Sunday, October 31, 2010

3 Up Yesterday - One More Today!

The garlic is all in the ground today, at least 98% is! My goal was to have it all planted by November 1, and after a great weekend of planting, we raced back to our house in Ann Arbor late this afternoon just in time to beat (most of) the kids going door to door for Halloween! Whew! We are close to having ~14,000 cloves in the ground and still have a small amount to plant from two new varieties that my husband ordered and what we decide to plant from the 17 varieties that "auditioned" for us this past year.

We had help over the season from several friends, a class of mostly student dietitians from Madonna College in Livonia, MI, the clinical dietitians from St. Joseph Mercy Hospital in Ann Arbor, MI, the farmer hired by St. Joe's in Ann Arbor this year, two dietetic interns from The University of Michigan, and several student dietitians from Michigan State University including one who helped us on the farm each week this past summer.  We LOVE our "help" and reward them all generously next year with their choice of garlic.

Here are a couple of photos to see what we have been doing!
(Photo: Dick showing the St. Joe's dietitian's the tricks to harvesting garlic correctly, i.e., without nicking the sides or bruising the heads)

(Photo: Garlic out of the ground and headed off to the barn)
(Photo: Some of the St. Joe's Staff with a small portion of the garlic they harvested for us in July, placed on wood pallets to dry for a few days first on the barn porch before being bundled to hang and dry for 3-4 weeks in the barn loft)

(Photo: Madonna College dietetic students helping in September to clean seed garlic to be ready to plant - they also finished weeding the garlic planting fields)

(Photo: Praying Mantis on old garlic stems in the garlic field - isn't it beautiful?!)

(Photo: Walking Stick found on the side of our garage - I repeat myself - isn't it beautiful?!)
(Photo: Diana and MSU students planting garlic at the end of October)

(Photo: Diana at the end of planting - never a fashionista, planting on a day when the temp was in the 40's and still windy, I have those heater things in my sturdy but dirty shoes, and I'm wearing warm socks, long underwear under my work jeans, long-sleeve and short-sleeve t-shirts, turtleneck, fleece hoodie that my younger son wore almost every day for 3 years when in middle school, fleece vest - my own, wristbands, earmuffs, work gloves, and knee pads - as I said, I have never been a fashionista, but I sure love being warm!)
(Photo: Garlic is up! This is the first variety we planted - Blossom - back on 10/7/10. Three varieties came up two nights ago and the next one planted came up last night. No problems if these little leaves get frozen or even smashed by deer. Seeing these leaves tells us that the cloves are developing a healthy root system to grow well next year and love their well prepared fields!)
(Photo: Kaya always supervising what I am doing plus guarding the yellow wagon filled with garlic planting supplies. She is really slowing down but still loves to eat and loves to bark bark bark at anything she thinks I should know about!)

I was recently interviewed for one of my favorite radio shows, Food Sleuth by Melinda Hemmelgarn, MS, RD, a show to be aired on Thanksgiving Day that covered a wide range of topics starting with the challenges of cancer survivorship, the importance of good food for healing, ending with a discussion about gratitude, and much more in-between. Melinda's final question was asking me if there was anything she didn't ask that I wanted to share. I was surprised but quickly had an answer. 

Whenever I have the time to add something to my blog, I always do so with deep gratitude, thanks for all the various blessings in my life along with gratitude for being able to share so much of my life in so many ways. One of the most meaningful things I enjoy doing is sharing a grace or blessing for our food and those who grew our food before meals and often ending my blog postings. For some reason, I had a copy of one of my favorite blessings near me when doing this radio interview, so I quickly reached for it and read it on the air. Whether reading it for the 10th time or the first, I hope you find it as inspiring and meaningful as I do, with a deep sense of gratitude for your food and your other blessings on Thanksgiving Day and every day, too. 

Be a gardener, dig a ditch, toil and sweat,
And turn the earth upside down
And seed 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.
~~ Julian of Norwich, c.1371

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

Diana Dyer, MS, RD

Tuesday, October 26, 2010

The storm that wasn't

We were so fortunate - the vigorous storm that brought so much destruction to other parts of the Midwest today missed us. So we still have a roof on our new barn and the new roof on our house at the farm, both of which we worried about all day. I changed my blog header photo today to show you our beautiful barn lit up at night. Hmmm, I'm already thinking of how to decorate it for the holidays, even though no one except us can see our barn. Too bad the full moon in the sky the night this photo was taken was not in the photo. It was beautiful hanging in the sky over our garlic field, too. :-)

We have approximately 2/3 of our garlic planted - woohoo! Dietetic students from Michigan State University are coming down to help on Saturday and with any luck, the planting will all be done by the end of the weekend.  Applegate, Inchelium Red, Kettle River Giant were all recently planted. Aren't those beautiful names? Silver Rose, S&H Silver, Legacy Braiding Silvers, and German Red are next. We are still in a holding pattern with the evaluation of our 17 auditioning varieties and waiting for delivery of two new varieties, but even if we end up re-planting all of them, the numbers are small and won't take long to do.

Hope you're all snug and safe wherever you live or were traveling to today.

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

Diana Dyer, MS, RD

Saturday, October 16, 2010

Garlic going down into the ground!

Not all 15,000 cloves are in the ground yet, but 4 more varieties were planted today, on an absolutely picture-perfect October day with blue skies, a light breeze, and the temperature getting up into the 60's. It was great day planting with two good friends, just chatting away and enjoying some delicious foods we all brought (dietitians know how to eat well while they also eat healthfully!).

Here is what we planted today: Romanian Red, Creole Red, Purple Italian (bummer, no photo and now they are all in the ground), and Silver Rose, beautiful names for beautiful garlic varieties.

(Photo: Creole Red Seed Garlic)
(Photo: Romanian Red Seed Garlic)
(Photo: Silver Rose Seed Garlic)
Next up tomorrow - the gorgeous and delicious and very popular Spanish Roja! It is a HUGE box of  big, beautiful cloves. I'll be sure to take a photo of the box of cloves plus the one bulb we have saved to show local chefs for consideration of future bulk ordering. We saved our biggest and best bulbs of all our varieties for our seed stock (a garlic seller's annual dilemma), so we'll have even more to sell next year, and if it is even possible, the heads we have to sell in 2011 will be even more beautiful than this year.

I enjoy planting each and every clove, wondering who will be purchasing the full bulb that each clove will grow into by July of next year. I give each clove a little pat for good luck before pushing it down into its home for the next 9 months before it is carefully dug up sometime in July. After all of the ~15,000 cloves are planted (hopefully we'll get this done during October), we'll spread about 8 inches of straw over the raised beds and then wait for the Michigan winter snows to cover them.

From harvest to harvest, garlic is a 12-month process, and for those of you (like us many years ago!) who first decided to plant garlic when those seed catalogs arrived in early January, that first garlic crop was an 18-month wait !! since the seed catalogs came too late to plant garlic for that year's harvest. From seed to cooking or seed to seed, there are multiple, multiple steps where our hands do something (including weeding, weeding, and more weeding!) to help nurture that garlic clove into a big beautiful delicious garlic bulb that is edible or plantable for you.

We are so excited to be into year 2 and already thinking about year 3, too, since we have already starting getting another field ready to condition with successive crops of green manure (buckwheat, winter rye, oats, peas, soybeans) so the 2012 harvest will also be beautiful and delicious for our customers. 

We'll know enough next year to know that we also need to set aside some garlic for us to use during the winter before we sell out, in addition to setting some garlic aside as gifts for special people and/or local fund-raisers. Our garlic's "popularity" caught us by surprise and thus we (the garlic family!) are now limited to the overlooked garlic that we are finding in our fields that is trying to sprout. So funny - I laugh each time I find one, thinking of us being the equivalent of "the cobblers whose children have no shoes". 

Lessons learned and learned well. Mistakes are only mistakes if you don't learn something from them! In fact, I believe that could even be the essential underlying meaning of the tag line for this blog: 

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

Diana Dyer, MS, RD

Wednesday, October 13, 2010

Farm Fall Updates

In contrast to my past few posts, which have been more like "what are they thinking" or "reprisals", here is an upbeat (hopefully) "what's new on the farm" post. Sometimes I am behind with posting on my blog(s) because I'm busy (always) but more likely because it has been so long since I downloaded photos from my camera that I am now intimidated about remembering what photos I took (and why) and then labeling them. However, I took a stab at doing that last night (350+ recent photos), so here are a few pix that show you what is going on right now.

 (Photo: Compost delivered to be spread on the new garlic field, which has also had a full year of successive cover crops plowed in to add organic matter to the soil.)

 (Photo: Garlic field for 2010 planting with raised beds made and ready to receive the 15,000 cloves, all individually hand-planted. This area is approximately 1/4 acre. Since we'll be using a 5-year rotational system, we are already choosing and preparing the 1/4 acre that will be planted with garlic in October 2011 for the 2012 harvest.)

 (Photo: Our new barn in background. Foreground - What is still left from an old, old burr oak tree apparently hit by lightning or topped by a tornado a few years ago. This area was such a thicket and mess when we first purchased the property that it has taken us this long to get it cleared to this point. We actually found functional tractor implements under the debris from the shattered tree! In addition, there is a great "stone pile" around the tree, including field stones that are so old that they are embedded in the bark of the tree and the massive roots of the tree. We'll be using all these old stones, pulled out of our fields when they were farmed in the past, in some way, somehow in the future.)

 (Photo: The new front porch is done. We often would eat our lunch in the shade here during the summer and even rode out a terrible storm sheltered on the porch.  New porch lights are picked out and installed, and yes!, the purple front door is finally gone. Repairs to the door frame still need to be completed and painted along with painting the shutters, making a real step to the porch, and planning the landscaping - I have not shown you that mess although it is 1000% better than last year just because of what landscaping we have continued to pull out!)

 (Photo: Chesnok Red garlic heads, dried and cleaned ready to break apart into cloves to plant.)

 (Photo: Inchelium Red garlic heads, including one that has completely opened up as the classic "stinking rose".)

 (Photo: Kaya is still enjoying her days as a "free-range farm dog".  She is a most attentive companion and supervisor, only leaving my side to go bark at any cars or trucks coming up the driveway or track down a chipmunk.)

 (Photo: All 23 varieties of seed garlic cleaned and ready to break into cloves for planting. Note drainage tile in the background, which has been a major focus this summer. We think/hope we have the water routed away from the house now, never to enter the basement again!)

 (Photo: The 17 varieties of garlic that "auditioned" for us this summer still hanging in the loft of our barn waiting for their "verdict" regarding a second chance for planting next year.)

(Photo: The barn loft with the 17 strands of auditioning garlic way way way in the back. Imagine that this entire loft was filled with 6,500 heads of garlic hung to dry in bundles of 25 heads, so much of it that strands (all labeled and labeled again by variety!) needed to be pushed aside to walk from one end to the other. Most was sold at the farmers' markets, the rest saved for our seed stock that we are planting now. Next year it will be even fuller, if that is possible!)

Here are a few of the garlic varieties we have already planted this month: Blossom, Stull, Chesnok Red, Shandong Purple, Shantung, and China Stripe. Such beautiful names for such beautiful and flavor-full vegetables. Already, I am looking forward to harvesting them next July and returning to sell them at our local farmers' markets!!

After our October planting is completed, then again, we can work on finishing up all the details before moving in. Our new goal? Cooking our locally-raised Thanksgiving turkey in our new convection oven (woo-hoo!) at the farm. Step, step, step, we are getting there. :-)

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

Diana Dyer, MS, RD 

PS - Confession - I have another block of ~350 photos taken prior to this last group that I have not yet labeled (yes, I am mentally stuck about that) so it is possible that I will be posting ideas and photos out of chronological (or even logical!) order when I buckle down to do that. :-)

Tuesday, October 12, 2010

Kale and Garlic - Garlic and Kale (again!)

Hmmm, I seem to be in a reprisal mode these days. Maybe as days become shorter, as we move fully into Fall, the harvest season and garlic planting season, I am reminded of how life continues full circle, events and thoughts coming around again and again, some as comfortable continuing traditions, but some may come with new interpretations based on what else we have learned during the past year.

Thus I could not help but laugh and smile broadly when I read through some of the memories of interns working at Tantre Farm this season, one of our area's local CSA's. I'll just share two of them, with full credit to their poetic authors:

You can pick your farm,
But you can’t pick your veggies,
They will pick you.   

m√Ęche, nettle, blue kale,
spinach, arugula, chard,
yukina, bok choy,
lacinato, turnip, spice
We are green inside  

Garlic and kale - kale and garlic. Yes, I do believe those beautiful and delicious vegetables have picked us. Dick and I love growing these vegetables and love sharing them with our communities. Together we recently taught a class for Preserving Traditions on kale and garlic, focusing on taste, taste, taste, not all the "should's" although we each did mention some aspects of the health and nutritional benefits of consuming these delicious foods, emphasizing delicious. 

Here are two photos I took at the kale and garlic class:

 (Photo: Varieties of kale, curly, lacinato, red russian along with some collard greens and honey mushrooms - this was an opportunity to actually taste different varieties of kale at one time and yes! they are different.)

(Photo: Kettle River Giant garlic heads and cloves along with a garlic press and peeling tube - neither are necessary tools but are fun gadgets to use)

Contrary to Kermit's lament "It's not easy being green", I think it is easy to be both green and garlicky on the inside. We made kale chips, kale balls, and chimichurri (using some kale along with the flat-leaf parsley). Kale will be available in abundance (and tastes great, especially after that first frost) for the next several months and in some parts of the country is also available year-round. 

What are you eating that is making you both green and garlicky on the inside? :-)

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

Diana Dyer, MS, RD

Monday, October 11, 2010

Recipe: Garlic-Tomatillo Salsa with Black Bean Dip

When I first made Garlic-Tomatillo Salsa back in August, I was won-over with how easy and delicious it was.  I confess that I have been thinking about it and tasting it in my mind ever since! Thus, when I had a chance to buy another quart of tomatillos, I grabbed them! I am going to re-post my recipe for Garlic-Tomatillo Salsa, with a new use and also two new ingredients. Again, this is SO good that I have made it twice and taken it to two food events, always hoping there will be left-overs to take home (first time no, second time yes!).

There is still time to find some tomatillos. Where you say? Check out the really useful and awesome website called to first find a farmers' market near you and then which one actually has tomatillos available (yes, if someone in your area is uploading the information, you can actually use this website in "real time").

Recipe:  Garlic Tomatillo Salsa with Black Bean Dip

  • 1 quart fresh tomatillos, husks removed, wash, some were purple but most were green
  • 1 red sweet pepper, seeded and cut into fourths
  • 1/2 small habenero (or other hot pepper) pepper - seeds removed unless you enjoy very spicy salsa!
  • 5 large garlic cloves, separated from their bulbs but still in their peels 
  • 1 large peeled clove of fresh garlic (save to add to the blender raw at the end)
  • 1 large leaf of kale (I used curly kale) - wash and then strip leaves off the thick stem
  • ~ 1 Tbsp. lime juice
  • 15 oz. can of vegetarian re-fried black beans - spread in serving dish (see photo below)
  • 1-2 green onions (or in our case, green garlic!) - chopped to sprinkle on top of salsa
  1. Preheat the oven's broiler. Arrange the whole cloves of garlic (except for the one being held back to add raw at the end), red sweet pepper pieces, habenero pepper, and tomatillos on a baking sheet. Place under the broiler, and cook for a few minutes. Remove garlic cloves first, as soon as they are toasted, to avoid developing a bitter flavor, peel as soon as they are cool enough to do so. 
  2. Continue to roast tomatillos and peppers until evenly charred, turning occasionally. Set aside to cool. Don't remove the charred parts of the tomatillos or the peppers. They add a really nice flavor.
  3. Place tomatillos, peppers and any juice from the roasted tomatillos now on the tray used for roasting in a blender or food processor with the roasted and fresh garlic plus kale. Add a little water to the mixture only if necessary to facilitate blending. (I have never needed to add any water) Season with lime juice, salt and pepper to taste. Refrigerate until serving. 
  4. Spread bean dip in shallow serving dish. Spread layer of salsa on top of bean dip. Sprinkle with chopped green onion, green garlic, or even chives.
  5. Serve with baked whole grain chips or crackers and also use as a dip with sturdy vegetables.
 (Photo: Garlic-Tomatillo Salsa with Black Bean Dip - topped with chopped garlic and green tops from a head of garlic accidentally not harvested in July and found starting to grow again in our garlic fields last week. Instead of "green garlic" in May, we got a gift of a few extra-large heads of "green garlic" in October!)
Notice how this recipe is red instead of green? That was from the one sweet red pepper used in the recipe. Also notice that the kale is not visually noticeable. Oh, yum, yum, yum and easy, easy, easy - you just have to find those tomatillos! Hint again: :-)

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

Diana Dyer, MS, RD

Baby carrots, again

I've been asked to share my thoughts for a short article being written about reactions from Registered Dietitians (RDs) to the marketing strategy for selling more "baby" carrots to children that I wrote about on my blog a few weeks ago, with such a heavy heart.

It will be a very short article so I was asked to write just a few sentences. Of course I wrote a bit more than what will be used due to space considerations (and other RDs will be asked to comment, too). So I let the writer know that I will post up my full comments and then link back to the article if/when it is available on-line for my readers to see the full range of comments.


"I am deeply disheartened to read about the new marketing strategy that the growers of "baby" carrots are taking, "Eat 'em like junk food™". Yes, the goal is to increase consumption of vegetables among children, but to do so, does the collective agriculture and food system really have to lower the bar to that level? I don't think so. Carrots are "cool" all by themselves, without any need to equate them to "junk food", when they have been grown in school, home, or community gardens, washed and scrubbed clean, and then eaten out of hand either whole or cut into pieces. RDs can help promote eating of food that is both healthy and delicious by encouraging people to understand that not only are we "what we eat", but "we are what we grow". As a profession, I hope registered dietitians not only teach and encourage people to eat whole foods (carrots being just one example) but to first grow them and then cook them by embracing and promoting The American Dietetic Association's 2010 National Nutrition Month motto of "Nutrition from the ground up" to help create truly healthy communities."

Diana Dyer, MS, RD, Ann Arbor, MI
Author: A Dietitian's Cancer Story - Information and Inspiration for Cancer Survivors since 1997
Farmer: The Dyer Family Organic Farm - "Shaping our future from the ground up" - Est. 2009

I could have said much more, but maybe more is not needed here, either for this blog or for the article. I will be very interested in reading the reactions and suggestions from other RDs, too. I have not had time to follow this issue on other blogs, so I don't really know if I am sighing and "ranting" along with a large group of colleagues,  if other RDs are sighing and resigned to the role of marketing in lowering the bar in this way, or even if there are RDs who think this campaign is a great idea.

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

Diana Dyer, MS, RD

Tuesday, October 5, 2010

Slow Food USA Lowers Dues

I have finally joined my local Slow Food Chapter. I didn't join years earlier because I have a philosophical objection to the cost of the baseline membership, which I have thought is too high and thus the organization created a feeling of membership being "elitist". 

Good News!! Dues have not been permanently lowered but until October 15th, you can join for only $25, which I just did. 

I fervently share Slow Food's mission and vision:

Our Mission: Slow Food USA seeks to create dramatic and lasting change in the food system.  We reconnect Americans with the people, traditions, plants, animals, fertile soils and waters that produce our food.  We inspire a transformation in food policy, production practices and market forces so that they ensure equity, sustainability and pleasure in the food we eat.

Our Vision: Food is a common language and a universal right. Slow Food USA envisions a world in which all people can eat food that is good for them, good for the people who grow it, and good for the planet.

My husband and I are working toward this vision with our new organic farm. I would add that we envision growing good food also being good for creating a healthy local community. It is the best way I know to help the cancer survivorship community, reducing it through good food leading to cancer prevention in the first place.

The needs for changing our agriculture and food systems are wide and urgent, and there is room under the Slow Food tent for a wide variety of people working together on a wide variety of areas for needed change.

I hope this special time for lowering of dues is offered annually. 

In the meantime, I encourage you to consider taking advantage of this short-term special opportunity to join your local chapter. I am inspired and energized by Slow Food's goals and the people I meet who share these goals. I am reminded by the famous quote by Margaret Mead:

Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.

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

Diana Dyer, MS, RD

Monday, October 4, 2010

Cancer and Nutrition again - yes it helps!

Yes, nutritional intervention helps both prolong life and improve quality of life for cancer patients, but only if the nutritional advice is individualized and is proactive, according to long-term follow-up data from earlier research done by Paula Ravasco, RD, MD at The University of Lisbon, Portugal. Full disclosure, I have been following Dr. Ravasco's work for years, and she is one of my "heroes".

Dr. Ravasco's long-term follow-up (median, 6.5 years) of 111 colorectal cancer patients in a prospective trial revealed that the shortest survival (4.1 years) and highest mortality rate (30%) occurred in patients who were not given any nutritional intervention. Patients who were given high-protein liquid supplements had a median survival of 6.5 years and a mortality rate of 22%, but the longest survival (7.3 years) and lowest mortality (8%) were observed in patients who received personalized nutritional advice.  

Recognizing malnutrition, the need for nutritional supplementation, and encouraging the intake of commercially available nutritional supplements (such as Ensure or Boost as just two possible examples) is certainly better than no intervention at all, but this study clearly shows which group did best, and I want to be in the group with timely and individualized nutritional assessment and intervention by an oncology RD if I have another cancer diagnosis!! 
These new long-term data have not yet been published in a peer-reviewed journal but were presented last week at the biennial meeting of the European Society of Therapeutic Radiation and Oncology (ESTRO 29).  In addition, a second study was presented at this meeting that showed nearly 100% of 1000 cancer patients assessed at diagnosis at cancer centers in Spain had some degree of malnutrition, with greater than 70% of them already having moderate to severe malnutrition.

Wow - I feel like saying "Do you know where your children are at midnight?", translating to "Does your cancer center have an RD, or two or three, to professionally assess the nutritional status of the  high number of potentially malnourished cancer patients at your cancer center (even you!) and then to provide the individualized nutritional advice, interventions, and appropriate monitoring?"

If not, why not?, and what is your cancer center waiting for? I feel the answer to both of those questions should be the same (a resounding "Yes!"). If the answer is "No", then some strategy change for providing optimal (i.e. comprehensive) care is urgently needed. 

Dr. Ravasco's long-term data also clearly show that in addition to improving overall survival, timely and individualized dietary counseling improved patients’ quality of life to a greater extent than did protein supplements or no nutritional intervention. Extending life is a worthy goal, but quality of life should have at least equal weight and equal attention. Extending life only to be miserable due to complications from the tumor type or complications related to the treatment(s) itself is an unfair and miserable choice for a person. If personalized nutritional intervention can improve both length of life and quality of life, what is not to want or provide here? What oncology professional would not want that double outcome benefit for himself?

Over my years of traveling around the country speaking at cancer centers which provided varying degrees of nutritional expertise included within their cancer care, I can tell you that there is no obvious and clear (i.e. mandated) path to including individualized, timely, and professional nutritional expertise by oncology RDs included as a "given" component of comprehensive cancer care.

I have seen cancer centers where a full-time art therapist was on board but NO nutritional support at all. I was asked to speak at another major cancer center that hired an RD for 8 hours per week to only see breast cancer patients who had referrals from their doctor plus also had insurance that would reimburse the center for the RDs professional fee. That last situation did not work at all because patients who did not meet those criteria got angry (good for them!) and started vociferously complaining to the cancer center administrator about how unfair this situation was (I'll say it again - good for them!).

In addition, there are cancer centers that have RDs on board who cannot possibly provide individualized and timely care that Dr. Ravasco's data show will provide benefits (i.e., work with a patient to prevent/minimize weight loss rather than only getting a referral after a 30# weight loss, which, sadly, happens all too often) because the staffing ratio of RD/patients treated at the cancer center is miniscual or astronomical, whichever way you want to configure that ratio.

So the answer, my advice? Speak up!, spread the word!, share these data! with everyone possible! at your cancer center! Somehow, some way, some cancer centers (see my previous post) are finding ways to provide nutritional care as a valued component of their comprehensive cancer care. I know that if you have found your way to my blog (either for the first time or regularly), I am likely "preaching to the choir". However, even with compelling data such as these two studies show, change will not come overnight and may not come at all unless there is a "nutrition champion" at your cancer center who is not going to let this gaping and neglected hole in the oncology care provided continue.

In your own way, I hope the information on my blog helps you take a step to "be the change you wish to see in the world (~M.Ghandi)", if not for yourself, then for all the millions of people who will be diagnosed with cancer this year and in years to come. I thank you from the bottom of my heart for your efforts to close this hole. :-)

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

Diana Dyer, MS, RD

Friday, October 1, 2010

Cancer and Nutrition - not just for breast cancer patients

October is Breast Cancer Awareness Month and for the first time in 15 years, I am not on the road speaking at cancer centers across the country. I admit that I miss meeting people, but I also admit that I don't miss the actual rigors of traveling.  In addition, I also admit that I would much rather be on my knees planting garlic during October!

Many breast cancer awareness events include information about (even focus on) the benefits of healthy eating for prevention, during treatment, and also during survivorship.  However, cancer centers are filled with hundreds if not thousands of patients with other cancer diagnoses who also have needs for timely, accurate, and individualized nutrition information and support from Registered Dietitians (RDs) to improve tolerance to therapy, quality of life, and health and wellness after treatments are completed.

Unfortunately, many cancer centers around the country still do not provide the beneficial expertise from oncology RDs as a pro-active component of their (so-called) comprehensive cancer care. However, here is an informative article about a cancer center in Massachusetts that has found ways to include oncology RDs as members of their professional oncology staff.  Reasons for not including nutritional oncology care provided by RDs, many of whom have received the advanced certification of an oncology nutrition specialty (CSO), from the point of diagnosis forward through recovery are now old, tired, and are simply worn-out excuses.

I learned to ask ahead of time if the cancer center inviting me to speak had an RD as a member of the oncology team (not just simply "available").  It was always slightly awkward to be speaking in the situations where the cancer center had no professional nutritional expertise or support. However, I always did my best to be an ambassador and advocate for the expansion of the care offered by that cancer center to include nutritional support from oncology dietitians. Time after time, I received feedback that after listening to my presentations (and more importantly, the never-ending questions afterward), administrators in the audience stated that they had no idea how important nutrition was to their patients, and best of all, at least a few centers where I spoke hired their first RD or even expanded the position(s) afterward.

My hat is off to this center (Hudner Oncology Center at St. Anne’s Hospital and the Regional Cancer Care Center in Dartmouth, MA) and the RDs on their staff who are dedicated to providing beneficial nutritional care to the patients receiving treatments at this cancer center.  May they serve as inspiration to those centers around the country who are still not out of the starting block. It can be done, and your patients will be the beneficiaries and thank you!

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

Diana Dyer, MS, RD