The 117th Running of the Boston Marathon

It's Friday of marathon weekend and I approach the expo hall with the usual mixture of excitement and dread. Excitement to interact with tens of thousands of marathon runners and their families and friends, and dread at how I know, from several years of experience, my body will feel by Sunday night. Over the next several days I spend hours on my feet handing out samples of Clif Bars, talking to runners about when they should use Shot Bloks versus Shot Gel, and answering the question over and over again: are any of our products gluten-free? (The answer: wheat free but not oat free so they may contain trace amounts.)

By Sunday afternoon I'm ready to finally sit down, so I head to the other side of the hall where I finish out the weekend by volunteering at registration, which is where runners come to pick up their bib number. I have several friends who volunteer with me and we all smile while family members take our picture as we hand the number to their runner, answer questions about where the runner needs to be in the morning to catch the shuttle to the start, and help calm nerves about the race that at that point is only a little over 15 hours from starting. This is my sixth year volunteering (that's every year but one since I ran the marathon in 2006) and I absolutely love it. During one point when I don't have any runners at my station a couple of students from Suffolk University approach and ask if I would mind answering some questions for them. They set up the camera and ask me whether or not I think the marathon is a good thing for Boston. Of course! I answer. It brings in people from all over the world, it increases tourism to Boston, everyone is out and about and seeing what a great city we have here full of active people. Next question: do I think that the marathon is a good thing for people in Boston to see happening. Definitely! Anything that might encourage people to get active and inspire them is a great thing, especially since people need to move more in order to increase health.

At 6:30pm on Sunday night I leave the expo hall having just spent what feels like every waking minute of the last three days there. I fall asleep on the couch after eating dinner but wake up in the morning feeling refreshed and ready for what many consider the best day of the year in Boston: Marathon Monday. My boyfriend lives on the course, so we have friends over and we alternate between watching outside on the street and coming inside to watch the finish line on TV. We cheer for some of the fastest people in the world as they stream by, just a few feet from his front door. It happens every year and yet every year it feels so special.

Today's Boston Marathon, the 117th running, will forever be remembered for the senseless loss that occurred when two bombs exploded at the finish line and to be honest I'm not sure that I'll ever have another weekend like the one I just described. I think that today's events will have a lot of people asking the same question that I was asked by the students yesterday: is the marathon good for the city? But now more questions will be added to that one: can we ever have another Boston Marathon? Will other running and sporting events everywhere be affected by today's violence?

My heart goes out to the people hurt today and their families. It also goes out to every runner and every spectator, both today and in the future, for what today's events might mean for us and our healthy, active, supportive lifestyles that were threatened today in an unimaginable way.

The Various Roles of an RD: Community Health Center Dietitian

Different community health centers have different services that they offer patients. Some have dental  and vision offices in addition to their medical practice. Some even have a WIC clinic located within the center. Some will also have a Registered Dietitian or two on staff to provide nutrition counseling.

At the community health center where I was placed during my dietetic internship, there was a bilingual dietitian who saw patients of all ages, from people newly diagnosed with diabetes to new mothers who needed prenatal nutrition counseling. There was also a dietitian on staff who was in charge of a program focusing on reduction of childhood overweight and obesity.

Several health centers run programs similar to this one where there is a case manager who helps the kids find physical activities that they are interested in and an RD who takes care of the nutrition counseling sessions. The nutrition counseling sessions are often done with several members of the family present. When a child is struggling with weight issues, the parents (who are often the ones providing the food) need to be part of the conversation. The counseling sessions would focus on small, realistic steps that the child and parents could make in order to best benefit the child's health. For example, based on the dietary recall the main suggestion may be the cut back on juice. In that case we would explore alternatives that the child might enjoy drinking or ways that the whole family could replace juice with water and still enjoy it - for instance by adding fresh fruit.

The RD in a community health center setting needs to have the ability to remain focused in a potentially hectic environment (for example being able to focus on the conversation with the parent while several siblings are playing loudly in the background) and be flexible when patients do not show up or re-schedule at the last minute. This is different from a hospital setting where patients are a captive audience or a private practice setting where patients may be paying out of pocket and are therefore more motivated to show up for their appointment.