January 22, 2010

VUSM students get a taste of budget dining

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Vanderbilt medical student David Marcovitz and his classmates found that eating healthy on $3 per day wasn’t easy. (photo by Anne Rayner)

VUSM students get a taste of budget dining

Jamie Robinson has always been a healthy eater, but she never had to work as hard to make a healthy trip to the grocery store as she did Jan. 7.
“I wanted to get a big bag of grapes for snacking, but they were $4, so no grape snacks,” Robinson said.

The un-bought grapes were lesson number one for the second-year Vanderbilt University School of Medicine student. Robinson and her 100-plus VUSM classmates were asked to participate in the SNAP challenge as part of a class. SNAP stands for Supplemental Nutrition Assistance Program — the federal program formerly known as food stamps.

VUSM student Jamie Robinson does some comparison shopping.

VUSM student Jamie Robinson does some comparison shopping.

The challenge was to eat for five days on the amount of money the average person on SNAP receives — about $3 a day, or $1 a meal. To make things tougher, students were instructed to track their calories and nutrition on a government Web site (www.mypyramid.gov) to make sure they were still eating healthy.

That meant no midnight trips to stock up on all-you-can-eat tacos, and for healthy eaters like Robinson, it even meant eating foods she considered less healthy.

“I wanted to get Dannon Light & Fit yogurt, but it was only 80 calories and I'd need almost 20 times that for my daily calories,” Robinson said.

Plus, the yogurt was more expensive than the dozen eggs she settled on for $1.49. Robinson doesn't like the cholesterol levels in eggs and prefers organic, but this time she couldn't be choosy.

At the end of her shopping trip, Robinson had white bread and bananas for lunchtime banana sandwiches, canned beans, frozen vegetables, eggs and no meat.

“The purpose of this experience is to help medical students better understand the patient's perspective on the challenges he/she faces to maintain a healthy lifestyle given certain financial restraints,” said Lynn Webb, Ph.D., assistant vice chancellor for Health Affairs. “We want to put the students in the shoes of the patients so they can be better clinicians.”

David Marcovitz spoons out a plate of pasta mixed with egg and tomato sauce, a meal he ate four nights in a row during the project. (photo by Anne Rayner)

David Marcovitz spoons out a plate of pasta mixed with egg and tomato sauce, a meal he ate four nights in a row during the project. (photo by Anne Rayner)

Webb coordinated the SNAP challenge for VUSM's Patient, Profession and Society (PPS) course. As part of a major curriculum revision in 2006, PPS was added to integrate topics like ethics, economics, communication skills and prevention.

This was the first year the SNAP challenge was used as an experiential project for the class.

Students began the challenge on Wednesday, Jan. 6, with instructions from nutrition experts, including Katie Hamm, an intern in Vanderbilt's Dietetic Program who is making the medical students' SNAP challenge a school project of her own. She offered herself as a resource to students, and plenty took her up on the offer.

“I did have a lot of contact with the students throughout the challenge. Many of them talked about trying to get creative at restaurants with a Coke with free refills, a $3 cup of soup and side salad. Others said either weekend temptations blew it for them, or they felt hungry,” Hamm said.

She also said the nutrition interns, herself included, had already taken the SNAP challenge — and there are almost always people who end up cheating.

“I haven't been starving, but then again I haven't been the perfect SNAP challenge participant either,” said second-year student David Marcovitz, who said he figures he went about $1-a-day over budget.

Marcovitz spoke over a dish of pasta mixed with egg and tomato sauce. He ate the concoction for dinner four nights straight.

Many students commented on the lack of variety in their diet. Marcovitz longed for a granola bar and blueberries on his cereal, but couldn't afford them. He was proud he located “day old” bread at Target so he could afford the whole wheat variety for sandwiches at lunch.

“The lesson from this is it's not really about hunger in the U.S., because anyone can take this amount of money and go to the dollar menu and get enough calories for the day. But if you want to have good nutrition it takes a lot of work, a lot of education, a lot of thought and a lot of preparation,” Marcovitz said.

For the estimated 600 SNAP recipients who come to Vanderbilt clinics every day, following the advice of practitioners about the importance of diet may not be easy.

Webb says that is the point. He hopes the SNAP project will give students the ability to make practical recommendations about nutrition and diet.

“Overall, the goal is to help our students maintain an appreciation for the human dimension of care; that the disease being treated is just one aspect of what's going on in a patient's life,” said Webb.