March 2011 Issue
TD10 — Meet 10 Dedicated Dietitians Who Are Making a Difference
By Maura Keller
Vol. 13 No. 3 P. 32
They’re devoted to their practice, delighting in every opportunity to help clients craft healthful lifestyles. They promote nutritious eating and the role of the RD in the community. They’re always eager to tackle new challenges. They truly exemplify what it means to be an RD.
To honor National Nutrition Month, we asked readers to nominate such deserving RDs, detailing the ways in which they inspire their colleagues and clients. This article spotlights 10 individuals chosen for their accomplishments and dedication to the field.
Enjoy these peer profiles—and give yourself a pat on the back for the wonderful work you do every day.
Tracy Bryars, RD, CDE, CLE
Healthy For Life Program Manager at American Academy of Pediatrics/St. Joseph Health System
Pediatric obesity is a top concern for many healthcare professionals, teachers, and child psychologists. Tracy Bryars is one individual who has been instrumental in helping fight childhood obesity by establishing a program called Healthy For Life that addresses the rising trends in obesity through its school-based intervention model.
“Healthy For Life is an innovative health and fitness program offered through the St. Joseph Health System and the Orange County Chapter of the American Academy of Pediatrics [in California],” Bryars says. “Our program provides resources to schools … in underprivileged communities. Resources include age-appropriate fitness and sports equipment and nutrition, fitness, and health curriculum.”
Bryars’ love of “all things nutrition” evolved during her high school years, when she found herself gaining weight. “I had put on 15 lbs over my sophomore year and went on a crazy diet, losing the excess weight. I decided at that time I wanted to learn how to eat health[fully] and avoid gaining the extra weight in the future,” she says.
As a senior, Bryars became interested in science and soon recognized that the combination of wanting to help others eat healthfully and her love of science would lead her on a journey toward becoming an RD.
Today, as manager of the Healthy For Life program, Bryars manages existing Healthy For Life school sites, organizes teacher trainings, and conducts program assessments and evaluations to facilitate quality improvement for the school-based childhood obesity prevention program. Bryars coordinated and directed the program’s growth from 12 classes in 2007 to 127 classes in more than 90 Orange County Schools by 2010.
Bryars has found it extremely rewarding to see the thousands of children, adolescents, and parents improve their lifestyle. So far, the behavior changes from the Healthy For Life program have resulted in students’ BMI percentiles decreasing to a more healthful range and a reversal of some identified medical concerns, such as prediabetes and hypertension.
“Providing the skills and tools to promote a healthy lifestyle through diet and exercise is what I enjoy most when working with individual patients, groups, or as a manager,” Bryars says. “Reversing the childhood obesity epidemic is my No. 1 priority. This is because children are our future and the way it is going now, we have a generation that will be the first to live a shorter life than their parents as a result of their unhealthy lifestyles.”
Upon completing a master of public health degree this May, Bryars hopes to continue broadening her reach by promoting healthful lifestyles through articles in research journals. “It would also be rewarding to develop an effective nutrition and physical activity ongoing program for children, adolescents, and families with type 2 diabetes that would promote a healthier lifestyle, resulting in reduced associated medical complications,” Bryars says. “I also would love to teach nutrition health at the college level. These are just a few of my dreams for the future. The sky’s the limit.”
Debbie Petitpain, MS, RD, LD
Clinical Dietitian at the Medical University of South Carolina/Sodexo
Dietetics may be Debbie Petitpain’s second career, but it’s her first love. Having originally worked in a lab as a chemist for four years after college, she always had an inclination for using food to promote health.
“Two things moved me toward a career in dietetics in 1999. First, I was inspired by Dr. [Dean] Ornish’s research to personally move toward a plant-based diet. Secondly, I started reading CSPI’s [the Center for Science in the Public Interest] Nutrition Action Health letter and was introduced to registered dietitian as a career,” Petitpain says. “I investigated my options for pursuing this, and my husband and I moved to Boston so I could start my training.”
At that time, Petitpain was also motivated to avoid the struggles with heart disease that plagued her father and simply wanted to inspire other people to be healthy through a “medicine” they were already taking every day: food.
“My daily goal is still to help people move toward a general sense of well-being by making healthy choices about their diet, exercise, lifestyle, or wherever they want to start,” she says.
Presently, Petitpain is employed by Sodexo and works full time for the bariatric surgery program at the Medical University of South Carolina (MUSC) along with another full-time RD, a physician assistant, a program manager, a patient coordinator, and four surgeons. With her RD counterpart, she helps patients move along the continuum of good health at every point in their journey to, through, and beyond surgery.
“I perform initial assessments on interested patients over the phone, then follow up with them in clinic when they come to meet the surgeon for the first time and when they return to sign their surgery consents,” Petitpain says. “I teach the preoperative nutrition class. I see every patient at every postoperative visit to assess weight loss, assess their diet, follow up on vitamin supplements and exercise, and order nutrition lab work when indicated. I also facilitate our twice-monthly support group; develop intense, hands-on, post-op classes for our patients; write an electronic newsletter that we send out once per month to anyone on our listserv—currently more than 1,200 subscribers—and update the nutrition pages of our website.”
Because MUSC is a teaching hospital, Petitpain also provides mentoring to dietetic interns and up-and-coming health practitioners, including medical and nursing students.
“What I find most rewarding in my role is sharing in what my patients call their ‘wow’ moments: the first time they ate something green and enjoyed it, the first time they went for a walk purposefully, the first time they looked in the mirror and were satisfied,” Petitpain says. “I am fortunate to work with surgeons and an interdisciplinary team that values the role of the RD in the success of their patients.”
Kelly Urbanik, RD, LD, CSP
Pediatric Clinical Dietitian, Ketogenic Diet at Arnold Palmer Hospital for Children at Orlando Health
Kelly Urbanik graduated from the University of Florida with a bachelor of science degree in food and human nutrition, with a specialization in dietetics and a minor in business. She completed her dietetic internship in Orlando, Fla., through Andrews University in Berrien Springs, Mich., where she discovered her love of pediatrics.
Currently, Urbanik works as a specialty clinical dietitian at Arnold Palmer Hospital for Children. “I am the lead ketogenic dietitian for the Arnold Palmer Ketogenic Diet [KD] program,” she says. “I am in charge of the nutrition portion of our KD program, which involves initiating patients on the diet during a three- to four-day hospital admission and then following them on an outpatient basis for the duration of their therapy.” Urbanik typically follows approximately 50 KD outpatients.
“The diet is very structured, detailed, and time consuming to prepare and provide, so I assist the family with calorie increases, new recipes, new products, medication information, and emotional and financial support,” Urbanik says. “When I’m not involved directly with my keto patients, I provide education materials and present to physicians, nurses, and other hospital staff regarding the diet. I also work as a nutrition consultant for Volusia County Head Start and Early Head Start programs.”
Urbanik has been a key leader in working to establish central Florida’s KD program. In fact, she has been working tirelessly, developing relationships with several neurology practices, providing their staff with educational information about the diet. But her outreach doesn’t end there. Urbanik has worked with hospital pharmacy and nursing departments to establish hypoglycemia protocols and medication administration guidelines for patients on the KD program.
Although Urbanik enjoys the challenge of her job’s technical and clinical aspects, such as nutrition assessment and constructing diet regimens, her favorite part is providing diet education to patients and families who are eager to learn. “The families that are referred to our diet program are typically very organized, compliant, and enthusiastic about the diet,” she says. “This makes a world of difference as I begin to tell them exactly what, when, and how their child will be eating for the next two to three years. I enjoy the rapport built with the families during the initiation period and throughout the diet therapy.”
Urbanik’s core focus is on the well-being of her patients, evident in her constant attention to their needs and her willingness to be contacted all hours of the day and night to answer questions from parents or medical staff. This “patient-first” approach is further evident in her effort to organize the first annual epilepsy awareness walk in Orlando.
Urbanik hopes to continue being challenged by new information and ideas: “If dietitians can continue to prove how valuable they are to the future of our health, I think that we will be thrust to the forefront of medicine and improve the quality of people’s health.”
Diana Dyer, MS, RD
Author, Private Practitioner, Cancer Specialist, and Farmer
When Diana Dyer graduated from college with a degree in biology, she found herself working as a lab technician, cutting the eyes off fruit flies for a professor who was doing ophthalmology research. She soon realized that she couldn’t imagine doing that for the rest of her working life.
Having taken an undergraduate introductory course in nutrition, she decided to start a PhD program in nutritional sciences. “I saw how everything I had learned about chemistry and biology had a true human application through the science of nutrition,” Dyer says. She completed her undergraduate degree at Purdue University, her dietetic internship at the University of Wisconsin Hospital, and her master’s degree in nutritional sciences at the University of Wisconsin-Madison.
After spending the first 20 years of her career in clinical positions, Dyer has continued her RD role, wearing many hats. In 1997, she began a private practice, focusing solely on providing nutritional guidance to cancer survivors. At the same time, she published A Dietitian’s Cancer Story and established the Diana Dyer Cancer Survivors’ Nutrition and Cancer Research Endowment in 1999 at the American Institute for Cancer Research.
Long-term and multiple-time cancer survivor and tireless advocate and ambassador for oncology dietitians, Dyer has been elected to the Oncology Nutrition Dietetic Practice Group’s executive board and received its Distinguished Practice Award in 2005.
“I have been exceedingly fortunate,” Dyer says. “I have had a long, full, interesting, and varied career. I have had opportunities I could not have predicted in my wildest imagination. I have been a ‘pioneer’ in several areas of nutritional practice, influenced public policy at the national level, and contributed significant funding for cancer survivorship research.”
Most recently, Dyer cofounded the Dyer Family Organic Farm in Ann Arbor, Mich., specializing in 40 varieties of organic garlic. “This is where I see myself as a true frontline healthcare provider—moving from a 15-year focus on nutrition for cancer survivors to being focused on pure prevention of all disease by growing organic food to be consumed by my local community,” she says. “I am also a food educator, emphasizing ‘food as flavor,’ and … I’m a source of inspiration to dietetic students and interns to learn about the importance of preserving and/or rebuilding our soil’s health….”
In her current role as an organic farmer, Dyer loves going back to her “biology roots” and finally having a job that is outside, where she is both a steward and a constant observer of her natural community. “Most rewarding to me is believing that I am also helping to expand and shape my dietetic profession, helping RDs to step back from ‘we are what we eat’ to embrace instead the starting point of our profession as ‘we are what we grow,’” Dyer says. “Put a face with your food by getting to know your farmer and buying his or her food. Good nutrition and great health will then follow naturally—for you, your family, your local community, and ultimately for our planet, too.”
Amy Jones, MS, RD, LD
Chief Clinical Dietitian and Celiac Disease Support Group Facilitator at Mary Rutan Hospital
For the past eight years, Amy Jones has been the chief clinical dietitian at Mary Rutan Hospital, a small community hospital in Bellefontaine, Ohio. Because of the hospital’s small size, Jones has enjoyed a wide variety of experiences, with tremendous support from her boss and hospital administration.
“I became interested in dietetics because I love to teach,” Jones says. “Watching my patients make changes and feel better, as well as truly feeling like I am making a difference in their lives, is what gets me going every day.”
Jones has a bachelor’s degree in dietetics from West Virginia Wesleyan College and a master’s degree in nutrition from Ball State University. She interned through Ball State at Parkview Hospital in Fort Wayne, Ind.
Last year, Jones took her biggest leap in starting and facilitating a support group for those with celiac disease, inspired in part by a friend’s young daughter.
“As I began seeing more and more patients with celiac disease come into our facility, I felt that my knowledge level was not where it should be, and I felt that support in our community was lacking,” she says. “I mentioned this to the wife of one of our physicians, and she said, ‘You have to meet my friend. Her 8-year-old daughter has celiac.’ So I met with her friend for lunch one day and learned about her daughter and her experiences after being diagnosed at the age of 5. … I told her of my idea to start a support group for celiac in our area, and she was very excited about having support so close to home.”
Over the next four months, Jones studied every book on celiac disease that she could get her hands on. She met with Mary Sharrett, a nationally recognized dietitian expert at Nationwide Children’s Hospital in Columbus, and scheduled her first support group meeting for May 2010. She hoped a few people would come and show the hospital that the group was worth the time and effort she was putting into it.
“My first meeting drew 45 people, far exceeding my wildest dreams, expectations, and the capacity of the room,” Jones says. “We have continued to meet monthly, with a different topic discussed each month, as well as product sampling and social time.
“One thing working with the area of celiac disease and gluten intolerance has taught me is that food is powerful,” Jones continues. “It can be an agent for peace and healing in the body or it can be [destructive]. And this is something I’m trying to tell all of my patients, not just those with celiac.”
Kathie Swift, MS, RD, LDN
Author, Private Practitioner, Nutrition Advisor, Developer of My Foundation Diet
Kathie Swift credits her mother, who loved to cook and was a fan of Adelle Davis, as her biggest influencer in becoming an RD. (According to the Adelle Davis Foundation website, Davis was “the first lady of nutrition whose writings are the foundation of health.”
“I went to college to study nursing and transitioned to nutrition because I observed that food was a powerful tool in healing and there needed to be more focus on food as medicine,” she says.
Swift obtained her bachelor’s degree in food and nutrition at the State University of New York, Plattsburgh, and her master’s degree in nutrition at Arizona State University. Much of her nutritional medicine schooling was obtained through course work and seminars in which she enrolled both in the United States and the United Kingdom in the 1980s.
“I actively pursued continuing education because I was hungry for knowledge in topics such as detoxification, herbal medicine, energy healing, and dietary supplements that my formal education did not provide,” she says.
Currently, Swift enjoys many different roles in multiple settings. “This affords me the opportunity to interact with extraordinary, dynamic individuals who share my passion for nutritional medicine,” Swift says.
Her functional medicine practice includes her private practice, SwiftNutrition, as well as the UltraWellnessCenter in Lenox, Mass. She is also the chief nutrition advisor for and creator of www.myfoodmyhealth.com and www.myfoundationdiet.com.
Integrative and functional medicine have been passions of Swift’s since the early 1980s, when she was determining how to better manage a chronic health condition.
“The advanced nutrition practice that integrates a systems biology approach to health and an awareness of genomics and core clinical imbalances such as detoxification, hormone modulation, [and] inflammation in chronic disease management is essential for dietitians to understand and apply in practice,” Swift says. “As former chair of the Dietitians in Integrative and Functional Medicine [DIFM] Dietetic Practice Group, I ensured that DIFM formed network relationships with key organizations such as the Institute for Functional Medicine, the Center for Mind-Body Medicine, University of Arizona Center for Integrative Medicine, and others that could provide the educational opportunities important for RDs to expand their knowledge and skills in this area.”
Swift’s hope is that dietitians become advocates for clean, sustainable food systems and that they expand their skills in integrative and functional medicine so they can help heal the suffering of so many with chronic disease through the power of truly good food as medicine.
“Each day I live, I strive to contribute to society in some small way—both personally and professionally—and leave a legacy of love and advocacy for my friends, family, and profession.”
Joyce Diacopoulos, RD, CSO, LDN
Dietitian Coordinator at the Hillman Cancer Center of UPMC
Although truly successful in her career as an RD, Joyce Diacopoulos did not originally set out to be one. Rather, she began her freshmen year of college as a chemistry major.
“I was a lab rat, figuring out all those reactions and molecules,” Diacopoulos says. “Then one day, as the experiment went bad, I had the ‘a-ha’ moment. That’s when I knew I had a passion for … foods and how they evoke reactions. I had a need to help people with their diets.”
Diacopoulos changed majors and completed her bachelor’s degree in food and nutrition at West Virginia University. After graduation, she started a dietetic internship at Good Samaritan Hospital in Cincinnati, Ohio.
“My current role at the Hillman Cancer Center, which is the headquarters of the University of Pittsburgh Cancer Institute, is to provide nutrition care to our patients prior to surgery or after, to guide them with nutrition tips during chemotherapy and radiation, and to be their nutrition ally in their fight against cancer,” she says.
Diacopoulos makes patients her top priority by routinely manipulating her schedule to be available to all patients that the Hillman Cancer Center serves. She frequently stays late to see patients past her scheduled shift.
“A dietitian has to be a good listener to understand patients’ problems and try to give them tools to stay well during their treatments,” she says. “I enjoy being with people from all walks of life—being someone [they] can trust to help [them] with the challenging nutritional issues during the cancer journey of surgery, chemotherapy, and radiation. The most rewarding thing is seeing a patient get good news that we beat the cancer.”
Diacopoulos participates in the cancer research being conducted at the Hillman Cancer Center, which includes a nutrition component, in an effort to advance the care that cancer patients receive. As an active member of the American Dietetic Association’s (ADA) Oncology Nutrition Dietetic Practice Group, she was one of the first dietitians in the area to receive the ADA’s nutrition credentials as a certified specialist in oncology.
Diacopoulos admits that working with cancer patients can be demanding on many levels. “It’s challenging trying to be upbeat, motivate patients, and push them to stay hydrated and eat,” she says. “I explore new concepts and ideas on how to best help the patient to maintain [his or her] nutritional needs, and I strive to provide excellent nutritional care to all patients.”
Brian Starck-Riley, RD
Assistant Director of Nutrition Services at Patton State Hospital
As the assistant director of nutrition services at Patton State Hospital, a 1,500-bed major forensic mental hospital operated by the California Department of Mental Health, Brian Starck-Riley oversees the nutrition care of his patients, which includes overseeing a team of RDs, dietetic technicians, and dietetic interns while they are on their clinical rotation.
Patton’s patients range in age from 17 to 80 and older and come with various medical conditions, such as HIV; hepatitis A, B, or C; end-stage liver disease; end-stage kidney disease (predialysis and postdialysis); wounds; and metabolic syndrome.
“Most notably, due to the side effects of psychotropic medications in this population group, is the overweight and obesity population, which is estimated to be greater than 80% of our patients, with an estimated diabetes rate of greater than 20%,” Starck-Riley says.
As part of his role, Starck-Riley assisted in the development and coordination of the hospitalwide diabetes management team. In addition, he developed and coordinated the nutrition student volunteer program, which has provided experiences for 15 student volunteers in less than two years. He also developed a heart-healthy diet program for all 1,500-plus patients. And he assisted in the development and coordination of the Rehabilitation Management Committee focusing on dysphagia and wound care.
“My desire to become a registered dietitian was twofold: My initial interest in nutrition began with my love for fitness and athletics and nutrition’s role in performance enhancement, disease prevention, and general health improvement,” Starck-Riley says. “However, after entering the course work, I became amazed with nutrition’s role in the clinical realm, particularly [in] cancer and very ill patients, due to my significant family history of cancer. Most notably, with my own mother’s long, ongoing battle with cancer, I discovered early on the importance of nutrition in the clinical setting as well as the preventive medicine setting.”
Being able to promote, understand, and increase the awareness in others that nutrition is the foundation of all health was the driving force behind Starck-Riley’s decision to become an RD. “My goal with my patients is to increase the benefits of healthy eating, improve awareness of health risks, and increase their knowledge so they have the ability to make their own decisions and take ownership of their health,” he says. “I want my patients to realize the power of nutrition in preventing and treating major illnesses.
“I have been fortunate to have the opportunity to work with so many different medical conditions and implement programs to help improve the welfare of our patients with diabetes, dysphagia, wounds, and metabolic syndrome,” he continues. “My role allows me to work with amazing, highly motivated, caring registered dietitians and other clinicians who motivate me to put our often-overlooked population on the path to improved health. I enjoy being a leader in the field, assisting students, and conducting research to improve my clinical practices.”
Peggy Redfern, RD
WIC Program Director at Tulare County Health & Human Services Agency
As a teenager, Peggy Redfern was an avid swimmer and became a lifeguard and swimming instructor at a local pool. At that point, she began to see the relationship between nutrition, overall health, strength, and endurance. The rest, as they say, is history.
Today, Redfern is the WIC program director for the County of Tulare Health & Human Services Agency in California. “We are the 12th largest of 84 WIC agencies in the state,” she says. “We have achieved the recognition of being the only WIC agency in the state of California to have had three consecutive perfect biennial program evaluations.”
Prior to her role at WIC, Redfern was instrumental in numerous areas in the field of dietetics/nutrition services. She worked as a clinical dietitian and a foodservice manager in various hospitals, at a retirement community, at a private boys’ school, at a college, and even at a Boy Scouts camp. She also shared her expertise as a hospital foodservice director and a corporate dietitian for a foodservice management company. While working as a corporate dietitian, she oversaw 20 facilities.
Currently, Redfern manages nine WIC clinics in a rural area of California’s Central Valley, serving a monthly caseload of more than 30,000 participants. She has a staff of 12 dietitians and 65 paraprofessionals.
She hopes that through the services of their program, the families in all of the communities they serve will survive and thrive in the continuing hard economic times. “Our frontline staff are seeing more families cope with unemployment, food insecurity, and stress,” Redfern says. “To help combat those difficult situations, our program benefits offer nutritious groceries that provide healthy choices with freshness and variety, interactive and learner-centered nutrition education, breast-feeding education and support, and referrals to other helpful services tailored to their real needs.”
What does Redfern find most challenging in her role? Being employed by a county government that has a contract with a state agency to run a federal program results in numerous regulations and policies to adhere to on all levels as well as various layers to report to on both county and state levels. “Also, although our county is one of the top agricultural counties in the nation, in many ways it is a food desert,” she says. “It has been very difficult to bring access to quality fresh fruits and vegetables into some of the rural communities that we serve. We have worked hard to establish small farmers’ markets in some areas, but it is difficult for the farmers to make it profitable in some of these areas.”
Redfern works in a county that has one of the highest unemployment rates as well as one of the highest teen pregnancy rates in the country. “We are almost continually in a growth mode, and despite the many benefits our program has to offer, it is still sometimes a big challenge to get our participants into their appointments,” she says. “We are always looking for new ways to better and more efficiently serve them.”
Lisa McDowell, MS, RD, CNSD
Director of Nutrition at Saint Joseph Mercy Health System
After Lisa McDowell completed her undergraduate work at Michigan State University, she had a difficult time deciding whether to attend medical school or begin a dietetic internship. “In my heart, I wanted to pursue a career path that would allow for a specialty in disease prevention through exercise and healthy food,” she says. “However, I will never forget my parents’ concern for my career. They said, ‘Who hires dietitians?’”
McDowell was fortunate to complete her dietetic internship at the University of Medicine and Dentistry of New Jersey, which provided an excellent clinical foundation through various rotations in New York City and New Jersey. She then finished her master’s degree and successfully passed the nutrition support board certification exam.
McDowell’s decision to pursue a degree in nutrition over medicine came full circle when her father was diagnosed with stage 3 pancreatic cancer. “I researched every possible component to impact his treatment and outcome. He became an active participant in the plan and incorporated key nutrients into his diet and began exercising daily,” McDowell says. “A year after his treatment ended, we completed the Disney Marathon together. As for my parents’ concern about what I might do with my nutrition knowledge—well, that has been laid to rest.”
After returning home from the East Coast, McDowell accepted two positions: a full-time ICU nutrition support dietitian at St. John Hospital in Detroit and a part-time wellness educator for Henry Ford Health System.
“Working in the ICU/trauma service was very progressive, and I then became board certified in nutrition support. I eventually found my way to the neonatal and pediatric ICU,” McDowell says. “Working in the pediatric setting was most rewarding. I volunteered with Make-A-Wish Foundation and began working with local professional athletes … which led to a new opportunity consulting for the Detroit Red Wings, Tigers, and Lions. … I continued to work many evenings with various athletes and next became involved with the U.S. Figure Skating Championships, which were held in Detroit. This led to an invitation to work [with] the Atlanta Olympic Games.”
After working three jobs simultaneously for many years, McDowell decided to take a position in Ann Arbor, Mich., as the director of nutrition at Saint Joseph Mercy Health System. “Working at St. Joseph Mercy Hospital has allowed me to grow in ways I could never have predicted,” she says. “I continue to have patient care responsibility, and I also lead a team of the most talented RDs you could ever meet. My role allows me to participate in research, publish, teach our interns, and partner with the University of Michigan to lecture at the medical school.
“I most enjoy having a strong clinical knowledge base that has allowed me to practice in numerous settings,” she continues. “It is very satisfying to help others, which is true for the entire healthcare profession. … At the end of the day, I feel most rewarded when I have connected with a patient and made a difference.”
— Maura Keller is a Minneapolis-based writer and editor.