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Job Spotlight: Belinda Barron, clinical nutrition specialist

Belinda Barron readily admits she has had a craving for helping people stay on the path to healthy eating habits since her high school days in Thomaston, Ga.

It was at that time she and other high schoolers were offered part-time jobs at the local hospital -- now Upson Regional Medical Center -- that had them delivering meal trays for patients at supper time.

That set her on the journey to becoming a registered and licensed dietitian and nutritionist, a career that has taken her from The Medical Center (now Midtown Medical Center) to a dialysis clinic and, ultimately, to Northside Medical Center (formerly Hughston Hospital), where she has been for the last 15 years.

It's there that the Thomaston, Ga., native and now-resident of Columbus works as a clinical nutrition specialist, spending much of her time in the 28-bed rehabilitation center, tending to patients suffering from strokes, chronic heart disease, kidney failure and diabetes.

One big thing, she says: "We probably eat 10 times the sodium that we need, and that's related to hypertension and high blood pressure."

Barron, 59, is in a job that nationally is in high demand and growing "faster than average," according to the U.S. Bureau of Labor Statistics. There are about 67,400 dietitians and nutritionists in the U.S., the bureau estimates, with the need for more than 14,000 more by the year 2022. Annual median pay is $55,240.

The Ledger-Enquirer visited with Barron recently to discuss her job and how it has satisfied her hunger for helping people through the years. This interview is edited a bit for length and clarity, with an expanded interview available at www.ledger-enquirer.com.

Why was this a natural career for you?

Actually, I was very health conscious and became a vegetarian early in my life. I was a vegetarian in high school, really more for aesthetic reasons and spiritual reasons than health reasons. At that time, I didn't know enough about it. But I became really interested in that.

An opportunity opened up in the hospital for me to be employed full time as a patient service rep, working under the mentorship of two registered dietitians. I worked there for five years while I completed an associate's degree.

What did that early job encompass?

I was doing patient visitation because I worked closely with dietitians at least two days a week. I did clinical nutrition. I was able to visit patients and do assessments and do education. So I learned all about dietetics.

You said there's a lot of malnutrition related to illness? Sick people just don't feel like eating?

That's right, and there's a lot of reasons why they're not able to eat. One of the things that dietitians do is a clinical diagnosis of malnutrition and treat it. The profession's come a long way. I've been a dietitian for 33 years and I've seen a lot of change.

How many dietitians are on the staff here?

I actually have two and a part-time person who helps us on weekends. So we're fortunate to be staffed well. And that has a lot to do with my director who recognizes our role here, because we have a high acuity level. In our rehab unit, we have a lot of older patients and lot of patients who have multiple medical problems.

That rehab runs the gamut?

We do any sort of illness that will debilitate a patient ... Patients I've had admitted just in the last couple of days have had surgery where they weren't able to eat for a couple of weeks. There's lung disease, congestive heart failure, heart surgery, we do trauma and car accidents.

It's called medical nutrition therapy -- what dietitians do -- because diet plays such a big role in management of so many conditions, chronic disease, but also acute illnesses.

What's your day-to-day life like on the job?

I had five admissions yesterday. What we do is go in and interview patients and do what's called a nutritional assessment. We get diet history and medical history and look at their labs (blood work) and their medications. We calculate their nutritional needs and formulate a plan and we prescribe diets. We can prescribe certain medications that have to do with vitamins or minerals or probiotics.

You set up meal plans for patients. There is a common perception that hospital food is too bland, with too little salt?

If you'll look at the Gallup polls, we have some of the best ratings in the nation for our food service acceptance. I've even had patients tell me, 'I've heard about your good food.' Frequently patients in other facilities have not eaten well because of poor food acceptance. When they come to me, if that is their problem, I know they'll be OK here.

We individualize their menus, such if they need to be a on a completely salt-free diet. There are a few patients that do; if you have renal failure or heart failure, you do. But our staff is trained. We use alternative seasonings.

Part of what we do is teach the patient. We share recipes and teach them how to season their food so that it's not bland, even if they have to be on a salt-free diet.

How do you determine a proper diet for a patient?

We have standard diets that are used for medical conditions. That's part of our education. Such as renal disease, it depends on what stage of you have. We learn things like how many grams of protein (are needed) per kilogram of weight. We calculate caloric needs, protein needs, fluid needs, potassium, sodium. There are diet plans and menus that my staff use. We have the low cholesterol, the low fat menu, and we have a diabetic menu.

It sounds like you see a lot of patients with kidney disease?

We actually do dialysis here in our rehab unit. It's getting more common in our nation and it's an epidemic, renal disease. There are stages of it, and a lot of my patients have chronic kidney disease where their kidneys are failing, but they are not on dialysis. And that's something that we help identify, because some may know it and some don't.

Hydration has a lot to do with kidney function and we monitor hydration really closely ... I have to recommend IVs for patients at times when they're not able to take in what they need.

So one basic piece of advice for everybody is drink lots of water?

Exactly.

You have to be brutally blunt sometimes, telling the patient they must stick to their new diet?

I am brutally blunt. The nurses call me the food patrol. Tenacity is a strong character trait for me. I became a dietitian because I wanted to serve others and it was a way that I thought that I could ... Now we have all the science that shows that most of the chronic diseases that we're seeing right now and treating are preventable with a lifetime of healthy eating.

Do you recommend that people become a vegetarian?

I recommend to investigate that. Something that helped me to sort of use that more in my practice is I had a co-worker who was a vegan and brought me some of the best tasting food that I have ever eaten in my life, (laughs) and encouraged me to read a book called "The China Study." It's written by a physician. There's a documentary called, "Forks Over Knives," and it's about him and his book and it's on Netflix.

People need to know how to eat healthy with plant-based foods. You've got to study and know how to get all of your nutrients. But you can do it.

What traits or skills does a dietitian need?

Compassion. I would say that's almost number one. Just to want to serve others. Most dietitians are compassionate and want to serve others. And probably the science of everything (and the ability to absorb and comprehend lots of information).

Are dietitians fully appreciated in the health-care community?

I think there is a disconnect -- because there are fewer dietitians and there are more nurses and physicians -- that there's not a good understanding of our role in health care. I know some physicians are pretty turf guarded. If I see a patient getting malnourished and they have not had an oral intake for seven days, and have lost 3 to 4 percent of their body weight in a week, that's going to affect that patient's survival.

What's the most challenging aspect of your job?

Probably not having more control over (patient) outcomes ... Usually, I'm good at developing rapport with patients. They see that I care about their welfare. They see that when I'm asking them not to eat that second piece of pecan pie, there's a reason for that. Usually, when I'm able to tell them why they need to make changes in their behavior, the ones that genuinely care about their health, they're really appreciative.

There's kidney disease, but diabetes is a major issue today.

Obesity is an epidemic, and it's sad it's that way with all of affluence that we have in our country, and the knowledge that we have, and resources that we have.

Any other challenges?

One thing that has been a challenge for me being a dietitian all of these years is ... a physical therapist, speech therapist, occupational therapist, they're here in facilities and they charge and they're reimbursed for their services. Not until recently have dietitians even been reimbursed for their services. So we tend to be just part of room and board in a hospital setting.

If the public does not have access to professionals who can help them with the behavior change that's needed to adopt the diet to prevent illness, then we're not making progress.

And it's about third-party payers reimbursing patients for access to dietitians. We're just now where Medicare will reimburse dietitians for treatment of a few medical diagnoses. Chronic kidney disease is one. Diabetes is one, gestational diabetes. Usually, insurance companies will follow suit with Medicare.

We need a lot more dietitians in outpatient settings working in education, working in school systems, working in areas that will help eliminate the financial burden of medical care (long term).

Speaking of pecan pie, what does a dietitian eat for Thanksgiving, since it's coming up?

(Laughs) You know, it's all in moderation. It's what you do day in and day out. I tell my patients that. I eat pretty much everything.

Except turkey?

I will say I will eat some poultry. I don't eat red meat at all.

What advice do you have for anybody with the holidays approaching? Simply moderation?

Yeah, just moderation. I don't really recommend diets. People need to, number one, utilize resources. I can give you some websites.

People just need to know that it's what they do day in and day out that makes a difference. What some people do during the holidays is throw everything in the (shopping) basket and do whatever they want to do. But then they don't get back on task with what their long-range goals are.

You just want to keep things in balance. Do smaller portions. We overeat, so just watch your portions and stay hydrated. A lot of people crave sweets when they're really thirsty.

What's your favorite food?

You'll probably laugh at me, but green, leafy vegetables. Greens, turnips, collards, kale is wonderful. My father has always grown our vegetables. Growing up, he's always had a big garden and still has a garden. So we all went out there (recently). He had one bed with two kinds of kale. He had Swiss chard, and collards and turnip greens, and he had this wonderful lettuce. Right now, in my refrigerator, I've got this wonderful combination of all of those beautiful greens that are so vibrant, and I just can't wait. You can eat some of it raw; you can saute some of it. Kale is wonderful sautéed with garlic.

Just don't slip some fatback in there?

No, I don't use fatback. (laughs) And I finally got my parents to where they mostly don't do it, because I grew up eating lots of fatback.

Bio

Name: Belinda Barron

Age: 59

Hometown: Thomaston, Ga. (Upson County)

Current residence: Columbus (since 1981)

Education: 1973 graduate of R.E. Lee High School in Thomaston; earned associate of arts degree from Gordon College in 1978; earned bachelor of science degree from Auburn University in 1981

Previous jobs: Dietitian at The Medical Center; worked at Dialysis Clinic Inc. for 17 years; has been at Northside Medical Center (formerly Hughston Hospital) for 15 years

Family: Mitch, husband of 40 years, and two grown daughters, Hartley Barron-Janney, a second-grade teacher in the Atlanta area, and Erica Barron, a Columbus State University student, and a cat named Pumpkin

Leisure time: She loves music (her husband is a jazz musician) and dancing; and enjoys hiking and bird-watching; did extensive mountain hiking with her husband in the Appalachians and in the Rockies early in their marriage

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