Story Number: NNS140317-05Release Date: 3/17/2014 12:16:00 PM
By Douglas H. Stutz, Naval Hospital Bremerton Public Affairs
BREMERTON, Wash. (NNS) -- There was no cake but there was compassion on the 7th annual Registered Dietitian Nutritionist Day of March 12 as Naval Hospital Bremerton (NHB) registered dietitians continued to improve their patient's health with timely intervention.
Registered dietitian Susan Yake ran into a beneficiary she has known and helped for the past 15 years and immediately extended the offer to come in and discuss his current nutritional status. He readily agreed.
"I saw Jim and told him to come on in," said Yake.
"Susan has taught me well. I have discovered new things continually about my nutrition and eating such as going over what foods can be an irritant," said Jim Wylder, retired Navy commander.
There are four registered dietitians assigned to NHB. Along with Yake, there are Cmdr. Kim Zuzelski, Nutrition Management head and Jennifer Meeks at NHB, and Cheryl Decker at Naval Branch Health Clinic Everett. Registered Dietitian Nutritionist Day is a national event put on by the Academy of Nutrition and Dietetics to bring awareness that dietitians such as the NHB four are committed to improving the health of their patients and community.
According to Yake, NHB's dietitians help patients learn about their nutrition to improve their overall health. If a patient has a health concern such as diabetes, heart disease, insufficient kidney function, gastro-intestinal problems, overweight or obesity, a dietitian can provide guidance to reduce symptoms and/or reverse the condition. If the patient has a food allergy, intolerance, or sensitivity, a dietitian can teach the patient how to avoid the triggering foods and learn what is safe for them to eat. Even when someone is preparing for surgery, the dietitian can provide support with a nutrition care plan to speed healing and reduce the risk of infection. Dietitians can also identify nutrient deficiencies and recommend supplements and meal plans to correct a condition.
"Our service can be life changing. Balanced nutrition provides the key nutrients for proper function resulting in increased energy and stamina," Yake said, noting that dietitians help patients with disease prevention and treatment, and even with medically-related cost savings.
Dietitians work to prevent disease as well as treat it. Studies show that lifestyle changes can prevent disease.
"An example is that diet and exercise prevents diabetes 58 percent of the time, even better than the 38 percent decrease seen from some diabetes medication," said Yake, with more than 30 years of experience, 27 spent at NHB.
Dietitians save medical costs by reducing the need for medication, emergency room visits, doctor appointments, and hospitalizations. A dietitian who is a diabetes educator can help a patient control their blood glucose levels through diet and make recommendations to the physician for medication adjustments to achieve good control of their glucose.
"Better control means reduced risk of complications. For every dollar spend on dietitian services, three to five dollars is saved in medical costs," stated Yake.
One hurdle that NHB's Nutritional Management staff routinely handles is dealing with the perception of the word 'diet.' People tend to associate that word with needing to lose weight, fast, or starve. Yake quickly points out that the true meaning is more than that. Dietitians still use the words 'diet' as well as 'meal plan,' but today there is more of a focus on the word 'nutrition.' This is also reflected in the fact that the name of the dietitian has changed from registered dietitian to registered dietitian nutritionist. The name of their organization has also changed from the American Dietetic Association to the Academy of Nutrition and Dietetics.
"There is much more to 'diet' than losing weight though weight loss is important for health with the obesity rate at 27.2 percent along with another 35.5 percent of Americans overweight. Limiting the focus to weight alone misses the point of how powerful nutrition really is to our bodies and health. What we eat has far more effect on our health than was once thought," said Yake, citing that increased awareness and enhanced knowledge are also powerful nutrition tools she enjoys sharing.
"Because some portions of food have been "supersized" many of us are eating too large of portions," continued Yake. "Learning what is normal for health is one of the hurdles. Another hurdle is learning what is balanced. Listening to the media and reading popular diet books can be confusing. Patients want to know how much carbohydrate, fat, and protein to eat, and what are they doing right and what do they need to improve. Dietitians can individualize diet recommendations based on individual health and nutrient needs."
Yake and the others also provide support to help deal with disorder eating patterns and food addictions. Dietitians can use specific tools such as cognitive behavioral therapy to assist patients in the healing process. Often support groups and referrals to mental health providers work well. Eating involves not just the physical side, but also the mental, emotional, and spiritual side of the person. In the healing process, all aspects of the individual need to be strengthened using the nutrition care plan.
"With all the conflicting information on the internet and in the media, it can be hard to sort out what is fact. Dietitians have the nutrition knowledge base as to what works and have evidenced-based clinical guidelines to follow. This provides our active duty members and eligible beneficiaries with safe, reliable nutrition information," explained Yake.
Yake states that the most gratifying aspect of her job is being able at times to see the remarkable improvement in her patient's health and wellbeing
"Some patients say that I saved their life. I think medical nutrition therapy saved the quality of their life after they made important changes to their lifestyle and diet," said Yake, also adding that on the flip side, seeing someone who is not ready to make changes, or who is struggling with disordered eating patterns or food addictions is the most difficult part of her job.
"They want the benefits of healthy habits without the effort to make the necessary changes. Overcoming old habits is not easy. Dietitians can guide and coach them, but cannot do it for them. It is the responsibility of the patient to act on that knowledge and use those tools," stressed Yake.
There are success stories like Jim Wylder. Yake attests that often times just implementing simple changes can bring results, such as one patient who cut his meat consumption in half and lost fifty pounds in one year.
Yake was worked with chronically ill patients suffering from inflammatory diseases such as fibromyalgia, migraine headaches, irritable bowel disease, eczema, and inflammatory arthritis. After identifying food intolerances and sensitivities, many patients can live normal lives. They can improve the symptoms of their disease or put them in remission. Dietitians support patients with food allergies and sensitivities to reduce symptoms of inflammation such as gastrointestinal problems, migraine headaches, and skin conditions.
"Dietitians can make a big impact on quality of life. For example, chronic pain patients have been able to drop their pain level by 80 percent after identifying food sensitivities contributing to their inflammation," Yake said.
Even children with attention deficit hyperactivity disorder (ADHD) or autism have functioned better at school and home allowing them to reduce or stop taking medication after guidance from a dietitian on diet modification.
NHB's dietitians additionally work with younger children and their parents to help prevent and treat obesity. Compiled data from the Center for Disease Control notes over 17 percent (or 12.5 million) of children are obese with 32 percent being overweight or obese.
Childhood obesity has also become a priority for dietitians. The Academy of Nutrition and Dietetics and the Academy of Nutrition and Dietetics Foundation launched Kids Eat Right Champaign in November 2010. This dietitian-driven campaign is dedicated to supporting the efforts of the White House to end the childhood obesity epidemic within a generation. Dietitians nationally have advocated for more nutritious school lunches and healthy school environments.
"At Navy Hospital Bremerton, the dietitians give expert advice to parents on creating a healthy food environment at home. Obesity rates have decreased for children ages two to five. We hope this trend extends to older children in the near future," said Yake.
Active Duty Members can self refer for weight control by checking with the Wellness Center (360-475-4179) to book into a class. A popular class is the Intro to Nutrition offered on the first and third Friday of every month. The Carbohydrate Counting Class is held once a month and there are also specialty classes taught, such as an Irritable Bowel Class offered every two months by the gastroenterologist along with a dietitian that is designed to restore quality of life.
"Irritable bowel disease affects 10 to 12 percent of the population and up until five years there wasn't a good treatment to offer. Now that has changed and most patients who take the class see improvement in as little as three weeks," Yake explained.
Yake encourages beneficiaries to ask for a referral from their provider for appointments and call TRICARE Regional Appointment Center (1-800-404-4506) to make their appointments.
For more news from Naval Hospital Bremerton, visit www.navy.mil/local/nhb/.