Preparing and Presenting at a Health Fair as a Dietetic Intern

Written By: Addie O'Neill; SLU Dietetic Intern

During my community health promotion rotation, I had the unique opportunity to design a handout and create a recipe for a diabetes health fair. My preceptor, Rosemary Catanzaro, RD, CDES, at SLUCare Maternal and Fetal Health, informed me that we would be hosting a table at the fair. This was an exciting chance to connect directly with the diabetes community while combining creativity with evidence-based education to address real-life needs.

While working with Rosemary, I learned that most of her patients either had diabetes and
needed preconception counseling or had been diagnosed with gestational diabetes (GDM). I shadowed her as she educated patients, from those newly diagnosed to those preparing to give birth and discussing postpartum plans. Witnessing how integral Medical Nutrition Therapy (MNT) was to their care inspired me to learn more about GDM and focus my educational materials on this condition. My goal was to create a resource that was clear, practical, and empowering tools that women could trust to navigate the challenges of GDM.  

Creating Educational Materials 

For women newly diagnosed with GDM, the experience can feel overwhelming. They often face a flood of new information, lifestyle adjustments, and concerns about their health and their baby’s well-being. Many are taught a new way of eating and may be prescribed medications that they have to learn how to administer. I had the opportunity to watch Rosemary demonstrate injection techniques to patients and then gave them the change to try by practicing on a pillow. This hands-on approach helped alleviate fears and improve the moms’ confidence in managing their condition for their health and for the health of their baby. While I knew couldn’t provide this level of reassurance to every attendee at the health fair, I aimed to create a handout that delivered not just knowledge but also practical tools and encouragement. 

When designing the materials for the health fair, I set a few goals for myself. First, I wanted the content to be clear, concise, and easy to read. I aimed for it to be something moms could quickly understand as they were walking through the health fair or reading it over after leaving a doctors appointment. I also needed it to be rooted in evidence-based research to ensure accuracy and gain their trust. I also wanted to make sure that I aligned my call to action with SLUCare’s mission, ensuring the handout served as a welcoming entry point for moms reading about GDM for the first time. Lastly, I focused on making the handout visually appealing and approachable, aiming to provide comfort during a potentially stressful time. 

Starting with the Basics 

GDM can feel complex and overwhelming for new moms, but understanding the basics helps make it more manageable so this is where I wanted to begin my handout. I started by explaining what diabetes is and why it happens during pregnancy. GDM occurs when a woman experiences high blood sugar for the first-time during pregnancy due to hormonal changes from the placenta. These hormones increase insulin resistance, requiring the body to produce two to three times the normal amount of insulin to maintain stable blood sugar levels. For most women, this adjustment is sufficient. However, for 5%–10% of pregnant women, the body cannot produce enough insulin, leading to GDM, typically between the 20th and 24th weeks of pregnancy. I wanted to reassure women that GDM is not their fault, rather it’s due to these hormonal changes. However, with proper nutrition and medical strategies, blood sugar can be managed effectively, promoting healthy outcomes for both mom and baby.

Highlighting Risks and Solutions 

While I didn’t want to overwhelm expectant moms, I included information about potential risks if GDM is not managed. For example, babies may grow larger than normal (macrosomia), increasing the risk of injury during vaginal delivery or necessitating a cesarean section. Other risks include neonatal hypoglycemia (low blood sugar) after birth because they are used to the surgery environment of the womb and respiratory distress syndrome (RDS). By pairing this information with actionable solutions, I aimed to empower moms to take proactive steps. The handout outlined clear, evidence-based strategies for managing GDM, demonstrating how working with your team of health care providers and following their medical advice can lead to healthier outcomes. 

The Role of Medical Nutrition Therapy 

One of my biggest takeaways from my internship with SLUCare was the critical role Medical Nutrition Therapy (MNT) plays in managing gestational diabetes (GDM). Watching Rosemary, the Registered Dietitian and Diabetes Educator, work with patients was easily my favorite part of the experience. Her role on the healthcare team is essential and seeing her in action inspired me to make MNT a major focus of my handout and talking points at the health fair. 

When GDM patients visit SLUCare, they meet with Rosemary to discuss their current diet, dietary recommendations, portion sizes, and target blood sugar levels. She emphasizes the importance of a consistent carbohydrate diet, answers their questions, and works through their food diaries to suggest small, practical changes that can help lower blood sugar. After reviewing their progress, she collaborates with the doctors to tailor their medication regimen and ensures patients know how to properly administer their medications. 

For many newly diagnosed pregnant women, this process can feel overwhelming. Figuring out what to eat and how to manage their new daily routine with medications and blood sugar checks often feels like a daunting task. I wanted my handout to address this apprehension directly. That’s why I included information about MNT and a sample daily menu to demonstrate how a consistent carbohydrate diet can fit into their lives. My goal was to show that managing GDM doesn’t mean sacrificing all of your favorite meals. But that that changes can make a big difference in managing this condition.  

One of the most common questions moms ask is, “What should I eat?” With busy schedules and the added stress of GDM, many are looking for healthy, convenient options. To meet this need, I included a recipe for egg bites, what I thought would be a simple, budget-friendly choice that can be prepped ahead of time and tailored to different tastes and dietary restrictions. Moms can mix and match toppings to suit the preferences or their individual family’s needs, making the recipe both practical and versatile. To ensure the recipe worked well, I tested two versions and brought them to the office for feedback. I even created a vegan version with red peppers, onions, and vegan cheddar cheese to accommodate any moms with dietary restrictions. Both versions received positive feedback from the office team! Knowing the recipe resonated with others reassured me that it would be a helpful resource for moms managing GDM and I should include it on the handout. When I was at the health fair many people that stopped by were intrigued and thankful to have resources about GDM and have a sample menu and recipes to try!

A Valuable Experience 

Creating a handout and working at the health fair was an invaluable experience. It enhanced my skills in designing educational materials and communicating with patients. Special thanks to Rosemary Catanzaro, RD, CDES, for teaching me about gestational diabetes, the importance of MNT, and how to connect with patients as a diabetes educator. This project was a hands-on example of how impactful evidence-based education can be, and I’m excited to carry these lessons into my future work in dietetics. 

Immunity During the Holidays

 Written By: Chloe Raben; SLU Dietetic Intern

        Have you ever gotten sick during the holiday season because of changing weather or being around others who are unwell?

        Almost all nutrients in the diet play a crucial role in maintaining an "optimal" immune response, and both insufficient and excessive intakes can have negative consequences on the immune status. Ferencik’s article summarizes the importance of two micronutrients, selenium, and zinc, and describes the mechanisms through which they affect the immune status and other physiological functions (Ferencik et al., 2003). This article claims that selenium is needed for the proper functioning of neutrophils, macrophages, NK cells, T lymphocytes and some other immune mechanisms.

        A 2024 study demonstrated that zinc cannot be stored in significant amounts, so regular dietary intake is essential (Stiles et al., 2024). Adequate nutrition is crucial during the holiday season due to the season often bringing colder temperatures and increased indoor activity, both of which can raise the risk of illnesses like colds and flu. Strengthening the immune system through proper nutrition is vital during this time. Several key nutrients support immune health, including beta-carotene, vitamin C, vitamin D, zinc, and probiotics. Beta-carotene, an antioxidant found in foods like sweet potatoes, carrots, and spinach, supports skin health and mucous membranes. Vitamin C, abundant in citrus fruits and bell peppers, helps maintain immune function, while vitamin D, from sources like fortified milk and fatty fish, plays a critical role in immune regulation.

        Zinc is essential for the proper function of white blood cells, can be found in beef, nuts, and beans, and probiotics in yogurt and fermented foods support gut health, a cornerstone of immunity. Zinc is indispensable for the proper functioning of all immune cells. It helps mount a balanced immune response to bacteria, viruses, and parasites, as noted in a 2021 study by Wessels et al. Meanwhile, selenium and beta-carotene supplementation can increase total T cells, which play a critical role in fighting infection, as detailed in the Integrative Medicine book by Wood et al. T cells work by destroying infected cells and signaling other immune cells to join the fight. It stated the selenium and beta-carotene supplementation caused an increase in total T cells by 27% and 31%. T cells are a type of white blood cell called lymphocytes. They help your immune system fight germs and protect you from disease. The T cells do this by destroying infected cells and send signals that direct other immune cells to fight infection. This demonstrates the importance of having adequate nutrition during these holiday times to strengthen our immune system. Foods that are high in selenium include, Brazil nuts, fish, poultry, eggs, etc. Foods high in beta-carotene are yellow, orange, and green leafy fruits and vegetables, such as carrots, spinach, lettuce, tomatoes, sweet potatoes, broccoli, cantaloupe, and winter squash. Luckily these foods are seasonal in the winter months as well.

Immune-Boosting Foods to Add to Your Holiday Meals

        The good news? Many foods rich in these immune-supporting nutrients are also delicious and perfect for the winter season! Here are some highlights:

- Selenium: Found in Brazil nuts, fish, poultry, and eggs.

- Beta-Carotene: Abundant in yellow, orange, and green vegetables like carrots, sweet potatoes, spinach, and winter squash.

- Zinc: Found in beef, nuts, beans, and seeds.

- Vitamin C: Found in citrus fruits, bell peppers, and tomatoes.

- Vitamin D: Found in fortified milk, fatty fish, and egg yolks.

- Probiotics: Found in yogurt, kefir, and fermented foods like sauerkraut.

        Incorporating colorful and nutrient-dense foods into holiday meals is an excellent strategy to support health. Eating a variety of colors—such as red tomatoes, orange carrots, green kale, and purple cabbage—ensures a broad intake of vitamins and antioxidants. For example, a rainbow-inspired salad can include spinach, red cabbage, orange slices, and nuts. Additionally, making thoughtful substitutions can reduce sugar and sodium while boosting nutrient content. For example, replace marshmallows on sweet potatoes with apples and walnuts, or use fresh green beans sautéed with mushrooms and garlic instead of traditional creamy casseroles. These swaps not only enhance flavor but also provide critical nutrients like zinc and vitamin C.

Flavorful and Healthy Substitutions

        Flavoring meals with herbs and spices rather than salt is another way to prioritize health without sacrificing taste. Spices like garlic powder, sage, and bay leaves not only reduce sodium intake but also offer additional antioxidants. Homemade dishes, such as roasted vegetable stuffing, can replace processed options to limit additives and maximize nutrient density. By making these adjustments, holiday meals can be both delicious and immune boosting, ensuring a season of joy and wellness.

Green Bean Casserole → Holiday Green Beans

    Holiday Green Beans Ingredients:

· 1 tbsp olive oil

· 2 bulbs finely chopped shallots

· 4 cloves minced garlic.

· 1 lb. fresh green beans, blanched in water for 2 minutes.

· salt and pepper

· 1 can Anchovy oil

· 2-3 chopped anchovy fillets.

    Holiday Green Beans Instructions:

· Blanch green beans for 2 minutes in boiling water.

· Add garlic, shallots, anchovy oil and chopped fillets to a skillet over medium high heat.

· Add green beans to the skillet and cook for 30-40 minutes.

· Serve and enjoy!

 

Waste as a Resource: Can "Humanure" Help Save the Planet and our Food System?

 Written By: Jordan Monson; SLU Dietetic Intern

Did you know that human waste was once a valuable resource? For centuries, in cultures worldwide, composted human waste, often called “humanure” was valued for its ability to fertilize soil and improve crop yields. In 18th century Japan, for example, “night soil” was so prized that farmers would trade fresh produce for it or buy it, ensuring a sustainable nutrient cycle between urban and rural areas. This was even the cause of many squabbles, particularly between tenants and landlords, who often claimed rights to their tenants' waste. Because human waste was a valuable commodity, the farmland was fertile and the cities clean, unlike many other large cities at the time, where overflowing latrines, smelly gutters, and widespread diseases were the norm.  

 

But these practices faded with industrialization, as the invention of modern sewage systems in the mid-20th century revolutionized sanitation and health, reducing diseases like cholera and dysentery. However, it also broke the nutrient cycle and the reciprocal relationship between urban and rural areas. Today, most waste travels miles through underground pipes to treatment plants, where it becomes sludge- most of which ends up in landfills. A small portion is recycled into fertilizers, but these biosolids often carry “toxic compounds, nanomaterials, hormones, dangerous pathogens… PCBs, flame retardants, heavy metals, and endocrine disruptors that all collect and are not filtered out by the sanitation process” which raises safety concerns, particularly if this sludge ends up back on agricultural land.  

 

A Crisis for Soil, Sewage Systems,  and Food Security 

Sewage systems have played a vital role in improving public health by reducing waterborne diseases and improving overall urban cleanliness, but today, these aging infrastructures face significant challenges. In the U.S., 15% of wastewater treatment plants have reached or exceeded capacity, and over 23,000 sewer overflows occur annually. These overflows contaminate clean drinking water, harm aquatic life, and release methane, a potent greenhouse gas, contributing to climate change.  

 

Simultaneously, agriculture is grappling with a fertilizer crisis. Since 2021, the price of nitrogen-based synthetic fertilizer has skyrocketed by 300% (and this was exacerbated by the outbreak of the Russian war in Ukraine in 2022, as Russia is a major producer of synthetic fertilizers), forcing farmers to either spend more or scale back on production. For consumers, this means higher grocery bills and reduced access to affordable food. Compounding this problem is the potential scarcity of phosphorus, a critical nutrient for growing crops. Most of the reserves of phosphorus are concentrated in just a few countries around the world, making global food systems vulnerable to geopolitical instability, as we have already seen some impact from.  

 

Here’s where the potential of humanure becomes revolutionary. Human waste is a natural and renewable source of the nutrients plants need to grow- nitrogen (N), phosphorus (P), and potassium (K)- all conveniently found in what we flush away daily. Instead of burying phosphorus deep underground or extracting energy-intensive synthetic nitrogen, we could tap into this abundant, overlooked resource.  

 

Rethinking Human Waste: The Nutrient Cycle 

To understand the connection between human waste and agriculture, consider another reciprocal relationship between humans and plants found in the air. Just as we breathe out carbon dioxide for plants to absorb and return oxygen for us to inhale, nutrients cycle through us and return to the soil in forms ready for plants to use. These nutrients, excreted as waste, can feed plants, which in turn grow into nutrient-rich foods ready for us to eat again.  

 

This nutrient cycle is a natural and sustainable solution that could replace synthetic fertilizers altogether. Synthetic options, while temporarily effective, require vast amounts of energy to produce and wash away easily from farmland into waterways. This runoff creates oxygen-depleted “dead-zones”, algal blooms, polluted drinking water, and acid rain. In contrast, humanure’s sticky organic properties help it bind to soil, preventing it from washing away and delivering nutrients more efficiently and long-term.  

 

Risks of Synthetic Fertilizers 

While synthetic fertilizers have played a significant role in increasing agricultural productivity, their drawbacks are becoming increasingly evident: 

1. Water Pollution: These fertilizers leach easily into water systems, causing algal blooms, oxygen-depleted “dead zones,” and contaminated drinking water that is unsafe for human consumption. 
2. Rising Costs: Synthetic fertilizer prices have surged, placing economic pressure on farmers and contributing to higher food prices for consumers. 
3. Soil Depletion: Long-term use of synthetic inputs weakens soil health by reducing its organic matter, compromising its ability to retain water and nutrients effectively. 
4. Climate Harm: The production and transportation of synthetic fertilizers emit significant greenhouse gases, exacerbating climate change and undermining global food security. 
5. Lower Crop Quality: Soils degraded by overuse of synthetic fertilizers produce less nutritious crops, impacting human health and reducing the overall quality of food. 

 

Benefits of Humanure 

Humanure addresses these challenges by leveraging natural processes to enhance agriculture while minimizing environmental harm: 

1. Environmental Impact: Recycling nutrients from human waste prevents harmful runoff and protects water sources, soil, and surrounding ecosystems. Its use helps mitigate the environmental damage caused by synthetic fertilizers. 
2. Economic Opportunity: By reducing dependence on costly synthetic inputs, humanure can stabilize farming expenses and support sustainable, locally driven food systems.  
3. Human Health & Nutrition: Crops grown in nutrient-rich, naturally fertilized soil are healthier, often containing higher levels of vitamins and minerals, which benefits both individual and public health. Initial studies are also showing improvements in crop yield with the use of humanure.  
4. Climate Resilience: Humanure’s low-energy processing reduces greenhouse gas emissions, while its application supports carbon sequestration in healthy soils—an essential strategy for combating climate change and securing future food production. 

A Solution Rooted in Sustainability 

Humanure not only addresses the environmental risks posed by synthetic fertilizers but also offers a viable path toward a more sustainable, circular agricultural system. Its ability to enhance soil health directly influences crop quality and resilience, making it a cornerstone of sustainable food security efforts. By rethinking waste as a resource, we can move away from extractive, harmful practices and embrace methods that regenerate both ecosystems and food systems for future generations. 

 

Sustainable Solutions in Action 

Rich Earth Institute (Vermont) The Rich Earth Institute is at the forefront of transforming human waste into valuable agricultural resources. By conducting groundbreaking research, promoting education, and advancing innovative technologies, they focus on urine-diversion programs. These programs harness the nutrient-rich potential of urine—particularly nitrogen, phosphorus, and potassium—found in the waste of those in industrialized areas with "highly digestible diets" Their work highlights how human waste can be safely and effectively reintegrated into agricultural systems. 

 

A spinoff from Rich Earth Institute, Bright Water Tools, builds on this mission by creating systems that separate water from toilet waste, turning it into non-potable reusable water and natural fertilizers. These tools help reduce wastewater management costs, prevent harmful runoff, and provide sustainable nutrient sources for agriculture and landscaping. 

 

Washington D.C. Wastewater Treatment Plant: The Blue Plains Advanced Wastewater Treatment Plant is a leading example of large-scale waste reuse. This facility repurposes biosolids, energy, and nutrients from wastewater into valuable products. Their “Class A biosolids,” sold under the brand name Bloom, serve as a slow-release recycled fertilizer. Additionally, the plant employs thermal hydrolysis to extract energy from waste, reducing its carbon footprint while powering its operations. 

 

Paris Pee Diversion Project: A broader effort can be seen across France to integrate green practices into upgrading its aging sewage systems. In the SVP eco-neighborhood, low flush toilets and dry urinals connect to a separate urine-connection network with on-site treatment plants that turn urine into concentrated fertilizers to be used locally. The La Fumainerie project in Bordeaux has been experimenting with composting feces and using dry toilets.  

 

Sanivation: Operating in Kenya, Sanivation addresses inadequate sewage systems by creating waste-to-energy solutions. Their projects include converting fecal sludge into briquettes, which serve as efficient, low-emission fuel alternatives. By improving urban sanitation, reducing pollution, and creating jobs, Sanivation not only mitigates environmental issues but also enhances the quality of life for underserved populations. 

 

S.O.I.L: In Haiti, SOIL (Sustainable Organic Integrated Livelihoods) offers a model for addressing sanitation and agricultural challenges simultaneously. Their initiative, EkoLakay, provides urban households with container-based toilets, which are collected weekly. The waste is then composted into eco-friendly fertilizers, revitalizing Haiti’s depleted soils. This program simultaneously promotes public health, creates local employment, and supports sustainable farming. 

 

Looking Ahead 

 

From small-scale community programs to city-wide wastewater treatment innovations, these projects underscore the transformative potential of human waste when managed sustainably. By implementing these systems globally, we can protect natural resources, bolster food security, and advance climate resilience, ensuring a healthier future for both people and the planet.