Nutrition Experts Podcast - A podcast about nutrition experts and all they do for the world!

Nutrition Experts Podcast Episode 42 You Can Alter Your Brain’s Chemistry At Any Age with Sangeeta Pradhan, RD, LDN, CDE

February 18, 2019 by matheaford Leave a Comment

Sangeeta Pradhan is a Registered Dietitian and Certified Diabetes Educator. She works as the Diabetes Program Coordinator of a large physician practice group in the Metro-West Boston area. She is also a professional speaker with over 18 years of speaking on the (very broad and yes, confusing!!…), topic of nutrition at non -profit and corporate accounts. She had the distinct honor of being a speaker at the Mass Academy of Nutrition and Dietetics’ state level annual conference in 2015, 2016, and 2018. In Feb 2017, she was invited to, and presented a talk on the “Gut microbiome” at Simmon’s College, MA. In the fall of 2018, she presented a talk on “Nutrition and Cognitive function” at Framingham State University and in December 2018 discussed the same topic on her local community access Television.

She is a guest blogger for Food and Nutrition magazine’s Stone Soup Blog and she is also currently the Chair of the Central Mass Dietetic Association.

Knowledge in and of itself is of no value unless shared with others. By sharing her professional knowledge that is based upon scientific evidence and current research with the readers, she hopes to inspire people to accomplish their health and nutrition related goals.

Having said that, she believes that understanding nutrition will only take you so far. At the end of the day, you need to translate these sound nutritional concepts into real foods that you can actually enjoy. To this end, she have created a repertoire of delicious recipes using whole and wholesome ingredients. She is blessed to be raised in a traditional Indian household in an era when everything was prepared from scratch, (not to mention with a dash of love and a pinch of passion)! By osmosis, she must have imbibed this because cooking soon became her passion and an integral part of her life. As an RD, somewhere along the way, she learned to tweak traditional, calorie dense recipes to make them healthier, without sacrificing flavor! (She also learned to not reveal to her family that it was a “tweaked” recipe)!!

So in addition to my articles, she inviting everyone to check out her recipe index, to dig in and enjoy!

For more information on her professional profile please visit: https://www.linkedin.com/in/sangeetapradhan/

Sangeeta Pradhan: [00:00:44] Thank you so much my dear. I’m so excited to be on your show.

Mathea Ford: [00:00:48] Well, I’m excited to have you on the show and share your expertise about the brain and the human brain and how it works with my tribe today. So, tell my listeners a little more about you and what you do besides this brain research stuff too.

Sangeeta Pradhan: [00:01:04] So, I am a Registered Dietitian and a Certified Diabetes Educator. I am the Diabetes Program Coordinator for a physician practice group in Metro West Massachusetts. I happen to be the chair of the Central Mass Dietetic Association. I also do a lot of community outreach projects and present at professional conferences, speaking at conferences or in my community groups is something that I really enjoy doing because I think it gives me a wonderful, gives us a wonderful platform to really put out the word about nutrition without the hype. So that’s something I really enjoy doing. So, I do various community projects ranging from presentations to workshops, occasionally food demonstrations.

Sangeeta Pradhan: [00:02:00] I’m also a guest blogger for the Academy of Nutrition and Dietetics Stone Soup Magazine and I also have my own personal blog when I’m not doing any of those you you’ll probably find me in my kitchen cooking up a storm and developing recipes which subsequently I post on my blog.

Mathea Ford: [00:02:27] Great! I love that you do so many different things and you’re kind of connected with your community because I think that’s where we kind of get a lot of our inspiration as dietitians is from our patients from the people we work with. So I know you’ve done research on the human brain and how it relates with nutrition, with cognitive function. And I think it’s transformative information that we’re going to talk about today. So, what makes that so exciting?

Sangeeta Pradhan: [00:02:55] Yeah Mathea. I’m really really excited to be presenting on how nutrition impacts cognitive function. So, our brain also is evolving at a mindblowing pace. No pun intended and is one of the most exciting frontiers in medicine today. We now know that our brain is not static and hard wired as previously part. But this dynamic organ where new neurons and new neural connections are created every day regardless of your age. Up until the 1990s it was mistakenly believed that our brain was static and that we did not grow new neurons at all. Well, turns out nothing could be farther from the truth and modifiable lifestyle factors i.e. diet and lifestyle can profoundly influence this whole process and indeed the course of Neurological Disorders and cognitive function itself. What is truly transformative about this research is that in a phenomenon called neuroplasticity we can actually change our brains for the better. So, that begs the question can be you simple bio hacks such as the food we eat or our ability to take a walk to upgrade our brain to the best version of itself. And the answer is yes. And that really is the crux of our discussion today and I hope to get that message across to your audience.

Mathea Ford: [00:04:36] Okay. So, can you talk about how our brains work? Talk about how our brains create new connections?

Sangeeta Pradhan: [00:04:43] Our brains are incredibly, amazingly complex. So, how the brain works as a whole is a very broad question but what I would like to do is narrow it down to how the neurons work and communicate with each other in the context of what we are discussing today which is neuroplasticity and neurogenesis and how does food fit into that picture. We’ve all heard of neurons which are basically brain cells. The brain is part of the central nervous system which consists of the brain and the spinal cord and the neurons communicate with each are though chemical and electrical signals.

Sangeeta Pradhan: [00:05:31] So, let me just explain that a little bit. When a neuron transmits a signal to its neighboring neuron it’s actually an electrical signal that gets transmitted and there is this little gap between the two neurons. And it’s called a synapse it’s very microscopic. It’s really really tiny. It’s about the it’s like one thousand the width of a hair. You can imagine how microscopic it is. So, this electric signal travels down what we would call the presynaptic neuron. That’s the neuron that’s emitting the message but that electric signal cannot just jump across the synaptic cleft. It has to be converted into a chemical impulse which we all know as a neurotransmitter. So, this neurotransmitter then drifts across the synaptic cleft lashes on to the postsynaptic neuron which is the neuron that’s receiving the signal. And in so doing it stimulates it. And this is how neurons communicate. And when these neurons connect with other neurons through their synapses they form complex neural networks that are responsible for all of the brain’s functions.

Sangeeta Pradhan: [00:06:59] Your next question I think was talk about how brains create new connections. Is that what’s your next question was?

Mathea Ford: [00:07:07] Yes. Can you talk about… You talked a little bit about well not about how brains create new connections but yeah tell us a little bit about how you said neuroplasticity a little bit and we’ll talk about that in a minute. But tell us about how our brains create new connections because you said we’re always changing always growing?

Sangeeta Pradhan: [00:07:27] Exactly! This process by which the brain creates new connections is called neurogenesis, neuro, neurons, genesis, the bulk of new neurons. In this context, I would like to introduce a tool called Neurotrophin. So, neutral neuron stroke Finns are basically proteins in the brain that allow fragile new neurons to grow and survive and proliferate. Now in case your listeners are wondering why would new neurons not survive. We have to bear in mind that we are living in a highly neurotoxic world and our bodies are under constant siege if you will by free radicals that are created from oxidative stress in our environment all from pollution, the foods we eat, the metabolic processes in the body. As a result of this, these fragile new neurons created from brain cells do not survive unless they have an adequate amount of it’s neurotrophins. So, you want to think about neurotrophins almost like a protective model taking care of the little ones and creating a nurturing environment for them. So, not only do these neurotrophins allow these little neurons to survive, more importantly these neurotrophins allow and enable these neurons to connect with each other through their synapses and to wire together. And it is this wiring of neural networks that allows the formation and consolidation of memory. This is how we learn. This is what promotes higher thinking. So we have these wonderful neural connections and we can grow new neurons every day. However, the rates of neurogenesis vary from individual to individual. And this is where we can use modifiable lifestyle factors, diet and exercise to influence this process which makes it very exciting and very empowering.

Mathea Ford: [00:09:54] So when people say that for example drinking beer kills brain cells it really can cause it’s going to create those free radicals that attack the brain the new neurons. Right?

Sangeeta Pradhan: [00:10:06] Exactly! So it could be of a food entity, tt could be something in the environment. Anything that causes oxidative stress and creates free radicals which for the benefit of the audience and just want to explain free radicals are simply lone oxygen atoms. We think of oxygen as being beneficial and of course it is. But when a free radical is created, you have this lone oxygen atom that is missing an electron. And that makes a highly unstable very reactive. And it begins to strip electrons from different compounds in your body. The loss of an electron creates oxidation, oxidative damage and of these free radicals can wreak havoc in the body. So to your point, yes, excess amounts of certain foods such as refined carbohydrates or high fat foods or beer and so forth can cause oxidative damage in the body. But we can counteract that by eating healthy foods. That’s the whole crux of the discussion.

Mathea Ford: [00:11:15] Are we going to talk about how do you create new more neutrophins? Or do you? Is that something that you can tell us a little bit more? Because I’m intrigued by this idea of neurotrophins being like moms protecting new brain cells. How did we get more of those in our brain?

Sangeeta Pradhan: [00:11:32] Absolutely! So, I think in this context again I want to introduce a molecule known as brain derived neural trophic factor. So it’s simply a no growth factor. It is a neurotrophin in but the reason why I’m bringing back into the discussion now is because brain-derived neurotrophic factor is the star of the show. A lot of experts refer to it as miracle grow for the brain. Isn’t that something? So, yeah pretty mind blowing. What the research shows is that a typical Western diet that is high in saturated fat and high in animal protein and high in refined carbs and added sugars literally drops levels of BDNF or brain-derived neurotrophic factor in the brain. So if you have fewer of these neurotrophins, highly protective neurotrophins, bearing in mind that they allowed the little neurons to survive and grow and connect and form synaptic connections there’s less of those connections now. But since it’s the wiring of neural networks that leads to the formation and consolidation of memory, new memories are not form and in fact this is exactly what happens to folks with Dementia and Alzheimer’s disease. No new neurons are produced in a structure of the brain known as the hippocampus. The hippocampus is actually a part of the limbic system. You could call it the central command in the brain for memory and how you’re thinking. So then BDNF levels drop and no new neurons are produced, no new memories form. So, people with Alzheimer’s for instance might remember something that they did 20 years ago but their short term memory is lost because they don’t form new memories and they end up becoming sort of a shadow if you will of their former selves. So by eating foods with antioxidant potential what you can do is you can combat some of the oxidative stress that causes the body to lose some of those neurotrophins. You can combat that oxidative stress and boost back BDNF levels and in so doing you promote cognitive function again.

Mathea Ford: [00:14:13] You mentioned that people with Alzheimer’s, Dementia aren’t building new tissues in connection, is there? I think I’ve always thought or maybe I just had this thought but that there is an age where we kind of stop getting new brain cells where we stop making tissues and connections. Is that true?

Sangeeta Pradhan: [00:14:32] Actually the research which is really exciting shows that that is not true which is truly staggering. There is no age where we stop making new neurons. How exciting is that?

Mathea Ford: [00:14:48] That is! Because that means obviously you can continue to have good brain health throughout your life.

Sangeeta Pradhan: [00:14:53] Right! So, there was a study in I think it was a 2013 study in the Journal Cell that showed that even into our old age we can create seven hundred new neurons every day. Now bear in mind that we have like 86 to 100 billion neurons and they have they fall thousands ff synaptic connections. So seven hundred might seem like a drop in the bucket but the fact that we are actually creating new neurons in itself is very valuable. So, yes we can continue to build new neurons into our old age. But as I said the rates of neurogenesis can vary. And this is where I think we can use the power of neurogenesis through foods and lifestyle to positively influence that process.

Mathea Ford: [00:15:52] Som you mentioned before neuroplasticity. So let’s go back to that. What is neuroplasticity specifically and how is it discovered?

Sangeeta Pradhan: [00:16:00] In very broad terms, neuroplasticity is the ability of the brain to adapt and change and rewire itself and reorganize itself in response to our experiences. Our brain is incredibly moldable in every thought. Think about this. Every thought, every emotion, every experience we undergo changes the brain for the better or worse. So, it’s pretty amazing. You asked how was it discovered. So, the history of neuroplasticity. Believe it or not goes back to the 1890s when William James in his book talked about it. He said that the brain was plastic but at that time that the concept did not really take hold. It wasn’t until the 1950s that they did an experiment with the rats. So I do want to mention that this cognitive science and this whole research is relatively new. It’s emerging research. Lot of the research has been done in animal models. We do need more randomized clinical trials but what we have seen so far is pretty compelling. Anyway, to go back to the 1950s, they did this experiment in two sets of rats and one set of rats was placed in rich, social environment where there they will basically be given rat toys; they were allowed to interact with their little rat buddies; they were made to run on running wheels and then they had another set of rats where the poor little critters were isolated from each other and they didn’t have their little buddies to play with and so forth. And what they observed was that the rats in the end rich social and white men had higher rates of neurogenesis and they also they had more cybernetic connections those connections that we were talking about earlier. So that was sort of a great breakthrough research that they stumbled upon in the 1950s and then later more research was done in the 1970s but again it wasn’t until the late 1990s that we discovered that we can actually grow new neurons.

Mathea Ford: [00:18:36] We’ve talked about neurogenesis and neuroplasticity. Is there a link between neuroplasticity and like the habits that we form? So does one being able to change our brain, being able to move it and create new memories? Does that help with habits or is that any at all related?

Sangeeta Pradhan: [00:18:56] So, to many get an understanding of how that works, Mathea, I’m going to take us back to what I was talking about very early on in our podcast today. If you recall we were talking about how the neurons connect to each other through their synapses and the neurotransmitter travels the synaptic cleft and so on so forth and the signal is transmitted. So, what the research shows is that repeated signals and high frequency signals strengthen synaptic connections in a process called Long Term Potentiation or the audience can just think about it as Long Term Memory to keep this simple. Repeated signal strengthens synaptic connections and the opposite is true. So that weak signals when weak in a sign up a connection you want to think about your brain like a power grid with these complex neural circuits going we can just impacted how we saw it working right. So when you engage in a particular behavior that neural pathway in the grid lights up. Then you keep repeating that behavior.

Sangeeta Pradhan: [00:20:11] Those neurons become more and more excitable and it gets easier and easier for the brain to use that particular pathway. Neuroplasticity follows the use it or lose it rule. Frequently used synaptic connections and neural pathways get stronger and stronger and the pathways that are infrequently used or seldom used will weaken and disappear over time. And this is called synaptic pruning which I thought was very apt. Your body says your brain says “hey! You’re not using this memory I’m going to snip it off” just like you would prune excess branches if you will in those shrubs in your yard that you don’t want need but a memory that’s revisited over and over again the brain says “hey! I guess you needed somebody to hold onto it.” That synapse that synaptic connection has strengthened over time. Let me share another example. In high school if you hated calculus like I did but you loved history. I knew I remember rattling off historical events at the drop of a hat because I kept reviewing history notes but speaking for myself I nearly flunked Calculus. That’s because the synapses associated with Calculus weakened over time because I didn’t pay any attention. But I kept reviewing history notes almost became the teacher’s pet because those synapses got stronger and stronger. The use it or lose it rule. We can use neuroplasticity to actually develop like the habits and give up the ones that I’m not working for us. So, drug addiction for instance is the darker side of neuroplasticity but you can see how you can tap into the power of neuroplasticity to engage and develop habits that work in our favor. If that makes sense.

Mathea Ford: [00:22:18] So that were the idea has come from that it takes 21 days to develop a new habit. Even though we know it’s not necessarily 21 days specifically but you have to give your brain that repeated stimulus.

Sangeeta Pradhan: [00:22:31] Again the expression Practice makes perfect. It just puts that into a whole new perspective doesn’t it?

Mathea Ford: [00:22:39] Yeah! Your brain’s practicing and your body is practicing doing whatever. Let’s talk a little bit let’s get more into the nutrition side since we’re both dietitians. We talked about what causes the brain to have neuroplasticity but what foods have been studied that can affect our brains?

Sangeeta Pradhan: [00:22:55] So a whole array of foods have been studied but in a very broad sense. Let’s talk about the big picture first. What they have seen is that the Western diet that we just referred to a little earlier on in the podcast that is high in processed foods and high saturated fat foods and high in sugar and whatnot. What they have seen is that it actually literally shrinks the Hippocampus. It’s called Hippocampus Atrophy. The hippocampus which is a part of the brain which as I said is combined central for memory and learning literally shrinks with the Western diet and also BDNF levels not surprisingly drop with the Western diet. So basically lower intake of nutrient dense foods and higher intakes of unhealthy foods can cause that hippocampus to shrink and have also been associated with increased risk of depression and cognitive decline. So that’s sort of in a broader sense but in terms of specific nutrients that have been investigated. DHA and Omega 3 fatty acid it’s a 22 carbon I believe omega 3 fatty acid it’s found found in fish oils found in walnuts found in seeds like flaxseed chia seeds and so forth. So DHA is actually an integral component of neuronal cell membranes.

Sangeeta Pradhan: [00:24:31] You know the a good analogy I can give. Well I hope it’s a good analogy is if you’re thinking about constructing a building you would want high quality building materials. So also when you if you want to build a good brain you need good amounts of these Omega 3 Fatty Acids. So DHA has been investigated. Here’s the catch. While prospective studies have shown that for instance just eating one fatty fish meal a week can reduce your risk of Alzheimer’s by 60 percent. Randomized clinical trials with two grams of algal DHA have been somewhat disappointing. That said I would still and create your audience to include a fatty fish and Omega 3 Fatty Acids because ultimately you know at the end of the day it’s really the whole foods that count and whole dietary patterns that count. We don’t want to get too hung up on isolated nutrients. So, that’s the scoop on DHA. And then there’s corcumin which is the active extract of turmeric. And back also in we know it has antioxidant at the inflammatory properties. But again in clinical trials the results have been somewhat mixed. So, there was this 24 week Siebel Controlled Trial. They were I think 36 subjects enrolled in the trial. So it was a relatively smaller trial. And they were randomized to placebo or two grams a day of corcumin all four grams a day. And it failed to demonstrate any efficacy.

Sangeeta Pradhan: [00:26:20] But again I just want to caution the audience that we need bigger you know broader well designed studies to really sort of draw any conclusions from this. It has been shown to have a very potent antioxidant properties. So I would certainly encourage the audience to use just a pinch. All it takes is a pinch of turmeric in your food, in stews. So, still try dishes to get some of the benefits. So that’s corcumin. Then there’s Vitamin E. We all know that’s a very potent antioxidant and about two thousand international units of that in mild to moderate Alzheimer’s disease has shown some modest benefits. This. Do you want me to keep going on? Just note some of the other nutrients that were used?

Mathea Ford: [00:27:11] Maybe a couple more.

Sangeeta Pradhan: [00:27:13] Folate. As the name implies fully leafy green vegetables, oranges, orange juice, legumes. That was this landmark study in the Baltimore Longitudinal Study on Aging. And in that what that study demonstrated was that folate at all about the RDA it was associated with a significantly reduced risk of Alzheimers disease. And then let’s not forget all the other antioxidants. The flavonoids you know anything with bright wavering colors. We know that the mark of an antioxidant is that it leaves a stain behind and foods with those bright, rich colors have antioxidant properties. So, in a 2000 study what they saw was that a flavonoid or antioxidant rich diet can actually up regulate genes in your body that are associated with learning and cognitive function and down regulate the genes that are associated with inflammation and loading deficits which again should not be surprising given that oxidative stress reduces levels of neurotrophins. So anything with any oxygen properties that would mitigate that oxidative stress would then boost BDNF levels and promote neurogenesis. Last but not the least intermittent fasting which has become a hot topic these days. And calorie restriction have also shown some surprising benefits. They both actually boost BDNF levels. And the theory behind that is that while chronic stress releases cortisol which is a stress hormone in the brain killing those little neurons we were talking about that are part of neurogenesis and memory formation of the mild stress that is caused by calorie restriction actually has the opposite effect.

Sangeeta Pradhan: [00:29:26] It forces the brain to think and triggers neurogenesis and all kinds of neural protective mechanisms are triggered. And so so those findings were to me and that was pretty was a little surprising that intermittent fasting actually helps.

Mathea Ford: [00:29:45] I’ve done a little bit of reading and understanding about a little bit more about intermittent fasting and I know one of the main things that happens is that your body stops producing insulin so then your body is also basically doing some of those reparative things. Your body goes through some repair processes and starts using and using those kind of things that are out there just hanging out that it hasn’t had the time to repair because it’s so busy with insulin doing the storage and the energy use that it kind of let your body calm down which you mentioned you’re saying it’s a mild stress vs. your body having to digest food you know so that allowing it to go through that process.

Sangeeta Pradhan: [00:30:35] The research shows that while basically there is an up regulation of receptors in the brain for stress hormones with chronic stress. And you don’t see that with when you get cold calories or you go to intermittent fasting and let’s bear in mind that any excess of calorie consumption in and off itself will increase oxidative stress to the body and then a whole cascade of reaction ensues. That’s unfavorable but also the results showed that certain neutral protective mechanisms are triggered by stress broking so-called Heat Shock Proteins and Glucose Regulatory Proteins are produced that have neuro protective mechanisms and also the ketones that are produced when someone undergoes fasting or you know a low carb diet. And fats are burned in the absence of carbohydrates. The incomplete oxidation of fats produces ketones and ketones, this has been demonstrated that ketones also have neuro protective effects. It’s a whole sort of if if they can actually impact epigenetics in the body that would be go beyond the scope of our discussion today. But suffice to say that intermittent fasting and calorie restricted diets did show favorable effects on BDNF levels.

Mathea Ford: [00:32:06] You mentioned this a little bit but vitamins. So, you mentioned using an antioxidants and you mentioned some specific ones but and I know that food is definitely better to get your because we just don’t know all the properties that are helping our bodies but are there vitamins that people might want to think about or is it good to kind of just take some extra antioxidants in a vitamin to improve your brain power?

Mathea Ford: [00:32:37] In this though Baltimore Study of Aging Longitudinal Study of Aging that I was talking about. What they found and basically they followed non demented elderly volunteers for like 9.3 years is a pretty long study and what they found was that higher intake of folate, vitamin E, vitamin B6 were associated individually with a lower risk of Alzheimer’s disease but when the three vitamins were analyzed together only folate at or about the RDA was associated with a significantly lower risk of Alzheimer’s disease. So, I hope that answers your question.

Mathea Ford: [00:33:23] Yeah! I think it’s good to always remember that food first. So, getting those dark leafy greens and good sources of folate. We’ve also seen I know this isn’t the topic today but when I was pregnant definitely they want people to young women in their childbearing ages to do the folate and to get plenty of that DHA because of the neuro benefits.

Sangeeta Pradhan: [00:33:47] Absolutely! So at the end of the day we just want to remember that it’s ultimately it’s Whole Foods that count and not individual nutrients. And the best way I can describe that is if you think about it pure it’s lovely to hear a violin playing. It sounds beautiful but you don’t get the full glorious effect until you hear the whole orchestra and that’s the same thing with food. You know those vitamins and nutrients and whatnot are wonderful but it’s not until you eat whole foods that you can hack into the real power of all those foods. So that’s one way of looking at it.

Mathea Ford: [00:34:28] Kind of another thing you mentioned at the beginning was talking about exercise and going for a walk or whatever. So, can we dig in a little bit to how does exercise affect BDNF?

Sangeeta Pradhan: [00:34:43] Yes absolutely! So exercise is actually one of the most powerful ways of changing your brain and rewiring its chemistry. Exercise has been shown to increase BDNF levels and in fact there was a study that was done in which they found that in that particular study exercise increased BDNF levels by as much as 32 percent. And you’re talking about moderate intensity to exercise engaging in exercise for about 30 to 40 minutes or so.

Sangeeta Pradhan: [00:35:25] And I also want to share this landmark study that was done in I believe 1999 at Duke University and the investigators actually had the nerve to test exercise against Zoloft and so they had these three cohorts of subjects. One cohort took Zoloft. The second cohort exercised four times a week for I believe a half hour and the third cohort to Zoloft as well as exercise and to their surprise after four weeks. Depression scores dropped to normal across all three groups. So then we had you know the brains of big pharma shall we say the skeptics who said “hey! You didn’t have a placebo!” So they they added a placebo and depression scores dropped to normal again across all three cohorts. So this was again groundbreaking research that really got the attention of the scientific community. And again underscoring the role that exercise plays in this whole picture. One Thing I forgot to mention Mathea is that a lot of the studies that were done on DHA, corcumin, vitamin E they also investigated the role of exercise concurrently or simultaneous me with these in rats and what they found was exercise synergistically increased levels of BDNF. So, the concurrent application of exercise or exercise along with a wonderful healthy diet clearly compounds the beneficial effects that we see from healthy foods.

Mathea Ford: [00:37:16] So, you’re talking about any type of exercise whether it’s weight training or it’s a aerobic exercise or is there one particular kind of mode that seems that they’ve studied?

Sangeeta Pradhan: [00:37:25] From what I can tell and there’s so many different studies on this but from what I can tell it seems to me that aerobic exercise appears to provide the greatest benefits from what I can tell from the research. And there’s a lot of studies that have been done on this from what I can tell.

Mathea Ford: [00:37:48] So, it really sounds like 40 minutes, 30 to 40 minutes three or four times a week provides this increase in BDNFthat helps with our memory and our brains.

Sangeeta Pradhan: [00:37:58] Absolutely! You want to get your heart pumping and you want to get more oxygen to the brain really that’s what it’s all about.

Mathea Ford: [00:38:05] You mentioned the Western diet being the biggest issue that causes brain problems. What diet changes are recommended to improve how BDNF works in our brain? So we’ve talked about what not to eat and a little bit I think we’ve touched on what to eat but what diet changes are recommended to help improve that and how long does it take before you start seeing changes?

Sangeeta Pradhan: [00:38:30] Basically a Mediterranean Style Diet that is high in fatty fish or if you’re a vegetarian then tapping into Omega 3 Fatty Acids sources through nuts, seeds and some leafy greens also by the way have some can provide some Omega 3 fresh fruits and vegetables, whole grains. Whole grains actually do have antioxidants called ligaments so we don’t want read that’s something you just want to bear in mind legumes as well as you know basically just whole and unprocessed foods that are and dietary pattern that is low in added sugars and refined sugars would have beneficial effects in terms of raising BDNF.

Mathea Ford: [00:39:17] If somebody is starting to or wants to improve their memory whether they’re feel like they have any sort of deficit or not they feel like you know they can improve their memory, how long eating this way do they before they start seeing some changes?

Sangeeta Pradhan: [00:39:31] So, Mathea. I just want to share with your audience some studies that were done in rats. I do want to just in so the word of caution these were studies in animal models not human beings but the evidence was pretty compelling. And in separate trials these rats were basically fed a high fat diet and then the poor little critters were subjected to a traumatic brain injury. So both of which causes oxidative stress. What they found was the set of rats that was supplemented with antioxidant rich nutrients corcumin, vitamin E and DHA. They actually aced a Spatial Learning Test. And the rats that was not supplemented with antioxidant rich nutrients flunked the test. So that’s the Spatial Learning Test is called the Morris Water Maze and what it is is these little of critters are made to run around an open swim area and they are supposed to locate a submerged escape platform so the rats that was supplemented with antioxidant rich nutrients aced the test. The rats that was not supplemented flunked the test which underscores the fact that antioxidant rich foods can mitigate the oxidative stress created from a high fat diet and from the traumatic brain injury boost BDNF levels and restore cognitive function. One other factor that I would like to mention at this point Mathea is that your diet actually causes structural and functional changes in the brain which is pretty amazing and this is why the hippocampus actually shrinks on a Western diet. This is also what we see the depression and schizophrenia by the way but the hippocampus actually shrinks.

Mathea Ford: [00:41:38] That’s amazing to think that it’s protective because we never know at what point we might have more oxidative stress than others so being preventative is definitely a good thing. And those studies you mentioned about rats were like three weeks or a month or?

Sangeeta Pradhan: [00:41:57] As I said they were like separate trials with DHA, corcumin and vitamin E and some of them were full week, some of them were eight weeks.

Mathea Ford: [00:42:06] So we’ve talked about diet, we’ve talked about exercise. Are there other factors that affect BDNF in our brain?

Sangeeta Pradhan: [00:42:14] Essentially, anything that we can do that challenges the brain is going to boost BDNF levels. It’s so funny but just using your brain actually increases BDNF. Any kind of visual and cognitive stimuli is going to increase BDNF in the brain but it doesn’t have to be cognitive. That’s really what is so empowering about this. It could be loading a new skill, a new motor skills. So if you’ve never learn to ride a bike if you do so that’s going to boost BDNF levels. Learning a new language can boost BDNF levels. Learning to play a new instrument that’s going to boost BDNF levels. So anything that essentially challenges the brain can work in our favor. Meditation has been shown to increase BDNF levels. Getting a full night’s sleep increases BDNF levels. Also enrich social environment. So, having those meaningful relationships with the people around you, having meaningful social connections, social circles and so forth, friendships all of this has been shown to have a favorable effect on BDNF.

Mathea Ford: [00:43:35] I remember when I was growing up my grandmother she refused to use a calculator to balance our checkbook and she was convinced that helped her to have like keep her brain healthy. And what you’re saying is that she was right.

Sangeeta Pradhan: [00:43:51] She was because unbeknownst to her she was using the fundamental rule of neuroplasticity. If you don’t use it you’ll lose it.

Mathea Ford: [00:43:59] Absolutely! And I would I believe she actually said that. She didn’t say the neuroplasticity part but she said if I don’t keep using my brain I’m going to lose this ability.

Sangeeta Pradhan: [00:44:08] Then in her infinite wisdom she knew what she was doing.

Mathea Ford: [00:44:12] My grandmother had lots of lots of things like that. Yeah! You’ve made me actually just hopeful that you know our brains don’t deteriorate if we take an active part and we eat healthy and we exercise which is normal healthy recommendations anyway that we can have that brain power well into our body. Yes it’s the quality not quantity. So you can have a quality of life you’re improving the quality of life.

Sangeeta Pradhan: [00:44:41] And it’s simple things that are already at your fingertips. The foods that we are talking about is probably already in the kitchen cabinet.

Mathea Ford: [00:44:50] Yeah you just have to make that effort to eat them in on a regular basis and keep those not to say sugar and everything is the worst thing in the world but definitely keep that at a minimum. So, tell me a little bit about listeners who’ve listen to this whole podcast are thinking you know “gosh! This is great I should eat healthy or whatever” but how can they use it in their day to day life especially if they’re like a clinician and they’re working with people on a regular basis to help them not necessarily for their brainpower but just help eat healthier and stuff?

Sangeeta Pradhan: [00:45:23] Are you talking about just the lay consumers? I just want to make…

Mathea Ford: [00:45:28] I think lay consumers as one and then clinicians is another so can you talk a little bit about how they may be different they may use it in their life?

Sangeeta Pradhan: [00:45:36] Again, back to some of the basics that we that we discussed. Your behavior is actually the biggest driver of neuroplasticity. Think about things that you can do that would challenge your brain. You know nurture behaviors that lead to positive changes. We talk a lot about neuroplasticity and developing good habits and trying to give up those behaviors that don’t create positive changes and watch that neural pathway disappear. So, for instance think about things that you can do that would favorably impact your brain. And it could be you know little things. It could be perhaps maybe if you’re drinking. I don’t know. So it is something like that and gradually cutting back on that carving out a new neural pathway which you know initially might seem awkward but as you keep practicing it the oil factory disappears and before you know it you’ve changed that habit. Think of things that you can do in your day to day life that would help create favorable changes in your brain and boost the BDNF levels. Back to you to whole foods, unprocessed foods, use spices. Spices have in your cooking. Spices have potent antioxidant potential. And as I mentioned turmeric earlier. Just a pinch goes a long way and you can use it in the stews and soups and stir fry dishes and whatnot. I do want to mention that it’s very pungent. So all it takes is a pinch. You don’t want to do more than that and you can put it in practically every dish except I want you dessert because that dessert will no longer be dessert and it will turn into something savory. Little things that we can do you know shooting baskets with your with your kids, riding a bike with your kids, maybe riding down a new path and now you’re killing two birds with one stone. Get the exercise and you have challenged your brain by going down on new paths if you will. So anything that we can do that will help boost BDNF levels and it’s these simple things that we can do in our day to day life. That was ultimately help improve and enhance cognitive function.

Mathea Ford: [00:48:00] So that makes a lot of sense. And I would like to end the interview where I always end it and ask you to tell me your favorite food.

Sangeeta Pradhan: [00:48:09] My favorite food is really decadent triple layer chocolate cake with homemade buttercream frosting.

Mathea Ford: [00:48:22] All right thank you. Thank you so much for being on the podcast today. It was a pleasure to have you on the show. I know my listeners have learned a lot about BDNF and brain health and how to just keep your brains active and have a good quality of life. So, if listeners want to connect with you what’s the best way to do that?

Sangeeta Pradhan: [00:48:41] Listeners who want to connect with me can find me on the WebDietitian WEB dietitian.WordPress.com and they can just click on the Contact tab on the menu bar. And that’s probably the best way of reaching me. If you Google WebDietitian it should pop up. And I have a Facebook page as well for WebDietitian.

Mathea Ford: [00:49:06] Okay. Well guys this has been another great episode of the Nutrition Experts Podcast. The podcast that is all about learning more so you can do more with nutrition in your life.

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Nutrition Experts Podcast Episode 41 How Can You Eat Better By Cooking More with Ranelle Kirchner, MS, RDN, CDE

February 11, 2019 by matheaford Leave a Comment

Ranelle is a Licensed Registered Dietitian, Certified Diabetic Educator, and Le Cordon Bleu culinary graduate with a passion for health and wellness, and a desire to help you understand yours.

She specializes in:

Diabetes and diabetes health management
Food allergies/intolerances
Medical Nutrition Therapy
General health and wellness
Meal plans
Private cooking classes and events

Ranelle loves food. She believes that eating is such an important part of our lives, rooted in cultural tradition, shaped by health, inspired by the smells and flavors of all our favorite dishes. But it can sometimes seem overwhelming; food politics, economics, and an ever-changing array of “fad diets” can make the world taste bland. Her overall purpose is to teach people what she knows and allows the consumer to make informed, healthy decisions. For her, eating doesn’t have to be difficult or unpleasant. She wants to call attention to, and teach others about, the important issues surrounding food & nutrition. She wants to give counsel on how to eat healthy, and share recipes that make good food exciting. Her background has provided her with a deep understanding and appreciation of these matters, and with strong feelings in regards to our nation’s food and nutritional health.

A story of health, nutrition, and most importantly, food

Before starting her own business as ChefRDN, LLC, she was the Food Service Director of Thorek Memorial Hospital in Chicago. While there, she counseled patients on nutrition in both in and outpatient settings. She have also worked with Rush University Medical Center in Patient Food Services as an Administrative Registered Dietitian and Supervisor. During her time at Rush, she graduated from the Morrison Internship program and later achieved a Masters of Science in Clinical Nutrition. But it all started with food: She originally graduated with an Associates degree in Culinary Arts from Le Cordon Bleu in St. Paul, Minnesota. Given her background in both cooking and dietetics, she is now enjoy teaching others how food and nutrition can improve their lives, and help them to prepare and enjoy food of any/all types, with an emphasis on eating and buying local. She became a Certified Diabetes Educator in 2018, which allows me to reach new audiences in new ways, and best serve those suffering from diabetes.

She spends her free time volunteering at locavore food and health-related events, and am an avid outdoors(wo)man. and enjoy traveling, reading, knitting, practicing yoga, bicycling, and gardening.

Mathea Ford: [00:00:26] Hi there! It’s Mathea. Welcome back to the Nutrition Experts Podcast. The podcast featuring nutrition experts who are leading the way using food starts today right now with our next guest. It’s great to have Ranelle Kirschner on the show today. Ranelle welcome to Nutrition Experts.

Ranelle Kirchner: [00:00:43] Hi! Thank you. I’m so happy to be here.

Mathea Ford: [00:00:46] I know I’m excited to have you on this show and share your expertise with my tribe. You have a very interesting story so I’d love to let you tell my listeners a little more about you and what you do.

Ranelle Kirchner: [00:00:58] Absolutely! So, I am a dietitian/chef and Certified Diabetic Educator. I have really paved this path of trying to combine the two worlds of both cooking, culinary arts and nutrition because as similar as they seem they’re two very different worlds and so I spend my passion and ambition to bring those two worlds together to better help people in terms of changing the way they live. To lead a healthier lifestyle and really show people how great food can be because there’s a lot of simple things that you can do to make it healthy.

Mathea Ford: [00:01:35] So, you mentioned that you have a culinary background and can you talk a little bit about how you chose that and where you went and then kind of where it’s led you.

Ranelle Kirchner: [00:01:45] My path is education is certainly a unique one. I went to school at the University of Minnesota to initially become a surgeon but my mind kept wandering during this time to the kitchen while I was studying. So after my first year pre-med I changed my career path left the U, started taking class at the Le Cordon Blue in Minnesota. It was amazing experience that led me to start working in France. But while I was abroad I gained a new perspective on life and in food. So, I was able to witness and live the French way of eating and living and realized that their relationship was so vastly different from where I… From what I knew and how I grew up. My views changed and I decided I wanted to be more on this path to becoming an educator. And that’s when I transitioned into the dietetic path.

Mathea Ford: [00:02:37] So you mention in France that you noticed they had a different relationship with food. What is the difference? What would you say was the difference that you found?

Ranelle Kirchner: [00:02:46] I really notice that the difference lied in the relationship with how they treated food, how they perceived food, respecting their body. When they felt full, they just stopped eating. There was no reason to forge themselves. And it was always about fresh produce and fresh foods really taking care of being ingredients as they were cooking. So, if something was in season that would be the highlight of their foods for that week or that day. It was different because it was more about them listening to their bodies and also just trying to incorporate those fresh flavors that were seasonal.

Mathea Ford: [00:03:30] So, I guess you didn’t see a lot of pre-prepared foods or processed, highly processed foods when you were there. Of course you were there for some cooking event or home schooling so that might have affected it a little bit. What was their process for getting food? I mean you said they always come fresh.

Ranelle Kirchner: [00:03:52] Right! A big emphasis was on Fresh. Even the refrigerators were much smaller and they went shopping on a weekly almost daily basis. And always just focusing on the fresh foods. And a lot of times it was just done at an open air market. Even in the middle of winter.

Mathea Ford: [00:04:15] Hmm. Yeah! That is a pretty big contrast to how we hear here huh?

Ranelle Kirchner: [00:04:18] It is! And you know everybody knew the vendors. Everybody had a relationship with who was selling their food so they knew where their food was coming from. They were able to ask questions about how it was grown and it was never about overindulgence. And price was never a factor. I think that having that good relationship with the farmers, the farmers weren’t overcharging because they knew who they were serving or one but it was a very unique experience.

Mathea Ford: [00:04:48] How would you compare that to a Farmer’s Market in the United States? Is it very similar or?

Ranelle Kirchner: [00:04:54] I think there’s a lot of similarities. But even from the different places I’ve lived in the States it does change state to state. I felt like in Chicago I didn’t feel like there was much of an opportunity for that bonding. It was more of an exchange process as where you know here in Minnesota we have so many Farmer’s Markets that I love to go to and I have a couple that I frequent a lot even in the wintertime. And the relationships I have with them I feel have been a stronger. So it’s definitely location based.

Mathea Ford: [00:05:30] Yeah! That makes sense that if you’re going to basically if you’re talking about the French people they’re going to the markets, they’re buying what’s in season, they’re using it within the next couple days. I think in the United States people feel like I really don’t have time to shop every couple of days and go to the Farmer’s Market. So do you have any thoughts on that? .

Ranelle Kirchner: [00:05:51] Yeah! You know I think that’s really important to address because we are a different society where we are more on the go. We don’t have as much vacation time or time away from work, even to enjoy our meals during the times that we’re working so when we take a lunch break. You know it’s rush, rush, rush and then back to work or eating while you’re working and that’s not healthy but it is. There are some things that you can do. So, for instance when you go to the market you can make your food last. You can you can go once a week. You can buy things that will perish faster but then balance that with foods that don’t perish as easily. So, buying things like squash in the winter time is a great example because you don’t need to squash that week or that day. You can store it for months. So I guess you could say it’s all about variety.

Mathea Ford: [00:06:48] That makes a lot of sense. Like your lettuce is going to go bad maybe three or four or five days and so you would eat that if you went to the market you would eat that earlier in the week and then maybe you’d have some squash with your meal later in the week.

Ranelle Kirchner: [00:07:04] Right. So, a lot of that comes into play with meal planning. If you are planning out your week then you’ll know which foods that you should be eating sooner rather than later in the week when you do your shopping either at the market or the grocery store and even a combination of the two.

Mathea Ford: [00:07:22] So, I want to come back to meal planning in a second but you know what made you decide to go on and become an RDN and after you had your culinary education?

Ranelle Kirchner: [00:07:32] I didn’t think anyone would listen to a chef about Nutrition and I certainly wanted to have that expertise and the evidence based in what I tell people so it was more that I felt like I needed to do my due diligence and go back to school and understand the nutritional aspect of food as well. So, I went back really for the credentials, the experience really just to make sure that I’m best helping people to my capabilities.

Mathea Ford: [00:08:02] You mentioned meal planning a couple minutes ago. How do you do your meal planning? How do you talk to your patients about or customers about meal planning?

Ranelle Kirchner: [00:08:14] Well, I use a couple different approaches because I do use a service called EatLove which is a digital platform that can tailor nutrient and these disease specific needs. So, I have that service which is great for maybe helping people get started with their own meal planning but I still try to address things that people can do for basic meal planning like keeping a pantry full of non perishables to keep it simple during the week. When you put together a menu one week at a time or cooking in batches. So, those are some tips that I use for meal planning that anyone can use so that it’s more approachable. But certainly for those who are really busy and don’t want to think about finding recipes. And they’re on the go all the time, the EatLove program and platform it is truly amazing and a lot of people find great benefit from it. There’s a lot you can do within it and it even prints out your grocery lists.

Mathea Ford: [00:09:15] So, do you have any specific tips about meal planning? You mentioned basic meal planning, cooking in batches that type of thing but when you’re talking to somebody about meal planning for maybe a week what do you encourage them to do?

Ranelle Kirchner: [00:09:31] I like to put a lot of emphasis on plant based foods in my teachings. So, really looking at Okay, where are your vegetables coming from in the week? Making sure that you’re getting those three to five servings” because a lot of people struggle getting the recommended vegetable servings in a week. So, I think focusing on one thing is a good place to start. And then gradually making changes throughout the week. Protein is typically not an issue for most people although some of my vegan patients it is. You can certainly have protein rich diet as a vegan.

Mathea Ford: [00:10:07] You really are going to encourage somebody to kind of change may be part of their meal not necessarily do the whole thing at once. But if you’re trying to move to more plant based or healthier eating your maybe changing a few things every week just building those in your process. Is that what you’re saying?

Ranelle Kirchner: [00:10:24] Absolutely! Because I think it can be overwhelming when someone comes to you and they ask you they want to make these these big changes in their life. But if you don’t do it gradually and slowly it can seem like it’s too much and that it’s unsustainable. And I want this to be sustainable and a lifelong change.

Mathea Ford: [00:10:42] So, can you talk a little bit more about your partnership with EatLove and how that works?

Ranelle Kirchner: [00:10:48] It’s a collaborative agreement where I write recipes for EatLove so you’ll see many of my recipes appear on their platform and in exchange I use the platform for my patients to essentially plan out their meals and we can start small for either maybe we emphasize dinners for that week but it has the capability of doing snacks, breakfast, lunch, dinner and you can also add on other members in the family too. So, even if it’s a meal plan that’s meant for you we can add on other people so that it is more more family friendly because let’s be honest we’re not it’s not all for ourselves. Sometimes we do want other people our loved ones to be included in the process. What it also does is I’m also able to tailor disease specifics so whether you have diabetes, if you have dietary restrictions all of that can be factored into this meal planning.

Mathea Ford: [00:11:50] So, is it all dietitians that contribute recipes or?

Ranelle Kirchner: [00:11:54] All dietitians write recipes.

Mathea Ford: [00:12:00] So, can any dietitian do that? Can they collaborate with EatLove to write recipes if they want it or to even just use the platform for their patients?

Ranelle Kirchner: [00:12:08] Dietitians can subscribe to the platform and pay a fee. I’m not sure that they’re looking for dietitians right now but if you are interested in writing recipes, I can certainly put you in touch with the correct person if you’re interested in writing recipes as a dietitian because that is what they focus on. I think it can be tricky writing the recipes because things that they look for is few ingredients that have a big emphasis on vegetables and then seasonality as well as trying to fit these different types of eating. So, right now there’s been a lot of requests for low FODMAP foods, diabetes or diabetic friendly recipes and certainly more plant based.

Mathea Ford: [00:12:58] You mentioned that you traveled to France. Do you travel doing anything else or do you I know you think you like to travel. Can you talk a little bit about that? Your learning, how you learned through your travel and how you use that in your practice?

Ranelle Kirchner: [00:13:11] Traveling has always been a big part of my life. And when I go to a new place, I really just throw myself in. So, it’s not staying in nice hotels, its trying to find the most rural parts of the country and really just engaging with the people. So, I do my best at trying to learn their language. It’s not always easy. But with the help of technology it’s become easier and really just picking my experiences based off of where I can learn the most from. “Okay well what’s going on with this culture? What what are their holidays? Am I or am I going to be there during a holiday or something that’s really important to them? What are their local foods? Where do they hang out?” And so I really try to go to those types of places and it’s all about finding those little hole in the wall restaurants and if I get sick I get sick. You know it’s a great experience for me.

Mathea Ford: [00:14:12] So, what’s the last place you went to?

Ranelle Kirchner: [00:14:14] The last place. I went to was where did I go? I was in Germany and Amsterdam. I had been to the southern part of Germany. But I went with my boyfriend to the northern half to go visit family and so we were able to go to these small little towns all throughout the northern half and really just see what people were eating. Learn some really great foods and cultural influences on you know Turkish food especially discovered a Lahmacun which is an amazing. It’s one of my favorite foods right now. It’s basically a flatbread like pizza with all these different spices. Tomato, lamb and then it has a nice then yogurt sauce with fermented cabbage and other fresh vegetables. It’s delicious. It was a really great travel as well because I was able to then meet a lot with the locals and hear about what their traditions were, how they eat. And then I’m looking forward to my next trip where I’m going to Israel this May.

Mathea Ford: [00:15:31] Okay.

Ranelle Kirchner: [00:15:31] So, it’ll be another another good food experience.

Mathea Ford: [00:15:35] Yeah! Yeah. Sounds like you really get in-depth with the culture and try to at least you try all the foods and then you can incorporate.

Ranelle Kirchner: [00:15:45] I will try everything once.

Mathea Ford: [00:15:48] I can’t say that I’m that way. If you tell me once again I’m probably going to judge. So, I’m probably decide what to do anyway.

Ranelle Kirchner: [00:15:57] And you know it’s interesting too because some of the places I’ve been, I’ve learned so much. For instance, when I was in Indonesia I spent three weeks traveling from island to island and realized how hard it was to find food. It wasn’t easy. It was first of all it was hard to travel and to find people to take me places. But once I got to a place you had to know someone in order to find a meal.

Mathea Ford: [00:16:25] Oh wow!

Ranelle Kirchner: [00:16:26] No, there weren’t restaurants. There weren’t markets. Occasionally you’d find a market on the side of the street just to pick up some fresh food. But really people were just growing food for themselves and selling it to each other. So, that was really interesting just to see that exchange. And also it was very spiritual and how big religion played a role into their culture.

Mathea Ford: [00:16:50] Yeah I just had another podcast a couple weeks ago about somebody talking about religion and how it can deeply affect someone’s choices and you need to understand it basically so you can have that basis to know if I if they’re a vegetarian because of religious reasons vs. vegetarian because of social reasons. You know it’s important to understand that that can help you do better with your education of them. So.

Ranelle Kirchner: [00:17:20] Absolutely! Absolutely.

Mathea Ford: [00:17:22] So you have this you go round you travel you learn about all these different foods and stuff and so obviously you like making recipes when you’re making a recipe or you’re looking at a recipe that you have. How do you modify it to make it healthier? What are some of the things you typically do?

Ranelle Kirchner: [00:17:39] Well because I am more plant based. I swap a lot of the animal fats for plant based fats. So, if it calls for lard which is common in many many cultures I will swap it out for maybe olive oil or a vegetable based oil maybe it’s even avocado. You know it’s really interesting because once you cook enough it’s easier to determine which things you can omit completely and then which things you can substitute or even cut half the fat out. So, it is recipe by recipe based. So, that’s one of the things to get started is really just getting in the kitchen and just cooking more, experimenting with food. So, you know what works and what doesn’t work but you have to just get started.

Mathea Ford: [00:18:31] So, when somebody is cooking in their kitchen, what are some of the things that you would say they should start with if they’re trying to change a recipe to make it a little healthier besides the fat thing and try but where should they start?

Ranelle Kirchner: [00:18:44] So, I guess it would depend. I think a good place though to start would be to look at your favorite foods. Maybe it’s Mac and Cheese. Okay? So, if we take Cac and cheese as an example let’s maybe avoid the cream and maybe we use a lower fat milk or maybe we do keep it full fat but then then look more at the portion size and then play with vegetables. So, let’s add some brussel sprouts, let’s add some kale, let’s make it healthier in that regard. Maybe even use whole wheat pasta or a bean pasta. Bean pastas are starting to become really popular and it’s great for those who are gluten intolerant.

Mathea Ford: [00:19:29] So, what do you think when you’re thinking of like ingredient that you use a lot. It seems to be just really versatile that you like to always have around what to put in recipes what what are you got anything like that?

Ranelle Kirchner: [00:19:43] Yes. The incredible edible egg. The egg is amazing. I use it. I always had eggs on hand because it’s a great source of protein. It’s affordable. You can soft boil it, poach it, fry, you can frier it, bake it. Use it in a sauce. I’m always amazed by the possibilities because you can use it for both sweet and savory as well. It can make or break a recipe because it offers that simple richness to a dish and can be a really nice finishing touch.

Mathea Ford: [00:20:19] So, egg in a dish tends to I know it’s an emulsifier, it brings things together. What other properties does it add to a dish that somebody might want that they might use it for?

Ranelle Kirchner: [00:20:31] People might use it just for its protein content but it’s an easy great ingredient to manipulate and it’s also you can have it hot, you can have it cold and I think it just offers that added fullness and roundness to a meal because if you think about when you’re cooking you try to create balance and it’s going to offer that fattiness as well as that structure to a dish so it can really make something complete.

Mathea Ford: [00:21:04] So, I know you mentioned at the beginning of the call that you were a Certified Diabetes Educator. How did you decide to go so you started cooking and then you said “Oh! I see how food and nutrition go together. So I want to be a dietitian.” What was then. How was the next step to being a Certified Diabetes Educator?

Ranelle Kirchner: [00:21:23] I was working in Chicago at the time and had just left working in Kitchen Management at Rush University Medical Center to then start running my own kitchen as a Food Service Director at a smaller hospital and because it was smaller I wore many hats and soon found myself doing outpatient care with an emphasis on diabetes because that’s what the population was. And after seeing how many people were affected by diabetes and how little resources there was available for patients, I decided that was my next move was to be… To put an emphasis on diabetes and work towards being certified so worked for a couple of years in that role. At the time I wasn’t certified but I later became certified when I moved to Minnesota but really just seeing the need for diabetic educators is really how I decided to make that change completely.

Mathea Ford: [00:22:27] So, now day to day in Minnesota what is it that you do with your patients? You do different types of classes? Do you teach them how to cook?

Ranelle Kirchner: [00:22:35] I do a little bit of everything. I teach, I certainly teach people how to cook. I offer lots of cooking classes. I cook at a couple of places actually I cook at four different sites all around food and then I also teach Nutrition classes through BlueCross BlueShield and a lot of times I get questions about how to change your diet and what can they do for cooking. So, it’s a little bit more integrated in that role. And then I’m also doing a lot with diabetes education at a place called Neighborhood Health Source which is an FQHCF (Federally Qualified Health Care Center) and then in addition to that is my telehealth business. So, I see patients online and it’s all done virtually.

Mathea Ford: [00:23:27] Yeah! It sounds like you really blended all that together where you started to where you are today you know kind of blend it all together and I know a lot of dietitians don’t love food service type things but I’m a food service dietitian. I love food service. I love recipes. I love cooking and so I love it when a dietitian blend it all together and talk about those practical things like adjusting recipes, changing the way you make choices about food. Do you have any tips for how you help people kind of get to figure out what goals they’re going to do and then how to stick to them?

Ranelle Kirchner: [00:24:04] The idea is to start small so choose one thing at a time and when you make that choice on what you want to fix then we put together a SMART goal. You know the Specific Measurable Attainable Realistic and Relevant and Time. Yes exactly. So we want to combine all those elements when we put together our goals and then slowly working towards that putting together a timeline. We want to make sure that it’s a goal that is relevant to you, achievable because otherwise then what’s the point? Is it going to be sustainable? Probably not. So, if it happens to be that you want to change something in your diet to simply add more vegetables then maybe we would start by saying “Okay, well, what do you want to do for this week? Okay? So this week maybe we look at what vegetables might be missing.” So, I tell people you know try to eat the rainbow meaning eat every color and then if there’s a color you’re missing then maybe we focus on that food group. So, purple, blue that’s often the one that’s forgotten. We want to make sure we we want to make sure we include those foods and take it from there.

Mathea Ford: [00:25:18] So, thinking about the listeners, they are dietitians, they’re health care professionals and they’re sometimes some of them are just regular people and I guess we’re all regular people. But so thinking about those people, what kind of tips would you give them to use the information we talked about today in their business and their life, in their working with patients?

Ranelle Kirchner: [00:25:43] Listen to the patients and their needs. What are they truly trying to accomplish. And is it realistic for them. Because so many times people come to me with a goal and it might not be realistic. And so working through the expectations of “okay, you come here you want help with weight loss. Let’s talk about it” because oftentimes too there’s underlying issues. So, you want to get to the root cause of why they’re doing something. And is it for them? Is it healthy? Also when you get stuck, it’s okay to reach out to other professionals and make referrals. Refer to each other. If I have a patient who comes to me and there’s clearly something that needs to be worked out with a psychologist, I’m going to make a referral because that’s not my area of expertise. And so building that network is also important so making sure that you are finding patients help that they need in other areas is vital and important to make them truly successful because that’s the point. That’s why we do this. We do this to help people and we want people to be successful.

Mathea Ford: [00:26:52] Absolutely! Those are great tips. So, the last question I always ask is right now tell me what is your favorite food? And since you’re foodie, you can pick a couple if you like.

Ranelle Kirchner: [00:27:02] Wild mushrooms are certainly one of those top favorite foods. One of my favorite dishes to make is this wild mushroom toast with melted Taleggio cheese and an easy over egg and a side green salad. It is just to die for. It is truly amazing. And I really cannot help but say that ice cream. I love my ice cream. Can be super simple vanilla is totally fine. You know I have it as my special treat but it’s just so good and creamy and rich and full.

Mathea Ford: [00:27:40] I think you have to enjoy food. I mean if it’s on third quarter it’s so not flavorful which is what people expect. They have to eat when they eat healthy. Then that’s that’s no good. You know.

Ranelle Kirchner: [00:27:53] Exactly! You have to live life. And food is part of that. So you should love the foods that you eat. It’s just all about respecting your body and the food as well.

Mathea Ford: [00:28:05] So, where do you find wild mushrooms? Do you go to a farmer’s market or do you find them in a store?

Ranelle Kirchner: [00:28:10] I do. I I often go to this place. It just opened up down the street from where I live called the Keg and Case and they have a vertical mushroom farm and so they grow all mushrooms on site. It’s pretty amazing. But the Farmer’s Markets also have great wild mushrooms that I like to go to. A little bit harder to find in the wintertime. So, during the winter I’ll certainly just walk down the street.

Mathea Ford: [00:28:37] All right. Ranelle, thank you so much for being on the podcast today. It was a pleasure to have you on the show. I know my listeners learned a lot about food, recipes, how you cook and how basically you can enjoy food. So, if listeners want to connect with you what’s the best way to do that?

Ranelle Kirchner: [00:28:52] Sure. They can go to my website at ranellekirchner.com that’s R A N E L L E K I R C H N E R dot com and you can also find me on social media LinkedIn, Facebook, Instagram. I’d be happy to answer any questions and I really appreciate taking the time your time to be on the podcast. Thank you.

Mathea Ford: [00:29:19] Thank you so much. Well, guys this has been another great episode of the Nutrition Experts Podcast. The podcast is all about learning more so you can do more with nutrition in your life.

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Nutrition Experts Podcast Episode 40 News Edition and Mediterranean Diets with Mathea Ford, RDN, LD, MBA

February 4, 2019 by matheaford Leave a Comment

Mathea Ford: [00:00:28] Hi there! It’s Mathea. Welcome back to the Nutrition Experts Podcast. The podcast featuring nutrition experts who are leading the way using food starts today right now. Today this podcast is just me talking to you. This is my news edition for the month and I just want to go over some things that I thought were really interesting that came out kind of at the beginning of the year and talk through those with you and get your feedback. So, go ahead and let me know. Reply your post on the blog or do whatever to let me know what you think of my podcast.

Mathea Ford: [00:01:09] So, I wanted to really talk about the Mediterranean Diet. It come out as being one of the best diets that is recommended and I think that’s because it’s fairly easy to follow and it is one of those things where you can incorporate a lot of the food that you already eat and do some small changes. So, what is a Mediterranean ?Diet? It is a heart healthy eating plan that’s based on typical foods and recipes of a Mediterranean style cooking. It incorporates the basics of healthy eating with a little bit of olive oil and some red wine or other types of wine that are similar to when you’re in the Mediterranean Sea area that those people eat. So, most of that is fruits, vegetables, fish, whole grains and very little unhealthy fat. So although they don’t have a problem eating healthy fats like olive oil some things that are a little bit different for us here in the States probably is that we are not used to necessarily being okay with eating fat. And in this case the fat is healthy for us and is going to keep us so you’re not going to raise your cholesterol and they’ve done some research that a meta analysis of more than one and a half million healthy adults demonstrated that following a Mediterranean Diet was associated with a reduced risk of cardiovascular mortality or less risk for death than the normal diet that we eat here in the US.

Mathea Ford: [00:02:46] So, it’s also associated with reduced incidence of cancer, Parkinson’s and Alzheimer’s and women who eat a Mediterranean Diet supplemented with extra virgin olive oil and mixed nuts may have had a reduced risk of breast cancer. So most scientific research has gone into this and said that this is a healthy diet.

Mathea Ford: [00:03:09] And what is the diet? The key components of the Mediterranean Diet are to eat primarily plant based foods such as fruits and vegetables, whole grains, legumes and nuts. You can replace butter with healthy fats like olive oil. Using herbs and spices instead of salt to flavor foods. Eating red meat no more than a few times a month. And that’s going to be in a reasonable portion so a four to five ounce portion of red meat. Eating fish and poultry at least twice a week. Enjoying meals with your family and friends. So, when I went to Italy what I found was they ate kind of later in the day and they enjoyed their meal. They kind of stretched out the meal and enjoyed it. And I think part of that also gave them the opportunity to feel that they were full and stop eating. And in America we tend to just eat what we have on our plate. Eat it so fast that we don’t even taste it and have that don’t feel full until later. When if we eat a little slower talked kind of enjoyed the meal then we might have a better kind of gauge for how much we needed to eat. They also drink red wine in moderation and getting plenty of exercise. They walk a lot, they walk to places it’s not a flat flat area. They’ve got to go a couple of blocks they tend to walk. So and it’s a lot of fresh foods. For example residents of Greece eat very little red meat and average nine servings a day of antioxidant rich fruits and vegetables. The grains that are typically eaten on the Mediterranean Diet are wholegrain and usually contain very few of the unhealthy fats and bread is an important part of the diet but it’s usually eaten plain or dipped in olive oil not eaten with butter and margarines. Also another thing is a handful of nuts or so as a snack or during the day. Nuts are a healthy part of the healthy Mediterranean Diet. They’re high in fat but most of the fat is not saturated. So because nuts are high in calories they shouldn’t be eaten in large amounts. Generally, just you know no more than a handful a day and avoid the candied or heavily salted or honey roasted type of nuts with the extra calories added to them.

Mathea Ford: [00:05:35] Okay, so let’s talk about fat. Healthy fats vs. the saturated fats, hydrogenated fats or trans fats. This diet incorporates lots of the healthy fats and very little of the unhealthy fats which are the saturated and hydrogenated. And I always remind people that if something is solid at room temperature that it would be solid in your arteries. So, those are kind of the saturated fats whereas olive oil, canola oil is liquid at room temperature therefore it’s going to flow fairly easily in your arteries. Olive oil in particular provides mono and saturated fat which is a type of fat that actually helps lower your LDL cholesterol which is your quote unquote bad cholesterol. The extra virgin and virgin olive oils the reason why they call them that is because they’re the least processed forms and they have the most of that protective compounds that give you the antioxidants. Monounsaturated and polyunsaturated fats such as canola oil and some nuts have the beneficial Linolenic acid, the Omega 3 fatty acid. An Omega 3 fatty acids lower triglycerides, decrease blood clotting, are associated with decreased sudden heart attacks, improve the health of your blood vessels and help moderate your blood pressure. And then there’s the fatty fish. We all know salmon is a fatty fish and it’s a good source of Omega 3 but you can also eat mackerel, Lake Trout, herring, sardines, albacore tuna but fish are eating on a regular basis in the Mediterranean Diet. And a little bit about wine, they do have wine and there’s some discussion and obviously if you have a concern I would recommend you talk to your doctor about it but alcohol in moderation has been associated with a reduced risk of heart disease. So, the Mediterranean Diet typically includes a moderate amount of wine no more than five ounces a day for women and more than 10 ounces a day for men. And again if you have issues with alcohol the benefits of drinking and are not outweighed by the issues that you might develop from that like alcohol abuse or any sort of issues interacting with your medications. So, let’s put it all together. The Mediterranean Diet is a great way to eat but it’s and it starts with this eating your fruits and veggies and switching to whole grains. Get some nuts every day. Don’t use butter use the healthy olive oil or canola oil. Add spices, spice it up. We have for my business Nickanny’s Kitchen.com, I have some spices that are salt free and they’re great to use and give you a lot of flavor without having that salt but I definitely recommend that you get some new spices in your cabinet and try them out. Go fish, get more fish, eat less red meat, avoid kind of processed meats like sausage, bacon. Use lower fat dairy whole or 2 percent can be a little too high in the saturated fat so you should try this skim or the fat free yogurt, low fat cheese and I want to get into some more a little more detail about some of those unhealthy foods. Foods that you should eat and foods that you should not eat. So, you’ve got things that you can eat are like vegetables, any type of fruit, nuts, seeds, legumes, potatoes, whole grains, breads, herbs, spices, fish, seafood, extra virgin olive oil, eat eggs, cheese, yogurt, poultry, just watch out for the amount of saturated fat that’s in there and eat only rarely red meat like once a month. And don’t eat or drink sugar sweetened beverages, added sugars, processed meats,, refined grains refined oils or highly processed foods. So, you probably wondering what some of those might be added sugar can be like soda, candies, ice cream, table sugar or many others. What I love when I wanted sweets is to grab a piece of fruit. It has the natural fructose sugar in it but it’s also got the other healthy benefits of the antioxidants and using that sweet taste without the extra calories of soda or candies.

Mathea Ford: [00:10:05] Watch out for refined grains like white bread and pasta made with refined wheat. Make sure you’re getting the whole grains. Avoid trans fat, avoid refined oils like soybean oil, cottonseed oil. Avoid processed meats like sausages and hotdogs and anything that is labeled low fat diet. You’re really not trying to be on a diet you’re trying to eat a healthier way that’s going to stick with you. And so thinking about yummy foods that you could eat that would be your base on a Mediterranean Diet. Something like vegetables would be tomatoes, broccoli, kale, spinach, onions, cauliflower, carrots, brussel sprouts, cucumbers. For some nuts and seeds, you might want some almonds, some walnuts, macadamia nuts, hazelnuts, cashews, sunflower seeds, pumpkin seeds. Remember those can be high in calories but they’re healthy fat so just grab a handful. Don’t overdo that. Some fruits are like apples, bananas, oranges, pears, strawberry, grapes, dates, figs, melons, peaches. You get the idea. Legumes would be beans, peas, lentils, chickpeas those types of things. And I love to make a salad and add chickpeas onto it because it gives you some protein but it’s not a you know like a red meat or anything. You can eat potatoes, sweet potatoes, turnips, yams. You’ve got for your whole grains whole oats, rice, brown rice, dry barley, corn, buckwheat, whole wheat, wholegrain, fish. I already mentioned some of those but things also like shrimp, oysters, clams, crabs. Herbs and spices, so think about using garlic, basil, mint, rosemary, sage, nutmeg, cinnamon, pepper. All those to augment your meals instead of salt and stick with your healthy oils like avocado oil or extra virgin olive oil and you should drink water.

Mathea Ford: [00:12:07] Water is your go to beverage. There is some wine in there maybe with your dinner meal but if you again have any issues with it don’t bother doing that. But coffee and tea your also completely acceptable but avoid the sugar sweetened versions or adding a lot of sugar to those. Thinking about you know what you want to do. It’s a little different. I want to remind you that you’re going to avoid you’re going to limit your red meat. You’re going to limit your processed meats, you’re going to avoid added sugars so you’re going to look on the label and see if it says added sugars and it’s really wine that’s on this diet. It is not hard liquor. So, vodka, whiskey, gin – none of that you’re really sticking with just the wine. Those don’t have those other hard liquor don’t have the same benefits and tax benefits of wine when you’re looking at grains look away from the white flour and the white rice and look more towards the brown rice whole wheat pasta replaced butter with olive oil. Watch out for the hydrogenated oil that you might be eating. And so I want to remind you if you’re thinking about you know “how do I change this? It’s February.” Maybe you made a decision at the beginning of January to do something different and it didn’t stick. I want to let you know I heard from the podcast by Brooke Castillo about… She talked about habits and research that had been done and we all “say oh it’s 21 days to get a new habit.” But the truth of the matter is the research showed that it could be 66 days is a good average. So I would encourage you if you want to switch to eating healthier that it’s something that you do a little bit at a time and it can take longer than you imagine. So, I’m going to have a guest on soon that’s talking about brain health and how brains form connections and how we can improve those to improve our habits. But I want to just encourage you that repeating a process So, you’ve basically taught yourself that you can you know when you’re hungry if you go get a sweet you feel rewarded. So, you’re going to have to start catching those things and then reminding yourself “Okay, what other reward can I give myself besides a sugary sweet thing?” It’s also good to have somebody to talk to you know just somebody maybe a partner that’s doing that exercise with you or knows that you’re doing it it’s hard to do it as a single person as far as if you have a family and you’re the only one following this diet then you may find it difficult. So, I encourage you to get your family to participate as well. And I don’t want you to forget that exercise is also important. You can out eat any exercise program. Trust me. But what you want to do is try to exercise just consistently because even if you just walked 30 minutes a day. Yes, it’s not going to make you lose hundreds of pounds but when you combine it just as a habit your body is healthier. You’re able to do so many more things, you get through your day a little better, you can focus better so I would just encourage you to making some changes if you want to switch to a healthier diet. Try the Mediterranean Diet. Make some changes and then you know after you kind of get those in your routine then get in a workout routine whatever you’re going to do so that you can build these habits. If you make a sudden changes a lot more difficult to stick with. So I just recommend that you consider doing you know some small changes and kind of taking a hard look at your food choices asking yourself you know “what do you do for comfort? How do you feel that? How does your body give you comfort?

Mathea Ford: [00:16:04] I found when I’ve tried different things even I’ve tried even intermittent fasting. And at that point it just when you’re doing intermittent fasting and it’s like “Okay, I’m not going to eat till noon.” One of the things you figure out is how often you eat because you really do go get that food you know in the morning maybe and then you get a mid-morning snack and then you eat lunch. So if it’s even just to the point of writing down what you’re eating so that you remind yourself how often you’re going to food may be for comfort and not from hunger then that would be a good thing for you to kind of learn about yourself. But I want to encourage you today to think about changing you know some more foods along the line of the Mediterranean Diet. It’s a plant based diet. I’ve talked a lot about plant based diets on this podcast so I hope that you found this helpful and enjoy your day.

Mathea Ford: [00:17:04] So, I really enjoyed talking to you today about the Mediterranean Diet and you know where to connect with me you, know where to find me. Just comment on my blog post or comment on my Facebook page. So thank you very much. And I hope you learned more so you can do more with nutrition in your life. Have a great week.

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Nutrition Experts Podcast Episode 39 Does Your Faith Influence Your Diet with Zach Cordell, MS, RDN

January 28, 2019 by matheaford Leave a Comment

Zach is a nutrition professor at Daytona State College, host for the Latter-day Saint Nutritionist podcast, author of The Creation Code, and public speaker.

Zach fuses food, faith and science to help nutrition education be relatable, but also personal. We all develop a culture, and faith can be a large part of the culture that defines who we are. When helping people assess their personal behaviors we often skip the role faith can have on our diets, but nothing is more personal than our food and our faith. Too often we would rather talk about a patients bowel movements than their religious beliefs. In order to help clients create lasting changes, we need to see individuals as a whole, and understanding their faith can be a way to open doors for sustainable health.

Mathea Ford: [00:00:27] Hi there! It’s Mathea. Welcome back to the Nutrition Experts Podcast. The podcast featuring nutrition experts who are leading the way using food starts today right now with our next guest. It’s great to have Zach Cordell on the show today. Zach, welcome to Nutrition Experts.

Zach Cordell: [00:00:43] Thank you very much for having me.

Mathea Ford: [00:00:45] I’m excited to have you on the show and share your expertise with my tribe. We’re going to talk about something that’s a little bit different most dietitians talk about so I want you to start by telling my listeners a little more about you and what you do.

Zach Cordell: [00:00:59] All right. So, I am a Nutrition professor. I am also a podcast host in public speaking but my full time position is to teach. So, I teach at Daytona State College in Daytona Beach, Florida. It’s a horrible location I know but it’s it’s a good place to be and I love it. But my podcast is the Latter Day Saints Nutritionist and so what I do is I mix food and faith. So, when you talked about it maybe a little bit different I think this will be a different conversation that some people have had in the past.

Mathea Ford: [00:01:32] Yes. So, what have you done besides teaching nutrition? What did you do before you became a professor?

Zach Cordell: [00:01:37] I just went straight into teaching.

Mathea Ford: [00:01:37] Oh!

Zach Cordell: [00:01:38] Yes. I got my Masters from the University Massachusetts. I did my internship at Yale New Haven Hospital in New Haven, Connecticut and then I moved down to Florida to get a little bit of sun and to teach.

Mathea Ford [00:01:52] All right. So, you mentioned you host a podcast called The Latter day Saints Nutritionist Podcast. Can you talk about why you created that podcast and what it’s about?

Zach Cordell [00:02:03] Yeah sure. So, I’m a member of the Church of Jesus Christ of Latter-Day Saints. I use the culture that people experience to discuss what is influencing their diet habits. So, most people when they think of culture they think of race or ethnicity or location but culture is just a combination of who you are because of your life experiences. Whether it’s your history your family your friends your environment all of those things influence what your culture is. And so my podcast is fusing food, faith and science and using scripture principles to just talk about how we can better understand nutrition and how we approach it.

Mathea Ford: [00:02:46] Talk a little bit about faith in nutrition. You mentioned it as far as like culture but how does faith influence a person’s diet?

Zach Cordell [00:02:55] So, you can look at it in the broad terms of if somebody is Kosher or Halal or vegetarian that can be based on very specific religious beliefs. But if you take it to the next step you can go to like soul food or linger longer is where somebody hangs out a church or like the post church Sunday brunch or your Sunday family meals. Some people don’t drink because of religious beliefs. Some people drink because of religious beliefs just depends on where you’re coming from. But all of those things are building up who you are. And my podcast isn’t just like for people that are members of my faith but people of faith. Whether that is like you go to church or you don’t. We all have beliefs that are going to influence us. So, along with Halal and Kosher, you can look at it in terms of if you believe that you have been fated an illness. Talking to someone about that is going to be a little bit different than counseling somebody that feels like they have a little bit of control over what is happening in their life right? So, if you feel that you got diabetes because of a burden or it’s a temptation or a punishment on you for some reason that’s a different conversation than just saying “Okay. So, diabetes happens and what can we do to manage it?” So, yeah food and nutrition go hand-in-hand together. But at the same time… Sorry nutrition and faith that faith is one of those things where it’s it’s becoming is taboo to talk about. And so getting into that can be a little hairy for some individuals.

Mathea Ford [00:04:33] Well, that’s very interesting because I think we try to think about what is their culture, what types of face do they typically eat. But I don’t know that you go to the next step and ask why if somebody says “I don’t drink diet soda “you say “good. Okay. Great. I don’t drink sodas.” Okay, but maybe the reason behind why they don’t do that or they don’t eat meat is more than obviously just a desire.

Zach Cordell [00:05:00] Yeah. I mean take a vegetarian for example. You can have a vegetarian that is a vegetarian because they don’t like the sustainability of our modern food system or you can have a vegetarian that is a vegetarian because they saw somebody on Instagram that they thought was really cool and they wanted to be a vegetarian like them or you can have some that’s a vegetarian because of religious beliefs. And so understanding why they are vegetarian can help you in approaching what needs to happen in order to help them to obtain optimal health.

Mathea Ford [00:05:32] So, Zach when you talked about dietitians not knowing enough for not wanting to look silly, not wanting to look like they’re not the experts. Really can you dig into that a little bit deeper and talk about what if you really don’t know or understand the faith that your client’s talking about? Or what if you don’t necessarily feel like that’s appropriate?

Zach Cordell [00:05:55] To the second question, if you feel that it’s appropriate or not I think it’s funny that we will ask people about their poop all day long.

Mathea Ford [00:06:00] Dietitians love to talk about that.

Zach Cordell [00:06:01] And we will ask them about if you’re a cystic fibrosis dietitian. You’ll ask them about whether or not they have a lot of phlegm that they’re making up and so you ask about other body fluids but you won’t ask about the religious beliefs that somebody has because you’re like “Oh no! No… no… no. That’s not okay.”

Mathea Ford [00:06:15] It’s too far.

Zach Cordell [00:06:16] Right. Yeah that’s personal. We don’t get personal but I find that nothing is more personal than somebody’s religion and because I don’t know if you’ve had arguments with people about their food. None of their arguments. But you like “Okay, it’s really not that big of a deal.” But to them you don’t touch the chocolate milk or you don’t touch a very specific food item and you didn’t realize it was a big deal.

Mathea Ford [00:06:44] Yeah that’s true. Especially with like schools or like I bought my son. He loves to drink milk. He’s 14 so he’s growing so I bought him some of the… So I bought a Fairlife milk and he is like “I’m not going to drink that!” I was like “Okay, don’t drink it.” It’s like “oh my gosh! this is so good!” And I was like “it has less sugar and more protein” but the chocolate milk thing is one of those things where I’m like it’s really not that big a deal if your kid drinks milk or chocolate milk or strawberry milk, they’re getting benefit anyway.

Zach Cordell [00:07:14] Yeah. So, to go back to the question of why should it really be that off limits. And I’m not saying that you need to go in and discuss all of their religious beliefs with them and see if you’re agreeing with them or not. It is solely to see if there is something that is part of their faith that influences how their diet influences their health. Right? So, if you go in and somebody says “I’m vegetarian because of religious beliefs” then you can say “Okay, that’s fine. Now, does that include dairy? Does that include eggs? Is it not? And if it does or not that’s fine.” You just understand where that person is coming from. Now to go back to the first question of whether or not they want to look like a fool or they they don’t know.

Mathea Ford [00:07:59] I don’t understand.

Zach Cordell [00:08:00] Yeah. I think we can all agree that there’s been a situation where somebody has said something in a counseling session and then you just kind of sit there and you know you’ve got to stone face on, you’re not trying to let anything arbitrary like “what in the world you eat like three packages of rum with two cups of manatees for breakfast? Okay. Like I didn’t see that coming.” But you can ask somebody for clarification like that’s what motivational interviewing is. Right? So, you’re asking them for information from them to help them to be able to explain to you what it is they need. And I don’t think that religion is any much any more different than any other question. I think we just have a wall that’s up saying that we shouldn’t be asking you about it. And like I said before if somebody wants to talk about it they’ll bring up that it does influence things whether it’s like the Sunday brunch, whether it’s going to be “we go to my grandmother’s house afterwards and everybody brings their specific dish. And if I don’t bring my dish then they’re going to harass me. And that doesn’t happen in my family.”

Mathea Ford [00:09:05] So, I think it’s a lot of like you said earlier in the podcast it is culture. So, even though it’s kind of in that category of religion, it is culture because we do a certain things for lots of reasons. Like when I was growing up my grandma told me potatoes and make you fat. And I know there’s plenty of people that would agree with that. But the fact of the matter is it’s it’s obviously part of a whole diet. But I had that kind of voice playing in my head for a long time and I recognized that it influenced my food. So, asking that question can help your patients even more because they may realize how it plays out in their life or how they’re using it is not necessarily congruent with where they want to go. If they want to change it may need to be from a place of being compliance with their religion or whatever. So, you can be a vegetarian but you can be all kinds of vegetarian. You can be an Oreos vegetarian or you can be one of those plant based lots of beans, lots of good vegetables and…

Zach Cordell [00:10:12] Right. And you can look at faith. It’s not just going to a church. You can have people that have a faith where they believe in and Mother Nature and all of the earth supplies for you as part of their greater good. So, it’s not just like they read a certain book and have a certain day and eat. It’s more so they have a culture and a belief system that influences how they behave.

Mathea Ford [00:10:32] Yeah. It’s their belief system. That’s a good good thing to think about as a dietitian like you’re really just trying to help them to get to where they need to go within their beliefs that they have that make it okay for them to do that.

Zach Cordell [00:10:47] Yeah. Exactly. I mean how is asking about if they have a religious belief different than asking you about if they like what or documentaries and avoid GMOs because of the different things you know. So, like food is kind of becoming a religion in some aspects.

Mathea Ford [00:11:05] How is that the best way or when is the best time to kind of approach the religious option in the therapy session? How does the flow kind of go where you and do you do it? You mentioned in a hospital you know it may tell you what their faith is based on the medical record but obviously if you’re seeing them at outpatient basis you may not have that information. So, how is it typically approached?

Zach Cordell [00:11:29] Well, so there’s a couple of things that you could do. So, if you’re doing outpatient you’re either associate with the hospital you’re doing your own private practice or you do private practice outside of the hospital. But either way you’re going to have records and you’re going to have an intake form, you’re going to ask what they’re coming in to talk to you about in. On that form when you’re asking height, weight and all the other biometrics that you’re you’re wanting to get it from that person, you can simply ask what’s their religion. And does that play any role in their diet. If they say “no religion. No, it doesn’t play a role” then you don’t necessarily need to bring it up. If they do say “yes, this is my religion and yes it does play a role” then as simple as saying “how does this influence you? Is it more so family? Is it upbringing? Is it restrictions?” And from there it doesn’t have to be this looming on “I want you to ask them about their religion.” You know it’s just more so “does this influence your health?”

Mathea Ford [00:12:31] So how? What do you say if they say “it that’s just not important.” That’s like if they put down a religion and they say you know either it influences or it doesn’t. And you ask the question then the go “why? Why does that matter?”

Zach Cordell [00:12:43] You can just tell them that culture is built up of all the experiences that we’ve had in our lives. And sometimes faith can play a role in the culture that we develop. That’s why I ask all of my patients that I’m not singling you out. It’s not to convert anybody in anything. It’s just it’s just to see if this is going to influence how we need to go about our counseling because I’m going to make this as applicable to you and relatable to you as I can.

Mathea Ford [00:13:09] That’s a good way to approach it. I think it’s faith. One of those things that you possibly advertise our market like you yourself are a Latter Day Saints. There’s people that are Catholics. Is there any anything people do that advertise or market so people feel more comfortable talking to you or do you avoid mentioning your religion altogether so people don’t feel like they can’t talk about their religion?

Zach Cordell [00:13:33] Sure. My niche market that I’m going for is the faith based community or just the cultural side of that. And so yes I’m going to put it out there. It is just something you’re going to put on your intake form. I don’t think that you need to advertise it. If it’s something that you are going to have a lot of clientele from that area say you are in the Deep South in the Bible belt and you know that that is going to play a large role in your clientele then sure you can put it in some of your marketing material but it doesn’t have to be. If you follow Islam, if you follow Judaism, if you follow Christianity these are the clients that I will see. We can have faith based conversations if that is part of the diet that they would like to discuss. So, it can be as much or as little as you want. From my experience it’s either that is who you’re targeting or it’s just part of the information that you’re getting.

Mathea Ford [00:14:27] How do a dietitian spend time learning more about religions related to because if you’re if you’re going to advise someone even though you ask them “okay. You’re vegan or vegetarian for your religion, can you tell me a little bit more about that?” You’re going to already know a little bit about a vegetarian diet but maybe some of the other religious beliefs if they don’t explain them fully, how do you learn more about them or how you might recommend better things for those types of patients who have this this concern or this belief?

Zach Cordell [00:15:00] Yes. So, I’ll actually send over some links to you that you could put in the show notes if that would be helpful for clientele in a different place or listeners so that they can know where they can listen or learn more about different faiths. If you note a blanket statement or blanket beliefs or a lot of these then it’s easy for you to just take a step back and say “okay. I understand this. I understand that. Is there any more that influences what you would do?” Because even within those that are Catholic, you have people that go to church every Sunday and those that go maybe once a month and maybe those who go Easter and Christmas. Right? So, even if they put on that paper that they do have a faith it can change on how much that is going to influence that person. But yeah like I said I can send over some links that will be good resources to the listeners.

Mathea Ford [00:15:47] Can you have success.? Obviously lots of dietitians do have success with nutrition counseling using facts based guidelines without getting into religion and beliefs.

Zach Cordell [00:15:57] Yes, you can. You do not have to incorporate faith into your conversation to have lasting behaviors. But at the same time it can open doors that other conversations may not be able to. Because like I mentioned before like food and faith are two of the most personal things to an individual. If you are going to open the door of food and talk about the things that their mother made that maybe that weren’t the healthiest for them or you’re going to talk about how this can affect the diabetes or the renal failure that they have then approaching it from the religious standpoint to say like “I understand you as a whole person. I’m not just treating you as a piece of paper or a patient but I’m treating you as a person” and understanding that person as a whole can help you to have a more lasting impact on that person. You don’t have to discuss religion if you’re if you’re really taken aback by those conversations or are really worried about it. You don’t need to but it is another tool in your toolbox that you can use to best help your clientele.

Mathea Ford [00:17:02] Yeah. I think the simple question of “does your faith influence what you eat?” Getting that answer because you can make recommendations to people and they can agree to them there in your face but they may never plan to implement them if they don’t have that belief at that. How do you think about our listeners are people that are dietitians, doctors, nurses and just regular everyday people. How does how is this information that we talked about today great to be used by listeners in their day to day life? What are some recommendations you might have?

Zach Cordell [00:17:35] Yes. So, I think to take it a step back so I’m not just this radical coming at you talking about how you should talk about food and faith. In the research community, there is a lot of research that comes up using congregations to provide nutrition education and that’s because you’re finding a gatekeeper to a community. So, if you’re a community dietitian most of you’ve been aware of community programs that use houses of faith to reach people in a way where they already have built in networks of some of a support group and you can present the information in a way that is very applicable to them. It’s not a new thing to discuss or to use the the method of religion to discuss food. So, I just want to make sure that that I brought that up. But if you are a doctor, just talking about religion with somebody again doesn’t have to be a big ticket item. It can be mentioned in passing and if they want to bring it up and talk about a little bit further they can. But you don’t have to sit down and say “okay. So, when were you baptized? Okay. How long has it been since you’ve been converted? Are there any others like you?” You don’t have to get into all of those deeper questions of theology saying “Okay. Were you a trinity person or are you a God?” Like it doesn’t like those things aren’t what’s important. And as a practitioner, you don’t need to put your personal beliefs on that other person like this is not a time to judge. Just like whenever somebody comes in and is looking for weight loss. You don’t sit there and say “wow! I can’t believe that you’re eating this, this and this! Don’t you know?” Like you’re there to be a support group for that person, an educator, someone there that is on their team that is cheering them on to succeed. This is just gathering information for them. But to use it in their day to day life it’s just as simple as dietitians that are now starting to do the physical examinations. They sit down with a patient. It might seem weird at first whenever you’re grabbing their hands, you’re touching their legs, you like seeing what’s going on with their faces if there’s any scooping but it’s just one of the tools that you use to assist in providing the best care you can for that patient.

Mathea Ford [00:19:55] That was always in my mind a couple minutes ago I was trying to think of but the fight about using the congregations, I was thinking if you really get to where you do understand a religion or you do connect to that religion or even just a person or a couple people that come to you. That’s an excellent opportunity to do a class with maybe that church you know couple of people, you get connected with their pastor or whatever their religious head of church is and connect with them and say “hey! I’d like to possibly do a weight loss class or whatever the particular thing that seems to be popular with.” And a great way to do some outreach you know you could even possibly charge a little bit for that class but you understanding that and knowing kind of some of their beliefs but just like you mentioned too there’s a lot of people that are at different ends of the spectrum. I remember when I worked in hospitals. I worked in hospitals for a long time and every year for Lent we would always do fish on Fridays and that was for everybody regardless whether you were Catholic or not. But at that time there was a large proportion of the hospitals that I worked in that were Catholic. So, it was important to have that fish option on Friday so that they would be able to find something that they wanted to eat. And that’s a way that I did it. Even I didn’t even really think about it. I did take into account that religious preference.

[00:21:30] That’s the other part of it. You may not have realized it in other employees that weren’t Catholic, might not have even thought of you think of it but for the people that were Catholic that meant a lot to them because it meant that they were understood and they were appreciated and their beliefs were validated in other people. Where they say I understand that this is important to you so it’s important to me that I might not hold the same beliefs but I understand that this plays a vital role in who you are as a person.

Mathea Ford [00:21:57] So, I want to ask you a question I always ask my peeps on the end of my podcast. I want you to tell me what’s your favorite food?

Zach Cordell [00:22:08] Lately for me, I think it’s been like chia seeds Greek yogurt. I really like tapioca pudding because of the texture of it and the chia seeds that have more protein, more fiber to it. I mean like there’s less saturated fat in those things less sugar. But it’s still got the same texture. So, maybe like a chia seeds Greek yogurt.

Mathea Ford [00:22:25] So, how do you soak the chia seeds and add them to the Greek yogurt. How did you do that?

Zach Cordell [00:22:29] Yeah. So, I literally just put the chia seeds into my yogurt and then I mix it up. Let it sit for a minute because it’ll soak up the fluid that’s in there and that’s it. I’m pretty simplistic in my approach.

Mathea Ford [00:22:43] I might have to try that. That doesn’t sound too bad.

Zach Cordell [00:22:45] Yeah. If you like tapioca pudding rice pudding like those types of textures then yeah give it a try.

Mathea Ford [00:22:51] So, Zach thank you so much for being on the podcast today. It was a pleasure to have you on the show. I know my listeners have learned a lot about how to approach faith and nutrition counselling and how it can be just a simple easy thing to do. So, if listeners want to connect with you what’s the best way to do that?

Zach Cordell [00:23:09] So, they can check me out on my website. It’s called CordellNutrition.com. I’m on social media both Facebook and Instagram @ZachCordellRDN.

Mathea Ford [00:23:19] And you have a podcast?

Zach Cordell [00:23:22] I do have a podcast. That’s a Latter Day Saint Nutritionist Podcast. That’s going to be in Stitcher, in Google Play store, in a Cast Box and iTunes. Basically anywhere that you’ll get a podcast. Wherever you’re listening to the great Nutrition Experts Podcast, you can probably find the Latter Day Saint Nutritionist Podcast.

Mathea Ford [00:23:36] All right! Well guys this has been another great episode of the Nutrition Experts Podcast. The podcast that is all about learning more so you can do more with nutrition in your life.

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Nutrition Experts Podcast Episode 38 Eating Disorders and Sports Nutrition with Amy Goldsmith, RDN, LDN

January 21, 2019 by matheaford Leave a Comment

Amy Goldsmith RDN, LDN (Founder and CEO)Founded Kindred Nutrition in 2010. She became a dietitian in 1999 and although she has worked with many realms of Medical Nutrition Therapy, specializes in Eating Disorders, Digestive Health, and Sports Nutrition. Amy’s specialty in Eating Disorders initiated the HOPE Consortium, helping people with Eating Disorders, which she co-founded with Dr. Albertson. Amy focuses on meeting all her clients where they currently are and focusing on education, re-framing the mind, and using food as fuel for your brain and body. She believes there is a strong connection between the gut and brain and focuses on both with all clients. In addition, as a sports nutritionist and dietitian Amy assists with getting the client to peak performance by incorporating optimal nutrition before, during training, race time, and recovery. Amy also enjoys speaking to many teams in the community such as FOX Swim Club, MAC Swim Club, Hood College Athletics, Mount Saint Mary’s Athletic Teams, Odin Crossfit, and more.

Amy has been featured in multiple media outlets and works directly with Frederick County Schools, Montgomery County Schools, Run Farther and Faster, The Frederick Steeplechasers, Odin Crossfit, Anytime Fitness, Multiple Swim Clubs & Division 1 Collegiate Athletes throughout the United States.

Amy is routinely quoted in the Frederick News Post, has been quoted in SHAPE Magazine and My Fitness Pal forums, and written articles for Frederick Child’s Magazine. She has been interviewed live through Frederick Advice Givers and WUSA-TV.

In her spare time Amy enjoys spending time with her husband, two children, and Portuguese Water Dog and Crossfitting, hiking, cooking, and just plain relaxing.

Mathea Ford: [00:00:26] Hi there! It’s Mathea. Welcome back to the Nutrition Experts Podcast. The podcast featuring nutrition experts who are leading the way using food starts today right now with our next guest. It’s great to have Amy Goldsmith on the show today. Amy, welcome to Nutrition Experts.

Amy Goldsmith: [00:00:54] Thanks so much for having me.

Mathea Ford: [00:00:26] I’m excited to have you on the show and share your expertise with my tribe. So, tell my listeners a little bit more about your expertise what you do.

Amy Goldsmith: [00:00:54] Okay. I have been a dietitian for 20 years and about 10 years ago I open to Kindred Nutrition which is a private practice. We specialize in eating disorders treatments, sports nutrition and G.I. health. We also focus on community outreach. And recently I accepted a position on the board of directors with the Maryland American Nutrition and Dietetics as a Consumer Protection Coordinator.

Mathea Ford [00:01:22] Wow! So, that is a lot of stuff. So, you mentioned that you help with eating disorders, sports nutrition, kind of what’s the biggest issue you you usually find your patients need you to help them work on?

Amy Goldsmith [00:01:33] Lots of times, unfortunately, I feel like patients are coming to my practice as a last resort. There’s lots of information out on the website or some quick fixes that are sold. And after trying and not getting the results that they want, clients will come to me for some evidence based help. I really start working with them on the acceptance of their current state of mind putting appropriate goal setting in place providing education and then focusing on accountability.

Mathea Ford [00:02:09] So, regardless of what their problem is you kind of help them get a better understanding of their issues and then like a path that you help them walk down?

Amy Goldsmith [00:02:18] Yes. I feel like it’s really important to help my patients have the right mindset. So, we work on that first and then we focus on the education and then the goal setting.

Mathea Ford [00:02:30] So, you also mentioned eating disorders and their treatment. Can you talk about maybe our audience doesn’t necessarily know exactly what an eating disorder is or what might cause them. Can you talk a little bit about what those are? what you see in your practice and where they come from?

Amy Goldsmith [00:02:47] Sure! There is not a lot of research that can pinpoint exactly what an eating disorder is from but there’s some research that shows there is a genetic predisposition to mental health such as anxiety or depression or OCD and the eating disorder can concur with that and be used as a need to cope or find a way to believe they can control something. I see in my practice too that there’s environmental triggers that can kind of lead to a eating disorder as well. Sometimes depending on the environment my clients feel so out of control. When they start to focus on the black and white it’s a little bit easier for them to distract themselves from that emotion and really say “Okay, let’s make some rules I’m going to eat this amount of calories. I’m good today, I’m bad today” and etc.

Mathea Ford [00:03:36] So, what typical eating disorders do you see?

Amy Goldsmith [00:03:40] So, I would say the typical eating disorders that we see here is Anorexia Nervosa which is more restriction over exercise, we see Binge Eating Disorder and Bulimia Nervosa. We are also starting to see a rise in Orthorexia as well.

Mathea Ford [00:03:57] What is Orthorexia?

Amy Goldsmith [00:03:59] So, Orthorexia is obsession with wanting to eat specific types of food. So, it’s similar to anorexia with restriction and maybe over exercising. But it is that particular individual wants to be very aware of everything that goes in their mouth. I don’t like to pinpoint any. The cause of eating disorders of anything specific. But I would say it’s similar to the person that you might know who will only eat clean or will not have any added sugar or you know they make rules and if they can’t follow that it completely disrupts their day.

Mathea Ford [00:04:40] What are some signs that someone might have an eating disorder or that a professional… Well, we have some dietitians, doctors, nurses that listen to the podcast. What signs would a professional see to indicate that that might be an eating disorder?

Amy Goldsmith [00:04:57] That’s a great question. It’s hard because I think a lot of the colleagues that I work with we’re lucky from a dietitian end because we get 45 minutes to an hour to spend with our clients and we’re trained to motivational interview. So, I think that’s an obstacle sometimes for some of our colleagues since we are really in and out you know in 10 to 15 minutes. So, unfortunately one of the only signs that physicians may see is a change in weight or a change in labs. But you are motivationally interviewing someone you can kind of determine if they are skipping dinner, if they are focusing on healthy eating like in an excessive way, if they are isolating themselves from family and maybe starting to make their own meals, not eating with others or leaving during meals to use the bathroom for example. So, I feel like it’s hard to determine if somebody has a eating disorder if you’re not trained to take the time to really be investigative of that relationship with food.

Mathea Ford [00:06:04] Yeah and I think by the time the weight loss shows or those signs that would be more evident it’s gone on for a while because I think people tend to be able to hide these fairly for a while.

Amy Goldsmith [00:06:18] Absolutely and I would say you know with some of the eating disorders we don’t see weight loss. And so if you’re trained in kind of that black and white thinking it’s easy to say well they’re stable so it’s tricky.

Mathea Ford [00:06:31] Do you usually see eating disorders for women because I know that’s a pretty typical thought that I’ve heard or is it equal men and women? What about athletes or young or old? What type of person is most likely you think?

Amy Goldsmith [00:06:42] I first actually started to train more with eating disorders because I work so much with athletes and I was absolutely in my younger years and early on in training I was absolutely shocked at how many athletes had disordered eating. But as I worked with athletes you know it kind of made sense to me because there’s such pressure on performance. And if you think about it even in the media you hear people say you know that you have to be a certain race weight. Runners have to be a certain race weight or wrestlers have to be a certain weight. I mean we have football players weighing in before season and high jumpers have to weigh in so they’re using the correct pole. So, it surrounds that athletic field. But I would say you know when it comes to my practice, there is a higher percentage of women but I see both males and females and all ages. Matter of fact, one of the things that’s been a little bit troubling is that I’m starting to see disorders at a very young age. So, I have lots of eight, nine year olds and that’s really been a change that I’ve had to get used to.

Mathea Ford [00:07:54] So, would you say with the younger crowd, does it kind of seem to start with picky eating and then go from there? Or is it the athletic stuff they’re trying to do better with that?

Amy Goldsmith [00:08:05] I feel like it’s a perfect storm with the younger kids which is…

Mathea Ford [00:08:10] Social media.

Amy Goldsmith [00:08:13] Right. Social media. You know my clients of eating disorders are very very smart, high achievers and it could be one little trigger that starts a eating disorder. So, maybe it’s maybe that child was bullied believe it or not and they weren’t able to talk to anybody about it and they felt so out of control because of the way that’s making them feel. They start to focus on what they’re putting in their mouths subconsciously but then they lose weight and people are giving them positive feedback. It could be believe it or not this is something that I’ve really tried to get a grasp on but health class believe it or not. If you have a child who is type A and maybe a little bit obsessive compulsive. Imagine what they process when they hear in their health class “if you eat sugar or you’re going to get cancer.” It’s very very scary to the individual and it may make them want to really change their eating patterns. And the picky eater as well, I think the longer picky eating goes on I think it really creates a lot of fear with trying new foods. It’s not necessarily that they have a issue with body image but they just become so fearful from food they can’t move forward.

Mathea Ford [00:09:28] So, I was kind of surprised the first time when I went with my daughter she’s 13 and we went to the doctor and she was mentioning her height and weight chart because it was her annual exam and she was telling her she’s gaining a little too much weight. I was just like “let’s not focus on the weight, let’s focus on activity. We’ve decreased activity so we need to do a little more activity and obviously the eating choices can be better.” I also know that weight her weight fluctuates. I mean so I was kind of disappointed to hear the doctor says like “uh! You just put weight into your her head as an issue.”

Amy Goldsmith [00:10:07] I know and I feel like there’s been such a high intensity training for physicians as you have to identify childhood obesity and we need to squash this. So, you know when there’s pressure like that I think it does kind of create this checklist right.? So, they do the weight, they do the height, they check the BMI. Oh! BMI is too high. But BMI is not the best indicator. It doesn’t take muscle mass into consideration. They didn’t really o enough to really look at children from you know as far as a BMI standard. So, there needs to be a little bit more questions that are asked when they look at weight. Plus lots of times as our kids grow in height. We expect the weight to follow. And I think sometimes that’s forgotten.

Mathea Ford [00:10:54] Yeah. Yeah it’s still very. At 13 still very transitional weight, height time. So, is there any tips or thoughts that you might give other dietitians to help someone who they were just in the way we talk to people to help with addressing kind of that issue if that makes any sense?

Amy Goldsmith [00:11:17] Yeah. That makes a lot of sense. One of my best friends is a dietitian. We met at our first job and cracks me up because she says “Amy, my gosh I see more eating disorders in my practice than I would like to. Right?” And she says “but lots of times it’s confusing because they come to me for weight loss or you know something like constipation or something” and she really will dig down and ask lots of questions but she really doesn’t feel comfortable working with eating disorders. And I try to normalize that and say “yeah. That’s you know I’m not the best with diabetes. Right? Like I’m not up to date on the newest insulin pumps and glucose testing and that sort of thing.” So, she’s gotten to a place where she assesses for the eating disorder. She normalizes it you know and has a pretty good try where she is. So, she says “you know I don’t really think that you have the best relationship with food. I have a great colleague that I think you may be able to work with and you know I am not abandoning you but this would be somebody else I could work on our team.” So she’s not afraid to refer that patient out. And I think sometimes when dietitians are younger and you know they kind of would see that as failure you know if they were. But we all have a specialty. That’s why there’s so many of us. And it’s okay to say “I hear where you are. I hear what you’re saying to me. I’m not the most comfortable with it. It’s my job to get you the help you need. Here’s my recommendation. ”

Mathea Ford [00:12:51] Yeah. I love that because like I’m a specialist in kidney disease, renal nutrition. So, I don’t know a lot about cancer and I have friends who get cancer and they’ll say “What should I eat?” And I say “you should find a cancer dietitian at the cancer center because I have general knowledge” but so I think that’s an excellent point that it’s not a problem to refer somebody especially if you’re helping them. And we have in Oklahoma we have a little group on Facebook that’s just our RDs in the state. And we kind of go in there and I’ll see things people Pediatric dietitian who takes our state sooner care you know for a failure to thrive in Tulsa for example. So they’re trying to find someone to help those people. So, if you have that resource in your area you don’t have it and you want to start building one. I would recommend that because it is the new. Like you said you know somebody and you know that they’re going to help. So they have a specialty. So, talking about consumers a little bit you mentioned you’re going to be the Consumer Protection person for the Maryland… Is it you’re having an Academy of Nutrition and Dietetics?

Amy Goldsmith [00:14:04] Yes I am.

Mathea Ford [00:14:04] Yeah. So, talk about being a better consumer, what does that mean?

Amy Goldsmith [00:14:10] We live in such a different time. I’ve been a dietitian for 20 years. So, it was very very different when I became a dietitian and I feel like nowadays you can go on just the computer and Yahoo and Google or you know they have ads running based off of your search engines. Joyce cracks me up because I’m a dietitian and don’t try to sell me you know your magic pill.

Mathea Ford [00:14:32] We have fake Dr. Google.

Amy Goldsmith [00:14:37] Right. But you know we also I would say obesity has risen and there’s a lot of attention paid to health but the nutrition or the pharmaceutical business is a multi-billion dollar business. Their goal is to make profits. And I hate to simplify it like that but it’s true. And they market to the consumer who is desperate or frustrated or sad and they make it a little bit more affordable price because they can get the volume. So, that’s one of the things that I hear a lot is if I don’t take someone’s insurance yes it is a discretionary fund to spend to see a dietitian. And it’s not going to be as cheap as someone’s shakes or some of the you know even the medication that some of the physicians are prescribing. But that’s because there’s a lot of investigative work and it’s individualized. Right? So, these numerous pharmaceuticals they can they can sell something for $19.99 because they’re going to sell it to millions of people. Also I feel like we’re in this new era which I’m really trying to calm myself down a little bit. There are a lot of people who really do get into nutrition. Athletes, you know they really do notice that they have a change of performance when they eat right. Women who have lost a certain amount of weight doing something specific. We’ve even got some pyramid schemes that go on that boast their individual experience. That experience does not give somebody the credentialing to be able to really determine what an individual needs to lose weight. And I know that lots of times people say calories in versus calories out that equals weight loss. I’m here to tell you that’s not necessarily the truth. There’s a lot that goes into weight loss which is why dietitians have to take biochemistry, organic chemistry, anatomy and physiology on and on.

Mathea Ford [00:16:42] So, how can people be a little bit better consumers related to food?

Amy Goldsmith [00:16:47] I feel like if they have an understanding of marketing. If there’s a particular food that’s marketing success, see if there’s a research behind it. And if there’s any research behind it, see who paid for that research to make sure that it’s not biased. I also think that if you’re going to someone who is going to be your nutrition coach or your life coach or nutritionist, even do a little bit more research to see what experience they have. I feel like I’m a great mom but I’m not going to start a business telling everybody how to be a parent. I just think it’s really important to see where that person got their education.

Mathea Ford [00:17:26] How can people be harmed by or not helped by talking to someone who is not necessarily trained but just kind of have this experience of either being part of a multi-level nutrition marketing scheme or even have gone to some some training but not or lost weight. And like you said you’re a great mom but you’re not going to necessarily write books and coach people of being mom, how to be a mom. So, how can how does that affect people what’s the harm in that?

Amy Goldsmith [00:18:01] Well, lots of times some of the programs will have people restrict a completely… A complete group of food so either restrict grains completely I’m just using as an example or cut them and we know as dietitians that there is a better affects the biochemistry within the body and also affects your lean muscle tissue versus your fat muscle tissue which affects your metabolism so you may see the quick fix and the weight loss but long term you may be increasing your fat mass which is more dangerous to your heart health. You may be decreasing your muscle mass which will affect your metabolism in a negative way. You might be you’re removing an entire food group. So, if you’re not checking your labs and that sort of thing you may be creating a deficiency within your body. So, it’s not a one size fits all. You know it’s the same thing with lots of times I work with vegetarians. Vegetarians who are athletes and I’m not against it and I meet all my clients where they are. But every vegetarian should be checked to see if they have an iron deficiency. And they have to go to the right person who knows how to assess that to improve their quality of life and their health.

Mathea Ford [00:19:16] So, I know it’s dietitians were often trained to do some physical exam assessment to look for those nutrition deficiencies. And I think that’s something that when we look at somebody we’re taking into account all their whatever you’d call it comorbid conditions. Maybe they have diabetes and they’re taking insulin and all of a sudden you tell him to not eat grain or flour products. You know that’s a pretty significant change that someone who may have lost weight and doesn’t have those issues may not recognize that the diabetes, the insulin is going to get them too low and they could potentially have a little blood sugar which hypoglycemia which could be very bad.

Amy Goldsmith [00:20:01] Absolutely! We’re trained to look at the whole body. I always tell my clients we’re trained to look at the body from the moment something hits your tongue until it comes out of your body and everything that goes along with that. Which I think is unique.

Mathea Ford [00:20:15] Yeah. I just think people want that quick fix and it can be more expensive to see a dietitian. It can take longer to see results. So, I think that’s what’s hard for consumers because they’re so used to that quick fix and they see these beautiful sculpted bodies on Instagram and they say “I took the supplement. You can too.” So, I was watching this past December the Heisman Trophy win by Kyler Murray who is from Oklahoma and he mentioned the nutrition staff as being part of the reason why he was so successful. And I’m not I was so appreciative of that because I know they have a dietitian and I am so excited that a lot of the colleges are starting to utilize dietitians and realize that like you mentioned they can get eating disorders, they can get other issues, they have dietitians teaching them in all the sports not just football. I’ve talked to the Oklahoma dietitian and she helps with golf. She helps with women’s softball, she helps with baseball. She makes sure they’re hydrated. You know she gets kind of ready and and she also manages their training table you know what they eat. I think that’s great that colleges are starting to recognize that it’s a performance improvement when you have a dietitian helping you with sports nutrition. So, can you talk about kind of what you do with athletes besides the eating disorders that help them with sports nutrition?

Amy Goldsmith [00:21:47] Yes. So, sports interest and they’re really fun because they’re so motivated and they have pretty specific goals usually and you know I think by the time people are athletic. The goals aren’t completely unattainable so they’re pretty realistic which is me. I think a lot of people are surprised with how much nutrition can help performance or recovery because I often think about you know I’m in my 40s and we don’t really talk about nutrition at all as it’s related to performance. So, I assess people’s needs based off of you know their general and the metrics I get but then also really really dig down to their activity which is fun for me I love to do that. And then even break it down even more into “Okay. This is what your needs are. But we can even focus on timing of the meals so you know if you eat this particular food half an hour before you start this activity you’re going to get energy for this long and then within 30 minutes after your activity let’s recover and we look at really key things. So, how do you feel 10 minutes into the workout, 20 minutes into the workout, 45 minutes into the work out, how do your muscles feel? Like are you seeing a decrease in your delayed onset of muscle pain and that sort of thing. So and then I always tell my athletes you know you train for an event so we don’t expect nutrition to be 100 percent correct. Like the prescription that we’re putting in place, you have to train for your nutrition.” But I would say I mean all of my clients are always shocked once they hit that right nutrition kind of prescription and it’s so fun like the Marine Corps Marathon is here every year and my phone is going off like you want to believe with text messages from my clients “Oh my gosh! I got a PR! I felt great! I was hydrated and what’s better than that?” So full!

Mathea Ford [00:23:53] It’s towards the end of January when this is airing. Most people have new year’s resolutions and may have given them up by now but any ideas or tips related to exercise and nutrition to keep from overdoing it and kind of staying the course if you’re like “Okay, I gave up but maybe I could start back in a more reasonable manner?”

Amy Goldsmith [00:24:12] One of the phrases that I always say that I think initially might turn people off is “you can’t exercise a bad diet. You can’t out exercise a bad diet.” So, you know oddly enough people always say to me “are you gearing up for January? You must be really busy.” It’s our slowest month at Kindred Nutrition. I mean everybody’s joining in their gyms and starting their shakes and that sort of thing. April’s our busiest month because by then everybody’s kind of decide that they want to take a new route. You know your goals have to be realistic. I do think there’s something about starting a new year and being positive and I’m going to make this this year great but you don’t have to make the year great by telling yourself you’re going to get up at 5:00 in the morning five days a week to exercise for 45 minutes. If it’s not something that fits in your lifestyle. And also I’m a huge promoter of physical activity but I look at physical activity more as a endorphin producer, stress reducer. You know 45 minutes working out is great but if you’re not eating the right way it’s not enough to help you lose weight and get to that magic number that you’re looking for if that makes sense. So, I’m a fan of SMART Goal I know that’s really really helped with our clients here and we actually even have a sheet. SMART Goal stands for a specific goal that’s measurable that’s attainable and realistic. And then it has a time expectation.

Mathea Ford [00:25:46] Thinking about setting goals and just being reasonable. I also know that we just mentioned people want quick fix. Exercise does take time to kind of see the change. So, does a diet a little bit. But I think you can see it a little quicker with a diet. Maybe you got burned out because you were sore after two weeks of working out every day for 45 minutes and be a little more reasonable find that good place. I know a lot of times we can’t see the benefit of exercise till all of a sudden we stop for like a week on vacation and we’re like “oh my gosh!”

Amy Goldsmith [00:26:19] That’s so true! Coming back to being active after being on vacation. You’re right. That’s a good way to positively reframe it like “wow! I wasn’t in a better shape.” Well, the positive thing about that is you do have muscle memory and you can build a back up.

Mathea Ford [00:26:38] I think that’s absolutely true. You don’t have to give up and fall off the wagon and not get back on it. So, Amy my favorite question to ask everybody is what’s your favorite food? Since we didn’t talk a ton about food but I’d love to hear what you love to eat.

Amy Goldsmith [00:26:51] Okay. So, even though I’m a dietitian my favorite food believe it or not is chicken wings with really good blue cheese and spicy hot and spicy.

Mathea Ford [00:27:03] Yeah! It doesn’t matter that your dietitian. I used to when I was in the army I would be in the grocery store in the commissary on post and I’d be shopping and people come into my cart. “What are you buying?”

Amy Goldsmith [00:27:22] Oh Frederick is a small town that happens to me sometimes in the grocery store it’s funny.

Mathea Ford [00:27:23] Yeah. So, Amy thank you so much for being on the podcast today. It was a pleasure to have you on the show. I know my listeners learned a lot about just eating disorders and sports nutrition kind of dealing with that. So, if listeners want to connect with you what’s the best way to do that?

Amy Goldsmith [00:27:38] We have a website www.kindrednutrition.com and we also are on social media and Instagram we’re @kindrednutritionreel and Facebook Kindred Nutrition.

Mathea Ford [00:27:54] Great! Well, guys this has been another great episode of the Nutrition Experts Podcast. The podcast that it’s all about learning more so you can do more with nutrition in your life.

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Nutrition Experts Podcast Episode 37 Elimination Diets Explained with Patsy Catsos, MS, DN, LD

January 14, 2019 by matheaford Leave a Comment

Patsy Catsos, MS, RDN, LD began using the FODMAP approach with her Portland, Maine, patients in 2007. The 8-step program in her book, The IBS Elimination Diet and Cookbook, introduced consumers and health care providers around the globe to the power of the FODMAP elimination diet. Patsy happily divides her time between caring for her own patients, developing new recipes, keeping tabs on the latest digestive health research, and teaching other health care providers how to get great results for their IBS patients.

Mathea Ford: [00:00:27] Hey there! It’s Mathea. Welcome back to the Nutrition Experts Podcast. The podcast featuring nutrition experts who are leading the way using food starts today right now with our next guest. It’s great to have Patsy Catsos on the show today. She is an author of an excellent book called The IBS Elimination Diet and Cookbook available wherever books are sold. And Patsy I want to welcome you to Nutrition Experts.

Patsy Catsos: [00:00:54] Well, thank you for having me on the show.

Mathea Ford: [00:00:56] I’m excited to have you on the show I want to talk about this IBS. We’ve gotten into it and a couple other episodes of my podcast with with other guests. And I really want to get into some more detail with you. So, tell my listeners a little more about you and what you do.

Patsy Catsos: [00:01:13] Okay. Well, I’m a Registered Dietitian in private practice in Portland, Maine where I see patients three days a week and at the beginning of my time in private practice I was mostly helping patients with more general nutrition problems like helping them reduce their cholesterol or manage their high blood pressure. But about 10 years ago I learned about a special diet that can really help people with irritable bowel syndrome. And when I found out how effective that was, I was really excited and that led me to eventually write my book. But also I’ve been helping patients ever since with gastrointestinal problems. So, that’s really become the focus of my practice over the years.

Mathea Ford: [00:01:58] So, Patsy what is the biggest issue that you would say that you help your patients work on?

Patsy Catsos: [00:02:04] You know there’s lots of general advice for people out on the Internet. Many books many websites and so on, lots of Facebook groups but helping people find a really individualized diet or you know selection of foods that work for them specifically is what I help the most with.

Mathea Ford: [00:02:26] What sorts of symptoms are they experiencing? What is it about their condition that they come to you to talk about?

Patsy Catsos: [00:02:32] So, gastrointestinal symptoms can include abdominal pain. I would say that right up there as the primary complaint that most of my patients have. They can also experience excess gas and bloating. They may have diarrhea or constipation or both. And those symptoms can be very general. They can be related to a number of different problems.

Mathea Ford: [00:02:58] So, how do you help people figure out if it’s something more than just the stress they’re experiencing you know eating too much fast food, having too much weight all those things can cause those types of symptoms that you talked about. How do you help people to figure out if there’s a deeper cause to that?

Mathea Ford: [00:03:18] Well, hopefully they’re working with their primary care provider or a gastroenterologist to evaluate those symptoms. Dietitians don’t diagnose people with medical problems right? We diagnose them with nutrition problems. But if a patient were to approach me first for help with their GI complaints and told me about any alarming symptoms like passing blood in their stool for example or having a fever in conjunction with their bouts of GI symptoms if they reported to me and the abnormal lab values they had that I thought might suggest a problem with absorption of nutrients. Those kinds of things would cause me to refer the patient back to their doctor to get a really good evaluation and diagnosis. So, the ideal scenario for me as a dietitian working with the patient if they’ve already been through that process.

Mathea Ford: [00:04:15] Can you talk a little bit about what is an elimination diet and how it’s used with IBS or other gastrointestinal issues?

Patsy Catsos: [00:04:22] There are a number of different elimination diet out there. They should have a really pretty clear theme or plan and they typically have three steps. First of all, the patient or the client eliminates all the foods that might be suspected of causing the problem. And then the second step they reintroduce the foods in a logical way to try to narrow the problem down to only the foods that can be proven to trigger the problem again. And then third, moving on from there to a modified diet that the person can live with over the long term that will both support good nutrition and help them manage their symptoms and feel great. That’s my goal for my patients.

Mathea Ford: [00:05:13] What are the different things that people might call whatever they have or how they’re picking their elimination diet? Does that matter based on what they’re diagnosed with?

Patsy Catsos: [00:05:24] Well a lot of the patients that I see irritable bowel syndrome that is considered a functional disorder. Which means that your guts aren’t functioning right. Even though you don’t seem to have an actual medical problem that would explain it. Many of the patients that I work with have that as a diagnosis but people who have other G.I. problems like inflammatory bowel disease. In other words Crohn’s or colitis have very much the same symptoms and we can often use diet to help them manage their symptoms which is awesome even if they have another diagnosis. I also work with patients who have celiac disease and who have been on a gluten free diet for a long time but they still have some of those symptoms that I mentioned. Patients with other GI complaints like reflux or GERD or diverticulitis or there’s quite a long list of potential problems. I can often help them with those as well.

Mathea Ford: [00:06:25] So, let’s talk about foods because I think obviously it’s dietitians we talk a lot about guts and stuff but sometimes we forget that where it all comes from is the food we put in our mouth. So, what are some of the top foods that seem to create this bloating feeling or diarrhea or even constipation?

Patsy Catsos: [00:06:45] Okay. This was a big surprise to me. You know when I first started learning about FODMAPs. Some of the foods I’m going to mention are really healthy foods. And so I just want to say that I’m not suggesting they are bad foods in any way shape or form but some of the foods that we actually try to eat to improve our diets can actually increase G.I. symptoms. And I’m thinking of things like milk products, fruit on certain fruits like apples and watermelon are especially problematic. But just large servings of fruit in general are difficult for some people to handle. You know some vegetables like cauliflower and broccoli and mushrooms and they are very healthy but if you eat a whole plateful of them for dinner you might regret it later on or even the next morning. Certain whole grains that would normally be healthy choices could be really troublesome for people with irritable bowel syndrome for that particular wheat richh products and even things like nuts and seeds that are really healthy for us now, in a small portion like a handful at a time could cause GI distress if you overdo it.

Mathea Ford: [00:08:02] You mentioned the word fried map and I mentioned it earlier too. So, tell us what does that mean? What is it that if fad map diet is and what does it do?

Patsy Catsos: [00:08:12] Okay. So, the theme that ties all those foods I just mentioned together is the fact that they have a lot of FODMAPs in them. And FODMAP is an acronym and I usually tell people it stands for a bunch of jargon that is referring basically to a group of certain sugars and certain fibers in food that can cause GI distress and they can do that because they have a few things in common. FODMAPs are the favorite foods of the normal gut bacteria that we all have. And so if they’re too much of them available for the gut bacteria they will ferment them too rapidly or too much and fermentation. It sounds like a little bit of a scary word but it’s actually a really normal part of human physiology so we don’t want to get rid of it altogether. But again if it’s too rapid or too much it can cause your intestines to you know I guess blow up a little bit like a balloon and that can be a very painful sensation. The other thing that these FODMAPs have in common is that they can sometimes pull too much extra water into the gut and that can promote loose stools or diarrhea and sometimes some pretty significant urgency to get to the toilet. A couple other interesting things about FODMAPs, they have a cumulative effect. That means that it’s the FODMAPs from all the different foods that we eat that can kind of add up to affect us if we eat too much of them in too short a time like in a single meal. That is one reason that we learn more if we take kind of a big picture overview and use a process like an elimination diet to stop eating all the high FODMAP foods for a few weeks. That can often be a more effective way to learn than if we tried eliminating just one suspect food at a time. That’s really the main reason for using the process.

Mathea Ford: [00:10:16] So, how do you do that? So, basically you give them a list of all the FODMAP food once you’ve determined that or you’ve been referred because they have IBS not necessarily Crohn’s or colitis or anything like that? What are your steps that you do with patients?

Patsy Catsos: [00:10:35] I’m glad you brought that up. There is a little bit of a determination process there at the beginning. The first thing I do actually is to make sure the person’s a good candidate for this type of approach. Not everybody can do an elimination diet safely or easily. So, I like to make sure the person does an appropriate diagnosis and that it looks like they actually are consuming FODMAPs on somewhat of a regular basis because if they’re already eating nothing but chicken and rice and they’re still symptomatic there’s really nowhere, no room for improvement. But if they seem to be a good candidate for the diet, I first do give them a list of low FODMAP foods and I ask them to stick as closely as they can to that list for a few weeks or until our next visit. If they seem to be a good candidate for the diet, I ask them to eat only low FODMAP foods for a few weeks and ideally they’re going to feel much better and that improvement can start almost immediately but usually within two or three weeks they’re going to know the answer to the question. Our FODMAPs part of my problem. And then they come back for a second visit typically. And at that point I asked them to begin reintroducing FOD MAPs so that we can find out more specifically what the triggers are for them. Because some people are more sensitive to some FODMAPs than others. We don’t want to have to limit anything that isn’t really making a difference.

Mathea Ford: [00:12:11] What is kind of the research behind or the data behind where they found out about FODMAPs?

Patsy Catsos: [00:12:19] The individual parts of this map idea have been known for a long time. For example, lactose intolerance is an old idea right and everybody knows what happens if you eat too many beans you’re going to be gassy and have a little GI distress. So, what was really new here was around 2000 a group of researchers at Monash University in Australia realised that some of these foods that cause GI distress probably have some things in common. They decided to create this acronym to describe them FODMAP and really it’s looking more at the forest than the trees. Looking at at the big picture here. And that’s where the idea came from. And when they began to try this in the research setting with patients they found that up to 80 or even 85 percent of patients with IBS who were good candidates for the diet experienced significant improvement of their G.I. symptoms. And there have since been many many other studies that have been performed in various places all around the world that back that up. Of course, the results are always best and are really controlled setting like in a clinical research centre. But even in people that are free living as they say but who are just taught the diet and asked to carry it out on their own. The vast majority of IBS patients get significant improvement with this approach.

Mathea Ford: [00:13:52] Yeah! I imagine there’s a lot of motivation to try it and then especially once you start to experience some of the effects. What foods you typically add back first because you mentioned everything from apples to milk to whole grains? So, where do you start adding foods back?

Patsy Catsos: [00:14:10] I’m going to list the FODMAP categories real briefly and I’m going to do that because I add foods back one category at a time rather than food by food. Sometimes you know sometimes the food by food reintroduction comes later.

Mathea Ford: [00:14:26] If you’re trying to narrow down?

Patsy Catsos: [00:14:28] Exactly! But the map categories that I work with our number one lactose. Which is also known as milk sugar and there’s a lot more of it and some milk products than others. So, things like regular old glass of milk is high in lactose. Yogurt is medium but aged cheeses are low in lactose. The next FODMAP is fructose and that’s found in sugars that are added to our food for example honey, high fructose corn syrup, agave but it’s also naturally present in all fruits. Of the next category of FODMAP is called sugar alcohols and these are easy to spot when they’ve been added to foods like sugar free gum and candy because they usually end with OL so things like xylitol, sorbitol, maltitol, mannitol. Those are easy to spot but I mentioned earlier they’re also naturally found in certain fruits and vegetables. So, those three I just mentioned are the sugar type FODMAPs and then moving on to the fiber type FODMAPs. They go by the umbrella term of oligosaccharrides which is the O in FODMAP and they are contributed to our diet by whole grains, nuts, seeds, beans and also by fibers that are added to boost up the fiber content of our food such as inulin and chicory root. So, those are the big categories. That’s the theme that I follow during the reintroduction process. It’s one category at a time.

Mathea Ford: [00:16:11] Yeah. I think that once people start seeing the results they probably are happy to follow this. Is there any part of the diet that ends up being too restrictive over the long term?

Patsy Catsos: [00:16:25] Yes. As a you know we discussed at the very beginning when you first asked me about individual foods we know these are healthy foods right? Especially the whole foods that are good sources of fiber and that’s probably the nutrient that deserves the most special attention ongoing is to make sure that you’re eating enough fiber. Even if you have to cut back somewhat on high FODMAP fiber. There are plenty of good options and I encourage people to continue eating a wide variety of fruits and vegetables and beans and nuts and seeds right up to the limit of what they can tolerate so that they can get the benefits of those foods without distress.

Mathea Ford: [00:17:12] So, we’ve been talking about FODMAP but you also mentioned at the beginning that Gerd was something that you help people with or reflux type things. So, what types of things do you do with people to help them with reflux or GERD?

Patsy Catsos: [00:17:26] This low FODMAP diet is not I guess not intended directly to help people with GERD but if people have IBS and GERD, I can tell you that their reflux symptoms often improved quite a bit with this low FODMAP at the same time. If they have GERD only no IBS, I would probably review some of the basics that have actually been known about for quite a long time for managing that problem. Things like eating smaller more frequent meals perhaps, not eating too close to bedtime, elevating the head of the bed makes a big difference because gravity can then help the contents of the stomach remain in the stomach instead of refluxing up into the esophagus. And then there are a few food choices that they might want to consider. There are certain foods that have a bit of a reputation for making GERD worse although I do find that’s pretty individual as well. And so I encourage people to try eliminating these foods from their diet but if it doesn’t make a difference they don’t necessarily have to stick with it but some of those foods would be things like chocolate, coffee, tea. Things that are real peppermint based high fat foods are often a trigger for GERD. Acidic foods. But again you know give it a try but if it doesn’t make a real difference for you you can move on.

Mathea Ford: [00:18:58] I’ve heard recently that GERD or reflux is not necessarily because you have too much acid in your stomach it’s because maybe you don’t have enough. So, is there any research you’ve seen about that or any comments about that?

Patsy Catsos: [00:19:12] I would say it’s pretty anecdotal and a lot of functional providers I think rely a lot more on their own experience with patients than necessarily the clinical research foundation. They’re you know they’re willing to try to implement some things without an evidence base. That’s not how I practice. So, I don’t really initiate that kind of treatment with people that would be based on that idea. But if they are doing it on their own or they’re also working with a functional provider that wants them to try to increase acidity by taking a supplement for example, I probably wouldn’t interfere with it or ask them to stop.

Mathea Ford: [00:19:51] Well, that’s a good point though. It’s just something that’s recently been in the news that I’ve heard and it is very intriguing thought. So with IBS and G.I. issues how are these handled in our current health care system? Because you mentioned you know that people typically come to you with the diagnosis from their doctor but I know a lot of times people suffer for a while before they either put their foot down with their doctor and say “you’ve got to figure this out” or are just some of the symptoms too general or too hard to recognize by doctors or how do you see it coming through the system?

Patsy Catsos: [00:20:27] So, years ago, it was quite a difficult and even expensive process to arrive at an IBS diagnosis. It used to be considered a diagnosis of exclusion. And people would have to go through the process of having a colonoscopy and multiple other tests that could be invasive and difficult and expensive before they would get the diagnosis. But these days we have some clinical guidelines that suggest that really it can be a diagnosis that’s made with out all of that. If the patient has a particular pattern of symptoms, these are called the Rome IV Criteria for irritable bowel syndrome. If they have a particular pattern of pain and altered bowel habits and the absence of those alarm symptoms I talked about earlier, then they can be diagnosed with irritable bowel syndrome right in the doctor’s office and that can pave the way for them to be treated more effectively.

Mathea Ford: [00:21:30] So, doctors are basically a little bit have a little bit more guidelines to say these are some of the typical patterns for that?

Patsy Catsos: [00:21:38] Absolutely! Absolutely! And so more people are being diagnosed with IBS right with their primary care provider instead of having to go through the referral process to see a gastroenterologist.

Mathea Ford: [00:21:51] How do you think this information can be used by our listeners in their day to day life? So, our listeners are dietitians doctors nurses and just regular individuals.

Patsy Catsos: [00:22:01] Okay. So, first of all if you’re suffering from abdominal pain, excess gas, bloating, bowel habits that are not satisfactory to you. Bring it up with your physician. Absolutely do not have to suffer in silence. It’s not something you should just have to put up with. Have your doctor evaluate you and if necessary you know maybe you do need to be seen by a gastroenterologist. But don’t just live with this situation. Then if you do get diagnosed with irritable bowel syndrome ask your doctor whether he or she can refer you to a registered dietitian who’s skilled in this area and see if they can help you work through whether food is contributing to your symptoms or not.

Mathea Ford: [00:22:48] So, if you’re a dietitian you work with just regular you know like you mentioned cholesterol, heart disease that type of stuff. What types of things are people going to be saying to you that help you to recognize “Okay, I need to mention to them that they should possibly follow up with their doctor about these things?”.

Patsy Catsos: [00:23:06] Okay. So about 20 percent of your patient population is going to have irritable bowel syndrome. So, whether you’re seeing people for diabetes or cholesterol or or anything else you could be listening for for signs and symptoms that might suggest IBS. And if you’re hearing patients complain about you know not only abdominal pain, diarrhea and constipation, excess gas and bloating. You know you can make that referral back to their doctor. Most patients that you’re going to be able to help with a FODMAP elimination diet for example are going to be aware that food has something to do with their symptoms. In fact they’ve probably been trying to manipulate their diet on their own long before they ever met you or heard of FODMAPs. Some patients will say you know “bread really really bothers me when I or when I was following the Atkins diet or paleo diet or some other variation of a low carb diet that they were feeling better.” Patients might say “the healthier I try to eat the worse I feel.” A lot of patients that have done programs that really promote the fruits and vegetables and skim milk and all that. For example Weight Watchers, patients can feel more symptomatic because they’re eating a lot more FODMAPs in those foods. So, those are some of the clues I would be listening for if I were in a more general practice.

Mathea Ford: [00:24:35] I think that’s great especially that is surprising to me to say that 20 percent of people have IBS because I did not realize it was that prevalent.

Patsy Catsos: [00:24:44] The statistics of course vary a little bit depending on who produces them. But that is pretty consistent around the world.

Mathea Ford: [00:24:51] So, Patsywe’ve been talking a lot about food and I’m going to ask you the question I ask everybody is what is your favorite food?

Patsy Catsos: [00:24:59] Well, I think that salmon is probably my favorite food both because I like it myself but also because I when I’m a hostess I feel like it checks almost all the boxes as dietitians we’re all is kind of aware of the dietary needs of our guests. Righ?. So I feel like I served salmon. I’m doing a good job for my guests who have irritable bowel syndrome or celiac disease. We’re eating the low carb diet and also most vegetarians seem to be willing to enjoy fish once in a while. So, all in all it’s a great food, very nutritious and delicious.

Mathea Ford: [00:25:44] So, how do you like to cook it?

Patsy Catsos: [00:25:46] My favorite recipe is a baked salmon which is kind of a crumb crust made of walnuts and olive oil and a little Parmesan cheese. Some something like bread crumbs or crushed potato chips or something to give it a little crunchiness. It’s really delicious and we usually have that on holidays.

Mathea Ford: [00:26:06] Oh that sounds delicious. So Patsy, thank you so much for being on the podcast today. It was a pleasure to have you on the show. I know my listeners have learned a lot about IBS and FODMAPs and I appreciate you going into such detail about those. So, if listeners want to connect with you what’s the best way to do that?

Patsy Catsos: [00:26:24] I think the best way to connect with me is to visit my website which is IBSfree.net and from there you’ll find plenty of links to everything from my book to my social media. So, I look forward to connecting with you.

Mathea Ford: [00:26:42] All right! Well guys this has been another great episode of the Nutrition Experts Podcast. The podcast that is all about learning more so you can do more with nutrition in your life.

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