A Unique Approach to Diet and Nutrition

Improving employee health, increasing health-related quality of life, and informing dietitians

Diet and nutrition are very important aspects of our everyday life, and adults who who spend the majority of their waking time in their workplace are at risk. In fact, two thirds of American adults are considered obese, and it is becoming increasingly necessary for them to have accessible resources and interventions to reduce health risks and maintain healthy lifestyles. Dr. Riva Touger-Decker, Professor and Chair of Nutritional Sciences at Rutgers University School of Health Related Professions, tackles this prevalent yet underestimated problem -- and more -- in her interprofessional, multilevel research. An expert in diet and nutrition, she researches three critical aspects of nutritional science: 1. cardiometabolic outcomes in individuals in workplace; 2. oral health and diseases related to diet; and 3. dietetic education. From a unique and original perspective, Dr. Touger-Decker develops protocols for interventions that will not only help promote wellness and decrease obesity in the workplace, but also revolutionize the way dietitians and dentists administer comprehensive care to patients.

The association between diet and oral health may not come readily apparent, but it is one that is rather intrinsic and important; the mouth is the gateway to food and nutrition, so anything that impacts the integrity of the orofacial region can potentially impact diet and nutritional well being. In collaboration with Tel-Hai Academic College and the Ministry of Health in Israel, Dr. Touger-Decker and her team looked at the impact of education and training of both students and health professionals like dietitians in nutrition focused physical exams (NFPE) of oral cavity and dysphagia screening. The Israel Ministry of Health has now taken the findings from this study and is integrating them into its practice standards. Therefore, Dr. Touger-Decker is not only making a difference in the American workplace, but her influence in the dietetic educational environment is far beyond the US borders, illuminating a field that has been far less traveled.

Current research includes:

  • Workplace Wellness Research: For about a decade, Dr. Touger-Decker and her team observed closely the changes of employees who enrolled in the workplace wellness program in cardiometabolic outcomes and health-related quality of life. In a clinical trial performed in 2006-2008, Dr. Touger-Decker found that people who completed the program not only lost weight but had reduced cardiometabolic risk. Dr. Touger-Decker and her team have since taken this intervention and implemented “LIFT UP” -- or Lifestyle Intervention for Total Health University Program -- in 2013, where they enroll overweight or obese employees in a two-year longitudinal weight management study. Integrating diet with physical activity, this study measures the individual’s body composition, cardiometabolic risk factors like glucose, cholesterol, and blood pressure, and physical activity and health-related quality of life over time. Such assessment and ongoing care, Dr. Touger-Decker hopes, will help provide practical resources to employees at work, improving their health and overall quality of life.
  • Oral Health and Disease: Our mouth is the gateway to eating and drinking, and impaired sensory and motor functions of our mouth -- whether it be due to cancer, chronic pain, or treatment conditions -- can impact our ability and/or desire to eat, consequently affecting our nutritional well-being and health-related quality of life. In this project, Dr. Touger-Decker looks at eating habits and diet among patients with head and neck cancers or chronic orofacial pain in association with diet and nutrition to improve nutritional well-being of patients and reduce associated comorbid conditions. Following collaborative work with Vanderbilt University, Dr. Touger-Decker is now exploring the coping behaviors of patients in order to better design diet interventions that will help them.
  • Dietetic Education: The condition of our orofacial region affects our diet and nutrition, and vice versa. Dr. Touger-Decker’s work in dietetic education and practice aims to prepare more well-rounded health practitioners to provide comprehensive autonomous practice and function as a member of the health care team. Internationally recognized, for almost two decades Dr. Touger-Decker has taught dietitians NFPE and its practices, barriers and limitations in multiple countries including Israel and Japan, and is now developing novel approaches to teach the programs virtually.

Bio

Dr. Riva Touger-Decker is Professor and Chair of the Department of Nutritional Sciences – School of Health Related Professions and Professor and Director of the Division of Nutrition in the Department of Diagnostic Sciences –School of Dental Medicine at Rutgers University Biomedical and Health Sciences (formerly University of Medicine & Dentistry of New Jersey). She is a registered dietitian and is internationally recognized for her expertise and leadership in nutrition and oral health/dental education, nutrition focused physical exam of the orofacial region and advanced practice dietetics education. Her research has explored diet and orofacial pain, nutrition and tooth loss, nutrition status and head and neck cancers, cardiometabolic outcomes of employees in a worksite wellness program, and nutrition focused physical exam practices of dietitians.

Dr. Touger-Decker has authored 60+ peer reviewed publications and is the primary author of the Oral Health and Nutrition position of the Academy of Nutrition and Dietetics. She is on the editorial board of Topics in Clinical Nutrition and the Journal of the American Dental Association where she is an Associate Editor for the nutrition section. Dr. Touger-Decker is the lead editor of the 1st and 2nd editions of Nutrition and Oral Medicine. She has been awarded both the American Dietetic Association Medallion Award and Excellence in Dietetic Education Award; the American Society for Clinical Nutrition Dannon Institute Award for Excellence in Medical/Dental Nutrition Education; and the UMDNJ SHRP Excellence in Research Award. She is also an elected Fellow of the New York Academy of Medicine and has served on committees for the Academy of Nutrition and Dietetics, the Commission on Dietetic Registration, and the American and International Associations of Dental Research. Dr. Touger-Decker holds degrees from New York State University College at Buffalo and New York University.

Dr. Touger-Decker has always been curious in knowing the why, and as a dietitian she felt it was important that she always understood the reasons behind what she does. She had excellent mentors along the way who taught her that research is the backbone of the profession and that research guides the practice, so she devoted her career to integrating research into practice. In the late 1980s-1990s during height of AIDS epidemic, she realized the connection between diet and oral health when patients couldn’t eat because of the pain in their mouth. When she followed her doctoral advisor’s suggestion to attend a conference on nutrition and oral health, the trajectory of her work forever changed as she learned the value of working across professions.

As a child Dr. Touger-Decker first got into nutrition because she was obese. She then started learning how to cook from her mother, who taught her the nutritional value of food. Meanwhile, she was only twelve years old when her father passed away at a young age of 46 from heart disease, which made her realize -- even as a child -- that this is a real problem that needs to be addressed. Combining these two significant events drove Dr. Touger-Decker’s interest in the cardiometabolic work, because if it was so prevalent in her family, it was probably also prevalent elsewhere.

Outside of her research, Dr. Touger-Decker does a lot of volunteer work for her profession and loves to walk in the streets of her hometown, New York City, whose parks and sidewalks provide great opportunities for all kinds of physical exercise. She also enjoys theater and cooking.

Awards

Fellow, New York Academy of Medicine, 2012

Excellence in Research Award, 2008

School of Health Related Professions, Rutgers University (previously the University of Medicine & Dentistry of New Jersey)

Award for Process Improvement as Member of the School of Dental Medicine, 2003

(previously New Jersey Dental School) Planning Committee, Rutgers University (previously the University of Medicine & Dentistry of New Jersey)

Excellence in Dietetic Education, 2003

The American Dietetic Association Foundation

Award for Excellence in Medical/Dental Nutrition Education, 2003

American Society of Clinical Nutrition, The Dannon Institute

Medallion Award, 2001

The American Dietetic Association

Dale Rasmussen Award for Excellence in Medical and Dental Nutrition Education, 2000

Nutrition Educators of Health Professionals Dietetic Practice Group and Society for Teachers of Family Medicine