Wednesday, April 6, 2016

2016 National Dietitian Day – Full Circle

What can I say? I'm (very, very) late to the party, again! However, tonight as I was searching for one file on my computer, I found another file, which is called "serendipity". I took that as a nudge from the Universe that I finally needed to put other things aside and dedicate the time to do my annual Dietitian Day post, which officially was March 9th. :)

Back in 2012, I was interviewed for a very nice article in Today's Dietitian called "Get to Know Diana Dyer, MS, RD". Many articles published in Today's Dietitian Magazine have links so that they can be read on-line, but not this one. I have a copy, but I was not able to easily share the article with my on-line readers or my students. However, bingo! I actually found a copy of the article in a computer file, so in honor of a late post for National Dietitian Day 2016, I thought I would share the article on my blog. As I read through the questions and my answers, it actually covered a lot of ground, the many ways I have worked as a Registered Dietitian. 

I hope you enjoy reading it, and I hope that dietetic students and new RDs find some words of wisdom as they embark on an interesting, fulfilling, and hopefully, fun career! The world urgently needs your knowledge, your skills, and your passion as you share your love of food and its impact on health in the widest sense possible with the widest audience possible, from the soil to the planet and everything and everyone in between. 


Get to Know….Today's Dietitian, July 2012, written by Juliann Schaeffer

Diana Dyer
From Cancer Dietitian to Garlic Goddess

Diana Dyer, MS, RD, describes her current vocation as  “CEO of tractor repair and weeding to bottle washer and barn sweeper,” yet looking back to her dietetics beginnings, you may never have guessed this one-time critical care specialist would end up trading in daily TPN feedings for a reign as “garlic goddess” (as named by one of her customers) overlooking a field of green. 

Dyer started out her nutrition career in the late ‘70s as a renal dietitian, then quickly took on critical care, at hospitals in Ohio, Illinois, Wisconsin, and Michigan. After two decades of caring for patients in ICU's, she mustered up the courage to make her first (certainly not her last) unconventional work choice “to leave behind my comfortable and rather insulated world as a well-respected critical care specialist for the complete unknown world in real life,” to instead focus on serving the cancer survivorship community. Having survived neuroblastoma as a child and two later bouts of breast cancer, Dyer felt the message of nutrition’s role in cancer prevention and survivorship wasn’t being heard by the masses—so she became that voice. 

Through writing A Dietitian’s Cancer Story, developing the website www.CancerRD.com, and speaking to audiences nationwide after her book received widespread praise by The New York Times, for roughly a decade Dyer brought her positive message of how nutrition and other complementary therapies can optimize cancer outcomes to Americans of all shapes and sizes.

In 2009, Dyer decided to mix it up yet again, with her husband this time. The team left behind their regular paychecks and returned to their roots, quite literally, to fulfill a longtime dream to become organic farmers, establishing The Dyer Family Organic Farm just outside Ann Arbor, Michigan, where today they specialize in all things garlic.

For someone who has been through so much hardship, you might think her life outlook would be a bit (understandably) hardened; this couldn’t be further from the truth. Instead of bitterness and bite, Dyer takes from her tribulations a good helping of graciousness and gratitude—and passes it on to whoever will listen. 

“I know for sure that neither cancer nor life is fair,” she says from what she’s learned from her three bouts with cancer. “So you have to figure out that in spite of the bad set of cards you have been dealt, you want to go on, you want to play this hand and do the best that you can, and that you can help write the script to your life—grabbing life, giving life everything we have, noticing everything, living everything, loving everything.”

For a taste of Dyer’s enthusiasm for nutrition and life itself, check out www.dianadyer.com, www.365daysofKale.com, or www.CancerVictoryGardens.com

TD: What’s your best advice for those new to the nutrition field?
Words of wisdom I have hoped to leave with new undergrads/interns:
"The larger the island of knowledge, the longer the shore of wonder." 
–Ralph Sockman. 

I used this quote on my last day teaching dietetic undergrads at Eastern Michigan University. I took time in class to let them tell me what it meant to them. One student found me years later to tell me that meant a lot to her. 

TD: What book has most positively impacted your professional life?
Dyer: Diet for a Small Planet by Frances Moore Lappé, which I read in 1974. This book opened my eyes to so many new ideas, vegetarianism of course, but also so many ways that food, nutrition, and social issues are related.

TD: If you could offer clients/patients only one piece of advice, what would it be?
Dyer: Please do not view cooking as ‘drudgery’; it is the deepest expression of love because it is creating a healthy body, a healthy family, a healthy home. Create and honor the time needed to cook simple meals, from whole foods, not convenience mixes or from ‘food in a box,’ and then sit down to eat a meal with friends or family on a daily basis.  

TD: What five items are always in your refrigerator/cupboard?  
Dyer: Only five? Here are eight, and I could easily list 20. Soymilk, tofu/tempeh, flaxseeds, kale, garlic, red wine, chocolate, green tea (all organic if possible).

TD: How important do you believe having a basic knowledge of farming and ‘where food comes from’ is in the battle to get Americans eating healthy?
Dyer: My ‘reaching for the stars’ wish for a new Farm Bill would be the inclusion of funding designated to have every single school in the country have a school garden with an RD—a master gardener coordinator who would lead and coordinate a grade-appropriate curriculum and activities for each school’s students that includes gardening, how good food is important (vital) for energy, learning, good health, skills for cooking, the enjoyment of eating food raised and prepared at school in groups together, and even selling the food raised by the school children to parents, local neighborhoods, etc. 

In addition, I believe all gardening, but particularly vegetable gardening, is the most all-encompassing ‘alternative or complementary strategy’ for achieving health after cancer. This awareness led me to develop my www.CancerVictoryGardens.com blog, but the concept is probably equally applicable to the treatment of all chronic diseases such as diabetes, heart disease, hypertension, etc.

TD: Local or organic? 
Dyer: Local AND organic is the gold standard. In addition, knowing the practices of your farmers/beekeeper/animal raiser/etc is even an higher standard, platinum perhaps? Know your farmer, know your food.
  
TD: What foods do you crave?
Dyer: Would you believe kale and other, even more bitter, greens? Yes, I do.

TD: How has cancer changed your outlook on eating? 
Dyer: Oh I love eating, I love food, but food is so much more than nutrients. Because of food, I also love life. I knew all of this before my 1995 cancer diagnosis, but only on the surface.  Now I know all of this viscerally, even more deeply, because I believe it, I live it, I grow it, and I teach it. When we sell our garlic at the local farmers’ markets, we sell a food grown for flavor and grown with love. We sell a story of happiness and all ‘food with a story tastes better’  (Wendell Berry).

TD: Your best farming tip that can also be applied to life?
Dyer: Our farm’s mission or ‘tagline’ is “shaping our future from the ground up.” Take care of your roots, your soil, and your foundation and you will grow healthy food, a healthy body and spirit, and be part of a healthy community. The word “our” in our tagline is meant to be very large and continuous, from our soil to our community and everything in between. 

*****************************
I enjoyed re-reading this article. In fact I found myself smiling so many times, realizing that even though this was written 4 years ago, I can hear myself saying many of the same things today! 

One aspect of what I do on our farm not mentioned in the article is my enjoyment from having dietetic students and dietetic interns work on our farm as part of the School to Farm Program that I wrote for the Hunger & Environmental Nutrition Dietetic Practice Group of the Academy of Nutrition and Dietetics. These future dietitians learn first hand (with their hands in the soil) not only where food comes from (and the challenges) but that the starting point for health is "We are what (and how) we grow" versus the more typical "We are what we eat". 

I would like to share a few of their words as they have reflected on this experience: 

• It was not until I began working on the Dyer's farm during my dietetic internship that I realized I do not often think about where my food comes from. I now urge my patients to know where their food comes from, to ask questions, to get to know their local farmers, with farmers' market shopping being a great first step. 

• I learned the importance of dietitians being advocates for a fair and healthy food system along with viewing food, nutrition, agriculture, and health in a connected, holistic way. 

• "Lessons learned"........Where to begin? I learned so much, about taking care of the land's health plus the importance of being very connected with the local food community and constantly nurturing that relationship. 

• My experience on the farm opened my eyes to the "big picture" of health which I will apply during my career as a Registered Dietitian. 

• I left the farm with many bricks in my career's foundation plus the courage and inspiration to be a leader.

• I learned the critical elements of a healthy and sustainable food system and left with the desire to promote diets for my patients that contribute to human health and well-being plus ecological and planetary health. 

• My time spent at your farm shaped my career and the path I am taking in more ways than I think I even know. I reflect on our conversations almost daily! I am now confident about my professional choices and excited about the changes I can make in the communities I serve. 

And these words from a dietetic intern coming to our farm this summer:

• When I started the search for an enrichment site, I was looking for a unique experience that would challenge me and broaden my understanding of and perspective on the field of dietetics. As our world continues to change, a sustainable diet for both our planet and our bodies will become more and more crucial. I feel strongly that it is the responsibility of the dietetics field to be the leaders in this movement, and I intend to focus my career efforts on this goal. Farmer-poet Wendell Berry once said "Don't think you can fix all the problems. Learn as much as you can and then work with it to increase the chance that you will make a good example." During these upcoming two weeks, I am eager to learn as much as I can and hopefully, someday, use this new knowledge to create a good example of my own. 

I am very humbled as I read through the full "lessons learned" from these students, some are short, some are essays, all are heart-felt. I have only taken snippets from what they wrote me. 

I am also very hopeful as these young people embark on their careers, sharing their passions by connecting the dots in all possible ways between food and health. Quoting Wendell Berry again "To be interested in food, but not food production, is clearly absurd". My students have clearly learned that individual health begins with healthy soil, teeming with helpful microbes as the foundation of a healthy soil food-web in order that the food we eat is both nutrient-dense and healthy for us, our community, and the planet. 

I look forward to hearing what interesting, challenging, and meaningful work they are doing as they go forward in the years and even decades to come! 

I hope it is not another full year before I post again on this blog, but that is possible and likely. 

Feel free to keep up to date with our farm via our farm's website, including information about our farm's new book Get Going with Great Garlic: Recipes from your garlic farmers' kitchen (ordering info is at the link) and our farm's email newsletter. Recent shorter updates (with photos) about what is going on at our farm are regularly posted up on our farm's Facebook page and Instagram. So in the meantime, feel free to check us out there, too. 

Lastly, to come full circle, most of my readers likely follow me because of my advocacy work (that began back in 1997 with the publication of my book A Dietitian's Cancer Story) to include nutrition assessments and information from a Registered Dietitian who is an oncology nutrition specialist (CSO) as a proactive and individualized professional service of true comprehensive cancer care, from the day of diagnosis forward to optimize treatment efficacy, survivorship health, and overall quality of life. 

Short story, I (and many others) am still working on that goal. It is a long road, but the need for and benefits from this goal have been given some long-overdue national attention at a recent workshop held at the Institute of Medicine in Washington, DC on March 14, 2016. All of the presentations from the full day-long workshop are available to the public to view on-line along with the slides

Although I was not involved with the planning committee for this workshop, I was involved in other ways behind the scenes. In addition, I was deeply honored to be invited to speak at this important workshop as an advocate, representing everyone who has had a cancer diagnosis along with all Registered Dietitians working with this patient population. My remarks were brief (less than 10 minutes) and can be viewed within the Session on Models of Care, moderated by Kim Robien, PhD, RD. They start at approximately 57 minutes into this video. 

This workshop is a step, an important first step. If you are at a point in your life where you can speak up (with your oncologist, the medical director of your cancer center, your insurance company, your place of employment), please ask when the professional services by a Registered Dietitian are going to be included as a component of comprehensive outpatient cancer care along with payment coverage that professional care. Feel free to be the squeaky wheel......we need all voices, all hands on deck, and don't take "no" for the final answer! :)

So yes, while I am now farming full time, I am still involved with cancer, right where I started back in the 90's, working now with more of a focus on prevention of cancer and other food-related diseases (versus my previous focus on cancer survivorship) by growing healthy food to nourish and educate my community. 

My message to my students: no matter how different our various paths and efforts as dietitians look, or the places where we work, my vision is that we are all working toward the same goal, which is the creation of healthy communities. I will end my 2016 Registered Dietitian Day post with a Swahili word that I (try to remember to) teach my students and have surely used in past blog posts:

Ujima - a Swahili word meaning "collective work and responsibility"

To build and maintain our community, to make our brothers' and sisters' problems our own, and to solve them together.                                                                                        

Two thumbs up for healthy communities, shaping our future literally from the ground up! 

Cultivate your life - you are what you grow - inch by inch, row by row,
Diana Dyer, MS, RD