January 2018 Issue

Farm-to-Table Nutrition Education
By Sharon Palmer, RDN
Today's Dietitian
Vol. 20, No. 1, P. 38

Sutter Health's Memorial Medical Center in Modesto, California, made this dietitian's dreams come true by teaming up with her to coordinate a farm-to-table nutrition education event. Take a lesson from this story and make it happen in your own community.

Picture this: A food and nutrition workshop hosted on a real live working farm in the heart of California. A plant-based cooking class, led by a local chef, held in the shade of the farmer's patio. A dietitian teaching a nutrition class, with samples of whole plant foods to touch, smell, and taste beneath an old citrus tree. A home gardening workshop offering people their own garden spades as well as practical information about growing their own vegetables. Local food artisans providing samples of their goods against the backdrop of a thick orchard. Long wooden communal dinner tables perched among grape vines and laden with healthful, delicious plant-based meals featured in the workshops. The crooning of country and gospel tunes by local musicians amid the chirping of crickets in the balmy evening on the farm. You don't need to pinch yourself, because this isn't a dream scenario. This community food and nutrition educational event actually happened on a gorgeous September day just outside of Modesto in Hughson, California. And I was elated to be a part of it.

How It Got Started
This story starts with a request I received from Sutter Health's Memorial Medical Center to conduct a plant-based nutrition class for a community cancer conference in Modesto, California, in 2016. As a dietitian specializing in plant-based nutrition and sustainable food systems, I was thrilled to accept the invitation to speak to the Modesto community—a region located in the center of California's thriving agricultural system—about the power of whole plants to help prevent cancer. My presentation provided practical information on how to include more healthful cancer-protecting plant foods in the diet. I was even more thrilled to see how enthusiastically the hospital leadership, as well as the attendees, responded to my presentation that day. This marked the beginning of a wonderful connection between Memorial Medical Center, me as a food and nutrition enthusiast, and local plant-based foods.

During the wrap-up for this event, Cheryl Casey, organizer and community outreach coordinator for Medical Center Cancer Services, asked me whether I'd like to return to Modesto the following year to do a more hands-on type of nutrition event for the community. Her idea was to use local produce and spend the day showing people how easy it is to prepare a delicious meal using seasonal fruits and vegetables. We could take people from visiting the farmers' markets to learning how to prepare those foods to sitting down together at the end of the event to eat a real meal made from the whole foods we'd been talking about. Casey was talking my language as she shared her vision of uniting people around healthful food in the very place it originates from. I proceeded to tell Casey about my long-held dream of teaching a practical hands-on food and nutrition class right in the middle of a real operating farm.

Dream Farm-to-Table Concept
In reality, I'd been exploring this farm-to-table nutrition education concept for several years. My dream had been to host a plant-based food and nutrition workshop in the middle of a local working farm in my home in Los Angeles County. I wanted to teach people a few nutrition lessons while they learned how to cook healthful, delicious plant-based foods using ingredients obtained in the fields in which they were standing. I envisioned us closing out the evening with a dinner in the middle of the farm composed of the dishes we'd all made together, enlivened with a healthful dialogue on sustainable foods. Sure, this might sound like a simple plan, but it was wrought with challenges, such as finding a suitable farm, budgeting, promotion, assistance, equipment, lighting … the list goes on. The problem was, I was trying to plan this event all by myself and the challenges were daunting. I had all but given up on my idea, but Casey said, "I think we can make it happen."

Day at the Farm
Fast forward to a year later, after hundreds of hours of planning, our dreams came to fruition as 269 people attended the first annual Harvest of Hope: A Day at the Farm on September 16, 2017, at the La Rosa Family Farms in Hughson. The record-breaking triple-digit heat wave in Modesto lifted just in time to bestow a pleasant, sunny afternoon upon the guests as they arrived. Excitement was in the air as members of the community (including the mayor of Modesto), dietitians, and volunteers from the hospital gathered together for a day of learning about nutrition, cooking, home gardening, plant-based eating, and local, sustainable foods.

Putting a Plan Into Action
Much goes into planning an event like this. But these three factors made the Harvest of Hope a reality: 1) the dedicated efforts of an enthusiastic, well-connected community outreach coordinator, as in the case of Casey; 2) a hospital, such as Memorial Medical Center, with the foresight, ability, and commitment to back a community event focused entirely on local food and nutrition; and 3) a local farm, La Rosa Family Farms, willing and able to host a large community event. On all three counts, the stars were in alignment for the Harvest of Hope.

Memorial Medical Center Cancer Services has been dedicated to supporting services within the Modesto community for several years, providing numerous educational events and support groups to enhance the wellness of the community. The hospital was committed to the event from the get-go, supporting Casey in her time and budget spent organizing all of the details, as well as enlisting departments within the organization, such as marketing and nutrition services to dedicate time in planning it. They took on the lion's share of the planning. In addition, hospital dietitians and oncology staff lined up to support the program.

La Rosa Family Farms dates back to 1910, when Joseph La Rosa, a Sicilian immigrant, farmed more than 300 acres of land in Hughson. The farm, which has remained in the family, now consists of 60 acres of its own land, and the family farm helps run a cooperative of fruit growers. The produce at La Rosa goes to farm stands, farm-to-school produce programs, local produce boxes, and local restaurants. Because the farm hosts events, it was well situated to facilitate this community event.

Recently impacted by a family member's cancer diagnosis and journey back to health, the La Rosa family became involved in The Celebration of Hope event that Memorial Medical Center presented in August 2016. Michael La Rosa didn't hesitate when he was asked to host this new event at the family farm. He and his wife Noel were very involved in the planning, including helping to come up with the name, Harvest of Hope. Both were interested in helping those who have been touched by a cancer diagnosis and loved the idea that this was a cancer prevention program as well.

Once we had these important factors in place, our team (mostly Casey, that is) went into full planning mode for the Harvest of Hope. Many considerations had to be addressed, such as programming, scheduling, use of space, registration, toilets, parking, lighting, tents, electricity, water, exhibitors, tables, chairs, beverages, catering, and promotion. We enlisted sponsorships from members of the community to help supplement the budget for the event, and charged a small fee of $35 for attendance, which included education, food, beverages, and entertainment. Marketing efforts included social media, print media, and posters in the community. A team of hospital and community volunteers was enlisted to help set up and register and direct attendees. It was impressive that so many of the hospital's key oncology staff members and others came out over the three-day set-up period to help make the event happen.

The basic event model was to greet people at the registration booth in the early afternoon, where they'd be assigned group numbers, hold a brief introduction in the main area, and then rotate the groups of attendees through the three workshops, which were taught every hour. This format kept the size of the workshops small and the content more interactive, compared with a traditional lecture style.

Local chef Jesse Layman hosted an interactive class on plant-based cooking, offering ideas for preparing plant-based dishes, from appetizers through desserts. Ali Stambaugh from the local Westurf Nursery instructed attendees on how to grow edible flowers, vegetables, and herbs in home gardens. And I taught a plant-based food and nutrition class, sharing information on how to include whole plant foods such as pulses, whole grains, fruits, and vegetables in the daily diet for optimal health.

The exhibit area included local food companies and artisans, such as a fermented foods expert, a honey maker, and a sustainable food organization. Dietitians from the community co-opted the La Rosa fruit stand to provide samples of fruit and vegetable smoothies and talk about eating more plant foods. There was even a petting zoo with a calf and goats to enable attendees to interact with small farm animals.

After the workshops, attendees gathered together for a social hour of healthful snacks and a local wine. This slowly gave way to the communal dinner, which featured long, wooden tables decorated with produce and twinkling lights right in the middle of the farm. The dinner was hosted by a couple of local culinary experts: Ann Endsley, an organic farm owner and founder of Greens, a local restaurant and catering company, and Chef Joey Jacobson and his team from the La Rosa Woodfire Farm to Fork Pizza. Dishes included wood-fired pizza, some of my own salad recipes (such as Southwest Black Bean Quinoa Salad and Provencal Bean Salad), and a pear crumble.

Capping off a lovely day, local gospel group The Rykert Trio, composed of father Joe, daughter Noel (married to Michael La Rosa and living on the farm), and son Joseph, hosted a live performance on the farm beneath the stars.

I'd be remiss if I didn't point out that the event was gorgeous, enlisting all of the senses of sight, sound, smell, and taste. The setting included a charming aged barn with a vintage truck, trellised grapevines laden with fruit, orchards heavy with fruit, rustic pots of herbs and sunflowers, checkered tablecloths, and baskets of produce. Helpers donned colorful farmers' market aprons. Jars of herb and fruit-infused water offered fragrant hydration. The aroma of Chef Jesse cooking vegetables permeated the air. Tastes of smoky pizza, crunchy grains, and savory pulses sparked the palate.

"My favorite part of the day was sitting down to a meal with cancer survivors, caregivers, physicians, nurses, and other health care providers, along with community members and supporters. It was absolutely magical. It felt like family in the best possible way. A true testament to the community and support we have created through our many cancer programs and services," Casey says.

Measuring Success
Pre- and postevaluations measured the effectiveness of the event, and, by all standards, the Harvest of Hope was a success. "The event inspired me to get back to basics, grow some of my own food, purchase locally from small-scale farms, eat more plant-based food with minimal processing, and make meals a time to relax and enjoy with family and friends," said one event attendee.

Talking with some of the dietitians who helped during the event, two significant aspects emerged: First, this occasion showcased food and nutrition, and dietitians front and center, perhaps a rarity among hospital-led events; and second, it focused on local foods within a community known for agriculture. Todd Imura, MHA, RD, chief clinical dietitian at Sutter Health Memorial Medical Center, says, "In the early 1900s, my great-grandparents were strawberry, peach, and pear farmers in the California valley. My grandfather suffered from prostate cancer, and my mother is a cancer survivor. After two generations, I'm trying to reconnect with the health benefits of optimal nutrition and gratefully appreciate the bounty of agriculture our state produces. The Harvest of Hope provided that opportunity. This event not only was a valuable community presence for Sutter Health but it also convened a number of local businesses with similar missions."

Faron Moreno, RD, CSO, a dietitian at the hospital who volunteered at the event, says, "It was a privilege to be a part of Harvest of Hope. The whole event had a special feel. What moves me as an oncology dietitian and daughter of an agriculture family is seeing a community come together to support the vital role of farming and nutrition for cancer prevention, while at the same time remembering those who have been affected by cancer. Food has the power to improve health and move people emotionally. I'm honored to do this kind of work."

Lori Spears, RD, CSR, a dietitian at Satellite Dialysis who volunteered at the event, says, "We were able to spend the day on a working farm providing nutrition education in an interactive way with hands-on workshops. Participants were inspired to make better choices that include more plant-based foods into their diets. This experience was truly a celebration of local, sustainable foods that help to support optimal health and nutrition."

In fact, the hospital leadership was so pleased with the outcome of the event, they authorized the second annual Harvest of Hope, offering an opportunity to further expand this food and nutrition education model in their community.

"Our core mission at Sutter Health is to enrich the lives of our community through a commitment to health and well-being," says Sue Clarot, RD, director of dining and nutrition services for the Sutter Valley Hospitals South Area. "As a member of the Sutter team and as a person having roots in the valley as a member of a local farming family, I was thrilled to be a part of this wonderful event, which is hopefully the first of many more to come. This was a day of educational enrichment that culminated with a delicious farm-to-table meal where guests joined in conversation and camaraderie at the heart of the farm among the tree-lined orchards. It was a privilege to partake in this event."

In the afterglow of the Harvest of Hope, I can't help but wonder, couldn't more hospitals and organizations spearhead a similar event in their communities? Isn't there enormous value in connecting communities to dietitians, local food, and health in a practical, hands-on, meaningful way? If you agree, let's see whether we can all make this happen in our communities. I'd love to hear your own stories of how you're connecting the dots between food, health, and agriculture, so please share them at info@sharonpalmer.com.

— Sharon Palmer, RDN, is the nutrition editor of Today's Dietitian, author of The Plant-Powered Diet and Plant-Powered for Life, and blogger at The Plant-Powered Dietitian. She's currently obtaining her master's degree in sustainable food systems at Green Mountain College in Vermont.

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