From Kitchen to Clinic: MANNA Highlights Role of Nutrition in Healthcare for Medical Students

It’s no secret that nutrition can directly impact health outcomes, and it’s well documented that when nutrition is poor, those outcomes can be devastating. One study found that nearly half of the deaths related to heart disease, stroke and type 2 diabetes are associated with suboptimal eating habits (NIH).

MANNA’s mission is to help treat those with serious disease through nutrition. Its medically tailored meal (MTM) intervention is evidence-based and associated with reduced length of hospital stays, decreased hospital readmissions, and improved malnutrition risk (Journal of Primary Care & Community Health).

If proper nutrition can have such a tangible impact on positive health outcomes, then physicians need to know who to turn to for the best nutrition care and resources available to patients in their community. Medical school training is already jam-packed, and physicians don’t have the time or expertise to advise patients on their dietary needs. MANNA’s medically tailored meal program, which includes nutrition counseling provided by registered dietitians, exists to provide community members with the resources they need to maintain their nutritional status while managing their medical needs.  

To help future physicians understand the impact of MTM programs, MANNA’s research arm, the MANNA Institute, hires medical fellows each academic year for an applied research experience. The Reid B. Reames Fellowship enables medical students to work on research projects that develop the body of evidence for “food as medicine.” Fellows study topics such as how MANNA’s MTM program affects malnutrition risk and the impacts of MTMs on health among heart failure patients. While some of the students begin their journey at MANNA unaware of the organization’s nutrition therapy mission, they quickly come to experience its role as a change agent in patient care.

“I needed volunteer hours, and my friend suggested that I check out MANNA,” said Kaitlyn Bartholomew, a 2022-2023 fellow. “I figured this would be like volunteering in any other kitchen, but when I watched the volunteer orientation video, I realized that MANNA’s work actually aligned perfectly with my interest in nutrition as a med student.  I found out about the MANNA Institute and emailed the team to get involved with research.”

This is a common theme when people visit MANNA’s kitchen – there is a sense of hope, learning that an organization is tackling serious health issues through food. Strangers stand side-by-side in the kitchen, preparing and packing meals together in an effort to not only feed people, but heal them.

“I always had a great time volunteering during my undergrad at MANNA,” said 2023-2024 fellow Jeffrey Zhou. “But I saw my time there as helping provide folks who needed it with nutritious food. Once I started working as a fellow at the Institute, I saw the bigger picture of how incredibly broadly nutrition can affect people, and how this work is not just providing people with good food, but with proven treatments, [delivered] right to their door.”

As these young professionals advance in their careers, they will take the lessons they’ve learned from the MANNA Institute with them.

“Since my time at MANNA, I am now very thorough when I ask patients about their diets, where they live, if they have access to good food and transportation to get to the grocery store,” said Zhou. “I always knew that nutrition is a huge factor for your overall health, and I have personally always had an interest in nutrition and food as a way to stay healthy. But now, I see nutrition through the food-as-medicine lens, and I plan to take this with me throughout the rest of my career to ensure I treat patients to the best of my ability.”

The Reid B. Reames Fellowship program is in its third year at MANNA. So far, six soon-to-be doctors have experienced the “aha” moment that food truly is medicine.

“As with everything we do at MANNA, our goal for the Fellowship program is to enhance awareness, in this case among the next generation of physicians and care providers, of the role of diet in nutrition-related disease,” said Jule Anne Henstenburg, Director of The MANNA Institute.

To learn more about the MANNA Institute’s Reid B. Reames Fellowship program, visit https://mannapa.org/mannainstitute/reid-b-reames-fellowship/.

American Heart Month is here

Did you know that February is American Heart Month?  The month of February is dedicated to raising awareness about heart disease and educating the population on ways to prevent it. Unfortunately, heart disease continues to be one of the leading causes of death in America prematurely ending the lives of 1 in 4 people.  Although there are many risk factors, a healthy diet and exercise continues to be the best defense.

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This infographic was created by The American Recall Center. Learn more here.

At MANNA we make every effort to ensure that our meals are heart healthy, following the nutrition guidelines of the American Heart Association. In each meal delivery, we send our clients fresh fruits, vegetables and whole grains. Our soups are made with low sodium stocks and they are flavored with spices, like garlic and sage, to ensure that they are heart healthy and flavorful.  In addition, to help our clients control their cholesterol levels, we limit red meat in our meals to once per week and we send low-fat dairy alternatives.

All of the MANNA clients are following a heart healthy diet, below are some tips from our Registered Dietitian on how you can do the same!

Heart Healthy Tips provided by Alura Costa, RD at MANNA

  • Incorporate fresh fruits and vegetables, whole grains and low-fat dairy into your diet daily. Think green!
  • Be careful with canned soups which contain a lot of sodium. Purchase a low sodium soup option or make your own soup utilizing low sodium broth instead. Try adding different types of whole grains like barley or quinoa…yum!
  • Use spices and flavorful herbs to season foods. Utilizing salt alternatives are key to reducing sodium intake. Basil and cayenne are some of my favorites! MORE
  • When using canned vegetables, make sure to rinse any excess sodium off by running the vegetables under cold water. This trick is simple and helpful.
  • Opt for sauce on the side when dining out. Sauces at restaurants are usually high in sodium. Also, some restaurants indicate which meals are low in sodium by placing a small heart icon next to menu items.

Take Action

  • Go red! Celebrate National Wear Red Day with MANNA and help raise awareness about women and heart disease on February 6th. More: goredforwomen.org
  • Share American Heart Month Tweets via your twitter account.
  • Get screened and encourage others to do the same with this e-card generated by Health Finder.
  • Make a vow to cook more heart healthy meals – recipes.

Making Realistic Health Resolutions

Each year we approach the New Year with excitement and vigor, vowing to challenge ourselves in an area where we think changes need to be made. Out with the old and in with the new!  Losing weight and eating healthier tops many people’s resolution lists. Although our intentions are good with a goal of adapting healthier habits, sticking with these goals is not always easy because we tend to set unrealistic expectations for ourselves. We end up making too many changes at once and deprive ourselves of the foods we love which is both unenjoyable and unsustainable.

 

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This year, start small and make just a few realistic changes that you know you can maintain.  Below are some helpful tips from MANNA’s Registered Dietitians on becoming a healthier you.

5-A-Day Challenge

Eat five servings of fruits and vegetables every day! Getting the recommended servings of fruits and veggies daily helps to provide your body with the vitamins, minerals and fiber it needs to stay healthy. It is also a great way to help you to maintain or lose weight. Try to keep your fruit in a bowl on your kitchen table so that you will be more likely to eat them. Make it a point to fill half your plate at every meal with fruits or vegetables.  At least once a week, skip the meat and try a new vegetarian recipe for dinner. Keep fresh fruits or cut-up vegetables at your desk for a healthy, mid-day snack.

Avoid Empty Calories

Try to avoid empty calories which are calories from solid fats and added sugars that contain few or no nutrients.

  • Cakes, cookies, pastries, ice cream and donuts
  • Sodas, energy drinks and fruit drinks
  • Pizza, cheese, sausages, fatty meats, butter and stick margarine

Get Physical

The goal is to get 30 minutes of physical activity every day. A variety of activities can count towards physical activity including: walking, dancing, gardening, hiking, swimming, household chores, games and sports. You don’t have to do the entire 30 minutes at once, you can break it up into 10 minutes intervals. Try getting off the bus stop a few blocks early and walking ten minutes to work or an appointment. At the end of the day all of your activities add up!

Keep Track

Nothing is better to keep you motivated than seeing the results of your hard work each week.  The USDA has created an easy, FREE tool called SuperTracker. SuperTracker allows you to keep track of your progress. You can look up nutrition information for over 8,000 foods, keep a log of the foods you are eating and your daily physical activity, get weight management guidance and receive support from your own virtual coach to help you achieve your health goals. Go to www.supertracker.usda.gov to personalize your experience and get a plan tailored for you!

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Healthy Holiday Eating

Do you teeter between counting down the days until your holiday feast and dreading the seemingly inevitable food coma to follow? It can be tough to practice moderation around the holidays and many people pay for holiday indulgences by carrying around extra pounds.  Try to keep a couple of tips in mind to curb your holiday hunger while allowing yourself to enjoy all the favorites.

Beat the Beverages

Many people only think about calories when it comes to food.  Beverages can be very calorie-dense as well and often offer little nutritional value.  Some holiday drinks are full of hidden sugar, fat and calories.  Here are a couple ways to cut back:

Eggnog

Try mixing ½ a glass of skim or low-fat milk with ½ a glass of eggnog

Passing on the alcohol also means passing on extra calories

Hot Chocolate

Opt for low-fat or skim milk instead of whole milk.

Pass on the whipped cream or keep it to 1 tablespoon or less

Apple Cider

Check for added sugars—make sure you’re drinking 100% juice

 

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Know Your Meal

This doesn’t just mean know the dish, but know the ingredients.  Being aware of common sources of fat, sodium, and extra calories can help you make the best choices at the holiday table.

Be aware of Sodium

Many holiday favorites like breads, rolls, canned stocks, soups, and sauces are very high in sodium. Use herbs and spices like rosemary and cloves instead of salt and butter. When you can, choose to use fresh fruits and vegetables instead of canned—these have added sodium too.

When it comes to turkey…

Choose lighter pieces of meat, as they have fewer calories than dark meat.

Remove the skin from your meat.

Remember portions—a serving of meat is 3 oz. or about the size of a deck of cards

Gravy is dangerous when it comes to fat, calories, and sodium.  If you choose to use some, keep it to 1 tablespoon and use it for turkey only.

Don’t Destroy Dessert

When it comes to sweet treats, try to sample rather than making a second meal out of pie and cookies.  These treats are sure to be packed with sugar and fat and that’s after the meal! Consider sharing a serving with a buddy or asking for a smaller slice.

Healthy Eating Starts with Healthier Cooking

Try some tricky culinary maneuvers to reduce the fat, sugar, and sodium in your holiday dishes.  Your guests will never notice, but they sure will thank you later!

When baking…

Try substituting ½ the butter for applesauce.

Use low-fat or skim milk instead of whole milk or heavy cream

Substitute ½ the white flour for whole wheat

When cooking, opt for vegetable oils instead of butter

Use whole-grain breads, pastas and stuffing instead of white

Compare labels to make lower-sodium choices

Use spices to ease up on salt and sugar. Consider things like cinnamon, cloves, vanilla; rosemary, thyme, garlic.

Finally—Remember to stay active

Go for a walk.  Try sledding again.  Ice skate…tis the season!

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A DAY OF THANKS AT MANNA

Thanksgiving at MANNA is truly the best day of the year. The MANNA community comes together to provide a decadent, yet traditional Thanksgiving meal to clients and their families. Everything from a turkey with all the trimmings to a delicious home-baked pie, the MANNA community supplies and delivers these loving meals free of charge! Nourishing our neighbors is what it is all about on Thanksgiving here at MANNA.

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Our staff will open the MANNA kitchen promptly at 5:30am to begin the day. The kitchen will be filled with 100 volunteers cooking, baking and packaging over 1,800 homemade Thanksgiving meals. 150 volunteer drivers will line up on Ranstead Street to deliver to 450 different MANNA clients and their families. MANNA looks forward to Mayor Nutter, along with other dignitaries, contributing to the volunteer efforts on this busy, yet gratifying day. We are thrilled to have District Attorney, Seth Williams volunteering in the kitchen again. It’s important to us that our clients celebrate this special holiday and have something for which to truly give thanks.

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Thanksgiving Day could not happen without our devoted volunteer force.

Our Thanksgiving Day sponsor, PECO is graciously underwriting the cost of the Thanksgiving meals. “MANNA is an incredible organization that provides a critical service to our community. As a PECO employee and member of their board for more than five years, I couldn’t be more proud of what PECO does to contribute financial and volunteer support to MANNA to help with their mission” shares Mike Giessmann, Director of Finance, PECO.

Want to get involved and help MANNA during the holiday season? Contact Glenda, our Volunteer Associate or call 215-496-2662 x100. We still have available volunteer shift opportunities!

 

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Food Safety, Access & the Impact on Low Income Families

A sobering study released by researchers at Drexel provides more evidence that inequities in our food system present health threats to low-income populations in Philadelphia. Taking samples from almost 400 corner stores and small grocery stores from 2008 to 2010, the researchers found that foods available in less affluent neighborhoods were significantly more likely to be rotten or contaminated. Milk, fruits, and vegetables were more likely to go bad soon after purchase than those sold in more affluent neighborhoods. Ultimately, the study showed that when staples and healthy foods were available in poor neighborhoods, it was often at the cost of food safety.

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This isn’t necessarily an insidious finding; people are not deliberately serving contaminated food to the poor. Rather, many stores in low-income neighborhoods seem to simply lack the capacity to store and serve foods the way that stores in middle or high income areas do. Refrigerated items are more likely to sit out longer as smaller staffs work to stock coolers and refrigerators, and profit margins are so thin that many stores may not be able to afford proper refrigeration

These issues of food safety are a part of the larger food access problem in Philadelphia, however work is being done to alleviate these ills. The city government, working with the Food Trust and several other organizations, is addressing healthy food access through the Get Healthy Philly program, which includes funding and capacity building for healthy corner stores and healthy food retail in under served communities.

However, while these efforts are making  great strides in improving food access in Philadelphia, Drexel’s study has striking implications for MANNA’s vulnerable clients. While healthy people might get sick from contaminated or spoiled foods, the illnesses are fairly mild and temporary. A person may experience nausea, diarrhea, or vomiting, but it will likely be short-lived, and many people won’t even know it was caused by their food. However, for critically ill patients, these food safety issues are far more concerning as a compromised immune system might result in more serious consequences of foodborne illnesses. This is yet more evidence that the critically ill deserve and need carefully prepared home-delivered meals, so that their safety and health can be protected.

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In spite of the food injustice emphasized by Drexel’s study, with the many initiatives to build a strong network of healthy food retailers in the city, Philadelphia is moving in the right direction to address the issue. However, at MANNA we also recognize that our clients are particularly vulnerable to the still-present issues in our food system, and we continue to work to safely nourish those who need it most.

MORE

This post is by Kelly McGlynn, rising senior at Brown University and former Advocacy & Health Policy Intern at MANNA.

 

Diabetes Awareness Month

November is National Diabetes Awareness Month. This month, we encourage everyone to take time to consider the risk factors for diabetes and to take steps to prevent it.

Did you know?

There are three types of diabetes: type 1, type 2, and gestational. Only about 5% of diabetics are type 1, and many of those are diagnosed in childhood or as young adults. Gestational diabetes affects pregnant women (about 2-10%) and typically ends after pregnancy. Type 2 diabetes is the most common type and tends to develop in adulthood and is preventable. Comorbidities or complications associated with diabetes are severe. Many are common and can cause serious, long-term consequences including: hypoglycemia, hypertension (affecting 71% of adults with diabetes), dyslipidemia (affecting 65% of adults with diabetes), cardiovascular disease (death rates are 1.7 times higher with diabetes), heart attack (1.8 higher hospitalization rate with diabetes), stroke (1.5 higher hospitalization rate with diabetes), blindness (in diabetics over 40 years in age, 28.5% have damage to blood vessels in eyes that may leads to blindness), kidney disease (diabetes is the primary cause of kidney failure in 44% of all new cases) and amputations (73,000 in 2010 alone, accounting for 60% of all non-traumatic lower-limb amputations).

Diabetes is the 4th most common primary illness in clients served by MANNA. In the past year alone, MANNA has served 433 diabetic clients, comprising 23% of all MANNA clients. As of 2012, 9.3% of Americans have been diagnosed with diabetes – almost 1 in 10! Over a quarter of all seniors have diabetes and it is now the 7th leading cause of death in the United States. There are 1.7 million new cases per year and approximately 7 million diabetics are undiagnosed.

Prevention

The most effective way to prevent and control diabetes is through a proper diet. A proper diabetic diet is more than just skipping out on cake and cookies. Managing diabetes through diet requires portion control, meal regularity and balance. Diabetics must regulate the amount of carbohydrates in their diets in order to keep blood glucose levels safe. Balancing carbohydrates with protein and fiber is important as well. If blood glucose levels spike too high or drop too low the effects can range from shakiness and fatigue to hospitalization and seizures. Working with a Dietitian and/or a Certified Diabetes Educator can help diabetics make smart choices and minimize the risk of high or low blood sugar. MANNA’s dietitians provide free nutrition counseling and education for individuals suffering from diabetes. To schedule an appointment, contact the Nutrition Department at 215-496-2662 x5.

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MANNA is also proud to share that we will Step Out for Diabetes! On Saturday, November 1st, the MANNAmals will once again be at the Art Museum to support The Walk to Stop Diabetes. We’re committed to walk and raise money in this inspirational event not because 29 million people in the United States have diabetes, but because we personally know some of them, and want to do something about it. So many lives are touched by diabetes. Chances are your life is too. Join us or donate – either way, you can change lives. For more information or to register, visit our Team Page or search for Team MANNA. We are forever grateful for your support. Together we can Stop Diabetes!

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MANNA takes on D.C. at ACBP ’14

MANNA’s advocacy team – Executive Director, Sue Daugherty, Director of Policy and Institutional Affairs, Ann Hoskins-Brown, and Community Outreach & Advocacy Specialist, Katelyn Baron – attended the 2014 Advocacy Capacity Building Project (ACBP) Symposium September 29-October 1, at NASTAD in Washington D.C. The annual symposium encourages collaboration between “sister” organizations from all over the country, with over 50 attendees from 20 diverse food and nutrition services agencies this year. Each participant had the opportunity to share their best practices and recent advocacy activities; MANNA presented updates on how we are working to leverage our groundbreaking research with targeted advocacy work. Together, we brainstormed and discussed topics including the power of evidence and developing and delivering an impactful message.

The symposium offered several opportunities to participate in advocacy trainings to learn the tools of the trade, helping to facilitate successful interactions with elected officials and academic institutions. This training was crucial for our visits with staff from the offices of Congressman Chaka Fattah, Congressman Bob Brady, Senator Bob Casey and Senator Pat Toomey from Pennsylvania, along with several New Jersey legislators. Our Hill meetings, scheduled for our final day in D.C., provided the opportunity to share our “food is medicine” model and research with policymakers to demonstrate its potential to change healthcare. MANNA’s services save Pennsylvania valuable healthcare dollars and our clients experience improved health outcomes. We believe our meal program should be a reimbursable standard of care and a right to everyone facing a life-threatening illness.

Overall, our time in DC opened our eyes to many new possibilities. There is still much to learn and we are excited to redefine our goals and continue to move forward with our mission. ACBP has empowered us to take on new advocacy goals focused at the state level. It was motivating and refreshing to share and hear new ideas about our unique services. MANNA has many challenges ahead, but we will continue to advocate for the incorporation of nutrition into healthcare.

We want to thank The M•A•C AIDS Fund, The Center for Health Law and Policy Innovation at Harvard Law School, AIDS United, the National AIDS Housing Coalition, Representatives from the Department of Health and Human Services (HHS), and the Centers for Medicaid and Medicare (CMS) for all of their support. To all of our sister organizations, we thank you for collaborating and learning with us. These organizations include: God’s Love We Deliver, Project Angel Food, Open Hand Atlanta, Project Angel Heart, AIDS Project New Haven, AIDS Services Foundation Orange County, Moveable Feast, Community Servings, Project Open Hand, Bill’s Kitchen, Inc., Heartland Health Outreach, Mama’s Kitchen, Long Island Association for AIDS Care, Food & Friends, The Poverello Center, Lifelong AIDS Alliance and the Academy of Nutrition and Dietetics.

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To see more pictures from our DC visit, see our Facebook album.