By Dietetic Intern: Amber Wall

“Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime.” This saying came to mind after completing my rotation with the USDA’s SNAP-ED Connection program manager, Janice Schneider, MS, RDN, FAND. The SNAP Program serves its participants by not solely providing them with funds to purchase food but also encouraging the establishment of healthy habits through SNAP-Ed. The information provided is truly a valuable resource. It opens doors to life-long health improvements and promotes generational successes. Through the material created, I was able to contribute to SNAP-Ed’s mission and help provide resources that could impact the future.

SNAP stands for Supplemental Nutrition Assistance Program. This federally funded program provides money via EBT card to assist low-income individuals and families with getting groceries. SNAP-Ed stands for Supplemental Nutrition Assistance Program Education.  This program is dedicated to the mission of “implement[ing] a nutrition education and obesity prevention program for eligible individuals that promotes healthy food choices and physical activity consistent with the most recent Dietary Guidelines for Americans”.  This rotation was dedicated to researching and preparing materials to be utilized by SNAP-eligible participants.

I was assigned multiple tasks during this rotation. The tasks consisted of creating electronic bulletins for their 176,000+ subscribers, creating two months of tweets for their Twitter account, recreating recipes, taking photos for their site, and more.  While the focus on knowing your audience was a very important element in creating resources, a larger picture was at play. I was creating material that could influence lifestyle choices and thus make a positive impact on health outcomes. While SNAP benefits provide funds to its participants to utilize at the grocery store, SNAP-Ed can influence what is being bought at the store. SNAP-Ed caters to the well-being of the participants before, during, and after the benefit funds are used.

The SNAP-Ed program provides recipes, training, videos, and nutritional information to complement the given funds. I attended a webinar during Native American Heritage month where I learned about some of the tribe’s cultures and traditions. I was able to hear the challenges and disparities amongst this population and how SNAP and SNAP-Ed have provided nutrition care and resources to those groups.  This experience reinforced my belief that dietitians have a responsibility to investigate not only current nutritional needs but also how those needs are met prior to and after nutrition care is provided.

Another task I was given was creating the E-bulletin for their email subscribers. The purpose of the E-bulletin is to provide information in a condensed format. Topics could vary from seasonal produce, food safety, and physical activity among other things. E-bulletins create shortcuts to direct subscribers to topics of interest on the SNAP-Ed Connection website. E-bulletins are also “food for thought”, consisting of tips to help members when it comes to changing nutrition and physical activity behaviors.  While working on E-bulletins, I used pictures to concisely provide as much information as possible. I created eye-catching images that provided information like this image below:

The picture can be absorbed within seconds and displays quick nutrition information that may influence participants to add more fruits and vegetables to their shopping carts. It provided an example of what the vegetables look like to help the participant identify these foods when shopping in the future. These types of infographics were usually accompanied by written information on how to use the food in recipes or as part of a healthy lifestyle. SNAP and SNAP-Ed are not only increasing nutritional security, but they are also improving the diet quality of their participants.

Twitter is another platform where participants can make quick connections to helpful health information. I created tweets and a brief seasonal infographic that would potentially reach a different audience on this social media platform.  The tweets consisted of quick teasers to encourage exploration of the SNAP-Ed site. The infographic I created on a winter vegetable was a fun way to grab the viewer’s attention by using wordplay while linking to a source on how to use it in meals and recipes.

My favorite task was making and photographing the food recipes for the USDA’s “My Plate Kitchen” online page. The recipes included on the site are healthy and budget-friendly. So, SNAP-Ed bridges the gap by providing nourishing recipes that are quick and affordable. The recipes I recreated included the Breakfast Parfait, Cabbage Stir Fry, and Chili Bean Dip. In addition to utilizing the SNAP funds and providing resources on how to prepare affordable nourishing meals, the recipes have the potential to become a generational staple meal. SNAP-Ed encourages including children in the kitchen when preparing meals. Including children in the cooking process helps establish healthy habits for the entire household.

The tasks I completed while rotating with the SNAP-Ed Connection allowed me to create content that is valuable and educational. Being part of such a hardworking and compassionate team made the experience even more rewarding. SNAP and SNAP-Ed are a powerful duo that truly embody the “Teach a man to fish” phrase. They could have stopped at just providing the funds to purchase food, but they have taken it a step further to implement a program that influences healthy lifestyle change. As a future registered dietitian, I now know the importance of not just evaluating and solving immediate problems, but also looking further into a person’s life and background to provide them with relevant resources that will help them establish and sustain healthy habits.

By: Julie Henderson

The fear of the unknown can be a stronghold. That is what I felt when I was assigned to do my first podcast in my dietetic internship program. I chose this internship program with the University of Maryland, College Park (UMD) because of what I didn’t yet know and what I wanted to gain better development in, technology and informatics. And one thing I have learned is not to let the fear of trying something new keep you from achieving new heights in your career goals.

You may not know much about podcasts if you are anything like me. I had heard of them, but I had no idea how to access them, let alone develop and record one. One of our wonderful preceptors, Megan Lautz, MS, RD, CSCS, TSAC-F has many talents working with and teaching technology and informatics. She created a schedule and assigned each intern specific dates that their podcasts would be due. During the 10-month internship, everyone must complete two podcasts. My first podcast was not due until February but knowing that I would have other assignments along the way, I chose to get started a few months early when I had more available time.

To start, I had to choose a topic and obtain approval from my preceptor. I chose to discuss the differences in packaged food labeling of sodium/salt. Even though I was intimidated by this assignment, choosing a topic made me realize that I had been taking my knowledge for granted. As it has been said, “knowledge is power,” and this was an opportunity to use my knowledge to educate others about nutritional topics affecting their health and well-being. My podcast highlighted the differences in the label wording and meaning of sodium amounts in food. For example, “Salt/sodium free” means that a serving of a particular food has less than 5 mg of sodium, while “Low sodium” means a serving has less than 140 mg of sodium. I learned that podcasting is not only an outlet to inspire or entertain people, but also a platform to educate on topics about which the speaker is knowledgeable. So, with my podcast, I hoped to educate future UMD interns and the public by cross-posting the podcast on multiple social media outlets.

The next step was to write the rough draft for the podcast. The requirement was 1 page, double spaced to accomplish a recording of 2-3 minutes in length. It wasn’t difficult to get to the 1-page requirement, especially since I knew what I wanted to relay and I had the knowledge and passion to discuss it. In this case, I felt like it was important to explain that there is a real difference in the amount of sodium in foods based on the food label wording.

The finishing touch was to record the podcast. As stated, the recording for this assignment was limited to 2-3 minutes. I first had to play around with the free downloadable recording software, Audacity Team and Sound Cloud. I then chose one and set it up to record in what I thought was a quiet space, my home office. The first 4-5 recordings were either too long or I got tongue-tied while trying to speak. Just as I finished the last couple of sentences on my sixth attempt, a family member walked into the office and ruined it. Although this was very frustrating, I moved forward and recorded my seventh attempt. And lo and behold, I did it! I accomplished my very first podcast. I happily submitted it to my preceptor for finalization and posting.

It can be intimidating to do things that you have never done before, although it is rewarding afterward. Completingthese podcast experiences will help me in my future as a registered dietitian by giving me an outlet to educate and interview others, research the latest food and nutrition-related topics, and promote the dietetic profession. I could create podcasts for my own nutrition business or private practice or be interviewed on someone else’s podcast one day. Thankfully, along with the schedule, Megan provided clear directions and helpful hints that allowed me to obtain the growth I needed to feel competent in creating podcasts. Looking ahead, I am no longer intimidated by my next podcast as I have realized that there are many topics I am interested in educating the public about when it comes to food and nutrition.

I felt accomplished after completing the assignment and look forward to the next podcast creation.If interested, you can find my first podcast at: 

By: Stephany Singh

While there are more than 160 known food allergens only eight have been considered major allergens and are required to be listed on food labels. But did you know that there are now nine major allergens? As of January 1, 2023, sesame has been added to the list.

You may be wondering why I am giving you this information. At my recent dietetic internship rotation at the Manna Food Center, I was tasked with creating an infographic for the staff in both English and Spanish. After I  developed the infographic, I had the opportunity to provide a 10-minute in-service for those who worked in the distribution center. I was up for the challenge.

 In addition to sesame, the other allergens include peanuts, crustacean shellfish, eggs, wheat, soy, tree nuts, fish, and milk. It is important for the Manna Food Center staff and volunteers to be aware of this information to keep their customers safe. This information is especially important for those who sort the donated foods and pack the specialty boxes.

Food allergy is a potentially life-threatening immune system reaction that occurs soon after eating a particular food. Even a tiny amount of the food causing the allergy can trigger signs and symptoms such as digestive problems, hives, or swollen airways.

Food allergy is a pathological reaction of the immune system triggered by the ingestion of a food protein antigen. For instance, if you have an allergy to cow’s milk, your immune system identifies cow’s milk protein as an invader or allergen. It then overreacts by producing antibodies called Immunoglobulin E (IgE). These antibodies travel to cells that release chemicals, causing an allergic reaction. Food allergy reactions can be mild to severe and, in some people, may cause a life-threatening reaction known as anaphylaxis.

According to the Mayo clinic,, food allergy affects an estimated 8% of children under age 5 and up to 4% of adults. While there is no cure, some children outgrow their food allergies as they get older.

Food allergy is often easily confused with a much more common reaction known as food intolerance. Food intolerance does not involve the immune system and causes less serious symptoms. A food intolerance means either the body cannot properly digest the food that is eaten, or that a particular food might irritate the digestive system. Symptoms of food intolerance can include nausea, gas, cramps, belly pain, diarrhea, irritability, or headaches.

The infographic I developed below gives an overview of the nine allergens and provides a couple of safety tips for the Manna staff and volunteers to follow that may reduce the risk of exposure to an offending food. Additionally, Manna Food Center has a specialty box packing guide which is also useful. For example, if a volunteer is not familiar with celiac disease, the specialty box packing guide instructs them on how to read nutrition labels to ensure they pack items that are gluten-free in the participant’s box. 

The experience of developing this infographic on the Big 9 Food Allergens has empowered me as a future registered dietitian to provide knowledge and education to others in an impactful way. I was able to think freely and strengthen my skill set through the use of a new language. I will lean on this experience to help me make effective social media posts that educate people on common food issues and concerns. My goal for the future is to use impactful infographics like this one to educate others to make sound decisions related to their food choices and overall health.

A Partnership Between a Dietitian and A Speech Pathologist

By: Amber Wall

Reading through multiple clinical notes as a dietetic intern can be overwhelming. There are notes from the nurses, surgeons, occupational therapists, speech pathologists (SLP), and more. I began to question the role of a speech pathologist compared to a dietitian. Prior to this rotation, I thought that only dietitians made suggestions on food consumption. Luckily, I was able to shadow Farlah, a SLP, and her intern to learn more about their expertise. This experience has provided me with a greater understanding of the importance of a second opinion. 

My time with Farlah and her intern, Edith, began with an assessment using a trial tray. A patient on a pureed diet had requested a diet advancement. The purpose of this assessment was to evaluate the patient’s  tolerance to a mechanical soft diet. The meal container included two pancakes and ground sausage. The patient did not like pancakes and consumed only the ground sausage, so the tolerance of the meal he ate was based on the number of times it took to swallow. Also, mouth-clearing and time of mastication were also taken into consideration. Edith placed her pointer and middle finger on the “Adam’s apple” to check for larynx lifting and esophageal closing to allow food passage. The patient appeared to be consuming the food relatively smoothly from just looking at him. Edith informed me that the “Adam’s apple” should rise and fall with ease if the swallow is complete and proper. Improper swallowing, also called dysphagia, may have a pulsing sensation and delayed or reduced motion. While to me the patient seemed to be tolerating his sausage well, Edith noticed a delay and a pattern of multiple swallowing for one mouth full of food. From the surface, this could not be noticed. After pressing my fingers to the patient’s throat, I was able to feel what Edith did.

The results of the physical screen indicated that a  Modified Barium Swallow study (MBS) would be helpful. Farlah, Edith, and I teamed up with radiology to take x-ray videos of the throat cavity.  After being shown by Edith, I was able to set up the barium-coated foods of different consistencies for the patient to eat during the x-ray observation. Barium is used to coat the food, so it is visible in the x-ray. Water was added to the powdered Barium to mimic thin liquids. Barium powder was mixed with applesauce and a fruit cocktail cup to mimic pureed food and a mechanical soft diet, respectively. A whole cookie was topped with barium to mimic a regular diet. From a side profile visual, I was able to witness the patient chewing and swallowing the barium-coated food, which appeared on the screen as a black blob. With the pureed food, the patient was able to clear the throat cavity properly without any signs of aspiration. When the texture increased to the mechanically soft fruit cocktail cup, things changed. I was able to see traces of residue building up in the esophagus and its surrounding cavities. This build-up with each swallow created a small stream of contents going into the airway. When food enters the airway, this is called aspiration. Food in the airway causes choking as the body is trying to remove the particle. As I watched the screen, I could see small and sometimes silent coughs as the patient tried to get down the fruit cocktail. Multiple sips of water were needed to flush down food residues as well. This moment was mind-blowing. Initially, I would have presumed the patient was safe to advance his diet due to him eating his ground sausage without apparent struggle. Internally, the patient’s body was not working properly for him to safely consume his desired food preference at the time. 

Additional screens can be performed by SLP using their “swallow bag”. This bag consists of apple sauce, fruit cups, cookies, thickened liquid, cold water, tongue suppressors, and many other assisting tools. These ingredients and tools can test swallowing ability and help determine a patient’s food consistency level. Muscular capabilities are then tested through an array of small mouth movements. This includes smiling, puckering lips, sticking the tongue out, and more. Dental orientation is also assessed at this time. The experience and array of information were very valuable to me as a dietetic intern. I was able to visit patients with my eyes wide open. I began to pay greater attention to other factors learned from shadowing Farlah and Edith. I was happy to include these factors in my skill box, in addition to assessing for muscle wasting, fat wasting, and edema, which were already a part of my assessment practice.  After performing these exercises, Farlah and Edith made a prediction about the cause of dysphagia and determined if the patient would benefit from seeing other health providers.

Reflecting on my visit with Farlah and Edith, this hands-on experience was very valuable to me. I was able to be more alert as a dietetic intern when providing patient care. I also was able to review notes with a better understanding and appreciation for SLP’s recommendations. I realized that the best patient care comes from multiple eyes and points of view. The end goal is to optimize the health and safety of the patients we are serving. Many tools and resources are utilized to assess and assist in patient care. Getting a second opinion from other professionals, especially from those with slightly different backgrounds, is a powerful asset. Having spent this day with another professional has provided more insight into why second opinions are so important in health care. Since then, with each note I read in the morning, I appreciate it a lot more. I pay deeper attention to each patient and request additional referrals when appropriate. I want to be a second pair of eyes to other practitioners whenever I can.  A second pair of eyes and hands can save lives. Second opinions matter.