(bright music) - Healthy eating is a cornerstone of healthy aging, but too many older adults regularly face food insecurity.

Nearly half of New York's older adults are at risk for malnutrition.

For older adults struggling economically, the least expensive foods are often highly processed with added sugars, fats, and salt.

Over time, an unhealthy diet contributes to lower quality of life, higher rates of chronic disease, and a shorter lifespan.

But the good news is that there are resources to make healthy food more available in New York State.

In fact, the New York State Office for the Aging and its network administer the largest nutrition program in the nation with more than 23 million meals served each year to nearly 300,000 people.

In this special edition, "Aging Together in New York: Food as Medicine Town Hall," we'll spend the next hour sharing resources for finding nutritious food, information on the science of nutrition as it relates to aging, and how improving diet can lead to a healthier and higher quality of life.

To start our conversation, I'm joined by Beth Richardson, Food as Medicine manager for The Food Pantries of the Capital Region, and Greg Olsen, acting director of the New York State Office for the Aging.

Thanks so much for joining us.

- Thanks for having us.

It's great.

- I wanna get started with sort of a definition of, what is food insecurity?

What does that mean?

- So food insecurity is not having access to enough food to maintain health and quality of life.

And then specifically, nutrition insecurity usually goes right along with that.

And that's looking at having the correct foods to really enhance your health and maintain a healthy lifestyle, not just being alive, but also thriving.

- And Greg, like, what are we looking at in New York State?

What's the situation for older adults across New York?

- Well, it really depends on the county.

I mean, you would think of, you know, differences between suburban, urban, rural areas, and there really is no rhyme or reason.

So for older adults, it could be, in some counties, anywhere between 12% and actually 39% who are food insecure.

And I know you talked a little bit about the economics.

That is a major factor, but it's not the only factor.

Food deserts, et cetera, transportation, oral health is a huge deal that we don't talk about very often.

So there's those types of factors.

But as you said earlier, there are a lot of resources that people may not know about, or people may know about but for some reason, you know, don't apply for those benefits.

And hopefully, we can talk about that.

- Yeah, and I know you've been working on the Master Plan for Aging in New York State.

To what extent is food and access to food a part of that?

- Well, it is a part of it, and I think, you know, when we talk about the Master Plan for Aging in New York, it has aging in it, so there's a focus on aging, but what we know is you begin aging the day you're born.

And so if we can have an impact on providing, like in this year's budget, there's free school meals for any student.

That's really, really important to help you learn.

But if we were able to impact the curve earlier on, whether you're a child, you know, middle age, or older adults, it's gonna have a positive impact over time.

So, of course, nutrition is a big part of the MPA, but it also is with other initiatives that tie around that.

So there's the Prevention Agenda, which is, again, a whole public health approach to making people healthier.

And a lot of that's in the community as well as what's called Health Across All Policies, which is that every agency, whether it be aging, children and families, housing, all has a stake because the built environment is a lot of reasons why we have food insecurity today.

- And the reality for older adults is, you know, you may be thinking school meals, but there's grandparents or family members that are caring for younger family members.

And so, you know, food for those kids may actually mean more access to food for the older adults in their lives.

- You are spot on.

There are two things in the budget that I highlighted this year.

One is the increased childcare tax credit, and the other is free meals.

And I remember getting a question from a legislator: why would you put that in your budget testimony?

It's exactly the point.

We have 350,000 grandparents who are the primary caregivers of the grandkids, whether it be incarceration, death, fentanyl, whatever it might be, so you're right.

Not only does that help keep cash in their pockets, but if you claim your grandchild on your taxes, you can get a tripling of the child tax credit.

Again, people don't normally think about that.

- What does this look like from The Food Pantries' perspective?

- From The Food Pantries' perspective, I know that last year alone, we're a coalition of 72 pantries throughout the Capital District, and we serve just over 9,000 seniors, individual seniors.

And they came on average of six times a year.

And so we're seeing that reliance on what is supposed to be an emergency food system, not necessarily something to go to regularly for your daily or weekly shopping, but it's being used regularly by quite a number of people, you know, over 9,000.

And going off of what Greg was saying about school lunches, that cognitive development and protecting against cognitive decline starts in childhood.

So addressing food security at any age becomes helpful for older adults - In New York, how does it stand against other states in the country?

Do you have a sense of where you are?

- In terms of food insecurity?

- Mm-hmm.

- You know, I think, nationally, the percentages are just under 10%.

And I think we're pretty consistent there, but I think that there's gonna be differences depending on where you go.

So I think we think less of it that way and more of, how are we doing?

How are we doing getting out there to talk about the variety of things, whether it be food banks and food pantries, the SNAP benefit, our home-delivered meal program, congregate meals, nutrition education, SNAP-Ed?

All of these things are available, but there's also other programs that put cash back in people's pockets.

So it's not always has to be linked directly to- - It's interconnected.

- a food benefit.

If we can get people who qualify... You know, if you make $2,200 a year, you could qualify for what's called the Medicare Savings Program, and we can help save people $7,000 a year.

You add then the SNAP benefit.

The average benefit for an older adult in New York is about $220 a month.

That's another $2,500 a year.

And then the Home Energy Assistance Program that helps with heating and air conditioning, is another thousand.

Those three programs alone can put $11,000 back in people's pockets that can then help in other areas.

- And what about the quality of food that is accessible through some of these resources, and the focus of that with The Food Pantries in particular?

- So The Food Pantries runs what's called a Healthy Pantry Initiative and helps our member pantries to offer more nutrient-dense, high-quality foods as part of the Healthy Pantry Initiative.

So we're working towards providing healthier, more nutrient-dense options just as the general food that's available within the pantry, not as part of a specific Food as Medicine program or targeted to any sort of particular condition.

It's just increasing access to healthier options.

- Yeah, and for us, I mean, I'll be honest with ya, I've been traveling the state for 33 years as a geriatric social worker.

I cannot tell you how many home-delivered meals and congregate meals that I've eaten.

I've never had a bad one.

There's a lot that we do to assure the highest standards.

We have registered dieticians not only within the office but across the state that are looking at menus, doing nutrient analysis, making sure we meet those high standards, especially for things like low salt and other types of nutrient dense.

And we get rewarded from that through federal funds for every meal that meets those standards.

So, again, I can't complain about the quality.

I think they're really, really good.

- Talking specifically about just how food is so fundamental and interwoven in people's lives, and the value of those congregate meal sites, which goes beyond the nutrition to, like, the socialization and the relationships that happen there, we actually, in the lead up, or you know, planning for this conversation, visited the Colonie Senior Service Centers, and we created a little bit of video looking at the role of food in their program.

So let's take a quick look at that.

- Pretty much everything we do is surrounded in some capacity around food, eating, celebrating, partaking in.

And a lot of times we're experiencing seniors who are really struggling with food insecurity in the community.

(gentle music) My name is Diane.

I'm the executive director of Colonie Senior Service Centers.

And our mission is really about supporting older adults in the Capital Region.

We have so many food programs.

And, again, we're always trying to tweak or add depending upon what the need is in the community.

So we are a congregate lunch site in six locations.

And what that means is we get subsidies that start off at the New York State Office for the Aging, and people are able to come in and have lunch with us.

You have to be at least 60 years of age.

And then there's a $3 suggested donation.

We do about 35,000 meals a year, and that number has progressively grown since the pandemic.

We're in three counties, depending on our program.

Our network has grown from probably about 20,000 seniors that we're working with to about 25,000 seniors.

And these seniors that are coming are seniors often who, in some type of need.

And that might be just having a good, nutritious meal, somebody to sit down with, feeling accepted and welcomed.

For me personally, right now, as we speak, my biggest concern is just cuts, cutting in funding, cutting in programming.

I always get concerned when I read the "Times Union," and I see The Food Pantries or the Food Bank are having some of their programs cut.

Meals on Wheels is possibly being cut.

You know, the need is growing.

It's not getting any less.

And I'm just wondering, are we going to allow people to starve or eat less or be malnourished?

That's my greatest concern.

As a little non-profit with 54 employees, we really have to partner with businesses and with the government.

We all need to recognize there's that need out there.

- So, you know, you all are part of that network that allows something like what happens at the Colonie Senior Service Centers to happen.

Talk about the strength of that network and the importance of sort of keeping it healthy and viable.

- Yeah, well, I mean Colonie does a great job.

We're fortunate in this area.

You got the town of Bethlehem, right, town of Guilderland, town of Colonie.

So you have municipal governments that are part of the network.

I think the beauty of how we were structured... And I do wanna say happy birthday to the Older Americans Act.

It's 60 years old this year, as well as Medicare, Medicaid, Social Security is 90.

So these are really important safety net programs that have been life-changers for older adults, going back to the first check, which was 1951.

But we are not a top-down type of agency.

We are a top-down, bottom-up, and meet in the middle.

So we don't succeed unless Albany County Office for Aging, town of Colonie.

And so the way that we approach things is, how can we partner with you, not as a regulatory agency, but as a real, legitimate partner, to be able to expand and provide as many services as possible?

Because while we're providing, for the most part, the funding and so on for communities all across the state, it's really the grassroots organizations, that start with the Offices for the Aging, and then the other 1,142 community-based organizations that we work with in every corner of the state that know who their communities are, know what they need, and they have the flexibility to meet those needs.

And I think that that's a real unique difference of how we're structured as a state agency versus everybody else.

- When it comes to these kinds of programs and, like, food insecurity, we're also talking about quality of life, right, survival and also quality of life.

And things like congregate meal sites are providing that personal social interaction that's so vital.

Especially as we age, there's this increased loneliness that happens.

And so congregate meal sites are not only feeding people nutritious meals but then also providing that social interaction.

They're getting social interaction, too, with those delivered meals.

If they're doing the home-delivered meals, they're seeing that delivery person and getting at least a little bit of that interaction, which can also be helpful 'cause some people can't get out to the meal sites.

- When you think about a program like SNAP or some of the resources that you've mentioned, what about convincing older adults to take advantage of those resources and make sure that they know they're there and that they're connected to them?

Because they really are fundamentally important to helping you have the quality of life that you want.

- Well, that's right.

I mean, one of my past jobs was working for Hunger Solutions.

And the specialty that I had was working with older adults around federal feeding programs.

I do just wanna go back to the video, because we're talking about how we can address meeting older adults who have some needs in nutrition, but I really want to highlight also what I saw there is how many older adults are volunteering to make that happen.

And we would not have the network that we have without them.

We have a million volunteers in New York providing 474 million hours of service at an economic value of $13.2 billion.

And they're holding up 33,000 not-for-profits.

So I just wanna shout out to those that give the biggest gift, which is your time.

You know, the things that I had learned over time in terms of why older people don't utilize SNAP benefits, and it's not just SNAP, but let's talk about SNAP, is, number one, they've been vilified as a welfare program.

They're not.

There's no difference between SNAP and getting your STAR property tax, getting TAP or Pell.

It's just, for some reason, we as a society, and I didn't do this, it's more on the political side, looks at that differently because it's for lower income people.

So that's stigma number one.

Stigma number two is, the only benefit I'm gonna get's $10.

That is not true, and I went over those numbers.

Number three is, well, I don't need it as much maybe as a younger family, so if I take it, then they won't.

That is not true either.

And so in this environment, where we're seeing costs go up, labor costs go up, fuel costs go up, impacts of tariffs, and I could go on and on and on, the price of foods are going up, and the good foods are extraordinarily expensive.

We've all gone to a supermarket, got one bag, and it's $80, versus at the end of the aisle, you can get 10 oatmeal cream cookies for $1.99.

And so it's not hard to understand why people are making the choices that they are.

But this is a benefit that my tax dollars, everybody's tax dollars support when you're, you know, have a fixed income after retirement and need some assistance, and it's nothing to be ashamed about.

- Absolutely, and do we have the resources in New York State to meet the demands that are there?

- Well, those are federal programs.

So SNAP is federal.

But as long as we're talking about that, you know, Congress has proposed to cut SNAP by $300 billion.

Now, that's a proposal.

It still needs to be negotiated with the Senate, and that's kind of how it works.

But I think, from our agency's perspective and our network's perspective, we're not sitting back and waiting for that to happen.

We are proactive in trying to let the communities know not only what's being proposed, because it hasn't happened, but there's a lot of those types of things, like eliminating all elder abuse funds, eliminating Adult Protective Services, the Long-Term Care Ombudsman program.

So we all have an opportunity over the next four months that if we don't agree with that, we need to be a part of democracy.

- What we're seeing already from at The Food Pantries level is that the Food Bank is not receiving as much food from USDA sources.

So The Food Pantries don't have as much either.

So when people are going there to find food and emergency food assistance, it doesn't exist in the same capacity that it did before.

- Could you talk a little bit about the difference between a food bank and a food pantry?

- Absolutely, so think about the food bank as a warehouse, right, and that's where we have large shipments of food come in, typically, historically from USDA, as well as some local agriculture throughout the state that gets sent to the food banks.

And then food pantries can go and get food, buy food, truly, from the food bank.

So your food pantry is purchasing their food from the food bank.

Sometimes some of it is free, but there is a purchase there most of the time.

And so where The Food Pantries for the Capital District comes in is to help with that connection, right?

Because somebody needs to get the food from the food bank to the actual pantry itself.

So sometimes we do provide that logistic service of transporting the food.

- Yeah, and one of the, again, just to... And you could talk much more about this than I can, you know, supporting local agriculture and then the food banks, Nourish New York has been a huge boost of revenue to exactly what Beth is talking about.

And I think, you know, we were fortunate in this year's budget to receive an additional $52 million in our budget that'll go out again.

But we can't fill, and we don't know what these are, these huge federal cuts.

'Cause $90 billion of New York's budget comes from federal sources.

We're not gonna lose $90 billion.

But if we are losing, you know, USDA funding, if we're losing home-delivered and congregate meal funding through NSIP, which is a different type of program, I don't know that state government can backfill those.

- For folks that are watching this and want to know a little bit more about what resources exist in their community and their county, across the state of New York, where can they go as sort of a open door, you know, single point of entry to find out more information.

- You couldn't have teed that up any better.

- Yeah.

(laughs) - So we have, in New York State, kind of a one-stop shop.

And it really doesn't matter.

You know, we provide over 23 core services everywhere.

And people don't need to remember what they are, but they need to know, where do you start the journey?

And that's through our local county Offices for the Aging or New York Connects, which is 1-800-342-9871.

And that will start, and they will have connections to NOEP programs, Nutrition Outreach and Education Programs, to help with, you know, SNAP benefits, in addition to what we do.

They should have a connection to, you know, the Emergency Food Network.

I mean, some of these things are online, but as we were talking about earlier, you know, older adults use tech at the same rate as everybody else, but there's still going to be pockets of individuals in all age groups that just don't.

So not everything can be virtual.

Not everything can be wired.

You need to be able to talk to a human being, and you will be able to do that if you call our Offices for the Aging, - We will reinforce that New York Connects resource throughout this conversation.

Beth and Greg, thank you so much for setting the table for our conversation.

All right, so we've learned about the realities older adults face regarding food insecurity and some of the resources available for finding nutritious food.

Next, we're going to talk to two registered dieticians who, among other things, are reaching New Yorkers through content creation on YouTube.

Take a look.

(gentle music) - Older adults are just older people.

And nutrition education is important in the entire life cycle.

And we teach the foundations of nutrition through SNAP education.

(gentle music continues) - Hello, everyone, my name is Wendy Beckman, and I'm a registered dietician with the New York State Office for the Aging at SNAP-Ed New York.

We are tasked with educating older adults with the SNAP-Ed principles, which are how to eat healthy on a budget.

Today, I'm going to be making roasted potatoes and apples with chicken sausage.

"What's Cooking with NYSOFA" started during the pandemic.

The communications team at NYSOFA came to us for SNAP-Ed and asked if we might be interested in sort of upping the production of that program a little bit more, because it was doing very well on our Facebook page and on the New York State Office for the Aging YouTube channel.

I love these one-pan meals, because it really does save time on cleanup.

I think a big challenge with trying to eat healthy on a budget is that healthy foods are expensive.

But there are ways to mitigate some of that by using different kinds of products, by purchasing fruits and vegetables when they're in season, by using fresh, frozen, dried, or canned.

I hope this recipe gave you some more ideas on how to incorporate more vegetables and lean protein into your diet.

The goal of the New York State Office for the Aging is to help older adults stay at home for as long as possible.

Nutrition is an integral part in keeping people healthy.

It's an integral part in keeping older adults at home for as long as possible.

- Welcome, Wendy Beckman and Lisbeth Irish.

We're so pleased to have you here.

Now, you're both registered dieticians who work as nutrition consultants with the New York State Office for the Aging.

Talk a little bit about what your role is and how you work with older adults in New York State.

- Well, I am the SNAP-Ed program manager for NYSOFA.

You know, we serve older adults 60 years and older throughout New York State.

SNAP-Ed is currently in 26 counties, the five boroughs of New York City and two Tribal Nations.

So we have a big, you know, span of services.

And I manage the program managing along with, you know, many of our other staff members.

Wendy was my predecessor.

She's always my go-to for questions that need some history.

But it's a great program.

And we have educators throughout the state.

We have nine regions.

Each region is led by a county Office for the Aging, and they provide programming not only in their region, but they also try to do programming in two or three counties near them.

So we have lots of registered dieticians throughout the state doing programming for SNAP-Ed.

- Wendy, what about you?

- So Greg Olsen was here earlier, and he spoke about the nutrition programs that are funded through the New York State Office for the Aging.

And one of those programs is congregate dining sites, and the other program is home-delivered meals.

And it is my job to go travel throughout New York State and visit different counties.

And we talked a little bit about the nutrient quality of the meals, and in the Older Americans Act, it is written right in the legislation that those meals need to meet at least 33 1/3 of the dietary recommendations for Americans.

So I look at the nutrient analysis.

I make sure that the kitchens are operating correctly.

And so it's really nice.

I get to go out throughout the state and see people who are benefiting from the programs that we provide.

- As a nutritionist, you know, SNAP educators, right, maybe not everybody may be eligible for SNAP, but everyone 60 and over can access information from a nutritionist that could perhaps be helpful for them, correct?

- So individuals who are 60 and older can contact their county Office for the Aging, and they are eligible to get individualized nutrition counseling even if they don't visit the congregate sites, even if they don't get home delivered meals.

So that is correct.

- And how would someone get connected to their area agency on aging?

- So, again, Greg mentioned New York Connects.

That phone number, you can call the New York Connects number, and the person on the other end of the line will ask you what county you are in, and they will directly contact the county Office for the Aging for you, give them your number.

- You talked about, like, keeping up on sort of the dietary guidelines.

How often do those kind of change?

- They change every five years.

They have been already drafted.

They're ready to release.

We just don't know when they'll be released.

- I remember the food pyramid, right, and then it switched to MyPlate, right, and which seems like a little bit more of a simpler design of, that shows you sort of portion size perhaps about what you're supposed to be eating.

Talk to us a little bit about, how do you describe MyPlate to someone?

- MyPlate is a picture of how you should eat every meal.

Sometimes I say, from personal experience, maybe I won't do my food choices exactly like MyPlate.

Maybe I didn't get to the vegetable for breakfast.

I'm not a fan of vegetables for breakfast.

I know I'm a dietician, but that's not my thing.

So I might have that vegetable as a snack later, maybe some carrot sticks with some hummus or something.

But it gives you an idea of what a meal should look like.

And that's, you know, assuming you're eating three meals.

But it's also portion controlled so you're not overeating or undereating.

People assume older adults might be overeating, but there's plenty of older adults that maybe are challenged to eat enough, too.

So it works, you know, in different ways for different populations.

- Researching for this program and looking at like half of older adults in New York State are at risk for malnutrition, but malnutrition isn't just undernourishment.

It's also perhaps overnourishment.

Talk a little bit about the definition of malnutrition, how you see it in the communities that you serve.

- Well, overnutrition happens with many populations.

You know, we live in a country that has an abundance of processed foods, and you might get overnutrition from eating too many calories, too much saturated fat, too much sodium.

So we try to guide people to pull that in and eat, you know, the adequate amount of, you know, different components of the diet, not under, not over, in the middle.

Moderation is a hard concept for a lot of us, and that's kind of the one of the foundations of nutrition.

And that's one of our aims is to help people achieve that.

- Right, and with overnutrition, if you wanna call it that, that sometimes can happen when individuals eat too many highly processed foods.

Now, not all processed foods are bad, but the more highly processed foods can be lower in nutrition and higher in calories.

So they have more of the things that you would like to limit in your diet, and they have less of the things that you really should try and get more of in your diet.

So less fiber, they have less vitamins and minerals, those types of things.

Whereas less processed foods tend to have more of those things that you want more of.

So the overnutrition can happen where it's more calories but actually less nutrition.

They're nutrient-deficient foods, where they don't have a lot of vitamins and minerals and fiber in them.

- When someone goes to, like, a congregate meal site, and they're able to get a, you know, properly designed meal that is, you know, nutritious, that's one thing.

That's an easy way to get a great quality meal.

But if you're going into the grocery store, are there any tips, like in terms of looking at nutrition labels, that sort of thing, to look for those key points of, like, fiber content or, you know, fats or sugars that you try to help people to know, like, is this even healthy?

You know, how do you determine that?

- This is one of the goals of the SNAP education, or the SNAP-Ed program.

We have educators throughout the state that teach workshops that are specifically designed to help people make healthy choices.

You know, we have small groups of people.

The educator might meet with them four times over the course of a month, and she will go over how to label-read, how to budget, basic nutrition based on MyPlate and the dietary guidelines plus a whole lot more.

And they make it fun.

There's also a physical activity component to most of our curriculum.

And the educators are wonderful.

So it's enjoyable.

You're learning about how to do these things in an enjoyable way.

- Yeah, I mean, I don't know if you have any particular tips when it comes to, like, reading nutrition labels or looking for a target number for fiber content.

- Usually, looking for labels that say that a food is a good source of fiber.

Everyone has different fiber needs.

So if you look at something, it's hard to give you a specific number.

But looking for labels that say that they are whole grain, not just wheat, because wheat can mean white flour, so whole wheat and whole grain items.

When I used to teach individuals in the community, I used to tell them to look at the bread, and if it had three grams of fiber or more per slice, then it was probably a good source of fiber.

Now, you have to be careful because they will try and trick you, and it'll say three grams of fiber on the label, but then you have to look at the serving size.

So you have to look at, is that two slices of bread?

There's three grams of fiber in two slices of bread or only one slice of bread?

So you wanna look at those types of things.

Fruits and vegetables, most Americans don't get enough of those.

Beans, legumes, nuts, and seeds are all excellent sources of fiber.

- You always wanna increase your fiber gradually though.

- That is correct.

- Doing it too quickly can have some not-so-pleasant results, (chuckles) but yeah.

- Talk a little bit about unique needs of older adults when it comes to nutrition.

- Older adults have higher protein needs, but they're not extremely high compared to the usual American adult diet.

Most Americans eat enough protein.

We actually eat probably a little bit more than we need, according to the dietary guidelines and the research.

But if an older adult can't maintain that because of some challenges, that's where our educators come in.

They try to explain, you know, maybe some cheaper, less expensive sources of protein.

'Cause protein can be very expensive.

Older adults sometimes run into challenges that they may not have had when they were younger.

They may have a more limited budget.

So, again, our educators help them find maybe some alternative protein sources.

They might have some increased physical needs.

You know, they might not be able to stand for a long time preparing foods.

They might have difficulty chewing.

That can be a barrier.

They might just not have the preference for some of the protein foods they used to eat.

I know myself, the older I get, I'm not as crazy about the chicken and the, you know, whatever that I used to eat.

Even fish, I'm just not that crazy about it.

I prefer some of the vegetarian sources.

But our educators help people identify those sources and know what to do with them.

They use a lot of SNAP-Ed recipes.

SNAP-Ed recipes are amazing because they're nutritionally balanced.

They have fewer ingredients than a lot of recipes.

They're easy to modify.

If you only wanna have maybe one or two servings as opposed to five or six, when you're an older adult, a lot of times you don't want that five or six servings.

And our educators explain how to adapt the recipes.

And they demonstrate the recipes.

You can find a lot of SNAP-Ed recipes on snapedny.org.

- Your YouTube show, "What's Cooking with NYSOFA," those are all SNAP-Ed recipes.

Y'all both, your "Ask the Experts: Nutrition Edition" on the NYSOFA YouTube channel, you've gotten a lot of views and a lot of response.

Has that been, in some ways, a surprise in terms of, like, the need, the hunger, if you will, for this information?

- It was to me.

So we started doing the cooking demonstrations and the "Ask the Experts: Nutrition Edition" during the pandemic when we were trying, the communications team at NYSOFA was looking for ways to engage older adults, especially during the pandemic, when people were being encouraged to stay at home.

And we know that social isolation is a huge problem for older adults, and it can become...

It became more of a problem during the pandemic.

So it was sort of pitched to me that we should, through the SNAP-Ed grant, do a cooking show.

And I was very reticent.

I was very hesitant.

But we started streaming it live from my living room.

I used my iPad to stream it live to Facebook.

And it was very popular.

I was shocked, especially since it was sort of a very low-budget way that we were filming it.

I had a little stand for my cell phone so that we could have an overhead view of what I was cooking on the table.

And after about two years of doing it that way, the communications team at the New York State Office for the Aging suggested that we sort of up the ante a little bit and increase the production value.

And we started filming those cooking demonstrations ahead of time.

And that allowed us to add some graphics and some music and make it look much more professional.

And we do that in conjunction with the New York State Office of General Services, and they make us look amazing.

So I use all SNAP-Ed, I use all SNAP-Ed recipes for that program.

So that means that they are lower in sodium, lower in saturated fat, much higher in vegetables, higher in fiber.

So all of those things put together can help people to learn how to eat healthy on a budget, which is the goal of SNAP-Ed, and to increase your vegetable and fruit consumption and things like that, so we did that.

We started the "Ask the Experts: Nutrition Edition," also, again, live from my living room.

And when Lisbeth joined our team, she took over management of that program, and she does it to this day.

She takes questions from the audience.

And she interviews the nutrition educators from our SNAP-Ed program, who are throughout New York State.

And she gets to talk to them about their expertise as well.

- Yeah, it's a great way to highlight the skills and the knowledge of our educators so that everyone can see what they know and, you know, a little snapshot of how they teach - Congregate meal sites, home meal deliveries, those are great ways to get high-quality meals, and you can reach out with New York Connects to get connected with some of those resources.

But let's talk about some myths and misconceptions, things that you try to educate folks on ways to get food that is both healthy and fresh and good tasting.

So let's talk about like canned foods, frozen, dried, like what are the typical, the advice that you give around those kinds of foods?

- So I hear a lot that eating healthy is expensive.

And in many instances, that is true.

But with the SNAP-Ed program, we have certain messages and certain teachings that we rely on.

So one of them is make half your plate fruits and vegetables.

And some people feel intimidated by that because they think, oh, that's too expensive; I can't afford that.

But one of the other teachings we have is fresh, frozen, canned, or dried, it all counts towards making half of your plate fruits and vegetables.

So it's really okay to use canned vegetables.

It is okay to use frozen vegetables.

One of the other things we teach is to try to purchase fruits and vegetables that are in season.

So if you are able to go to a farmer's market, or if you go to your local grocery store, trying to purchase items that are in season.

In New York State, an easy one is apples, right?

We all know that Apple season is September through October, November, December of the year.

And you can get apples all year long, but they're freshest during that time of the year, because that's when the apples are growing.

And so those things happen.

There's a lot of surplus at those times, when those items are in season.

And so sometimes the prices go down.

Look for sales.

I always buy things on sale.

Things like apples, I look for the apple on sale.

There's not a lot difference between the different apples.

So things like that can help people to stretch their food budget.

We teach people how to use up their leftovers, just 'cause if you're not wasting food, you can stretch your food budget that way.

That's another thing that we teach for- - And sometimes people question the frozen and canned items, you know, like, well, don't they have sugar, and don't they have salt?

There have been studies actually that prove that you can decrease the sodium in a canned vegetable by rinsing it, rinsing it well, and not just, you know.

But, also, a lot more vegetables are made without salt now.

So, you know, even store brands you can find with no added salt.

When it comes to canned fruits, even just rinsing the syrup off.

I mean, if you can't afford the ones that are packed in juice, or even light syrup, sometimes those are a little more expensive than the ones in heavy syrup, you can still rinse off the heavy syrup, and you're still ahead of the game.

You're still getting the nutrients in that fruit or vegetable.

And frozen vegetables and fruits are harvested at their peak.

So you're getting really high-quality fruits and vegetables when you buy them frozen.

Sometimes they're fresher than the fresh, depending on how far that fresh vegetable traveled to get to the store that you shop at.

- Wendy and Lisbeth, thank you so much for joining us.

It's been a pleasure talking with you.

- Thank you.

- Thanks for inviting us.

- Now, we know that an unbalanced diet can contribute over time to an increase in chronic disease and poor health outcomes related to malnutrition.

But can a healthy diet improve one's health and quality of life?

To explore what a Food as Medicine approach looks like in practice, I'm joined by Dr. Alexander Ford, of Community Care Partners, and Stacy Pettigrew, associate professor and director of the Collaboratory of the Albany College of Pharmacy and Health Sciences.

Dr. Ford and Dr. Pettigrew, thank you so much for joining us.

- Thank you.

- Dr. Ford, I wanted to start with you.

You're a DO.

Folks may be familiar with MD, but what does a doctor of osteopathic practice mean?

- Absolutely, so DO stands for doctor of osteopathic medicine.

In the United States, there's two ways to become a physician.

You can get a DO after your name or an MD.

MD is uncommonly affiliated with allopathic.

So you might hear that word interchangeably between MDs and allopaths.

They're the same thing.

So we get the same basic four years in medical training.

But what's unique about a DO is, in addition to that, we also have hands-on manipulation called manipulative medicine.

That's called OMM, and there's a lot of alphabets, right?

But, again, that's what really sets us apart.

So the art of osteopathic philosophy is that we not only study the body, but we look at it as a unit.

So when we're doing our osteopathic labs, we're looking at the body from head to toe and understanding the nuances between structure and function with the body, and how our hands might be able to provide a non-pharmacologic, non-surgical intervention and help the body ultimately heal itself in some situations.

So, again, when we have our allopathic colleagues there doing their same lectures as we're learning, so the basic medical training is the same, but then we have that other modality that we can use when necessary or when it compliments our additional training, which is awesome.

- A lot of the healthcare system in the US is dealing with symptoms, you know, whereas the approach that you take is a more systematic one, I suppose.

- Absolutely, absolutely.

So the DO philosophy is, again, more holistic, whole body.

So when I have a a patient for an initial encounter, let's say it's a physical, I'm going over their environment, you know, their finances, their socioeconomics, because that's integral to me being as impactful as possible as a primary care physician.

I tell my nurse that when they're rooming my patients, right, that medical appointment starts from the initial standpoint of them walking into that building.

I'm looking at their gait, a.k.a.

how they're walking.

Do they look like they're favoring a certain side of their body versus another?

Are they using a ambulation device, as far as a wheelchair or a walker?

Why are they doing that?

So just, you know, more and more, and using our osteopathic lens to get to the root cause, and ultimately prevent the disease whenever it's possible.

- And Dr. Pettigrew, you know, it seems to me you take a similar perspective of looking at systems, and not necessarily just an individual choice or something around the foods you eat, but looking at environment.

And so talk a little bit about the work that you do from a public health perspective.

- At the Collaboratory, so the Collaboratory, we're a health resource, a community health resource center that is operated by Albany College of Pharmacy and Health Sciences.

And we operate in partnership with Trinity Alliance's Community Health Worker outreach team.

And so we have a range of different programs that we offer.

The Community Health Workers offer wraparound services to address social determinant of health needs, and helping connect people with insurance and primary care, and then housing, transportation, food.

And so, and then we have a Public Health Pharmacy team that also operates there that does medication reviews.

And we have a hypertension program called Connected HEARTS, which helps people get control and monitor, and it empowers people to really monitor hypertension and prevent its progression.

And then we also are launching a new cohort very soon of our Food as Medicine program.

And this cohort, we're looking to do a study with it to try to document the impact that it has on people's health, and can we use healthy food deliveries, weekly deliveries of healthy food for people with either hypertension or type 2 diabetes or both, and document that it is slowing the progression of those chronic diseases.

- It's interesting to sort of look at, everything is interconnected, right?

Like, we can't just say, well, we just wanna focus on diet.

You know, we look at the environment, that sort of thing.

I'm thinking about what Greg Olsen said earlier in the program and talking about, like, you know, some of the resources with home heating, you know, are connected to helping, then you have more money for food or whatever your needs are.

So talk a little bit about just the concept of Food as Medicine and what you are trying to accomplish with that.

- The food desert was mentioned.

And so I think access to food is a really, really important issue.

And transportation, are you able, do you have a car to get to the grocery store?

Or is the grocery store close to you?

Is there one that you can walk to in your neighborhood?

Or are there only corner stores with ultra-processed foods?

What access, besides just being able to afford healthy food, can you get to it and buy it?

And so the Food as Medicine program we're running, we have, like I said, it's people with chronic disease.

And we're giving food to the whole family as well, not just the individual that's enrolled in the program.

And we're doing this in conjunction with Trinity Alliance's food pantries.

And so each week, people will get a box of healthy food, and that is enough for some of the meals for the week, not everything, but to take some of that burden away.

And then we're gonna include recipes, and we're gonna be checking in with people and have, you know, a holistic look, connect them with the community health workers if they score in any social determinant of health needs, connect in a medication review if that's desired.

And so, and then we're gonna, we're gonna do A1C, so blood sugar, long-term blood sugar levels testing, and then also lipid panels to see about blood, blood lipids, at the beginning and the end.

So can we move the dial in any of these measurements by providing, you know, a stress-free, delivered-to-your-door box of healthy food for your family for a week, each week, for six months?

- Dr. Ford, what is the relationship with diet and nutrition and food when a patient comes into your office?

And what part of their care is that portion?

- Sure, sure, sure, so it's the crux of my patient visits.

And what's beautiful is I've been at my practice long enough where patients, clients are deliberately seeking me out because I'm one of the few physicians in the area that also has that extensive nutritional background.

So, again, I have the reputation of leading with the nutrition prescription whenever possible and instead of a pharmaceutical one, right?

I understand medications exist for a reason.

But when we can, let's try to enhance what we have and, again, augment our parts within our body which we are born with, which I think is beautiful.

So from the initial start of a appointment visit, I'm going over medications.

I always do a dietary recall.

So I like to get more context about dietary patterns, affordability of foods, who's doing the shopping.

And then, also, nutritional literacy is extremely important.

Just because somebody knows how to read a book does not necessarily mean that they know how to read a food label, and they go hand in hand.

So, again, it gives the patients a lot of ease and comfort that, again, I'm not leading with that prescription pad, and I wanna have more of a conversation to see how we can get the buy-in together, and I can help quarterback your health in a comprehensive, holistic manner.

- For folks who, you know, aren't your patients- - Yes.

- But what could they ask their own medical provider, care provider to help maybe, in navigating some of these situations?

- Yeah, great question.

So, again, as we age and go through the different developmental or life stages, the nutrient demands on their body are gonna differ, right?

For instance, so we have a pregnant patient.

I'm making sure that I lead with that conversation on folic acid and making sure that they're supplementing that within their diet for the unborn baby.

So, again, for our older age, our older patients, I believe that one of the other panelists was mentioning protein, right, and how that needs to be a focus of emphasis on the older adults.

So there's a condition called sarcopenia.

And that's natural loss, progressive loss of muscle mass, lean body mass as we age.

And so when I'm looking at my patients for maybe a Medicare Wellness Visit, I'm asking them about the sources of protein, the differences between animal protein, right, from a meat source and then from a plant source.

And that emphasizes the fact that, okay, I don't have to a steak and potatoes every night to be able to get my adequate protein.

So there's like, there's an art to the science of medicine and broaching that conversation, and then, again, planting that seed that, okay, there is a stylistic option, and I don't have to restrict myself to this limited amount of foods to stay alive and perform to my optimum and continue to age gracefully.

So it's a lot of education, insightfulness, and collaborative effort.

- One of the things about the Food as Medicine work that you are doing as well in the community, what you're trying to learn, are you able to get some insight into how successful or impactful these things will be?

Talk a little bit about what you all are trying to achieve with your study.

- We are going to do, we have a pre-survey and a post-survey, and then we have the biometrics, pre and post.

And so we'll do the, like I had said, the A1C and the blood lipid panel, blood pressure, and BMI and waist-hip ratio, and then do those again at the end.

So can we move these very, you know, calculatable measures?

But we also have a survey that looks at a lot of the things that you have in your intake.

So where do you get your food?

What types of food do you eat?

What does your diet look like?

What access, do you have access to kitchen appliances?

And do you know how to use them?

Do they work?

And things like that, and then we're also gonna do some mental health screening in there as well.

And so then we'll have our six-month intervention, and then we'll do them again at the end.

And we'll see pre and post, have we moved the dial at all?

- And anecdotally, I mean, I guess you have patients.

Like, do you see that you're able to perhaps, you know, more easily manage chronic disease or maybe reduce medications?

- Sure, absolutely, so again, like I said, more of my patients and clients coming to me intentionally are seeking me out because they, at minimum, want to decrease some of the medications, if it's reasonably possible, or thwart, or prevent that prescription for a medication.

So yes, for instance, I do have a patient that had high blood pressure.

It was stage 1, so it was at the lower end, but it was technically hypertension.

And we started her on a low-dose blood pressure medication.

But, again, knowing her occupation, she was in the middle of primaries.

And she works in, like, the legislative aspects.

So it was very high stress.

So I started on a low dose intentionally because I was confident she could get off of it once that season kind of quelled down.

I also talked to her about the importance of diet and exercise.

And I emphasized and targeted nutrients that could help naturally lower her blood pressure.

Specifically, I talked about beet roots, and I also talked about fruits and vegetables that are robust in calcium, potassium, magnesium, which have studies that have supported the relaxation of blood vessels and translating to lower blood pressures.

And when I saw her for a three month follow-up, she was completely normalized.

She had been off the blood pressure.

She's discontinued it herself after four weeks.

I was happy.

She was happy.

And, again, she was able to do it by using food as medicine.

- Talk a little bit about, like, the relationship between adequate nutrition, good nutrition, a balanced diet, and the quality of life that you want.

I mean, I know, like, there has been data that, you know, linking fall prevention and, you know, that inadequate nutrition can put you at more risk for falls.

This is really about, you know, helping someone have the kind of quality of life that they want, whatever stage of life.

- Yeah, absolutely.

So, again, when I have my initial visits with patients, I want it to be conversational.

I'm on your team.

I'm your primary care doctor.

I'm taking care of not only you but every component of your family.

So I need to know, right?

And with that being said, I wanna know, what's your relationship with nutrition?

Unfortunately, in Western culture, there's a lot of stigma around health, right?

There's a lot of confusion, especially with social media.

You have TikTok, you have Twitter, a.k.a.

X, saying something else.

You have- - A lot of myths out there.

- Right, right?

- Yeah.

- You have blogs, Reddit, things of that nature.

So you're getting inundated by multiple sides, and you really don't know what is true, what's real, what is conducive to my health, and what can be deleterious as well.

So I explain to my patients that I'm a proponent of a health span, right?

And I explain the difference between that and a lifespan, right?

If one of your goals, and I ask about that, is to watch your son or daughter graduate college, what does that visually look like?

Put me there.

Do you wanna be standing, taking photos with that person?

Are you gonna be wheelchair bound?

Are you gonna be using that cane?

Are you gonna be able to ambulate the stairs, you know, in that gymnasium?

When you put that person there, it makes it real to them.

So when I'm having those conversations, for instance, about smoking, you know, and how it can increase and progress to worsening COPD, emphysema, things of that nature, and you might need that oxygen tank while you're in that gymnasium, that's where that light bulb goes on.

And I use the same thing again with the foods that I'm teaching.

If I have a truck driver, you know, I really try to emphasize, how about you plan out your meals?

Why don't you pack?

Because with you go to these rest stops, the high saturated fats, they're gonna compromise your heart disease, not now possibly, but five years, eight years down the line.

And maybe your daughter's pregnant.

Do you wanna be able to see that unborn grandchild?

How does that really look like?

So I really try to play the long game with my patients.

And that's ultimately the root medicine and that flare that gives osteopaths that differentiation.

- Dr. Pettigrew, what about this idea that, you know, so much of diet and food, we think of it maybe as individual responsibility and yet our environments don't necessarily do us any favors when it comes to those access to healthy food, that kind of thing.

So what about public health and sort of taking that environmental approach versus, like, saying like, this is just all about individual choice.

- When we think about population-based interventions, again, it's programs like the ones that, like SNAP and different things that are helping people purchase food.

And then there are different programs that can help transportation to food sources.

And so I think all of these are very important, increasing not only the the financial aspects but the transportation and where, you know, where are grocery store located?

Where are food pantries located, and farmer's markets and things of that nature?

I think Nourish New York, too, and we think of, which is a program that helps get food from New York farmers and support the New York, buying of the New York farmers' food and having that distributed for free to people through the food pantry networks and food banks.

And that, that's just a win-win, because we're supporting our farmers, and we're getting healthy, like, fresh fruits and vegetables out to people, and meat and dairy.

And so just working on this access.

I mean, we think about the food system, and like, this, I can go on and on about it, but it's broken.

It's so broken, and from farmers being bankrupt, the small farmers being bankrupt, to the amount of pesticides and different petroleum products that are being put, you know, on our foods and our crops, to the distribution systems, we have chickens all... Do you remember during the pandemic when the there was a few main sources where chickens were being processed, and workers got COVID, and we thought we weren't gonna have meat, like everybody... You know, there was a shortage of meat because it goes through these narrow, narrow pathways.

And so I think that, and then we throw away so much food, too.

All of it really, you know, there's a bigger systemic picture that we need to look at, I do believe.

- Well, I have to say, we've run out of time.

To learn more and to share this program with someone you know, visit our website, wmht.org/agingtogether.

Thank you for watching, and thank you both for joining us.

- Thank you.

- Thank you.

- Appreciate it.

(audience applauding) (gentle music) (bright music)