Dear Members,

Summer is upon us, which means an exciting new year has officially begun for
BRAND! Id like to say a special thank you to all of our loyal returning members and
send a warm welcome to all of our new ones. Im also happy to report that many of our
dedicated board members have graciously offered to serve another year, while some
new faces are keeping things fresh. In particular, Im thrilled to introduce you all to our
President-Elect Linda Lee, who brings varied experience from the clinical, business,
and research arenas to the table. I have no doubt that Linda will put together two very
enjoyable, educational, and affordable meetings for all of us this coming year, as BRAND does every
year. If you are new to the Blue Ridge or simply want to be more involved in nutrition happenings
around the district, we do have a few openings left on the board. For someone who is creative and
interested in engaging the public to promote the importance of nutrition and our role as Registered
Dietitians, the National Nutrition Month Chair is available. If you have a knack for noticing a job well
done, the Professional Recognition Chair might be for you. And finally, if you know your way around the
Internet, we welcome your help as the Website Liaison. Please contact me directly at
blalockbe@gmail.com.
I also want to let you know about a special opportunity from the wonderful Lynda Fanning for an RD
with a passion for locally grown and sustainable foods: Lynda has worked with the Virginia Food
System Council for 6 years to connect all the sectors of our food system, with an emphasis on health,
community economic wealth, food justice, and preserving the environment, and now she is looking for
an official alternate. As so many of her former employees can attest, Lynda will be an excellent mentor,
so please contact her directly at lyndafanning3@gmail.com and check out
www.virginiafoodsystemcouncil.org if you are interested.
Thanks for all you do for the health of our communities. Stay cool this summer, and enjoy some much
deserved vacation time! ~Bethany Blalock, BRAND President
_________________________________________________________________________________

The 24
th
Annual UVA PKU Picnic, organized by Barb
Goodin, MS, RD, CDE, was held on May 17
th
. As usual, it
was enjoyed by all 78 PKU family members who attended.
The event has turned into an annual event that the PKU
children look forward to every year, and here is why.
All the food that is available at the picnic is low protein. The
children dont need to ask permission before eating
something. This seems to be a really important aspect of the
picnic for them.
They meet other children with PKU who are similar in age.
They become pen pals, or stay in touch with each other
through the year, and see each other at this event.
Parents take recipes home for food at the picnic that their child
tried and liked, saving money and effort for the parents. As the children get older, they are more willing
to try new things.
Activities, piata, door prizes and games are all geared toward the children. The day ends with a water
balloon fight. They talk about the picnic for weeks afterward.
July 2014



Vendors attend the picnic giving the opportunity for families to try new PKU formulas or other products
developed by the companies that support the event.
The parents benefit from learning about new foods, networking with other parents and company
vendors. They share ideas with parents of younger PKU children, and also participate in learning
activities set up for them.
The event would not be possible without the help of the dietetic interns at the UVA Health System.
They cook low protein food and run the activities, keeping the children engaged while parents network.
We are so fortunate to have this group
of students to volunteer every year.




















Position Name
President Bethany Blalock
President-Elect Linda Lee
Secretary Kris Bonham
Treasurer Linda LaFontaine
Bylaws Chair Rita Smith
Legislative Chair Sara Mastrantonio
Media/Public Relations Sarah Wilfong
National Nutrition
Month Chair

Newsletter Editor Wendy Phillips
Professional Recognition
Chair

Recruitment and
Retention Chair
Angie Hasemann
Scholarship/Awards
Chair
Dana Cullen
Website Liaison
Intern Liaison
Student Liaison (JMU) Ivy Haines
Nominating
Committee
Linda LaFontaine
Viola Holmes
David Stebbins
Julie Woods
Meeting Planning
Committee
Bethany Blalock
Linda Lee


Congratulations to BRANDs 2014
2015 Board of Directors! We still have a
few spots remaining as you can see in
the chart. If youre interested in
becoming involved in one of these
positions, please contact President
Bethany Blalock at blalockbe@gmail.com

Update to Order Writing Privileges for Registered Dietitians in Virginia
Wendy Phillips, MS, RD, CNSC, CLE; VAND President-Elect and CMS Advisor to VANDs Public Policy Division

The Centers for Medicare and Medicaid Services (CMS) issued a final rule enabling
registered dietitian nutritionists (RDNs) in the hospital setting to become privileged to
independently order therapeutic diets effective July 11, 2014. For now, this rule
change ONLY applies to hospitals and critical access hospitals, not long term care
facilities or other care settings. The Academy is working diligently to get this privilege
expanded to these care settings.

As communicated previously, CMS outlined the process for privileging for qualified dietitians in
hospitals. Hospitals will have the flexibility to either
1) Appoint RDs to the medical staff and grant them specific nutritional ordering privileges or
2) Authorize ordering privileges without appointment to the medical staff, all through the hospitals
appropriate medical staff rules, regulations, and bylaws. The required and essential medical staff
oversight of RDs and their ordering privileges will be ensured if one of these processes is followed.

CMS has decided to leave the decision to individual states to determine the regulatory processes by
which these professions are governed and that hospitals, through their medical staff privileging
process, should be allowed the flexibility to determine the credentials and qualifications for dietitians
and nutrition professionals, in accordance with their respective state laws.

There is a Virginia law that is currently in effect that will affect order writing privileges for RDs
in this state. This document is titled Rules and Regulations for the Licensure of Hospitals in
Virginia. Section 12 VAC 5-410-260: Dietary service states that All patient diets shall be ordered in
writing by a member of the medical staff. Therefore, until this regulation is changed, RDs in
Virginia may only write independent nutrition orders in hospitals who appoint the RDs to the
medical staff (option 1 above).

What you can do now:
Please contact your Credentialing Committee, Medical Executive Committee, or equivalent
governing body in your hospital and ask if they will admit RDs to the Medical Staff. Be prepared
to discuss the recently updated CMS ruling for Condition of Participation 482.28 that clearly says
RDs may be made members of the medical staff.
If the hospital is unwilling to admit RDs to the medical staff, ask them if there is another way they
will grant hospital privileges to the RDs and what is involved in that process.
Begin working towards obtaining these privileges based on the criteria outlined, whether by
admission to the medical staff or in the other way they describe. These processes generally
take some time to complete.
Notify me at wp4b@virginia.edu the responses you receive from your hospitals. I have been working
with the Academy and state level agencies here in Virginia to have those regulations revised to reflect
the updated CMS wording, and having information from hospitals within the state will be vital to the
success of those endeavors.

Until the regulations for licensure of hospitals in VA is updated, RDs can continue to write dependent
order writing privileges per nutrition protocol if granted privileges via a method other than admission to
the medical staff. A tip sheet for guidance on how to do this is available at www.eatrightvirgina.org.





New Nutrition Facts Label!
Jackie Krainski and Callie Neelands, UVA Dietetic Interns

The FDA is currently proposing a change to the look and content of the current existing nutrition
facts label that was introduced for the first time 20 years ago. The purpose of the new and improved
labels are to increase the general understanding of nutrition science, to update the serving size
requirements and new labeling requirements for certain package sizes, and to introduce a new design
of the label. Some might view this switch as a great change and a way to improve public health, while
some might think otherwise.

Possible benefits to making the change
With the addition of the new nutrition facts label, there is more opportunity to increase teaching
points and education provided by health professionals and especially Registered Dietitians. First, the
proposed changes would allow for greater understanding of Nutrition Science. New labels would
require information about added sugars, which could become helpful in Diabetes Education. Certain
daily values would also be updated for sodium, dietary fiber and vitamin D to help consumers
understand information through means of a total daily diet. Potassiu and Vitamin D will now be required
to be listed by manufacturers because they are considered nutrients of public health significance. New
labels will no longer list calories from fat because current research shows that the type of fat, such as
saturated and Trans fat, are more important than the actual amount.
Another positive change, which influences the current struggle that everyone battles with, is the
change of serving size to actually mimic how people drink and eat as of today. This may be confusing
at first but serving sizes will now be based on what people actually eat, not what they should be. An
example of this would be a 20 oz bottle of soda, which is now normally labeled as 2.5 servings. In
reality it is being consumed by one person and not measured out in servings, so under the new law this
will be only one serving. Also, for different types of packages that are larger, but yet could be
consumed in one or even multiple sittings, a double column would be needed to label both per serving
as well as per package for the calories and nutrient information.
Finally, a new innovative design will make calories as well as serving sizes larger in order to
emphasize their importance. Most of these more prominent parts involve public health concerns like
diabetes, cardiovascular disease, and obesity. Percent Daily Values would also be switched from the
right side (normally read last) to the left side (where it is read first), as another teaching point to show
that the percent daily values represent how much a specific food will contribute to a persons total daily
diet. The last time the nutrition facts label was changed was in 2006 with the addition of trans fat to the
label, causing many manufacturers to reduce partially hydrogenated oil from their products.

Possible cons to the new label
Although these changes create the opportunity to teach the public about nutrition and proper serving
sizes, there are some downfalls to this change, including determining actual serving sizes of these
foods. How will the actual or typical amount of food being consumed be determined? Everyone
consumes different amounts of food for their individual needs. A child will not be eating the same
amount as an adult, and an athlete will eat more than a non-athlete. Changing the serving size amount
listed on the label may not change the amount a person actually eats.
The nutrition education opportunity with the new label is promising. However, in 2013, 48% of people
read nutrition labels of the food they bought according to National Eating Trends. Of these 48%, it is
likely that many of them know how to read and determine important/specific ingredients on the label
already. Additionally, education doesnt necessarily effect behavior change.
For these potential benefits of nutrition education, manufacturers will need to spend about $2 billion
with more than 2 years for this to be effective.

Implementation
These new changes would affect all packaged foods, except for certain foods which are regulated by
the U.S. Department of Agricultures Food Safety and Inspection Service. Final implementation of the
proposed rule will become effective 60 days after the date of the final rules publication in the Federal
Register. After this day manufacturing companies will have 2 years to comply with the new nutrition
facts label and new mandatory nutrient claims.


























Old Label New Label



References:
http://www.fda.gov/food/guidanceregulation/guidancedocumentsregulatoryinformation/labelingnutrition/
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm387418.htmucm385663.htm
https://www.federalregister.gov/articles/2014/03/03/2014-04387/food-labeling-revision-of-the-nutrition-and-
supplement-facts-labels#h-120
http://www.takepart.com/article/2014/02/27/after-20-years-fda-proposed-changes-nutrition-facts-label
http://www.foodnavigator-usa.com/Regulation/How-much-do-consumers-use-and-understand-nutrition-labels


Action Alert! The Academy has issued an Action Alert to support legislation to create NATIONAL
DIABETES CLINICAL CARE COMMISSION ACT (H.R. 1074/S. 539). You can learn more about this issue from
the American Association of Clinical Endocrinologists:, https://www.aace.com/files/advocacy/diabetes-initiative-
fact-sheet.pdf. You can send a letter of support to your Congressmen through the Academys Grassroots
Manager at www.eatright.org/members/actioncenter.org.






Please help us spread the word! (Article written by Jackie Krainski, UVA Dietetic Intern)
On June 5
th
Virginia officially recognized the kickoff to the Summer Food Service Program
(SFSP), a federally funded meal program. The summer meals program helps low-income children have
access to healthy food when school is out. These summer meals are free and available to children and
teens ages 18 and under, but currently only 17.6% of the children who receive free or reduced lunches
during the regular school are partaking in the summer meals program.
In order to raise awareness and encourage participation in the summer meals program, First
Lady Dorothy McAuliffe has partnered with the Virginia Broadcasters Association who will start running
Public Service Announcements throughout the summer on local television channels. To reach more
children at risk of hunger during the summer months, Mrs. McAuliffe, USDA officials, and the Virginia
Departments of Health, Social Services and Education have been increasing coordination with local
partners by helping to promote school district participation as well as outreach efforts to families. This
year there are 58 school districts participating in the summer meal program, a 20 percent increase
since last year, and 170 sponsor applications have also been submitted.
Efforts to raise awareness of the summer meals program in Virginia have included:

First Lady Dorothy McAuliffe addressed a letter to School Superintendents across the Commonwealth asking
them to consider providing summer meals in their communities
The Department of Social Services is coordinating with Share Our Strengths No Kid Hungry campaign to
promote summer meals program in 120 Social Services offices across Virginia
Outreach to local libraries has led to an increase in both summer meals awareness and the creation of
several new summer service sites to be hosted at libraries across the state
Targeted Facebook ads will reach an audience of over 360,000 Virginians, informing them about a text
service that connects families to summer meal sites in their area. Families can text Food to 877-877, call
211, or dial 1-866-3 HUNGRY to locate the closest summer feeding site
The Virginia Academy of Nutrition and Dietetics is working with community partners to increase awareness

Families can text the number stated above and will be prompted to reply back with their full
address. After submitting an address, the messaging service will send back a variety of summer meal
locations which are available. The messages include the address, phone number, dates of which the
summer meals will be taking place, days of the week or times, and meals/snacks provided.
Around the Charlottesville area, three locations were found to be available for the summer meals
program:
1. CALM-Trinity #2, 3101 Fontaine Avenue, Charlottesville VA, 22903.
Phone: 434-970-2077.
06/23/2014-07/23/2014 M,T,W,R, F- Breakfast (8:45-9:15) Lunch (12:30-13:00)
2. Johnson Elementary School, 1645 Chery Avenue, Charlottesville, VA 22903.
Phone: 434-245-2507.
06/16/2014-07/25/2014 M,T,W,R,F-Breakfast (8:30-9:30) Lunch (11:45-12:45)
3. Southwood, 387 Hickory Street, Charlottesville VA, 22903.
Phone: 434-245-257
06/16/2014-08/15/2014 M,T,W,R,F- Lunch (12:00-12:45) PM snack (15:00-15:20)