to winter over, our strawberries), get the compost pile turned over, sifted, and ready to spread, get our wren house cleaned out and up, etc, etc, etc. Once gardening season starts, there are not enough daylight hours to do all that needs to be done, and all we want to do! Our hands, clothes, and shoes or boots are always dirty!

I cannot wait. In the early clean-up days before we start planting, we can still bring our dog Kaya and let her roam around smelling and chasing little critters (like the voles that were disturbed from their warm winter home when we turn the compost). She loves to lie in the dirt, warming her black fur in the sun, often just resting on her back with feet in the air. She is one happy old dog when she is with "her pack". I don't seem to have a photo of Kaya in our community garden, so here she is enjoying lying in our (resilient) herb garden at home last summer. :-)

There are so many ways to mark a new year, such as the traditional New Year's Day, birthdays, anniversaries, and the like. I know many cancer survivors who mark their year by the date of their cancer diagnosis, their surgery, bone marrow transplant, or the date that all treatment ended. In my case, I have so many of these types of anniversaries that I would get confused so have never used one of them as my "marker" for a new year.

Instead I just use Spring, with its myriad ways of hoping for it, looking for it, feeling it, and knowing it has finally arrived.

Since our days of graduate school at The University of Wisconsin-Madison back in the 70's, my husband and I have looked forward to March, when we would put enough gas in the car to leave campus and drive in the country, looking for migrating tundra (formerly called whistling) swans who had stopped for respite in flooded farmers' fields. Seeing them was my true sign that winter was ending and a new year was beginning with spring just around the corner, a tradition that we continued for years. Only recently have re-introduced trumpeter swans in our area of Michigan actually stayed around all winter on our river, so the anticipation of looking forward to finding swans as a sign of coming spring during the dreary month of March is now diminished.

I did not hear a robin singing this year before March 1, so I really had ample opportunity to enjoy our beautiful outside Christmas wreaths this year. However, they'll come down tomorrow. I should have done it today per family tradition (they come down on March 1 or the day I first hear a robin sing, whichever comes first), but I was sorting seed packages and doing other important things.

As other signs of spring today, I saw a family flying a kite in our neighborhood park this afternoon, definitely a sign of spring with the early March winds, plus I saw a dead skunk along the side of the road, again definitely a sign that winter is ending in the upper Midwest (now I'll have to start being careful again when I take Kaya for a night-time walk to make sure we avoid an "encounter" with strolling neighborhood skunks, which thankfully we have avoided since we adopted Kaya although other neighborhood dogs have not!). I also noticed that it was still light at almost 6:30 last night - yippee!

However, I think from now on, I will add the "first smell of dirt" to my mental list of marking another year. I am under no delusion that snow won't cover it up again this month, but after the next snow, comes the next thaw, and pretty soon we'll be able to dig in our dirt, put our hands in our dirt, that small section of precious soil on this planet that we cheerfully take direct and personal responsibility for not just conserving, but more importantly, repleting and rebuilding.

I'll end by sharing my favorite springtime quotation from one of my all-time favorite books, A Sand County Almanac by Aldo Leopold. I re-read this book every year or so.

"One swallow does not make a summer, but one skein of geese, cleaving the murk of a March thaw, is the spring." (opening sentence to the March chapter)

Life doesn't get any better than this. Enjoy hoping for and watching spring unfold, first a peek or a petal at a time and then the final burst into full bloom while you also breath in the smells and get your hands dirty!

Diana Dyer, MS, RD