Prescribing change: Using healthy food to break the cycle of poverty and chronic disease

As a child, Brian Frank, sat down at the beginning of every week with his father and brother to plan each of the family’s meals for the next seven days. Every morning, he knew he would wake up to a delicious breakfast, that he would have something in his lunchbox and that he would return home from school to a nutritious meal on the table.

“What I didn’t realize at the time,” he said “was the incredible sense of security that gave me.”

Now, as a physician at OHSU Family Medicine at Richmond, Dr. Frank understands all too well that food security is a luxury that many of our community members do not enjoy. In fact, an astounding 75 percent of Oregon’s Medicaid patients lack reliable access to affordable, nutritious food.

So what does this mean for our community? Lack of consistent access to nutritious foods, especially in childhood, can have devastating and long-lasting health effects. In particular, food insecurity leads to patterns of overconsumption of calorie dense, but nutrient poor, foods. This “high calorie malnutrition” can cause or worsen chronic diseases such as diabetes, leading to poor health outcomes. Once people develop chronic diseases, food insecurity prevents them from making changes that would improve their health. In turn, people suffer worse outcomes, driving up the cost of medical care as a whole and leading to financial devastation for patients and their families due to hospitalizations, illness and lost time at work. These catastrophic events send families further into poverty and worsen food insecurity. What we end up with is a cycle that continues until patients are dying at an earlier age than their counterparts who have better access to food. “Hunger is more than nutritional or physiological deficit,” Dr. Frank explains. “It’s a dangerous medical condition that requires urgent treatment.”

This year, OHSU Family Medicine at Richmond, the Oregon Food Bank, Multnomah County, Zenger Farms, and researchers at Portland State University have partnered to launch a research project with the aim of changing how we think of, and provide, food. The project, collectively called CSA Partnerships for Health (CSAP4H) provides weekly, subsidized boxes of fresh, locally-grown fruits and vegetables.

Building on the work of a pilot program at Multnomah County’s Mid-County Medical Center, and supported by grants from Kaiser Permanente and the OHSU Knight Cancer Institute, CSAP4H hopes to show that this simple intervention can change eating habits of its participants.

Over the course of the 20-week growing season, patients will also have access to free cooking classes hosted by the Oregon Food Bank, and food education by Zenger Farms.
At the end of the 20-week period, the team will conduct an in-depth evaluation, with the hope of proving the medical benefit of “prescribing” healthy foods to patients in need.

OHSU Family Medicine’s mission to address food insecurity and malnutrition extends beyond this summer’s project. Other efforts will include additions to OHSU’s curriculum across all healthcare professions, which will arm providers with the ability to better understand, treat and manage food insecurity. Final steps will also include coming up with best practices for evaluating and addressing food needs across the country, so there is a standardized, evidence-based method that can be easily used by all healthcare organizations.

Want to learn more? Visit OHSU Family Medicine at Richmond to see Dr. Frank in action, learn more about healthy eating, and enjoy delicious giveaways.

OHSU Family Medicine at Richmond

Friday, August 12

1 – 5 p.m.


Dr. Brian Frank is a Family Medicine physician at OHSU Family Medicine at Richmond, a Federally Qualified Health Center. OHSU Family Medicine at Richmond treats infants, children, adults, and seniors in the Southeast community, regardless of their insurance status or ability to pay.

Scientific Research Advocates bring the patient perspective to science

This Saturday, August 6, a free, public forum about the science behind evolving breast cancer screening guidelines will be held as part of the 30th International Association for Breast Cancer Research Conference. June Cooley, an OHSU Scientific Research Advocate, will be one of the panelists presenting from the patient perspective.

Research advocates are volunteers with a personal connection to cancer who are passionate about helping translate research findings into meaningful outcomes for patients and their families. The primary role of a research advocate is to represent the collective patient perspective, or the disease experiences of many patients, in the research process.

June’s journey began when she was diagnosed with stage 2 breast cancer in 2008 after a routine mammogram.  After interviewing local surgeons that quickly recommended a lumpectomy and radiation, she chose to be treated at OHSU where she was invited to participate in the Onko Type DX clinical trial.

After determining that she was at high risk for recurrence, it became evident that needed a mastectomy and chemotherapy. She credits OHSU care givers for saving her life.

After finishing treatment, June wanted to do more to help. “I was fascinated by the changes that were going to be possible at OHSU,” she said. “When Phil Knight made that donation and proposed the Billion Dollar Challenge, I had to be involved.”

June soon joined the first cohort of OHSU Scientific Research Advocates, a trained group of cancer survivors and caregivers who work with Knight Cancer Institute investigators to ensure that research at OHSU reflects the needs and interests of the cancer community. Advocates also support dissemination of research findings via community outreach and partnerships with community organizations.

“I’ve learned so much—the trainings have been great. I’ve attended national meetings. The advocacy program at OHSU is so well-received by the researchers and the scientists. They’re incredibly generous.”

Confronting the confusion: How to think about breast cancer screening is a free, public forum held during the International Breast Cancer conference hosted by Susan G. Komen and the OHSU Knight Cancer Institute. The event takes place on Saturday, August 6, 2016 from 2:00PM to 5:00PM PDT. Space is limited, please register to reserve your seat.

Click here for more information on OHSU’s Scientific Research Advocate Program.

Summer road trips: Making the most of fast food

This is a continuation of our best tips for eating well on the road. Read the first article here.

As much as I’d love to have only freshly prepared meals on road trips, being on the road (and on a budget) can at times make fast food inevitable. Use these tips to make the most of a potentially unhealthy situation.sub sandwich

Make it a true “happy” meal

Wherever you end up, always remember the formula for the My Heart-Healthy Plate: one quarter of your plate should be lean protein (chicken, turkey, fish, beans, tofu – avoid anything crispy, crunchy, or breaded); one quarter should be starch, preferably from whole grains (e.g., whole-wheat bread, corn tortilla, brown rice – avoid fried potatoes and white bread), and half should be fruits and vegetables. Create your own happy meal using this model!

  • From the sub shop: a 6-inch turkey sandwich on whole wheat (no cheese, no mayo) with extra veggies and a piece of fruit on the side
  • From the burger joint: an open-face grilled chicken sandwich or veggie burger with a side salad (only use half the packet of dressing provided)
  • From the Mexican restaurant: a chicken, black bean, and vegetable bowl (hold the sour cream, cheese, fried shell, and chips; ask for a half-portion of brown rice so you get more of the beans and veggies)
  • From the pizzeria: one slice of thin-crust veggie pizza (with extra vegetables, light cheese, and whole-wheat crust, if available) with a salad (avoid the bread sticks, extra cheese, and high-fat meats).

Stay hydrated

Water, water, water! Avoid sugar-filled sodas, milkshakes, energy drinks, sports drinks, and coffee drinks, which will just fuel more sugar cravings and make you feel sluggish.

Put on some good road-trip music, eat well, and have fun out there!



Tracy Severson, RD, LD, is the dietitian for the Center for Preventive Cardiology at the Knight Cardiovascular Institute. She specializes in nutrition counseling for cardiovascular health and weight management.


Eating well on the road

Planning on getting out of town this summer? Road trips are a great way to unwind, spend time with family, and see the gorgeous sights of the Pacific Northwest. Unless you’re careful, though, they’re also a great way to pack on a few extra pounds and derail your usual healthy diet choices. But it doesn’t have to be a losing battle! Before you hit the road, use the following tips to help make your next road trip a healthy road trip

Plan ahead:

  • Stock the car with healthy snacks such as fresh or dried fruit, veggie sticks (carrots, bell peppers, sugar snap peas are all great choices), and whole-grain crackers. Make your own trail mix with dried fruit, nuts, and whole-grain cereal (leave out the chocolate—it would just melt and make a mess anyway!).
  • Measure out higher-calorie snacks like nuts and trail mix into small containers or baggies to help with portion control. Snack bars can be a convenient and portable choice, but make sure they aren’t candy bars in disguise! Larabars are a favorite in my family and are made with only dried fruit and nuts. I also love individual packets of peanut butter, almond butter, and hummus—convenient choices when you’re on the go! Try them on apple slices, celery, carrots, or bell peppers.
  • Bring a small cooler packed with fruit, vegetables, edamame, and hummus, and while you’re at it, pack sandwiches to have a picnic lunch at a rest stop. Use the break to take a walk and let the kids run off some energy.

Do your homework:

  • Use your smart phone to find healthier restaurant choices along the way ( is helpful for selecting healthy meals at a variety of restaurants), and look up nutrient info on restaurant websites to help make the healthiest selections.
  • No smart phone? Most restaurants have nutrition data available, so ask to see it before you order. The CalorieKing Calorie, Fat, & Carbohydrate Counter is a great pocket-sized book to keep in your car that lists nutrient info for tens of thousands of foods, including 200 fast-food chains.

Stay tuned for more tips for eating well during your summer travels.



Tracy Severson, RD, LD, is the dietitian for the Center for Preventive Cardiology at the Knight Cardiovascular Institute. She specializes in nutrition counseling for cardiovascular health and weight management.


Addressing gun violence: A message from OHSU President, Joe Robertson

OHSU is a community of people dedicated to healing others and advancing the frontiers of scientific knowledge. Many of us choose to work at OHSU because it offers the opportunity to protect the most vulnerable in our society and improve the world around us. Those values often impel us to take on challenges that might seem impossible.

Today, our country is in the middle of an epidemic of gun violence. For those of us committed to service, each incident is mind numbing, leaving us weary from the cumulative weight of our grief. It is worth remembering that a community of people dedicated to healing must sometimes turn its attention to healing each other. Let’s take the time to support and care for one another when tragedy strikes.

Part of the healing process must involve taking positive action. This is not an issue that OHSU can solve alone, but there are things we can do to contribute to broader solutions. I’m proud to report that OHSU has joined with a number of peer organizations to call on Congress to lift the ban on CDC funding of research into gun violence. OHSU is uniquely positioned, particularly within Oregon, as a research university and public health leader, to evaluate the type of data necessary to inform a public policy discussion on gun violence.

Even more important, we can work in our own community. All of us at OHSU are torchbearers. We take on the biggest threats to human health, casting light into the darkest parts of our universe, inspiring hope. One of the ways we do this is by becoming a more inclusive community that can respond to violence and racism with compassion, humility and intelligence. This means not only acknowledging that violence is a preventable public health issue. It means understanding that violence can be a reflection of greater structural problems in society — and that the threat of trauma from violence affects all of us — students, faculty, staff, and patients. We cannot fulfill our mission unless we understand this. It must be a part of our culture of integrity as much as data protection is.

Earlier this year, we welcomed Dr. Brian Gibbs into our community as our vice president for equity and inclusion. He is also a faculty member in the OHSU-PSU School of Public Health and has a deep research background in violence prevention among adolescents and young adults in urban settings. I am asking him to lead all of us in a series of institutional conversations to help us ensure that our OHSU community can bring together diverse perspectives to address violence as a public health issue — and that OHSU can act as a convener to bring together others in the communities we serve. We will let you know how to participate in the near future.

In the meantime, thanks for everything you do for OHSU.

This message originally appeared in a Directline email to staff from OHSU President, Dr. Joe Robertson

Knight Cancer Challenge: a progress report

In June 2015, the OHSU Knight Cancer Institute announced to the world that it had achieved a $500 million fundraising challenge set by Nike co-founder Phil Knight and his wife, Penny, raising $1 billion for cancer research. During the year since then, the institute has been busy expanding research and outreach capacity, improving patient care and science facilities, and establishing productive new collaborations.

Sadik Esener Below is a sampling of accomplishments:

In March 2016, the OHSU Knight Cancer Institute kicked off a major new initiative on the precision early detection of life-threatening cancers with the hiring of Sadik Esener, Ph.D., as director of the Center for Early Detection Research and Wendt Family Endowed Chair in Early Cancer Detection.

As a nanotechnology expert, engineer and computer scientist, he brings a systems-based approach to integrate cancer biology and state-of-the-art imaging and computing technologies.

In December 2015, Cancer Research UK, one of the largest funders of cancer research globally, and the Knight Cancer Institute formed an international collaboration to accelerate research in early detection.

This collaboration is part of the Knight Cancer Institute’s long-term commitment to invest in early detection research, to understand the biology behind early stage cancers, find new detection and screening methods and enhance the uptake and accuracy of screening.

In June of this year, the two organizations launched an early detection conference, the first of a series of annual events planned through this collaboration.

The Knight Cancer Institute continues to grow clinical trials capacity both on the main OHSU campus and throughout the state. In 2015, close to 700 Oregon residents consented to participate in interventional clinical research studies associated with the Knight Cancer Institute.

These research subjects represented 29 of the 36 Oregon counties. During the past twelve months, faculty researchers reported their study findings in such prestigious journals as CellNatureThe New England Journal of MedicineLancet, and many others.

The Knight Cancer Community Partnership Program, established in October 2014, provides funding and technical assistance to local organizations working to meet community-identified cancer needs. To date, 43 projects have received support in 32 of the state’s 36 counties. The projects represent the full range of cancer-related needs from prevention through survivorship.

The state of Oregon provided financial backing for a new research building for the Knight Cancer Institute in Portland’s South Waterfront District. Nearly 500 came to celebrate the groundbreaking on June 16.

The facility will house research programs in early cancer detection, computational biology, immuno-oncology, leukemia, prostate and other areas, and it will also have administrative offices, a conference center and street-level retail space. It should be move-in ready in July 2018.

Delivering high-quality, effective cancer care to patients is the backbone of the Knight Cancer Institute. Outpatient cancer visits totaled more than 84,000 in the last fiscal year.

In October 2015, the institute formed the OHSU Knight Cancer Network to collaborate with community hospitals, health care organizations, and physicians across the state to reduce cancer risks for Oregonians and improve clinical outcomes for cancer patients. The network also offers resources and support in directing patients to appropriate clinical trials.

“It’s because of those we’ve lost [to cancer] that we feel an urgency for our mission,” Knight Cancer Institute Director Brian Druker, M.D., told the crowd at the recent groundbreaking. “Our success will be measured by patients thriving and living normal lives because of the work that we will do here.”

View our OHSU Knight Cancer Institute 2016 Progress Report 

Safer Summer Grilling

Summer has arrived in Portland, and for many of us, that means firing up the grill. Grilling is a great way to prepare meals — no added fat (such as with sautéing or frying), the kitchen stays nice and cool, plus the smoky flavor of grilled foods can’t be beat.

However, cooking meats at high temperatures (mainly grilling, broiling and pan-frying) can form carcinogens called heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs). HCAs form when meats, poultry and fish become charred during grilling, while PAHs form from the smoke that’s produced when fat and juices drip onto the flame. For more information on HCAs and PAHs, visit the National Cancer Institute’s website.

While there is no research that directly links grilling to cancer, there are simple ways to reduce your intake of these potentially harmful compounds. Follow these tips to stay healthy this grill season:

  • Choose lean meats. Fattier meats such as ribs, hamburgers, marbled steaks and dark-meat chicken produce more drippings when they are grilled (in addition to providing more artery-clogging saturated fat than leaner meats), leading to more smoke and thus, higher carcinogen formation. Choose lean meats and proteins such as fish, shrimp, skinless chicken breast, turkey burgers, pork tenderloin or flank steak, and trim away any visible fat before cooking. Remember to stick with the recommended 3-ounce portion of meats (the size of a deck of cards).
  • Marinate meats before grilling. Studies have shown that marinating meats before cooking, even for a few minutes, significantly reduces the formation of HCAs and PAHs. Choose marinades with vinegars, citrus juice or wine, and add fresh herbs such as rosemary, basil or thyme to further increase the antioxidant benefits.
  • Limit time on the grill. Pre-cook meats and finish them on the grill to add flavor, or try cutting meats into bite-sized pieces and cooking them on skewers so they cook faster. Fish cooks faster than meats and poultry, and less time on the grill means less HCA and PAH formation — one more reason to increase consumption of fish and seafood! After grilling, trim away any charred spots on meats.
  • Choose produce. Plant foods such as vegetables, fruit and tofu don’t produce HCAs or PAHs when grilled, so make sure you’re piling on the produce. (As always, aim for half of your plate to be vegetables and fruits.) Try using a grill basket to keep smaller veggies from falling through the grill grates, and for dessert, grill fresh fruit such as peaches, pineapple or plums for a delicious, caramelized treat.
  • Keep it clean. Always clean your grill well after each use to prevent charred foods from building up on the grates.

This summer you’ll find me outside, safely enjoying Portland’s bounty of vegetables, fruit and fish on the grill. Here’s one of my family’s favorite recipes — try it and let me know what you think!


Tracy Severson, R.D., L.D., is the dietitian for the Center for Preventive Cardiology at the Knight Cardiovascular Institute. She specializes in nutrition counseling for cardiovascular health and weight management.




Your health questions answered: Heart care for a father with diabetes

You ask. OHSU health experts answer. This National Men’s Health Week, one of our cardiovascular experts is on the hot seat.

We know that facing a heart condition can be difficult for patient and families, and that getting the right information can provide peace of mind. With Father’s Day on the horizon, a recent question to our providers about care for a father with diabetes is especially timely.

Q: My father has diabetes but is in good health. His cholesterol is a little high. Should I be worried?

Diabetics suffer from heart disease and stroke at twice the rate of everyone else. Due to diabetic neuropathy (nerve damage), diabetics are less likely to9482286976_39caaeebd8_z feel the symptoms of heart disease, such as chest pain. That said, they can control their risk of heart disease by monitoring blood sugar and lipid levels (blood fats, including cholesterol). A cardiologist can also watch for high lipid levels and atherosclerosis, (hardening of the arteries), which are precursors to heart disease.

Like all diabetics, your father should also avoid smoking, engage in regular exercise, lose excess weight, and consume a diet high in fiber, fruits, vegetables, fatty fish and whole grains, and low in processed sugars for a lower risk of heart disease and increased quality of life.

For more information, contact the OHSU Knight Cardiovascular Institute’s Center for Preventive Cardiology.


Chadderdon_S_08Dr. Scott Chadderdon is a cardiologist at the OHSU Knight Cardiovascular Institute focused on caring for adults with heart disease and diabetes.

“War on Skin Cancer” event to bring community together

Join the OHSU Department of Dermatology on Saturday, May 21, at the Collaborative Life Sciences Building for a fun and educational weekend event helping to advance the science of skin cancer prevention and treatment.redheads

OHSU and Portland dermatology providers will be available to provide screenings and sun safety tips about how attendees can monitor their skin health.

Attendees will also learn about the best sunscreens to use and can take a turn playing educational games containing skin cancer facts. Skin checks will be first come, first serve.

OHSU scientists will also be hand to discuss their latest research efforts. Presenters include:

  • Sancy Leachman, MD, PhD, Chair, Department of Dermatology and Director, Melanoma & Skin Cancer Research Program, will speak on genetics factors as it pertains to melanoma and skin cancer risk.
  • Oliver J. Wisco, DO, FAAD, FACMS, is a fellowship-trained melanoma specialist and skin cancer surgeon at Bend Memorial Clinic. This talk will explore the common question of, “are we are harming ourselves by blocking potentially-beneficial Vitamin D through sun protection?”
  • Amanda Lund, PhD, is a cancer immunologist who is working to understand the mechanisms how lymphatic vessels, key communication highways of the immune system, influence the body’s ability to fight skin cancer. She will talk about the development of new strategies to predict who will respond best to therapy and how immunotherapy could turn non-responders into responders.
  • Anna Bar, MD is a fellowship trained Mohs surgeon and Assistant Professor of Dermatology at OHSU. Bar is teaming up with Dr. John Vetto, OHSU surgical oncologist, for a Phase 3 clinical trial of POL-103A polyvalent, a melanoma vaccine, to test potential efficacy for melanoma patients who are at a high risk of recurrence.
  • Pamela Cassidy, PhD, is a Research Associate Professor in OHSU’s Department of Dermatology. She will speak about her studies that are designed to find both the beneficial and harmful effects (if any) of antioxidants that are candidates for use in melanoma prevention.
  • Tracy Petrie, PhD, is a computer scientist overseeing the continuing development of the Mole Mapper apps for iPhones and, soon, Android phones. Written by Dan Webster, a cancer biologist, Mole Mapper is a free app that lets you map, measure, and monitor moles over time. Learn about how you can participate in melanoma cancer research while you use the app to help manage your skin care.

Other events such as the 5th annual AIM Melanoma 5K Walk will be taking place as part of the event. Registration info can be found here with all proceeds benefiting the OHSU Melanoma Tissue Bank Consortium.

There’s also a chance for attendees to be a part of history if they are a natural redhead! Redhead Events, a local non-profit, will attempt to break the world record for the largest gathering of natural redheads in one place.

Training tomorrow’s data scientists

The following is an abbreviated version of a blog post titled “Technical education for a connected world,” authored by Stephen Wu, an assistant professor of medical informatics and clinical epidemiology at OHSU School of MedicineIn it, Wu shares how including peer reviews in his class led him to develop a new approach to technical education: one that centers around five core values that he believes to be essential to both scholarly and professional development. The original post can be viewed here.

Who’s going to grade these? I needed a TA. I was three weeks into teaching my first full-fledged Computer Science class — Natural Language Processing (NLP) — and I was getting a little desperate. All my students had submitted Homework 1 on time. Great! But now I had a stack of programming assignments and writeups to grade.

I had just stayed up late (after my kids went to bed) for a few nights in a row, prepping Homework 2, then trying to prep Lecture 5. I ran out of time on the latter, so, embarrassingly, I’d had to let class out early after my under-prepped interactive whiteboard lecture on word similarity. Coming up in less than 48 hours was another 90-minute lecture, and I would need to find another 5-10 hours (with my kids sleeping) to prep that. This is ironic. When I was a student, I never imagined that my professors lost more sleep over my classes than I did.

So, grading Homework 1. No time. No TA. No free computer science experts to bail me out. If only my students could grade their homework themselves…technical education

And all of a sudden, it all made sense. Peer reviews!  

I turned this epiphany over in my head. This one thing embodied so much of the process I had gone through in entering academia and growing as professional. It was conspicuous in every journal article that I got accepted, and essential in every grant that I got funded. It was embedded, as code review, in the seasoned software engineering process at the tech startup I’d worked at, Trapit.

At a broader level, this collaborative collegial activity, this humility to accept and learn from criticism — I needed it in my marriage, relationships, spiritual life, everywhere.

It was too late to do peer reviews for Homeworks 1 and 2. I’d just have to buckle down with a few more late nights to finish that. And I knew that when I first got students to do peer reviews, I’d have to coach them on how to do them — meta-review their reviews. I wondered if this would actually save me time. Certainly not in the short run, I thought, but this is what I want them to get out of my class. More than NLP. Character.

What emerged from that CSEE 562 NLP class is my modern-day re-imagining of technical education, centering around five core values that I believe to be essential in scholarly and professional development. Transparency. Excellence. Collaboration. Humility. Innovation. I call it techi education, or techied.

Those values are articulated in a grading scheme, expressed in a process for peer review, and implemented in modern collaborative software tools (git). My class was far from perfect, but that’s why I’m writing! Fellow educators: let’s build a new generation of scholars, coders, and teachers who know how to be in the emerging collaborative world of data science. Clone my techied git repository. Build on these ideas. And join me in a new kind of technical education.

Stephen Wu

Stephen Wu is an assistant professor of medical informatics and clinical epidemiology at OHSU School of Medicine whose research aims to make medical information understandable to computers and actionable for people. He also teaches graduate courses in computer science.


Why 96,000 Square Miles?

OHSU Health Fair at Pioneer Square.

President Robertson is fond of saying that OHSU has a 96,000 square mile campus, serving Oregonians “from Enterprise to Coos Bay, from Portland to Klamath Falls.”

This blog aims to highlight that breadth. 96,000 Square Miles (96K for short) will focus on the people of OHSU, the Oregonians we serve and the ripple effect of our work in Oregon and beyond.

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