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Nutrition Experts Podcast Episode 32 Never Be Caught Off Guard Regarding Research with Casey Colin, MS, RDN, LN, CNSC, ACSM, CPT

December 10, 2018 by matheaford Leave a Comment

Casey Colin is a registered dietitian nutritionist with more than 10 years professional experience and a Master’s degree in dietetics. Casey is board certified in nutrition support (intravenous nutrition) and she is an American College of Sports Medicine Certified Personal Trainer. Casey is also a proud Veteran of the US Army. She has a strong love for God, her family, avocados, and personal growth.
My link: www.lettucetalk.blog

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 Casey Colin on the show today. Casey welcome to Nutrition Experts.

Casey Colin: [00:00:44] Hi! Thank you so much for having me today. I’m glad to be here.

Mathea Ford: [00:00:48] I am so excited to have you on the show and share your expertise with my tribe. I want to know if you can tell our listeners a little more about you and what you do.

Casey Colin: [00:00:57] So, my main gig is an outpatient dietitian with and a clinic. A local VA clinic in town. But I have multiple sort of branches off of my main job. One of them is I am a dietitian with Army Reserve and the one that I have the most fun with is I am a blogger with lettucetalk.blog Lettuce like the food yet.

Mathea Ford: [00:01:27] What made you want to start a blog?

Casey Colin: [00:01:29] I sort of take away a lot of the trials and tribulations of an outpatient practice. I take these things home with me and I needed an avenue to sort of channel some of the challenges, some of the funny things I experienced but also I have a lot of friends and family who really want to know more about nutrition. So this was a way to funnel all of those things into one I’ll call it a therapeutic resolution. I can answer some of those questions with no filter and have a little fun with it.

Mathea Ford: [00:02:07] I have to admit I read several of your blog posts in the last week and yeah, you definitely feel like it is. I mean it’s not good or bad it’s just it is sometimes you have to say it. So what’s your favorite article you’ve written in the past few weeks?

Casey Colin: [00:02:26] The “Does Pooping Make You Sad” article mainly because the title makes me laugh but I kind of toggle between whether I love the title or the actual article I wrote at any given time. Sometimes I write an article because I think of a fun title.

Mathea Ford: [00:02:46] So what “Does Pooping Make You Sad?” about?

Casey Colin: [00:02:49] I’m inspired by different things throughout the week, throughout the day depending on what’s going on. And I had a friend who had mentioned some difficulties with that in all seriousness with some digestive issues that had sort of come on and some other things that were pointing toward food sensitivities and rather than have a conversation with this person and then separate conversations with all the others that deal with this. I just decided to roll it into a blog about digestive issues.

Mathea Ford: [00:03:22] We were talking before the call and you told me you just got your Masters and what was that experience like getting your Masters after you’ve been a dietitian for a while?

Casey Colin: [00:03:32] It was interesting. I had been in practice for about ten years when I had decided to go to grad school and it was enlightening because we always can learn new things which I of course did. But having been in practice for so long I was able to better apply the information. You know we went into a lot more complex detailed data on how nutrition impacts our body on a cellular level but being able to translate this a little more after seeing what people struggle with on a day to day basis was really I felt useful getting my master’s degree at this point in my life.

Mathea Ford: [00:04:13] Yeah. I think there’s a lot more biochemistry and labs and other information that we have now. When I became a dietitian twenty one years ago we didn’t have. So it’s interesting to be able to put them together into “I’ve seen that and this is where I see the labs and I can now see how I can help that person better or yeah that application having gone through it.”.

Casey Colin: [00:04:40] Right! It dug a little deeper into the “why” not the “what” but the “why.” Why is this happening?

Mathea Ford: [00:04:47] So, you said you did a capstone project about saturated fat and cardiovascular disease so can you talk a little bit about that?

Casey Colin: [00:04:56] Yeah! It’s pretty fresh. And as a matter of fact, hopefully everyone listening can keep their fingers crossed by the time this airs hopefully it will be accepted for publication in a journal. It’s sort of just waiting there right now. I am anxiously awaiting acceptance but this was a narrative review on what the title was “Should Saturated Fat Be Limited To Treat Or Prevent Cardiovascular Disease.”

Casey Colin: [00:05:23] And I think especially as dietitians, we hear a lot of people coming to us because they’re told they need to implement a low fat or a heart healthy diet because they have high cholesterol or they have all these different things. I really wanted to explore that. You know. Basically, because the more emerging research that I had seen was a little bit against the grain in terms of saturated fat. And so I did a narrative review and I started by examining three hundred and seventy four articles that were found as a result of my specific search terms. I had some intricate exclusion and inclusion criteria but ultimately three hundred seventy four articles were found, 211 actually were excluded after combing through the very specific criteria that I use. And then I was left with 37 primary research articles and 21 reviews. So, although I was doing my own review I did feel compelled to include reviews because they have such an impact on this particular topic. So, long story long, it was a fairly complex project but the evidence that we do have surrounding a reduction in saturated fat to prevent cardiovascular disease is very limited in sound reputable really good methodology. We’ve sort of been taught to limit saturated fat for a number of years and it seems like this is not supposed to be the focal point. So, there’s still of course as with any research more research needs to be done. That’s what I’m left with is the conclusion is more research needs to be done but we really have to kind of use these results as a means to look at things totally differently. In my opinion, my professional opinion.

Mathea Ford: [00:07:22] What did the review show you has better evidence or has good evidence or is nothing really showing good evidenc?.

Casey Colin: [00:07:30] Well, as you can imagine doing a review of this caliber there’s so many different branches that I thought of. If only I had the time to do more reviews on it. Starts to open a whole Pandora’s box of I need to explore this further because there were some indications of different avenues that we could look at. One was indicated as a result of this research that reducing reactive oxygen species. In other words free radicals that we get from heating a lot of our polyunsaturated fats could be an entire review in and of itself. But that was something that I got a glimpse of when combing through this research is that you know we’re looking at inflammation, we’re pointing at inflammation as a risk factor for cardiovascular disease. Pretty intense one regardless of what our actual cholesterol numbers are. I think our focal point has gotten a little off track. So, if we have a lot of cholesterol but we have damage in our arteries that’s where our cardiovascular disease is coming from is that inflammation not the higher the low cholesterol in and of itself. So, the way I’ve explained it to some of my patients is “if we have a lot. This is going to be a Casey analogy so bear with me. If we have a lot of leaves and gook going into the drainage and our street after a rainstorm. Most of that drain system is designed for all the leaves and gook. So, in this case that would be cholesterol. The leaves and gook would be our cholesterol but if a twig or a branch or something gets hung up in that drainage system now all the leaves and gook are going to get stuck on that branch. So, the the twig in this case would be inflammation or damage to the lining of our arteries. And so looking at things that cause that damage or contribute to that damage in the arteries is far more valuable in preventing you know these blockages and these different things than the cholesterol itself and so much attention has gotten put on the actual cholesterol levels themselves. In some ways rightfully but we’ve got to look at how do we better serve the lining? How do we better reduce that inflammation that precludes that damage in the first place?.

Mathea Ford: [00:09:49] It’s very interesting because I hear a lot of talk about inflammation contributing to all kinds of diseases, affecting us in lots of ways. And I’ll be the first shipment that I didn’t this wasn’t even a topic when I did my studies. So, what types of things are causing inflammation for people are creating inflammation in bodies? Did you look at that at all or was that part of your research?

Casey Colin: [00:10:13] That was not part of this project that I had but again it was a it opened up Pandora’s box of things that I would love to spend some time doing entirely different reviews on inflammation itself. And as you can imagine, a person would have to dedicate particular reviews to each aspect of inflammation not just inflammation as a whole but what I feel it is you know supported by the research is that inflammation is multifaceted. It’s that some things that we have control over and some that we don’t. So, there is a genetic influence that could probably preclude our inflammatory risk but also a whole lot of stuff that we have control all over and as a registered dietitian of course some will look toward what we eat. Some of the standard things that we know are really valuable for preventing inflammation. These haven’t changed. Even with decades upon decades of research, we know that eating mostly fruits and vegetables is going to be useful for us. So, sometimes getting back to the basics I think could help people to really reduce their risk for inflammation if that’s a concern even without having done the reviews and things on inflammation particularly getting back to the basics could be a really valuable tool that we have to reduce inflammation. And of course different health conditions would have their own different conversation. Yeah! I mean just kind of the old tried and true stuff first.

Mathea Ford: [00:11:45] Having done this review when you see people with cardiovascular disease or heart disease or whatever, what is the type of advice that you typically are giving them now that you’ve done this review?

Casey Colin: [00:12:00] So, I haven’t changed a lot because this review sort of solidified some professional opinions I already had but some things that really have been useful for my patient population is the results in this narrative review indicated that saturated fat was not negatively impacting our health when we were consuming enough fiber and when we were consuming enough omega 3 fats and so I really tried to incorporate that explanation into my conversations with these these patients is that you know bacon and butter are not harmful for us independently. They’re harmful when we consume them with very little fiber, with very little omega 3s with a lot of added sugar, refined carbohydrates. So, just explaining that if we have the bacon and eggs with a whole bunch of vegetables at breakfast for example. Maybe we throw you know onions and peppers and spinach into a nice omelet and we have that with our eggs and bacon. That changes how these nutrients work into our body and making sure we’re having things like salmon or tuna or sardines or other omega 3 rich foods at least three times a week. That changes how these foods work in our body. And so it’s a conversation that includes not just teaching people to go wild and crazy with their saturated fat intake. Where is the saturated fat coming from? Is it coming from Whole Foods sources? Is it coming from nutrient dense food sources? And if so, then great! Especially when it’s consumed with those dark, rich, colorful vegetables and maybe some fruits but really looking at where is the saturated fat coming from not how much are we having, what kinds are we having and what are we having it with.

Mathea Ford: [00:14:01] So, when you look at the Omega 3 and I know you mentioned eating certain types of fish. Did any of your reviews show any sort of value to taking supplements or did any of them look at that like the omega 3?

Casey Colin: [00:14:16] No. Because of the particular studies I looked at we’re really focused on specifically the impact of saturated fat. I think kind of going off on one of the branches of things and discoveries that I learned from this. That would be a very useful thing to look at is you know do we get the same impact from Omega 3 supplements? And you know my knee jerk reaction to this based on the evidence is that maybe not the evidence from this review in particular but making sure that we’re getting good quality omega 3 supplements if and only if we are truly unable or unwilling to have adequate omega 3 throughout the week. So, for example I have certain patients that absolutely refuse to eat any kind of fish and they’re just not the type to have chia seeds or flax seeds as part of their world. They’re a little off the reservation kind of people. And so in these cases that would be where a supplement would be useful. A good quality supplement which again would be an entirely different conversation but yeah! I mean we always want to try to get the foods first mentality.

Mathea Ford: [00:15:32] We expect large corporations, large organizations to kind of have a dual level of review if they’re doing it, if they’re going to spend the money on it. So, that’s very interesting. And I agree that people should probably read it and review it to understand kind of the full implication of it. Thinking about that. What can RDs do to find research, to look at research and implement it in their practice? Kind of on an ongoing basis because I know there’s always new research coming out. And so how do RDs or other health practitioners find ways to get research and implement it in their practice?

Casey Colin: [00:16:13] I’m actually really glad you asked that because that’s something I’m pretty passionate about. I will admit early on in my career, I wasn’t a big researcher. I just wasn’t. I thought I was ready to save the world. That right out of my internship as a fresh RD and what I have found is setting aside the time to truly look things up as basic as that sounds. So, even when I hear a friend or a family or some something on Good Morning America or a TV of any sort of a new hot topic or a new trend, I try to keep a running list whether it’s on on the notes on my iPhone or literally a post it note or something and I jot these things down these buzz worthy things so that in between patients or when I have a block of time at work or even at home. I mean even though we’re dietitians, we can leave work at work but it’s sometimes useful to spend a little time at home looking some of this up. But you know jumping on to you know search engines like PubMed or Cochrane Reviews or some of the other very useful research databases you know setting aside the time to look up those things you have listed some of those buzz worthy terms because somebody is going to ask you. And so that’s something I think as a registered dietitian, I have to keep up on this stuff if it’s talked about on the news. I can almost guarantee that within the next seven days somebody is going to ask me about that and if as registered dietitians we want to be sought after as the Premier Nutrition experts we actually have to be. So, something that I really set out to do is to never be caught off guard. And in order to do that, every moment that I have especially in my work day where I have better access to these things, I spend 15 minutes looking up some of the latest reviews. And if you really are pressed for time reviews or where is that. You can look up a Cochrane Review. That’s one of the you know the well or if not the gold standard for analysis and systematic reviews of the literature and then plug in some of these new buzz worthy terms and plug in things that you’ve been wanting to learn more about. See what you see what comes up. You know type in diet soda and the microbiome into PubMed and you’ll be blown away at what pops up. Some of it might be reputable and useful and some of it might not. But if you have 10 minutes or 15 minutes or more, really taking that time to be prepared for these questions that we’re going to get.

Mathea Ford: [00:19:06] Cochrane review is that like a website? Or?

Casey Colin: [00:19:09] So, it’s kind of like PubMed. It’s another sort of database of the literature and you know for a lot of RDs, you know a lot of people might not have a subscription to it. So, for people who are employed by other entities, a lot of these different you know subscribed oriented databases might be very reachable through the employer but typically it would have to be a subscription I believe. I’m not completely sure on that but even at the very least, PubMed can really brought in some things in and that’s something that everyone has access to. We might not always have access to the full text but you know different libraries can help with that too. Whether it’s through an employer or university. A lot of times connecting with librarians through these entities, even a local library might be able to help you get a full text for minimal or no cost at all. I’m a big advocate for free. So, if you can get it for free you do. But just really you know start to sift through what’s out there so that we can actually be the experts because nutrition information changes by the second. And then it’s really easy to be caught off guard and if someone has a question about a lot of these hot topics and we can’t answer it as registered dietitians, they’re going to keep asking until someone can even if it’s not the greatest advice that they get.

Mathea Ford: [00:20:37] Yeah I know my local library. Speaking of PubMed, I believe that through just having a library card that we can access PubMed for the full text online and so that is a great resource. You might check with your local library if you don’t have access to like a hospital type database or something. So, that’s a great example. How do you think the information we talked about can be used by the listeners in their day to day life? How can they implement some of this besides going out and looking at the research studies?

Casey Colin: [00:21:07] So, first and foremost I would say for someone who is not immersed in the professional nutrition field, being able to critically review the literature is difficult and it’s difficult enough for us as professionals. Let alone someone who’s not immersed in the field. Try not to feel like you know as a person that’s not a dietitian going into PubMed that you’re going to find your answers because you might end up more confused than you anticipated or maybe not. But the real thing is to have a cynical ear and a cynical eye when you are reading about nutrition information because we’re in a day and age where we are inundated with nutrition advice. I would say every single day. Even when I’m in my office at work, I hear people talking about nutrition all the time and it’s not an exaggeration to say everyday. Whether I’m at the coffee shop, whether I’m you know passing by. I was on a hike one day and I was telling my husband and I get nutrition information everywhere I go and on the way up the hill people coming down we’re talking about nutrition and it wasn’t the greatest of advice I’ll tell you that.

Casey Colin: [00:22:22] So, for people listening is to really you know gather up all the knowledge. Knowledge is power but really be cynical about the source because we can be really easily misled by people who we trust and people who we think are the Mecca of knowledge but don’t have that background or that ability to truly critically review the research in a way that we can use that properly in our daily life. And also you know not to forget the basic tenets of healthy living and healthy eating is to eat mostly plants. Even if you’re not vegetarian or vegan still eating mostly plants is a really great thing to live by. Drink water as your main beverage. Try not to get so convoluted with the latest and greatest that you forget about the basic stuff that really fuels our body and makes us healthier.

Mathea Ford: [00:23:20] You have additional certifications. Can you talk about those a little bit and how they contribute to your practice?

Casey Colin: [00:23:27] Yes! So, I have CNSC which for non dietitians, that stands for Certified Nutrition Support Clinician. Which means I am certified to administer the intravenous nutrition if you are in a coma in a hospital bed. That actually came about because of graduate school, I was immersed in the nutrition support curriculum for a minute and I thought well I hate to waste this fresh knowledge in my brain. Plus in the nutrition world that is a coveted certification and I was you know as fresh as I was going to get with it. So, I decided to study for and take the test and the other really underlying big reason why I took that certification is because having to study for it I knew would make me better at what I do in ways that I wouldn’t have the self-discipline to do, to learn about otherwise. I’ll just be completely honest about that. Because diving into a really specific critical care nutrition and the cellular processes that are involved in that, are things that are you know really helpful. But again, I wouldn’t have dedicated the time and energy to it without an end goal. So, that was one of the reasons why I did that one. I also took the American College of Sports Medicine Certified Personal Trainer Certification. Funny enough, I had started studying for this in 2009 and I bought all the materials and got super jazzed up and motivated and then didn’t do anything for what is that? 8 years, 9 years. Anyway, but what happened was the reasons for that one were more multifaceted I’ll say. One of them is that as a registered dietitian, I think to be well-rounded I think we have to have a little more training and education in the fitness realm because a lot of our clientel whether young or old are into “I want to be healthier. I want to increase my fitness. I want to eat healthier. I want to do the whole bit” and we know having both fitness and nutrition is really useful and critical for good health and so I wanted to be a little more well-rounded and educated in that sense on the fitness side of things. A little bit small of a reason but definitely a reason why I did the Personal Trainer Certification is that I often have encountered personal trainers who educate people on nutrition and I thought “I want to know what exactly they learn. What’s in the curriculum” and so the only way to truly understand what’s being taught and what the level of expertise in nutrition is for a personal trainer with no other nutrition background is to go through the motions. And so I did. And what I found is the nutrition education aspect of preparing to be a Certified Personal Trainer is very limited and very basic and I will credit the American College of Sports Medicine heavily for explaining in their curriculum for the personal trainer to refer to a registered dietitian over and over and over and that recommending supplements and different therapeutic diet techniques is not in the scope of practice for a Certified Personal Trainer that is not also a nutrition professional like a registered dietitian of course but. So, yeah I mean it made me a better practitioner because I have that fitness side of things but I’d be lying if I said that was the only reason I did it. So, I’m being completely transparent today.

Mathea Ford: [00:27:41] I have my bachelor’s in Nutrition and a bachelors in Exercise Science and I do when I listen to people advising who are doing training advising about nutrition. It’s one of those things where I’m like “Oh! I understand.”.

Casey Colin: [00:27:57] It’s well intended I think. The nutrition advice but there is just a lot of times it’s misleading without intending to be because of that lack of background.

Mathea Ford: [00:28:10] So, all of that said I love to ask my favorite last question is tell me your favorite food because I like to know what dietitians eat.

Casey Colin: [00:28:20] So, it’s not really a meal but a food that is my absolute favorite in the entire universe is avocado and I don’t think I had an avocado until I was 24 because it’s not something that was part of our farm country Midwestern repertoire.

Mathea Ford: [00:28:40] I don’t think I had avocado till I went to Texas and had Tex Mex food. But I love avocados too. They’re great!

Casey Colin: [00:28:49] I’m obsessed.

Mathea Ford: [00:28:50] A wonderful healthy fat.

Casey Colin: [00:28:52] Yes! Yey fat!

Mathea Ford: [00:28:56] All right Casey, 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 cardiovascular disease and the review that you did and just some different aspects, different ways to look at it. So, if listeners want to connect with you what’s the best way to do that?

Casey Colin: [00:29:13] The best way to connect with me would be through my blog. On my blog it’s Lettuce Talk, like the food. Lettucetalk.blog and there is a Contact Me section where you can e-mail me your thoughts or questions and also a lot of other useful information that you’ll find along the way.

Mathea Ford: [00:29:35] 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 31 News Edition, Mindful Eating and Enjoying Your Holidays with Janet Brancato, RD

December 3, 2018 by matheaford Leave a Comment

Janet Brancato is a Registered Dietitian Nutritionist with a Masters degree in Nutrition from New York Medical College, Valhalla, NY. She did her undergraduate studies and received a Bachelors of Science in Nutrition from Montclair State University, NJ.

She is experienced in the field of Nutrition for over 20 years, teaching groups, and counseling individuals on diet modifications and lifestyle changes to promote health. She is experienced with kids, teens, and adults. Her specialty is weight management but she also works with various medical challenges.

The past 15 years she has worked at a local hospital in NJ as an outpatient dietitian and community health speaker.

Janet decided to expand her scope of practice and created Nutopia, LLC a virtual private practice about 5 years ago. She can meet with clients using telehealth technology from the comfort of their home or office.

The motto for her business is “Simplified & Personalized” taking the information and breaking it down into manageable goals and giving clients a personal experience. She motivates and supports clients in between visits.

Janet is also a food blogger, you can check it out on her website www.mynutopia.com.

Follow her on social media:

Facebook – @Nutopia, LLC
Twitter/IG – @janetmsrd

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 special guest Janet Brancato. Janet, it’s great to have you on the show today.

Janet Brancato: [00:00:43] Hi Mathea! So glad to be back!

Mathea Ford: [00:00:45] Yes! So, this is our monthly News Edition where we kind of talk about current events and what’s coming up in the next month. And I’m excited to have you on the show and talk through our topics today because I think these are things that are just in general good to remember but also very specific to the holiday season. So, we’ve just finished Thanksgiving. What did you do for Thanksgiving?

Janet Brancato: [00:01:12] So, Thanksgiving. I had a wonderful Thanksgiving. I usually go to my mom’s house she has a full house of people on my husband’s side and also my brother’s family and everybody brings dishes. So everybody helps out. She does the main event which is the turkey and we all help with the sides so and I love to do the roasted vegetables because that’s something that I really love. So, I bring that. Yeah! It was amazing! We had a great day of family and good food.

Mathea Ford: [00:01:43] Yeah! So, I love roasted vegetables because you really… I just love that flavor that the roasting in the pan gives them. You know it’s not the in water or steamed but it’s got a depth to the flavor I guess is the right way to say that. So that sounds awesome.

Janet Brancato: [00:02:02] Yes! I like to roast up butternut squash, cauliflower, broccoli. You can really you know you use that sheet pan and some spices that you love, a little drizzle of olive oil and like you said it takes on a nice crisp flavor, brings out the sweetness of those vegetables and everybody loves them even the kids. So, it’s always a win win.

Mathea Ford: [00:02:22] So, for my Thanksgiving we had prime rib because it’s my birthday the week after Thanksgiving so that’s my favorite meal. And we have my nephew and my mom and my dad and my husband’s mom and dad and we had a great meal and just so you know you’re right it’s so nice to be together and we actually had pecan pie which the good thing is is that it’s not my favorite. So, instead of an eighth of a pie I just really took like a 16th of a slice. So and then a little bit of ice cream. I love having that wonderful meal to sit around. We all put our phones away and just have a good discussion and talk about what a wonderful year we’ve had because regardless of what has happened you know we’re here together as a family. We’re having a wonderful year.

Janet Brancato: [00:03:14] Yes, I agree. It’s always a special time. And like you said just to reflect on the things that you’re thankful for and family is up there at the top. So I totally agree.

Mathea Ford: [00:03:24] Into some of our topics, this year Starbucks has come out with some very good probably the same ones they have every year espresso beverages different types of high kind of seasonal products. And I wanted to talk through because I think you can easily forget how many calories are in a liquid drink because it’s so easy to just get the drink and drink it and not realize how much is in it. And so I wanted to talk through some of their seasonal drinks maybe talk through the calories in a grande with like a 2 percent milk and then compare to the calories in a different size or with some different changes. So, a couple drinks I wanted to talk about was the eggnog latte because that was really surprising to me. The eggnog latte for a grande which is a 16 ounce with 2 percent milk has 470 calories, 20 grams of fat and 57 grams of carb.

Janet Brancato: [00:04:27] Wow! That’s a lot!

Mathea Ford: [00:04:29] That’s like how many teaspoons of sugar?

Janet Brancato: [00:04:31] You know the carbs there – 57 carbs. I mean you know you’re up there with you know definitely carbs are up there you’re getting at least what we say you know..

Mathea Ford: [00:04:44] I think you said like 14.

Janet Brancato: [00:04:45] Yeah! You mean that did not tell me the specific sugars there but they’re telling you the carb. But definitely, yeah, you look at it like five carbs. You know if you’re going by the you know each carb serving so a little weight like you said it’s a liquid. So, usually you’re eating something along with it. You know you’re having a nice warm beverage but a lot of times you’re eating something with it. So, it’s generally a lot of times people are not just having that alone and maybe they’re having another little sweet component with it. So, it can really kind of add up. And like you said a lot of it has to do with the size. You know that grande is 16 ounces but they do you can bring it down to a tall or even a short which the tall is 12 ounces and the short is 8 ounces. So, you’ll stumble over.

Mathea Ford: [00:05:37] So, the short cuts it in half. Basically 8 ounces. Obviously 16 to 8 but you still get that flavor like you said that you want but it’s not as high in calories and carbs. It’s only 230 calories.

Janet Brancato: [00:05:52] Exactly! Yes. So that would really bring everything down just by changing the size.

Mathea Ford: [00:05:58] Yeah. And switching to nonfat milk so you’re getting a little bit less fat too.

Janet Brancato: [00:06:03] You’re getting less calories, less saturated fat. Some of these can be high in the saturated fats as well. The caramel brulee latte I was looking at was 40% saturated fat, 8 grams there. So and that’s the type of fat that can raise our lipids so we know we don’t want to overdo the frequency of that. If you switch it to a nonfat milk then you bring in everything down then bring that 0 down to we bring in that fat component down to zero. So that will really help.

Mathea Ford: [00:06:33] So in a caramel brulee latte with grande with 2% milk is 370 calories, 6 grams of fat and 66 grams a carb but you’re right it’s not all bad carb but it’s just a lot at once especially if you’re drinking it. So, if you put in a grande with nonfat milk and you go down to a tall which is a 12 ounce it’s 250 calories, no fat and 51 grams of carb. So that cut out a whole serving carb just by bringing it down to the tall size. It’s still a lot. So, I think you know the important thing to realize is frequency like you should not go to Starbucks to get a caramel brew a latte every day. There’s also which I already told you this is my favorite but a peppermint white chocolate mocha. I don’t even know if I want to talk about it because then I’ll have to realize how much…

Janet Brancato: [00:07:34] Even just the names and descriptions can definitely make you want to go there.

Mathea Ford: [00:07:38] Oh yeah! Absolutely!

Janet Brancato: [00:07:40] These drinks you have to look at like a dessert. That’s how I usually look at them. You know if you really want to have a dessert and you’re in the mood for it again and get it. Definitely! But maybe like you said have less you know or maybe make substitutes there so that you know it’s not as decadent. You still enjoying the flavor but I generally look at these drinks as the dessert.

Mathea Ford: [00:08:04] Yeah. So, a peppermint white chocolate mocha is 430 calories at a 16 ounce grande, 10 grams of fat and 71 grams of carb. Let me see. So, if I bring that down to just an 8 ounce with nonfat milk and it comes to try to see. Oh! It’s not even available in an 8 ounce. Well, maybe it’s maybe it is. No. Oh yes it is. Okay, peppermint white chocolate mocha has 190 calories, two and a half grams of fat and 36 grams of carb. So, that’s definitely an improvement. And you would get your little bit of flavor that you were looking for.

Janet Brancato: [00:08:44] Bringing down the size, bringing it to a nonfat milk or they have dairy free options you could get a soy milk and a coconut milk. So, they do have dairy free options. You can ask for no whipped cream. Some of them do come with whipped cream but you can ask for a no whip and you can ask for less syrup. They will do less pumps. Just tell them to go light on the pump for less syrup and they will also that will cut back on the sugar, a lot sugar is coming from the syrups.

Mathea Ford: [00:09:16] I think they also have some sugar free syrups.

Janet Brancato: [00:09:18] Yes! They do have that too. You can ask for a sugar free syrup and that will have splendid in it.

Mathea Ford: [00:09:24] Okay. So I think those are good ideas for your favorite drinks if you’re paying attention because there’s lots of ways to get extra calories during the holiday season. And so why not try to manage that as well as possible. But I don’t want you to give up if you really love Starbucks and you really want a Starbucks drink. I don’t want you to not take it. I want you to pay attention.

Janet Brancato: [00:09:48] Again, yes. A lot of it is just awareness. Just building awareness and having a plan. You can have it. You can enjoy it. A lot of these flavors are only around in the holiday season. So, again you know enjoy but like we said maybe it’s the frequency. Maybe not you know so often. Make it something special.

Mathea Ford: [00:10:10] So, speaking a little bit about portion control I know we just got done with Thanksgiving but we will have lots of opportunities to have similar foods like the green bean casserole, the candied sweet potatoes, mashed potatoes, turkey, ham all those types of things. Pumpkin pie. Let’s talk about a little bit I read this Consumer Reports article about how an average calories that Americans take in is 3,000 to 4,500 calories at a Thanksgiving meal. And that’s really I think just because we can easily take two or three servings of a food without even thinking.

Janet Brancato: [00:10:50] Exactly! Yeah. The foods are a little richer and the portions tend to be a little larger. Everybody’s getting those either large portions at your first plate or you going back for seconds or thirds like you mentioned. So, that’s where it could really add up.

Mathea Ford: [00:11:03] Even a little bit extra calories on Thanksgiving or a holiday thing is not bad. It’s because as long as you go back to kind of eating your normal healthy diet the next day. Let’s talk about what are some normal portion sizes and how many calories those might have and how we might even be able to identify that when people are eating like mashed potatoes?

Janet Brancato: [00:11:27] A cup serving about 237 calories. So, if you think of a measuring cup as a visual that could be you know like a typical serving size although a lot of times we say a serving is half a cup which is like a handful or an ice cream scoop amount. So, a lot of times for those carbs we tell people for advice using half a cup as a serving but here in the article they’re mentioning a cup as a serving size. So, that makes sense for a holiday.

Mathea Ford: [00:11:59] Yeah! And they’re saying the 237 calories is talking about making it with whole milk butter and salt and really you can use nonfat milk. You can use you know 2% milk and replacing some of that butter with low sodium chicken broth. You need the broth and the milk to make it mash and stick together but you can change a few of those ingredients and make it a little healthier mashed potatoes.

Janet Brancato: [00:12:27] Yeah! That’s great! That’s excellent! And I know some people even for a lower carb option do cauliflower mash or they do half cauliflower, half potato and bring the carbs down a bit. But either way even just by lightening up using like you said a non-fat, low fat milk and then the broth is going to give it nice flavor, a little you know use the low sodium but it will give it a savory kind of flavor. I think it would be a nice addition.

Mathea Ford: [00:12:57] Yeah! So, green bean casserole. Did you have green bean casserole at Thanksgiving.

Janet Brancato: [00:13:01] I did! Yes, the tradition.

Mathea Ford: [00:13:03] I love that stuff.

Janet Brancato: [00:13:05] I do too.

Mathea Ford: [00:13:05] Yes! It mentions a third of a cup which is smaller than a half a cup. Its a serving is still the 227 calories because you use the cream of mushroom soup and the French fried onions. A regular half a cup of green beans I think is about 20 calories if you don’t put all the other stuff in it. So, you may consider doing that just a small serving or you may consider not dressing them up so much and just doing plain green beans.

Janet Brancato: [00:13:33] Yeah! I mean a lot of times even at Christmas I just like a little drizzle of olive oil, some garlic and some sliced almonds on it or just a little squeeze of lemon and it gives it a nice flavor. You’re tasting those green beans where I feel like sometimes it gets lost in that casserole you know but I think if you lighten it up a little bit you know it gives nice color, festive and it’s really delicious. Green beans are very versatile you could even roast them I’ve roasted green beans and it’s a little crisper. So, they’re pretty you know versatile but you can definitely lighten it up a bit. Same thing when you’re making that if you want to make the green bean casserole use like maybe like a low fat milk or non-fat milk. I think they have a lighter version of the mushroom soup too. You can look for it and maybe add a little less of those fried onions just maybe just at the top instead of throwing them in.

Mathea Ford: [00:14:28] You know what kind of surprised me is the the turkey or the main you know what you’re thinking about when you’re thinking about the meal, Turkey about the size of a deck of cards which is about 3 – three and a half ounce portion is just with the meat white meat with the skin is just about 175 calories and dark meat has about 200 calories and that’s almost the lowest calorie thing on the plate.

Janet Brancato: [00:14:57] Yes! That’s the protein and that’s the item that’s really going to fill you up so you can opt for a little more turkey and then go lighter on the other options you know and will really fill you up if you’re getting for that. Even just that 3 ounces you’re getting a good 27 grams of protein there. Trying to get at least 15 to 30 grams at a meal will fill you up and satiate you so you’re definitely in that zone of getting that you need just in a 3 ounce portion which is like the palm of your hand or the deck of cards.

Mathea Ford: [00:15:31] Yeah! And then there’s some other things people like like stuffing and sweet potatoes. Same thing just a half a cup serving, you might look at the box and see what the serving size says it is and just pay attention to kind of how much you’re taking. It is about the size of an ice cream scoop. Most people don’t use an ice cream scoop unless they’re in a commercial kitchen. So, use the lower sodium broth. Think about like you mentioned. So, if you’re even if you’re using a box stuffing you could chop up some cauliflower pretty small and maybe even some other veggies like carrots or celery and add it in so that gives more volume but the calories from all the breading and stuff in the stuffing is less because you’re getting more of those vegetables which are higher fiber, lower carbohydrate in your meal. I love that idea. I’m going do that at Christmas.

Janet Brancato: [00:16:27] You could put mushrooms in it and they also really fill you up. They give you that savory umami type of flavor that flavor that it’s like a meaty texture to dishes so you could add mushrooms to the stuffing like you said you could add any vegetables that you love that your family loves. You could really roll them in there.

Mathea Ford: [00:16:52] Yeah! And you Just heat up your stuffing and then heat up the veggies chop them up and heat them up and then mix them together. And that sounds really good. So… Let’s talk a little bit about holiday weight gain because I know that’s something that people are concerned about a lot this time of year. I found this Time Magazine article that talked about it’s from December of 2016 but it mentioned that people even though they think they gain about five pounds they gain about one pound, one to one and a half pounds over that November to January timeframe they just don’t tend to lose it. So, then it comes back and just stays on your body that next year you add another pound next year you know just people don’t tend to lose that. So, did you have any thoughts about kind of helping people manage their holiday weight gain or how to approach it?

Janet Brancato: [00:17:44] I always tell clients if you could even maintain your weight over the holidays, it’s not always a good time to be losing weight because obviously you want to be part of the festivities. You want to enjoy the you know all the holiday options and that type of thing. But even if you can coast through with your weight that will be a great goal you know. And again I think it starts with like you said being mindful, being aware maybe how much you’re eating or how often you’re frequenting like a Starbucks or something like that. Or am I exercising? You know. What am I doing to try to like keep my lifestyle going? The holidays shouldn’t throw off your lifestyle completely. I mean obviously it’s going to be a little bit more than what you’re used to. But I think if you kind of tune in and have a plan ahead of time you know. Watching portions a little bit more, making sure we’re not skipping meals because a lot of times what people do is they might skip meals, don’t have breakfast, saving up all their calories for that one meal. They’re so hungry by the time the meal comes that it’s hard to watch those portions they tend to overeat. So, I say try to treat it like a typical day. Have your breakfast, have a lunch. Maybe you need a little snack before you go. by Being a little bit full, you’ll be a little bit more apt to hold back on those extra portions or extra plates and that kind of thing. You know keep your exercise going. Even if it’s not the full amount of time. You usually do a half hour and you can’t do it, if you do 15 minutes. That’s grea!. You know just try to build in some activity into your day.

Mathea Ford: [00:19:27] Well, if you have Amazon Prime you may not realize this but on Amazon Prime they have videos that are exercise videos. So, even if you can’t make it to the gym if the weather’s too bad whatever or you just don’t feel like going to the gym you can pop on one of those videos either on your computer or a lot of smart TV have Amazon Prime you can connect. And what I love about exercises, it helps reduce stress. And if you have you know if you’re affected by the less daylight or you have more stress at this time of year, you know a lot of times we miss family members that may have passed or other things that have happened and exercise teaches your body to deal with stress, teaches your body to raise your heart rate and lower your heart rate quickly using those Amazon Prime videos or other videos if you have a you know a video on a DVD or something like that. YouTube is free and there’s plenty of exercise videos on there that you can find different topics about but I just love that exercise is good for that reason. I don’t think about exercise necessarily. Like you said it doesn’t help you. You’re going to try to maintain your weight but not being stressed when you’re going to that family meal or going to out for that party. If you’re not feeling stressed you’re not going to be as likely to overeat.

Janet Brancato: [00:20:51] Yeah! Exactly right. Stress. Exercise definitely counters the stress. And like you said this could be a very stressful time of year. I know too that a lot of people get less sleep this time of year which that’s another factor that can affect our eating, our weight you know because when we have less sleep those hormones or stress hormones tend to go up and sometimes we have more cravings. So, I know it’s a tough time of year but trying to keep up with your good sleep habits is another key component to overall obviously good health but also helping with the stress relief and the holiday weight gain.

Mathea Ford: [00:21:33] Yeah! And Just another thought about what you’re eating. Try to pair like if you have say you’re you brought home from Thanksgiving or a holiday party a special dish that you really like. You brought home mom’s banana bread that you really love and you’re going to eat it over the next three or four days, just make sure that when you pair that which may be a higher sodium, higher carb, higher fat item you pair it with something that’s kind of the opposite so you have a slice of banana bread with some salad mix or like a lighter sandwich. So, you’re not eating your full regular meal plus the dessert that you brought but you’re more making that part of the total plan.

Janet Brancato: [00:22:18] Yes! Maybe even with a protein which might fill you up and satiate you a little bit more. Putting a little peanut butter maybe on that bread you know or either something on the side that this way if you can get that little flavor from the baked good but then you’re also pairing that with a protein that will be filling you up so you’re not up to fill maybe more slices.

Mathea Ford: [00:22:44] Yeah! And I also think drinking water. So, this year in about June or July I gave up Diet Coke and I love Diet Coke and I miss it a little bit but I drink pretty much plain water all the time and I do find that the more water I drink the less kind of hungry I feel in between meals. I just grab water I drink it. And so you may want to add some water, even more water to your daily meals. If you’re used to drinking sodas try to drink you know a little more water so that you’re staying hydrated and you’re not.. It helps you not feel as hungry.

Janet Brancato: [00:23:27] Yeah! And I find that water actually energizes me. Like I can feel a little sleepy middle of the day and I drink you know a cup of water or maybe half of my bottle and somehow like my brain wakes up I feel more energized. Yeah! So, when you have that midday slump try to go for drinking more water. Really try to make sure we’re well hydrated.

Mathea Ford: [00:23:51] Yeah! And I really wanted to end this news edition talking about mindfulness because in addition to stress and all the available food I think being mindful can help lead you into a good place for the coming year and instead of thinking about diet, you’re thinking about different ways that your food feeds your body and feeds your soul. Some of the mindfulness tips I found this on the Health Harvard blog from 2015 but they mentioned some tips for eating more mindfully. Their first tip was to reflect and it was kind of like taking a minute before you start shoveling the food into your mouth to think about what are you getting ready to eat. And being a little bit maybe grateful for that food that’s in front of you. Grateful that you’re there with your family and why you’re there.

Janet Brancato: [00:24:50] I love that. I think that’s so important. Like you said just reflecting and you know taking that time like you said for the gratitude and just that like you said you have that food in front of you. It’s such an awesome thing you know. And just slowing down, I think that so much of our lives are rush rush rush and even the meals become rushed. We’re not even tasting them, we’re not even savoring them, we’re not enjoying them. So, we feel like we need more because we don’t feel satisfied. So, I think like you said even just stopping from moment before you put that fork, the first forkful. And again how do you feel it? Do you feel ready to eat? Maybe take a breath for 5 to 10 seconds and before you put that bite in and really just start to slow down. Eat it nice and slow and savor it.

Mathea Ford: [00:25:45] Yeah! They also mentioned sitting down instead of standing. So, instead of grabbing a plate of food and standing around eating kind of without thinking about it. Sitting down, focusing, not having the TV on, not having your phone there and something else that I have my kids do is they have a tendency to grab the bag of chips and take it to their room and I’m always like “serve yourself a portion in a bowl. Put the chip bag away and you can eat that. And then instead of just mindlessly putting the food in your mouth.”

Janet Brancato: [00:26:19] Yeah! And that’s an excellent tip. And you know your hand is a good tool for a portion size. Just take a handful. If you have a bag or a box you know I mean obviously if you don’t want to stick your hand and you want to just serve it out but you could pour it into your hand, your hand is a great serving tool. You know you take it wherever you go. It could be a great you know portion size or you could read the label if you really want to see what a portion is you could lift that bag or box over and say “oh! It says you know five crackers” or you know whatever it is. You fill those out. But like you said in a little napkin or a small plate or something like that.

Mathea Ford: [00:26:54] They mention chewing 30 times. I have an aunt who did this and I think her stomach loved her for it. I know it’s hard to chew two or three times if you’re not even thinking about it. So, just chew your food a little more before you swallow. It gives your body a chance to start those hormones and stuff that then tell your brain when you’re full and allow you to kind of stop.

Janet Brancato: [00:27:20] Yes! And I think too you take less air which could definitely cause gases and GI upset some people have stomach aches or feel bloated after meals and if they’re eating very fast or chewing very quickly they might get more gases you know as well. So, I think like you said slowing down, chewing more helps you to really enjoy those bites. It’s better for your digestion and you’ll get those full sensations. You’ll get that full feeling.

Mathea Ford: [00:27:50] And putting down your utensil between bites. So, we have a tendency to eat, stick in our mouth and go grab the next thing before we’re even then chewing. And when you chew 10 or 20 or 30 times that will help you to put your utensil down to that by fully get the full flavor out of it and swallow. And feel like we said fill full quicker because your body has that time to adjust to what you’re actually feeding instead of being behind. When you eat really fast your body doesn’t have time to tell you hey “I’m getting full!” So.

Janet Brancato: [00:28:26] Yeah. And also when you put that fork down that’s a good time to maybe take a glass of… Take a sip of your water, make a drink of your water. That could even help with the process, enjoy the conversation with your family, if you’re with other people you know. So, really making it more of an experience rather than a rushed activity.

Mathea Ford: [00:28:47] Yeah! And maybe even using a smaller plate. Taking smaller portions and because the thing about mindful eating that’s always reminds me is those first couple bites are really good and I really feel the flavor and I enjoy that flavor. But after four after four, five, six bites it doesn’t give me that same amount of satisfaction. Eating slower, eating a smaller portion and really enjoying and savoring that portion you thought might find that you really don’t get the satisfaction out of eating the whole amount that you used to eat because you got the satisfaction from enjoying it and eating it a little slower.

Janet Brancato: [00:29:29] Yeah! That’s great! Definitely! That’s that’s another key.

Mathea Ford: [00:29:32] Any other thoughts on mindfulness?

Janet Brancato: [00:29:34] Yeah! And then when you feel like you’re getting full that’s when you stop you know. I know they say resigned from the clean plate club. A lot of feel like we have to clean our plates or eat everything that’s on the plate but if you are full, your body is kind of telling you to stop and you can always wrap it up. You could always have a full lunch the next day or another meal. Don’t feel like you’re going to throw it out. So, tune into your body with mindfulness is that you’re tuned in. You’re in the moment and you’re checking with your body. Your body’s telling you. So, really try to listen to it until it gets easier as you keep doing it. Maybe it sounds a little strange but as you practice it it does get easier and your body feels better.

Mathea Ford: [00:30:24] Remember kind of what the holiday weight gain and almost everything we talked about today. It’s really about portion control. Kind of it’s really it truly is it’s about thinking about what is a serving and enjoying that food and enjoying the company.

Janet Brancato: [00:30:41] Excellent! All good tips!

Mathea Ford: [00:30:43] So, Janet, thank you so much for being on the podcast today. It was a pleasure to have you on the show. I know our listeners love listening to this News Edition every month. So, if listeners want to connect with you what’s the best way to do that?

Janet Brancato: [00:30:56] Okay, Mathea. Thank you so much for having me. They can find me at mynutopia.com. I have a virtual private practice. Also a food blog and meal plans and recipes.

Mathea Ford: [00:31:07] Great! 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 30 Motivational Interviewing with Susan Dopart, MS, RD, CDE

November 26, 2018 by matheaford Leave a Comment

Susan B. Dopart, MS, RD, CDE, is a medical nutrition and wellness consultant. She specializes in child and adult medical nutrition-related issues associated with insulin resistance, diabetes and endocrinology. Before establishing her own practice, Susan worked at UCLA as both a medical and kidney dietitian.

She is a member of the Motivational Interviewing Network of Trainers and conducts weekly workshops in Motivational Interviewing for clinicians wanting to learn collaborative language skills to assist with behavior change.

Susan has written and contributed to multiple publications, including The Huffington Post, SELF Magazine, UCLA Medicine, Sports and Cardiovascular Nutritionists SCAN publications, Diabetes Health and Diabetes Forecast.

Susan is the author of A Recipe for Life by the Doctor’s Dietitian, Healthy You, Healthy Baby: A Mother’s Guide to Gestational Diabetes, A Healthy Baker’s Dozen: Gluten-free low sugar cookies, and 101 Ways to Control your Diabetes.

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 Susan Dopart on the show today. Susan, welcome to Nutrition Experts!

Susan Dopart: [00:00:45] Thank you Mathea for having me. I really appreciate it.

Mathea Ford: [00:00:49] Great! I’m Excited to have you on the show and share your expertise with my tribe. Can you start with telling my listeners a little more about you and what you do?

Susan Dopart: [00:00:59] Sure! I’m a Registered Dietitian and Exercise Physiologist and also what we call a MINT – Motivational Interviewing Network Trainer. And so I have a private practice in Los Angeles and I do motivational interviewing trainings on a weekly basis both in person and virtually. And I also actually have four books out as well on different nutrition topics but mostly they really related to insulin resistance and diabetes.

Mathea Ford: [00:01:33] So, can you talk a little bit about motivational interviewing I’m sure dietitians have heard about it maybe even done a little training on it but can you go through and kind of talk through what it is and why we would want to use that?

Susan Dopart: [00:01:49] Sure. Well, Motivational Interviewing is a collaborative partnership language that helps evoke someone’s own motivation for change because when you think about it everyone’s ambivalent about something and most people are very ambivalent about changing their diet. You know the last thing they want to hear from a dietitian is just eat chicken and broccoli. How do we have a conversation with a client? So, they’re the one talking about change versus us the dietitians telling people what to do. Years ago, I was working at UCLA as a renal dietitian and I remember one Sunday a physician had written a diet order that said no cholesterol, no salt, no phosphorous, no potassium, no sodium. And underneath the diet tech wrote “no fun.” And I thought to myself in that moment that’s what patients think of us. We’re no fun. Right? And how do we have a different conversation so that someone isn’t cringing when we’re walking in the room? “I know another person just telling me what to do. Telling me what I can’t eat.” Fast forward about 15 years ago, I read the book Motivational Interviewing and thought “well, this is a great way to help people with changes that they’re struggling with.” And so I trained in it and about 10 years ago I became a trainer and I will say it is completely rocked my world. It is a beautiful way of being and talking to people that you evoke their motivation for change. And I would say more lasting change than the typical way we usually talk to patients in terms of just telling them what to do.

Mathea Ford: [00:03:45] Can you give us an example?

Susan Dopart: [00:03:48] It’s a way of coming alongside your clients and reflecting what you hear and reflecting with their own internal wisdom is about how to have a conversation. So, I thought I could do with you is a lot of times we ask a lot of questions and people in my training say I wish I just knew the questions to ask. And we think of questions as looking at the problem from the outside and what we call reflections and I’ll get to that motivator. Reflections are looking at the prompt from the inside. So, how do we as clinicians trust that the person that’s in front of us has the answer inside of them and reflect what we hear? So, we get to what will make them be successful. So, let’s just do a little little role play. If you’re willing to play and we call it in Motivational Interviewing Checklist versus the Conversation. So, we can have two different conversations one. The first one will be the checklist and the second one will be the conversation. So, tell me where did you go on your last your last vacation? Your last trip?

Mathea Ford: [00:05:03] Orange Beach, Alabama.

Susan Dopart: [00:05:06] Okay. And how did you get there?

Mathea Ford: [00:05:08] I flew there and drove home.

Susan Dopart: [00:05:12] And how many hours did it take to fly there?

Mathea Ford: [00:05:17] 5 – 6.

Susan Dopart: [00:05:18] How Long did it take to get home?

Mathea Ford: [00:05:22] A day and a half. We stopped halfway.

Susan Dopart: [00:05:26] And there, who’d you go with?

Mathea Ford: [00:05:28] My husband and my two children.

Susan Dopart: [00:05:31] And how many days were you there?

Mathea Ford: [00:05:34] We were there a week.

Susan Dopart: [00:05:36] Okay. So, let’s rewind. Let’s pretend that we never had that conversation. That’s our Checklist Conversation. So tell me about your last trip?

Mathea Ford: [00:05:50] Well, I went to Orange Beach, Alabama with my family for a beach vacation.

Susan Dopart: [00:05:56] So, you got to be at the beach? You know enjoyable atmosphere with the people that you love?

Mathea Ford: [00:06:03] Absolutely right on the beach. Got to go out to the sand every day and yeah! Or sit in the pool. Whichever one I wanted.

Susan Dopart: [00:06:12] You had a choice?

Mathea Ford: [00:06:14] Yes.

Susan Dopart: [00:06:14] Yeah. About how you wanted to be in nature and enjoy yourself?

Mathea Ford: [00:06:21] Yup!

Susan Dopart: [00:06:21] No real responsibilities of usual daily life?

Mathea Ford: [00:06:26] Right! I Just had to make sure my kids were fed.

Susan Dopart: [00:06:31] Yeah! Everyone fed and happy.

Mathea Ford: [00:06:33] And sunscreen. That was a responsibility sunscreen.

Susan Dopart: [00:06:37] Right! So, you do sunscreen and then the rest of the time you got to just chill and relax?

Mathea Ford: [00:06:42] Yeah! I actually usually read a book or two and I read one called Story Brand by Donald Miller.

Susan Dopart: [00:06:51] To expand your horizon to help out with your show?

Mathea Ford: [00:06:56] Yeah! It’s just it’s a really good book about telling stories. We all know telling stories is more compelling than just facts.

Susan Dopart: [00:07:07] Right! You love a story then?

Mathea Ford: [00:07:10] Yeah!

Susan Dopart: [00:07:10] If I can summarize you, you had this lovely vacation where you went with your family. You’ve got to be in nature, you’ve got to be by the beach or be at the pool. You didn’t have as many responsibilities as you have in daily life and you’ve got to expand your mind with some new cool book.

Mathea Ford: [00:07:28] Absolutely! Yup!

Susan Dopart: [00:07:32] So, how did you feel with the first conversation versus the second conversation?

Mathea Ford: [00:07:38] Well, the first conversation it wasn’t a Yes/No questions but it was almost Yes/No questions. It was like not… Normally, I probably answered them just a little bit more because I don’t really know you that well if you were my friend and you’re like “Where did you go on vacation or what did you do on your last vacation?” I would have elaborated but because I don’t necessarily know you personally and talk to you on a regular basis I really didn’t feel like you wanted me to elaborate. Didn’t really feel safe to do that. Yeah!

Susan Dopart: [00:08:13] Absolutely. And how did you feel in the second conversation?

Mathea Ford: [00:08:20] I felt like you were listening and kind of following what I was saying and then asking follow up questions and really interested in what I was saying.

Susan Dopart: [00:08:35] Interested in you as a human being.

Mathea Ford: [00:08:36] Yeah!

Susan Dopart: [00:08:39] So, that’s just a little snippet of asking a bunch of questions which creates that Yes/No answer and promotes what we call disengagement. Right? And the second way was reflecting. I say all the deliciousness of what you are telling me to move the conversation forward. Part of what we want to do in motivational interviewing is reflect what we hear and Stephen Rollnick is one of the authors of the MI says that 90 percent of people do not know how to reflect. They just know how to ask questions or give advice. So, how do we help people in a different way and reflect what we hear? And there’s two different types of reflections and motivational interviewing. One is called Simple where you just reflect basically what you heard. But the common way or the most effective way to help a client is reflect in a way we call a Complex Reflection which adds meaning to what we heard to move the conversation forward.

Mathea Ford: [00:09:48] So what would have been a complex reflection in that back and forth we just had?

Susan Dopart: [00:09:57] Basically, when you talked about being at the beach or at the pool said you’ve got to be in nature, you’ve got to enjoy yourself. Those are things you didn’t say but I added meaning to what you said to help you want to talk more.

Mathea Ford: [00:10:17] Okay. That makes sense. So, a simple reflection is really more just like “So, I hear you saying that you went to the beach?”

Susan Dopart: [00:10:25] Exactly! Exactly! Does it really do… It doesn’t do anything. Someone says “Yeah! I went to the beach!” You know but if I add meaning to what you said it makes someone go in their head and think about saying more. Now, it’s a guess on my part and a lot of complex reflections are guesses but we say in motivational interviewing it’s okay to guess because if you’re wrong the client will correct you and tell you what their truth is. And that brings me to another really important part of motivational interviewing which is called The Spirit of MI which is compassion, collaboration, partnership, and evocation. And even though we are experts in nutrition in our field we are not the expert in the client in front of us. So, how do we combine our expertise with their expertise in them and have what we call Equal Power Sharing. Because if we keep telling people what to do it’s human nature that they’re going to take the opposite approach and tell us why it’s not going to work for them. And there’s a big problem with that. If you’re telling someone you need to exercise and they tell you all the reasons why it’s too much work for them or does not going to fit in their schedule. When someone says that out loud it reinforces to their brain that they’re not going to do it. They become more committed to it. Right? So, Bill Miller one of the other authors of MI says “don’t take the good lines because if you’re taking the good lines of you need to exercise, you need to eat healthfully your client is going to take the more reluctant or resistant lines and say you know that’s not going to work.” You know “I can’t do that, I’ve tried that before.” And the problem with that is they get more committed to that. And it creates more ambivalence. So, we try to evoke the good lines. So, when you’ve exercised in the past or you’ve lost weight, what worked for you? They have to go in their head they have to say it out loud which reinforces to them. How they’re successful and then all you have to do is reflect it back. “So, when you were able to exercise in the past you got up early in the morning or you joined a class or you took a walk with your spouse.” You just have to reflect whatever they said to move that conversation towards change. MI is a language. It’s a language that gets layered in your brain the more you use it. And a lot of times clinicians say “Oh! I know MI. I Went to a class or I took a webinar or I went to this introductory day of it.” And the problem with that is it’s a great way to start to learn MI but it’s because it’s a language you can’t learn French or Spanish in a day. So, it’s you know you have to be committed to really putting in time to really learning it so you can utilize it effectively with clients.

Susan Dopart: [00:13:46] And one thing I say in my training as well, is it worth it? Well, if you find yourself having the same conversation with your clients where you’re the one arguing for change and they keep staying stuck in their ambivalence. Then maybe there’s a different way that you could talk to them so that you are truly getting them to talk about change versus you talking about change. You know and if you feel like you’re always stuck in the water with people this is a way to help move through that stuckness.

Mathea Ford: [00:14:23] You mentioned the four processes or the Spirit of MI – engage, focus, evoke plan. And you talked a little bit about evoke. Can you talk about each of those a little bit deeper?

Susan Dopart: [00:14:35] Sure! Sure. And what was interesting is motivational interviewing is in its third edition now so and that came out a few years ago and that’s when they added these processes called Engage, Focus, Evoke, Plan and a lot of times you hear people try to get to the plan immediately. “Well, what’s your plan? What do you want to do?” Without ever using the other three processes. So, engage. That’s the process where you know you really get getting someone on board with a conversation with you. And research shows that a client will make a decision about whether you can help them in the first one to two minutes. So, how do you engage someone and make those two minutes really count? Right? And part of that is reflecting what you hear so they feel safe. Because if someone feels they don’t feel safe if they feel like you’re going to tell them what to do or give them advice that they’re not sure they want there’s not going to be engagement. And without engagement there’s really not going to be a conversation. Steven Rollnick says “20 percent of the conversation is engagement.” Right? And so when someone walks in my office I’ll say “you know thank you for coming in.” That’s a great way to to show engagement. “Thank you for being here. Tell me what would be most helpful today? What would you like things to look like?” And you see people kind of look at you like “I’ve never heard that one before” you know and then they kind of start to relax and they go in their head and they think about their motivation but why they’re there and then all you have to do is do a few reflections and within two minutes they’re engaged. They feel safe. You create what we call a working alliance with them because without a working alliance, people don’t change. They don’t come back. You have to create that working alliance from the get go. And once you have that then you can you know ask some open ended questions like “Tell me what would be most helpful today? What would you like to talk about? What would you like to work on?” That’s the focus because many times they have like a lot of things in their head. And if you haven’t found the focus then you can’t go on to working on what they really came for. Right? So, someone says “you know I’d really like to figure out a way to lower my blood sugars.” You know a reflection might be “So, you came here because you really care about your health and your diabetes? You really want to figure out a way how to get those blood sugars down that’s why you came in?” It’s a complex reflection that leads towards change. We’re always trying to go towards what we call Change Talk. In Motivational Interviewing, we say there’s three types of talk there’s Discord, there’s Sustained Talk and Change Talk. And our goal is to always pull. We call it Pulling for Change Talk. So, the other types of talk, one is called Discord. You want to… That’s when there’s smoke in the room. Conversations going South. You know someone says “you know you don’t understand me. You don’t get my world.” You know you never want to have conversations that lead towards that. And if you hear that you have to repair you have to say “I’m sorry” or else there is no working alliance. There won’t be any conversation about change. Sustained Talk is about someone’s ambivalence. It’s about you know just their wanting and not wanting incompatible things at the same time which is many times thought of as resistance. But it’s really just ambivalence. And a clinician can invite ambivalence with what they reflect. For example, here’s how you do it. Someone could say you know it’s in response to that same conversation with the diabetic. “You really want to change your blood sugars and yet it’s really hard for you and you’re not sure how to do that?” I just reflected on the second part of my reflection someone’s struggle which the client will talk about the next thing that you said. So, the next part they’ll talk about their struggle. If I flip it and say “although, this is really really hard for you you came here because you want to figure out a way to help your blood sugars come down.” The next thing they’re going to talk about is how to get their blood sugars to come down. So, it all depends. We have so much control and direction in how the conversation is going to go and we don’t even know it. We don’t even know it. But many times I mean I work with a lot of dietitians who are working to learn Motivational Interviewing and there’s a few of them. They’re always reflecting the struggle and the whole conversation is about the struggle. Right? And if you flip it you can acknowledge the struggle because you want to be empathetic but you can reflect what we call the dream or the vision or the values that you’re pulling someone’s brain to go towards what makes them be successful. What makes them go in the direction of change. And if you know how to do that it makes your job so much easier. You know you get out of that struggle with clients you know you get out of that stiffness. At the end of the day your life is so much easier. You know it’s so much more simple because your clients are happy. They’re talking about change, they’re talking about ways they know they’re successful in their lives and they want to come back because they know that you’re going to help them get through what’s getting in the way of them not being successful.

Mathea Ford: [00:20:42] And then the Change Talk is really when you’re kind of making, they’re making those decisions. Those commitments I guess. Or how is that different than this?

Susan Dopart: [00:20:54] There’s different types of that getting into a little more details. Some motivation, everything. But there’s two types of Change Talk. There’s Preperatory Change Talk where they’re talking about their desire, their abilities, the reasons for change or their needs and then there’s Commitment Talk which is like what you said “I’m willing to do this. My plan is to do this.” We say in Motivational Interviewing “If you’ve done a good job of engaging, finding the focus and evoking what makes someone successful the plan or the commitment language will just emerge. You know you don’t even have to ask about it.” So, when you’ve been successful with checking your blood sugars you set a timer or when your blood sugars were more even keeled you made sure to have protein at every meal and then someone just blows it up. “Yeah! You know I realize now talking to you I was able to control my blood sugars when I included protein at every meal and I watched my carbs or whatever it is.” You’re trying to go in and say “I must be a detective about what has made them successful in the past.” And can they pull from that? And use it in their current situation with whatever they’re ambivalent about.

Mathea Ford: [00:22:16] When you think about clients and kind of how they do a little bit of resistance or you said it’s ambivalence. What is typical that people are going to… Or you see clients usually showing what kind of ambivalence, what kind of resistance?

Susan Dopart: [00:22:36] I mean everyone’s ambivalent about something. Right? You know “should I pay bills or should I go to the movies? Or should I go for a walk when I get home from work or should I sit in front of the TV and watch Netflix?” You know it’s like so many things in our life we’re ambivalent about and we’re procrastinating about. And like I said it’s thought of as resistance so how do you know a lot of times people will come in and they’re resistant because you know they think you’re dietitian you’re just going to tell me what to eat. Right? And food is very intimate. Right? Many times people don’t want to be told what to eat. I will say if someone is super motivated and comes in I don’t need to use Motivational Interviewing but most of the time I will use it because people have been ambivalent. They’re struggling with how to be successful. They may say something like “and I’ve seen a lot of dietitians in the past. Nothing’s worked. I’m just here because my doctor told me to come in.” Those are some resistant statements. So, I’m just going to reflect what I hear and say “So, you know you haven’t had a lot of success in the past. You had experiences with people telling you what to do it really hasn’t worked. And even though your doctor said for you to come in I’m wondering you know you had a choice about that. You had a choice about whether you want to come in and I’m wondering what made you decide to really make that appointment to come in?” Okay? They have to go in there. They have to think about their motivation. You have to say it out loud which reinforces to their brain why they came in and then all I have to do is reflect it to make the conversation move towards change because what they’re doing is they’re throwing out a smokescreen and we don’t want to do is take the bait. Don’t take the bait with a smoke screen or sometimes your clients will say to a dietitian “well, tell me what you eat?” You don’t take the bait. Never. You never tell what you eat. You emphasize autonomy. You say “well, you know what I eat is going to be completely different than what you eat. Because we’re different people we have different physiology. So, today we have to figure out what’s going to work for you. What’s going to be the way that’s going to work for you. And together we’re on this journey to figure out how to help balance your food, control your blood sugars. Tell me you know even though you’re struggling with this now, is there anything that’s worked for you in the past?” Right? Because remember we’re trying to evoke what has made them successful. So, there’s a lot of different ways you can navigate these Motivational Interviewing conversations. But if you have resistance you have to roll with it. We don’t head into it. You just roll with it. So there’s nothing left to resist against.

Mathea Ford: [00:25:37] Because all the things they’re saying are things that are things that they’ve been successful with in the past. Or they’re telling you what they’re they’re struggling with so you can I guess you’re reframing it for them in a way by reflecting.

Susan Dopart: [00:25:53] Yeah! Another thing that’s you know interesting with dietitians when people come in they start confessing. Right? Like you know “I haven’t done this, I haven’t done that, I have done that.” It’s kind of like you’re the parent. You know, way to kind of deflect that in Motivation Interviewing, you know “let’s put that aside. You showed up today. I’m making what I call an affirmation. I’m noticing what they’re doing well and affirming that you know you could have canceled, you could have no showed but you came in today show and you really want to change this. So, I’m wondering what actually worked for you this week. Would you feel like you did well? Right?” I’m pulling for Change Talk. I’m pulling for them to tell me what they did well. Say it out loud. I reflected to have the conversation go towards change. Right?

Susan Dopart: [00:26:49] So you want to stay away from being punitive or you know being the taskmaster. Right? Or some things that are you know normal sometimes with conversations with professionals where you’re it’s kind of a setup for you telling someone what they didn’t do or they’re wrong or you know threatening types of statements because it doesn’t lead towards change.

Mathea Ford: [00:27:17] So, how do you dig a little deeper if you feel like someone’s not telling you the whole story so they’re just really “I came here cause my doctor wanted me to they’re like I don’t know why.” If they start kind of not telling you the whole story or you suspect like you mentioned you the food police sometimes they’re like confessing. But they also come in with a perfect story because they’ve been to so many dietitians. They know what they’re supposed to say.

Susan Dopart: [00:27:49] Right! Why Don’t we do a little role play? And you’d be that person and I’ll model it for you.

Mathea Ford: [00:27:54] Okay. So, where do you want to?

Susan Dopart: [00:28:01] So, you start with being just say what you just said and all.

Mathea Ford: [00:28:06] I don’t know. My doctor sent me here but I eat fine. I eat three meals a day. Good food. I always have vegetables. And I don’t know why I’m not losing weight.

Susan Dopart: [00:28:20] So, it’s a little bit of a quandary. You’re doing everything possible. You know how to do and yet the scales not budging.

Mathea Ford: [00:28:34] Yup!

Susan Dopart: [00:28:35] So, tell me a little more about that? Tell me about kind of what your day looks like and all the things that you feel like you’re doing?

Mathea Ford: [00:28:46] Well, I get up in the morning. I always have breakfast. I usually eat a bagel and I put a little bit of cream cheese on it and then I go to work, take my lunch. Always take a salad, put a bit of grilled chicken on it and then I use like a low cal salad dressing and I have an afternoon snack. I try to get a little handful of walnuts and then in the evening I come home and three days a week I walk for an hour on my treadmill and while after dinner and then dinner we usually eat as a family and we always have a green vegetable and some meat and potatoes or you know like rice or something like that. So, I am not seeing any change at all.

Susan Dopart: [00:29:39] You have a lot of things that you’re doing in your life. You’re making sure you have your meals and your snacks. You’re getting in your exercise, you’re really thinking about how much you’re eating. And somehow it doesn’t seem to be leaning towards the plate you want to go. So, I’m wondering in the past is there anything that has worked for you in terms of weight loss?

Mathea Ford: [00:30:10] I think it was being younger.

Susan Dopart: [00:30:14] Having a better metabolism.

Mathea Ford: [00:30:18] Absolutely! Now, that I am 45 seems to have slowed down.

Susan Dopart: [00:30:24] Going towards menopause. Right?

Mathea Ford: [00:30:26] Yeah! Yeah Something like that.

Susan Dopart: [00:30:29] So, I’m going to demonstrate something a technique in Motivational Interviewing called E.P.E – Elicit Provide Elicit – because I think a lot of dietitians will think “well, you know I’m trained to tell people what to do. What do I do?” Right? And so I’m going to demonstrate that. So. Elicit a minute I listed it for you. What has made you successful in the past. So Mathea, when you’ve lost weight I know you’re on a roll. You know when you’ve lost weight in the past. Besides being younger, is there anything specific that has seemed to work for you that you can remember?

Mathea Ford: [00:31:09] I did Weight Watchers and I counted on my points. And I did that. That seemed to work at least for like a month. And then if I didn’t count points it didn’t seem to work too much.

Susan Dopart: [00:31:25] So, you had to really be super conscious about every bite you made?

Mathea Ford: [00:31:35] Yeah! Paying Attention to portion and then just tracking it knowing kind of how much I could have.

Susan Dopart: [00:31:43] What helped with the tracking do you think would help you to likes to be focused with that and motivated?

Mathea Ford: [00:31:54] Well, at first you have to believe that it’s going to work. So, I just kind of said “Okay, I’m going to give it a try and give it an offer you know see what happens.” And then I did show some weight loss. And so after that it’s like “Okay, if I track I’m going to have the results” and it does keep me from going into the office, seeing people with donuts and going “Ohh! I cannot have a donut today.”

Susan Dopart: [00:32:22] So, the results really helped you and kept you on track with not getting sidetracked with things at the office?

Mathea Ford: [00:32:34] Yeah! Just knowing that if I eat that donut I’m going to have to not pay for it later. But just later.

Susan Dopart: [00:32:45] Well, you realize in that moment that eating the donut wasn’t going to lead you to the place you wanted to go?

Mathea Ford: [00:32:51] Right!

Susan Dopart: [00:32:52] Right. Yeah! And I’m wondering, you know we could in our session today, we could talk about food. We could talk about exercise. We could talk about sleep or you know mindfulness with eating or we could talk about something else. So, I’m wondering which of those resonate with you in terms of what would be most helpful to talk about in our session?

Mathea Ford: [00:33:22] Well, whichever one of those is going gonna lead to me losing weight.

Susan Dopart: [00:33:25] Yeah! Well, part of that is figuring out for you what makes the most sense to you today. Right. Because really it’s all about you. You’re the driver of this and how do we together figure out what’s going to be most doable or sustainable for you.

Mathea Ford: [00:33:46] Yeah! I mean I didn’t really enjoy accounting for food type stuff but I did see success with that in the past so that might be a good thing to talk about.

Susan Dopart: [00:33:57] Right. So, maybe kind of how do you balance your meals or work on your food without having to be so super tight about the numbers? That might be helpful.

Mathea Ford: [00:34:08] Sure!

Susan Dopart: [00:34:10] Okay! So, I just modeled what we call EPE (Elicit-Provide-Elicit) So, what I did is elicit from you what you’ve been successful with in the past. And then I provided you a number of options and the research shows and you provide options, everyone wants control and choice so they’re more likely to make a choice and pick the thing that they want to talk about so that you can actually go to you know Elicit Provide Elicit and you can elicit and give them information about that thing that they’ve gotten on board with. Even though it’s a little bit of a setup if you’re willing to trust that and use it your progress will be much quicker because someone’s brain will be more onboard with receiving and listening to information.

Mathea Ford: [00:35:04] Yeah! I felt like I was being really difficult but I know I’ve had a lot of people that talk us to like that like I’m doing everything perfect but yet you know you know there is something wrong because there’s it’s out of balance. So, yeah! That was good at being a really bad pain in the neck patient?

Susan Dopart: [00:35:25] No! You were actually a very normal patient. You know. I mean I always say “I’m the end of the line” when people come and see me. You know they’re like “I’ve tried everything! I’ve done this! I’ve done that!” And you know they show up because they really do want the help. So, how do you kind of reflect and hone in on what got in the way of them being successful? And that’s a question you can ask someone. You know “I wonder what’s getting in the way of you doing what you truly want to do?” You know they have to go in their head. They have to think about it. I have to say it out loud which helps them realize what is getting in the way. And then if you reflect that statement towards change you know it’s like makes your life and your work so much easier and so much more fulfilling.

Mathea Ford: [00:36:17] This is the thing I talk about sometimes with other RDs like if knowing how to lose weight was the way to lose weight then we would all be skinny. Right? But it is that next step after we know what to do. We know we need to eat healthier, not eat so many calories. You say that all the time but kind of having that in a way that is like “I understand what you mean” when you say the agreement and that kind of the working agreement like “Okay, we’re going to work together but I’m not going to be the food police” type of thing.

Susan Dopart: [00:36:56] And telling people they’re the driver. You know they’re the ones that are in control because emphasizing autonomy is really a way for people to think about “well, what is it that I truly want? What is it that I’m going to do? I need to take responsibility for my choices.”.

Mathea Ford: [00:37:12] Yeah! And they don’t come with a list of things that the dietitian told them to do. They leave with a list of things that they’ve agreed and feel like is possible over the next terrible long till they see you again. Right?

Susan Dopart: [00:37:27] Right! They start to leave with hope.

Susan Dopart: [00:37:29] Yeah! And that’s what we we truly want is how do we help people and keep our eyes on the horizon for change in people who don’t have hope for themselves. And that’s really what our true goal and mission is is you know a lot of times we say “meet people were there at” and in Motivational Interviewing, w”e don’t say that and say meet people at their dream. What’s their hope? What’s their dream? Why did they walk in that office?” Even though they’ve had all these lack of successes in their life. There is a part of them that is still looking for hope. That is still looking for a way to help their health, their life, their blood sugars or whatever it is. And how do you evoke whatever it is that’s there so that you almost work yourself out of a job. So, they realize they could do this. That it’s possible, it’s reasonable, sustainable and now we just give people lists of information and folders of things. Most the time it’s you know in the trash. You know it’s not. So, how do we really figure out the piece of what it is they really need so that when they leave they know what we know they have some hope about what they could do.

Mathea Ford: [00:38:52] So, how do you measure the results of Motivational Interviewing? Because I know we have Medical Nutrition Therapy Plans that tell us what to go through and what to track and all that stuff. But how do you measure the results when you’re working with patients when you’re using Motivational Interviewing?

Susan Dopart: [00:39:08] Well, there’s about 800 clinical trials that showed when clinicians use Motivational Interviewing there were much better outcomes. But I guess personally for me it’s you know now are people losing weight? Are their blood sugars they’re going down? Their A1Cs going down? Is their health changing? That happens all the time. I mean I have a man in my practice who is 75 years old and he came to me about a year or nine months ago. So, almost two years ago in December his A1C was nine and a half. His creatinine was 1.8, he’s 5 foot 8 and he was 330 pounds. And his physician said to him “you know I think you need to put your affairs in order because your health is not going in the right direction.” And he walked in and the physician said to me “I don’t know if this is going to work because he’s eats a lot, drinks a lot. Very overweight you know. Got a lot about risk factors but let’s see how it goes.” And I used a lot of Motivational Interview with him. He never knew about insulin resistance so we talked about that and you know when I basically made it his choice. “You know it’s your choice but this is what we could do together.” And you know this is one of those cool success stories where today he’s 158 pounds. He just… All he did was watch his carbs. You know we had a metformin. He brought activity back into his life and you know he was really meticulous about his carb intake. And I can say you know I saw him a couple days ago. I see him every two or three weeks and he said “you know my blood sugars are creeping up on meat and a little too many carbs. And I just need to you know cut back on that.” And I have to do is reflect that. That’s all I had to do. And he e-mailed me this morning and said well he e-mailed me “blood sugars less complex because look I cut back on my carbs and they’re coming right down.” So, he was the one giving the solution but that came from all the work we had done with Motivational Interviewing. And I truly believe he’s going to be one of the ones that completely maintains his weight and his A1C is now 5 which is unbelievable.

Mathea Ford: [00:41:34] Unbelievable. Yeah!

Susan Dopart: [00:41:36] But his Creatinine came back down to 1.2. So, you know he’s one of those success stories but you know he’s not unusual. I mean I have a lot of people in my practice that if you know they’re willing to go the road with you and their brains work well with Motivational Interviewing they can be quite successful.

Mathea Ford: [00:42:01] If you think about I did mention you know we have these Medical Nutrition Therapy Plans that when you get Medicaid or Medicare, you kind of have these guidelines that you follow. How do you still do that while you’re doing Motivational Interviewing? Is the Motivational Interviewing kind of the precursor to that? Or how does that work together?

Susan Dopart: [00:42:25] Well, I mean it’s easy to weave in Motivational Interviewing with your assessment but I mean one thing I always say in my trainings is “you may get the best assessment at the first session but if you haven’t created that working alliance with someone how good is your assessment if they don’t come back? If they don’t feel like you were able to create that alliance with them.” Right? So, you know engagement is easy. I mean if you’re reflecting within those first two minutes and creating engagement then someone is much more willing to have a conversation with you. And sometimes you know if you have questions to ask for your medical you know in respect your Medical Nutrition Therapy you can just say “you know I have a few questions I need to ask would that be okay?” Because a thing in Motivational Interviewing we say “when you ask permission, its about to show respect.” So, we always want to show respect. So, if you have to ask a few questions, you just ask permission to do that and then you kind of weave in the Motivational Interviewing with engagement, finding the focus of why they’re there and then evoking. So, it can be a very fluid conversation. You know when you watch it it can be very natural you know and it’s just where you’re evoking more of these solutions from the client versus us the clinician. And if we need to talk about things because of course we do you know especially with people who are diabetic or someone with gestational diabetes you ask permission. You get them on board with receiving information. And Stephen Rollnick you know one of the authors of MI says “if you trust the method and you slow things down in your mind, the progress will be much quicker” and a lot of times us as professionals we’re in such a hurry to get to the plan that we end up getting all this resistance and it slows our progress. Right? It creates people who are more resistant or reluctant to change. So, Motivational Interviewing, it’s a way of being with people. Are we present? Are we truly listening to what they need and reflecting that? Do we know really why they’re there? You know a lot of times we think “oh! They’re diabetic! They’re here because we have to talk about their food” but is that really why they’re there?

Susan Dopart: [00:44:56] Maybe they want to talk about you know Blood Glucose Management or they want to talk about exercise. You know the more we go with where they want to go, the quicker our progress will be. And so it’s just a lovely way of talking to people and making our job easier.

Mathea Ford: [00:45:16] Do you have any quick tips or thoughts for how the listeners could use this in their day to day life without obviously knowing the whole scope of Motivational Interviewing? Any little thoughts?

Susan Dopart: [00:45:27] Well, listening is hard. Most people don’t do it. And a way you can practice is maybe with start with a friend or start with their child is ask a question “how was your day?” And then whatever they say try to do a reflection of what you heard or add meaning to what you heard rather than asking a bunch of questions. And you know people laugh when I do the Checklist versus Conversation like I did with you. But yeah people do it. You know I’m a coder in Motivational Interviewing. So, what does that mean? When people are trying to learn the language they can submit a 20 minute tape, an audio tape of them having a conversation with a patient or a client and then it’s coded to the fidelity of the language and are you evoking Change Talk? Are you showing empathy and partnership? Right? And that’s a really great way to start to learn Motivational Interviewing after you’ve gone to an initial workshop because even if you actually never had the conversation coded, if you actually get permission from a client to tape a conversation and you just don’t use any names so it’s anonymous. You can hear what you said and what the client said and this is a very important point. When I became a coder, I started realizing that a code that you can almost 99% predict what a patient’s going to say based on what what the client says. What we say really does matter. Right? So if we are telling someone what to do we might get Sustained Talk, ambivalence. You know if someone feels judged, there’s gonna be discord but if we’re reflecting what makes them somewhat successful we’re going to get Change Talk. Right? So, how do we choose our words carefully so that we get more Change Talk? And part of that is through affirmations and reflections and reflections like I said are hard to learn. But if you practice in your day to day life it’s going to be more natural when you’re with the client. Now one qualifier I will say is it’s very hard to use motivational interviewing with your spouse or someone that you have an agenda about and then this is a very important point in Motivational Interviewing. We are guiding towards the possibility of change but we don’t have an agenda because if we have an agenda in our head we’re going to be forcing that agenda which is going to result in Sustained Talk or Ambivalence Talk. Like with my husband, he doesn’t like exercise so I can’t have a Motivational Interview and conversation with him about exercise because my agenda is I want him to exercise but I can have my conversation with him about something else. Something related to work where he just talks about what’s going on and I reflect. I add meaning to his statements about what what he’s feeling or thinking and that’s a way you can practice with with your friends or people that you come in contact with so that it’s more natural when you’re in the office.

Mathea Ford: [00:48:43] That makes sense. It does seem like you said it’s a language it needs practice and building up your skill level so. All right. So, my last question is what’s your favorite food? I try to ask everybody that. So, what’s your favorite food Susan?

Susan Dopart: [00:49:02] My favorite food is almond butter like fresh ground almond butter. And my treat of the day is I always come home and have a tablespoon or so of almond butter with a score of 85% dark chocolate and my favorite dark chocolate is Alter Eco. So, that’s kind of my treat with a cup of tea when I get home from work. I’ve done a big training or seen a bunch of clients. That’s kind of my transition before dinner.

Mathea Ford: [00:49:32] I love it. It’s almost like Reese’s but much better.

Susan Dopart: [00:49:35] Much better. Much healthier.

Mathea Ford: [00:49:39] Yeah! Yeah! Well Susan, 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 Motivational Interviewing and just even making some small changes. If listeners want to connect with you what’s the best way to do that?

Susan Dopart: [00:49:58] My website is Susandopart.com S-U-S-A-N D-O-P-A-R-T.com and I have a lot of information on there about trainings both in-person and virtual trainings but I also have an MI blog and what I try to do is once a month or so I’ll put a type of tool for Motivational Interviewing like what type of talk are you hearing or how do you evoke Change Talk and you can read a couple paragraphs on each thing and you know a lot of times it’s a good way to reinforce in your brain how to use Motivational Interviewing especially if you don’t have time to go to a workshop or expand your use of it in any other way. It’s a nice way to read about things so. But I do have virtual trainings for people that aren’t in California. I started doing those about a year ago with Zoom. It’s actually as what you and I are on it right now it’s a pretty cool platform. It’s actually better than I thought. It would be because you can put people in virtual breakout rooms and show videos on the whiteboards and that’s pretty much the next best thing to being in-person. So, that’s a great way for people to learn those who don’t have access to workshops and other areas as well as being more affordable. So, you can if you have questions about Motivational Interviewing you’re welcome to email me at Susan@susandopart.com or send me a message via the website. But I’m just. I love this beautiful collaborative partnership language and I guess my hope is that more clinicians specially dietitians will get more proficient in Motivational Interviewing. So, thank you for having me on your show so I can spread the word and really really appreciate it and thank you for being my model for demonstrating the skills. Truly a pleasure to be here.

Mathea Ford: [00:52:05] Yey! All right! Well, guys it’s 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 29 RDs Are Like Coaches Not Referees with Melissa Joy Dobbins

November 19, 2018 by matheaford Leave a Comment

The Guilt-Free RD® – “Because food shouldn’t make you feel bad!”
CEO of Sound Bites® Inc. – Sound Science. Smart Nutrition. Good Food.®
Creator of Do M.O.R.E. with Dinner – Make Ordinary Rituals Extraordinary TM
Recipient of the Media Excellence Award – Academy of Nutrition & Dietetics – 2016
Named one of “10 Dietitians You Need to Follow on Social Media” by U.S. News & World Report
Podcast: Sound Bites Blog: Food for Thought Twitter & Instagram: @MelissaJoyRD

Melissa is an award winning, nationally recognized food and nutrition expert, certified diabetes educator, media trainer, spokesperson, speaker, blogger and podcaster with more than 20 years’ experience and a proven track record of providing real solutions for real people so they can enjoy their food with health in mind.

People are hungrier than ever for realistic options that empower them to make healthier choices, while bringing back the enjoyment of food. Melissa helps people digest food and nutrition information so they can make their own well-informed decisions based on facts, not fear – and most of all, come away with meaningful steps toward better nutrition and health.

Melissa’s background includes nearly a decade of clinical nutrition and outpatient counseling as well as corporate wellness, public speaking, academia, and research. She’s a former supermarket dietitian and also specializes in diabetes, weight management, family nutrition, and food safety/technology. Melissa has extensive media experience as a spokesperson for the food, grocery and healthcare industries, and received the 2016 Academy of Nutrition and Dietetics’ Media Excellence Award. She has conducted over 200 live TV interviews in Chicago and has been quoted in countless publications including the Wall Street Journal, Shape Magazine, and Men’s Fitness. She was recently named one of “10 Dietitians You Need to Follow on Social Media” by U.S. News & World Report.

Utilizing her communications expertise, Melissa enjoys coaching other food, nutrition and wellness experts on media, social media and public speaking skills, with an emphasis on creating and delivering meaningful messages that engage and empower audiences.

Melissa lives in Chicago with her husband and two children. She enjoys weight lifting and all kinds of dancing from ballet to ballroom. She has survived her midlife experiment of competing in events ranging from 5Ks to triathlons.

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 Melissa Joy Dobbins on the show today. Melissa welcome to Nutrition Experts.

Melissa Joy Dobbins: [00:00:45] Thank you so much for having me on.

Mathea Ford: [00:00:47] I’m excited to have you on the show and share your expertise with my tribe. So, let’s start with just letting you tell my listeners a little more about you and what you do.

Melissa Joy Dobbins: [00:00:57] Well I am a Registered Dietitian for twenty five years I believe it’s almost exactly 25 years and I’ve been a Certified Diabetes Educator for 20 years. I’ve had a little bit of a traditional start to my career but then I like to call myself the accidental entrepreneur because I didn’t intend to start my own business but my career path led me that way and my family path sort of led me that way. But I’ve done clinical, as an outpatient and I was a supermarket dietitian. I was a [00:01:33] dairy dietitian [0.8] and I worked in a diabetes clinic. Now, since about 201, I have been on my own doing Nutrition Communications Media training other dietitians anything from traditional media because that’s for all of my media communications experience is live TV interviews in Chicago. So, I train dietitians on anywhere from that all the way to nearly improving your public speaking skills. I get that out of all dietitians are educators. So, we’re all communicators and whether it’s one on one counseling or group classes or community presentations, blogging, writing like I said TV, radio, print interviews. With all that you know we have to be compelling because we have a lot of nutrition nonsense out there a lot of people sharing information that they don’t have the credibility that we do and we have the evidence based that’s kind of a tall order. We have our work cut out for us so I really like helping dietitians improve their communication skills.

Mathea Ford: [00:02:45] Okay, Melissa you said that you have been a dietitian for a long time. So have I. Since I like twenty one years so I just want… I have a curious question: what do you think has changed the most in dietetics since she became an R.D?

Melissa Joy Dobbins: [00:03:02] Well There are certain like milestone type things that been stood out to me. I remember when I first started working in clinical learning. This is maybe three. This is before hurricane and I remember we had like two beatings like this glucerna and then all of a sudden I was like “No you don’t have to have a specialty thing for diabetes.” And few years later I became a certified IBD educator and it was like hard counting that was just such a huge shift. And then also I think the whole concept of “yes, we want to get nutrient rich foods which I think is a concept so lost on patitents and clients. I wish we could just focus on it doesn’t matter what the food is. How much nutrition are you getting out of it? Is it empty calories or does it have nutrients in it? Just the whole concept of like you know “you can’t get everything from food always.” So, for example the vitamin D deficiency that I think is this time is the biggest thing with happened in my career saying that “wow! Lots of people have a vitamin D deficiency giving physicians onboard even check their levels. Realizing that the part of the world we live in. I’m in Chicago, we don’t have a lot of sun here always. And yeah! You’re probably going to need a supplement. It’s about exactly answer your question because those are some of the things that come to mind.

Mathea Ford: [00:04:37] I think it’s just an interesting thing because I remember they didn’t even have food labels. They were just coming out with the first food labels in 1994 and I graduated in ’96 from college. So, we were just learning about them. And now to think of a food without a food label is crazy. But yeah! Okay! So, I know you talked just a second ago about the media trainings that you do for dietitians and you do them in person. I personally met you in 2014 in Oklahoma because you came to do a training with us The Oklahoma Association Dietetics and I want to know kind of how do you help other dietitians speak out to be the voice of reason because like you were talking about there’s lots of other messages out there and not look like the food police? Because I always hated it when people would recognize me in a grocery store and be like “don’t look at my cart” and I’m like “I really don’t know what I don’t know how to tell you I don’t care about what’s on your cart.” Right now, I mean I’m not. Yeah. So, how do you help dietitians with that?

Melissa Joy Dobbins: [00:05:47] Yeah! I always say “well, don’t look at my cart I won’t look in yours.”.

Mathea Ford: [00:05:51] Yeah.

Melissa Joy Dobbins: [00:05:52] Yeah! In fact, when I was a supermarket dietitian, I have a funny story. Well, I think its funny and then I’ll answer your question. When I was a supermarket dietitian, I was kind of recognizable because it’s kind of creepy but they decided to use my picture as part of the logo. So, I was off work one day and I went to the store to get hotdogs and wine for a cookout. And I don’t think I have like a stitch of make up on and I was just wearing my little t shirt shorts and that checkout person recognized me as the Jewel dietitian. So embarrassed. Here I am buying wine and hotdogs. Yeah great!

Melissa Joy Dobbins: [00:06:31] This is so important in fact during one of my media trainings, during this our hands on activity that I do, this messaging activity we came up with the phrase “Dietitians are not the food police we’re more like coaches than referees and these are the types of things that I try to do is to take the information, the fact that the data whatever and package it up a little bit more in a compelling way that when people hear it they’re like “Oh! I get it!” Because we can say all day long “we’re not the police” but kind of giving them that analogy like “we’re going to be your coach, we’re going to be your cheerleader, we’re not you know calling the shots and telling you what you’re doing wrong.” That’s the sort of thing that know dietitians are uniquely qualified and poised to do. We just have our work cut out for us like I said. So, we need more dietitian voices out there you know kind of taking those sensational headlines and translating them into meaningful helpful bottom lines for people. A great… Yes. We do a lot of great work with one on one counseling and group classes. But when we expand that communication to reach larger audiences through traditional media or social media there’s some changes that happen with that. It’s challenging to take a recommendation or somebody who’s sitting in front of you and your tailoring everything to their preferences and then trying to translate that to the masses. A lot of challenges inherent in that but when we’re reaching a larger population with these realistic and let’s say helpful tips and advice you know that helps everybody. It’s a win win. You know it elevates the presence and appearance of the dietitian. You know the understanding of what we really do and who we really are. And it helps the public you know eat healthier. So, that’s what I try to do with my media trainings and in my own nutrition communications whether it’s a TV segment, my podcast or you know writing a blog or just simply a social media post.

Mathea Ford: [00:08:50] So, do you have any ideas or tips for dietitians who maybe you know on social media if they see some false information? What types of things do you use to respond to that or do it to educate and help the public?

Melissa Joy Dobbins: [00:09:10] Well that’s a great question and I’ll tell you when I was on a National Dairy Council spokesperson I had the privilege. I won’t say the pleasure because it was hard but I had the privilege of engaging in several Crisis Communications Trainings. And what I learned whether it’s again traditional media or social media, what I learned is the best defense is a strong offense. So, I’d encourage dietitians not to just wait around and sort of reply or respond when they see something inaccurate. I do encourage that you speak up when you feel the need and there’s a few lapses we can discuss. But in general, if you’re just putting out credible helpful meaningful information on an ongoing basis instead of just kind of responding when you see something that’s negative. And so like a specific suggestion is “I’m a Diabetes Educator” that’s kind of the lane I swim in. I don’t know as much about gluten intolerance or paleo or keto so I won’t talk about those things very much. So, I swim in my own lane and when something that icy comes up that’s not right about diabetes I’ll set the record straight either again like with a reply or response but more importantly, I try to put credible information out about diabetes all of the time so that when people hear something and they’re not sure if it’s true or not. When they go looking for information there’s a lot of credible information that they’re going to find. One caveat to this is sort of those haters on social media. You have to be really careful. I tell people that you know you don’t want to get into a food fight for lack of a better term with haters.

Melissa Joy Dobbins: [00:11:02] And there are people who are willing and able to have healthy respectable conversation and kind of share different viewpoints and listen. And then there are people who are just really out to be mean and hateful. I did… I wrote a 250 word book review on a Paleo Diet book review when I was an Academy spokesperson. You can’t say a whole lot in 250 words but I did say you know this is “I’m reviewing this book because the paleo diet has lots of different iterations and some look a lot different than others.” But this book I shared my thoughts on it. I tried to be as professional as possible. My word choices and somebody didn’t like that review and posted on Facebook and they called me the C word and I was shocked. I know of course you know I’m just got sick to my stomach and so mad and I wanted to respond. And I thought this is not something you respond to if they’re going to call me the C word. These people are unreasonable and they’re not going to listen to the facts and the information or anything that’s not what they think.

Mathea Ford: [00:12:17] Yeah! I understand that dilemma because I have several books on Amazon and people write reviews and you’re like “oh! I want to respond to that so bad. But yes, sometimes people are just irrational so and you do have to not take it personal. But I love what you said about having those messages already in your social media and on your website and stuff because when you respond to that information that needs to be corrected, adjusted, explained whatever then something clicks on your name goes to your profile, your information, they’re going to see that “oh! She consistently posts about this topic and therefore she knows what she’s talking about. So that also lends to your credibility.”.

Melissa Joy Dobbins: [00:13:08] Yeah. And you know another thing that I think is really important I think that we you know when we’re thinking about credibility and evidence based information down science we think “oh! I’ve got to make sure everybody knows I’ve got all these credentials and I did schooling in this and this and that” and yes that’s definitely important and that differentiates us from the celebrity quote unquote experts. But really we need to remember that being real and human and relatable is just as important because people are listening to advice from people like them and people that they trust and they may not just automatically trust the credibility factor. You know they hear it they know it “Okay, they know where you’re coming from” but we need a little bit more to engage that trust.

Mathea Ford: [00:14:04] I absolutely because I know people do things based on referrals. Absolutely so I know people do things based on their friends, referrals or whatever so yes being somebody that people can know, like and trust and being that personable like I don’t put every day perfect pictures of my food on Instagram so I act like I never ever eat you know a piece of cheesecake type thing. So, yeah that makes a lot of sense. What do you say to people when they bring up these celebrity diets or their fad diets that seem to have a grain of truth. You know they they started somewhere with some truth or some scientific basis but they’re not nutritionally sound? How do you help dietitians to respond to that too?

Melissa Joy Dobbins: [00:14:53] I think you know we all know how to respond with “Well, you know let me tell you about the pros and cons of this particular diet.” And again I do think it’s important to swim in your own lane. I think we’ll be starting talking about things that we’re not real experts in that particular area. We can be a sort of loose footing you know we’ve got to kind of make sure that we’re addressing the science and in order to do that you know that the diabetes is uncomfortable. There’s still even areas within diabetes that I’m not comfortable taking a deep dive into and I work for the colleagues of mine for that but I think that what we forget is everybody is an expert in food because everybody eat and we really go a long way to emphasize when we’re talking to either somebody one on one or social media that you have the choice to choose what’s best for you. I would like you to make an informed choice as possible. And I like to tell people like I want them to be informed and unafraid. We know that people make decisions based on feelings. They’re not going to stick to just the facts but hopefully the feelings are here. We don’t want people to make food choices out of fear. So, we want to kind of present them with the information and let them make their own well-informed decision. And here’s a specific example. A few weeks ago in ballet class my friend was talking about organic and she said “well, you’re a dietitian. Do I need to buy all organic produce?” And I said “Well, you know what’s your concern?” “So, my mother is recovering from breast cancer and she doesn’t want meat and this woman is probably mid 40’s. She wants me and my family to only buy organic.” And I said “Well, I don’t use only organic. It’s a personal choice. However if you’re telling me that you don’t think you can afford it and you just don’t think it’s realistic to buy organic all the time. Let me refer you to a website eatfruitsandveggies.com. The Alliance for Good in Farming and it’s a group of… It’s an organization that is made up of organic and conventional farmers and it shares all the research on actually you know as we know the benefits of getting produce far outweigh any potential risks of pesticide residues and that people aren’t getting enough fruits and vegetables and the best thing you can do to prevent cancer is to get more produce. So, they have all the research and everything there. So, I said this is you know my experience but here’s a place where you can go and take a deeper look to take a deeper dive and make your own decision.

Mathea Ford: [00:17:50] I know you also have some things that dietitians can use. You have a sound science toolkit?

Melissa Joy Dobbins: [00:17:56] Yes. So, I created this. It’s basically just a compilation of resources to help dietitians and really anybody can can look at it. It’s a free downloadable on my site but it’s a compilation of resources to help dietitians understand and communicate nutritional research better. So, it’s not specific to any food or product or disease. Say it’s things like what are the different types of studies? Which ones are stronger than others? What are some of the limitations in nutritional research? What’s the difference between risk and hazard? What’s the difference between correlation and causation? In fact I just came across a new resource today that I’m going to add to it in the article that Karen Collins wrote for Today’s Dietitian on Communicating Nutrition Research and it just addresses things like bias and it’s not just the funding source that could be a potential source of bias. There’s other things that we need to understand and be reminded of. You know maybe we learn these things in school but there’s really nobody reminding us of these things so I put everything together in this down science tool kit and people to go to my website soundbitesRD.com right on the home page. I’m actually in the process of revising it. I’m constantly adding new resources to it. You should either see it as a pop up or on the home page and yeah it’s something that I felt would be helpful for me. So, I thought why not put it together and share it with other dietitians.

Mathea Ford: [00:19:36] Yeah! I love that because it is sometimes hard to make sure that you’re being just clear and doing and understanding the studies and stuff if it’s been a while since you’ve been to school then you may be out of practice. So, I know you work with brands a little bit. Any tips for RDs that want to work with brands that align with their work?

Melissa Joy Dobbins: [00:20:01] Basically, you said of make sure that the food or product aligns with your values and what you stand for. Not all dietitians will agree on the same foods and products. We’ve seen that within our community and I’ve just thrown in a side note there you know. Don’t judge others. There’s different people have different preferences and different types of clients so they’re going to want to know more about different foods, different brands. And you know if I’m working with the diabetes population and my clients are you know eating fast food I want to know as much as I can about those food products. But I definitely think that you know you want to think about is this a food group or a food product that you’re willing to go to the mat on? I think that you know it’s easy to say “Yeah I’m working with a fruit and veggie company.” When you start. Like even juice. Oh! My gosh. I consulted with Welch’s. I firmly believe that 100 percent juice fits into our diet and can help us meet our produce recommendations. Even if you have diabetes and you know no one saying to drink a gallon of it you know the haters just come out of the woodwork. Even with dairy I can’t believe how many haters came out of the woodwork when I worked with dairy I’m like “For crying out loud! If you don’t want to drink it don’t drink it but don’t try to malign the science that that’s behind this.”

Melissa Joy Dobbins: [00:21:34] And you know I was willing to go to the mat and say “No, I stand behind this and I’m not going to waiver.” If it’s something that you might not be willing to do that then I wouldn’t work with that product or that company.

Mathea Ford: [00:21:50] Yeah. That’s interesting because I do a lot of kidney disease stuff. I tend to look for like the lower protein less you know not whole wheat white bread. So, I know that that kind of goes against recommendations but it doesn’t go against recommendations for that condition. So that’s a great example. What you talked about. I mean even if I just talk about tomatoes not necessarily as part of a brand but just talk about tomatoes. There’s a huge group of people that are like “How dare you ever tell people with kidney disease they could eat tomatoes?” So anyway…

Melissa Joy Dobbins: [00:22:26] It depends on your population, it depends on the person.

Mathea Ford: [00:22:30] So, if a dietitian was approached by a brand, how do you recommend that they think about working with them? What types of things can dietitians do when they work with brands?

Melissa Joy Dobbins: [00:22:40] Well I’ll back up one step because I get this question a lot from dietitians. How do you start working with brands? They’re not approaching me. So I always say become a super fan of that food or product and get to know that company whether it’s a commodity or manufacturer. You know show them that you are a superfan on social media. Now there is a there’s a little caveat to that sometimes if a company sees that you’re already a super fan they may not be as interested in hiring you because you’re already kind of promoting their stuff but hopefully they would see the value that “hey! This is somebody who we could give them more information about our product and kind of have a really good relationship with.” So, if you get approached or if you reach out to a company to work with them, one of the things that I recommend is personal. You don’t have to do it all. So, for example when I work with a company I don’t do recipe development. I don’t do recipe testing. I don’t do nutrition analysis.

Mathea Ford: [00:23:50] Analysis. Yeah!

Melissa Joy Dobbins: [00:23:50] I know people who do. So, I say I can subcontract that out or I can refer. I can suggest somebody who does that but here are my areas of expertise I can do television interviews, I can do podcasts interviews, I can write a blog I can do social media posts. There’s so many things I can do a webinar, I can speak for you but I’m not going to do recipe development because that’s just not my area of expertise. So you don’t have to do it all. And I think ideally you want to work with a brand in a way that is the best fit for you. So, I’ve had clients come to me and say “Okay, you’ve been writing some consumer focused blogs for us. Next year we want you to write some health professional focused blogs and dig into the science.” And while that sounds really interesting and like that this is an opportunity to get into more science and learn more about this particular product. In reality it would not be the most efficient use of my time and I know others who do that. So I know instead of just saying yes I’ll do whatever work comes my way. I went back to the company and I said “you know this sounds really interesting but these types of activities podcasts interviews, satellite media tours, television interviews those types of things are really more in my wheelhouse right now and would be the type of work I would prefer to do with you. And have you thought about so and so” named a couple of specific people who do a lot more science writing and they ended up hiring that other person to do that. I need to do the types of things that are really more the type of work I’m doing right now.

Mathea Ford: [00:25:32] So, I think that’s two great points you know. Like you said “know your expertise know what you’re good at and know what you just do not want to do.” And then number two networking. So, can you talk about how you network how you know people? What you do to network with other dietitians?

Melissa Joy Dobbins: [00:25:49] Oh yes! It’s my favorite thing. The friendships and relationships I’ve had in my career are just so important to me. I left my outpatient job in 2000 to become a supermarket dietitian and just a few weeks ago I had my 18th annual reunion with the dietitian I used to work at that job including our boss. Every summer I get us all together. Those relationships are so important. And when I became an entrepreneur and you know you’re all by yourself I really love team environments. But you know you’re all by yourself. Your home office not only could I join the Nutrition Entrepreneurs DPG but I was on the board of the speakers and media specialty chair. And that was just such a great way to get involved and not have too much work or pressure. It wasn’t like I was the chair like the president but I got to really meet some really cool people doing some really cool things. Whether you’re seeing them online or you know like you like we met in person. And now we stay connected online. It’s just it’s really fun. And my philosophy has always been I’ve always had you know “I’m not an expert in this but you are. So, I’m going to refer to you or can you help me understand? Even as an outpatient dietitian and all my clinical dietitians that were on my team I would say “Okay, I’m the only outpatient dietitian but I’ve got this patient coming in. Maybe they have a food allergy or some other area that just wasn’t my area of expertise.” And I said How can you help me help this patient? I do this a lot with media interviews. When I get asked to do a media interview that’s just kind of not my cup of tea. I’ll say “Hey! I’d like to refer you to so and so. They are an expert in this area.” And it’s just you know there’s enough work and enough opportunities to go around. Let’s not be selfish. I’ve never wanted to hog this thought why I always want to lift others up. I have called myself a dietitian enthusiast for years. I just think it just come second nature to me.

Mathea Ford: [00:28:15] Excellent! So, go into meetings, go to even just your local association you know your state association meetings and meeting people and just knowing… We have a little in Oklahoma we have a little Facebook group for the dietitians in Oklahoma that some mail post in there. “I need a dietitian in Tulsa who does Peds or who does this or that and or Peds with food allergies or autism or whatever” and it just helps us all to like you said I don’t want to see those parents if there’s somebody that could do them so much better you know and I still like you said there’s plenty to go around. So, that’s excellent. So, you talked a little bit about being a podcaster. We’re both podcasters. So, what do you love the most about being a podcaster?

Melissa Joy Dobbins: [00:29:06] Oh! Definitely the interviews. Talking to my guests. So much so that I think I have a little problem because I think I have like 13 shows in the can right now and maybe you can relate to that. Mathea. I just packed the rest of the it, the production even though I outsource the editing and everything just the production aspect is not nearly as fun. I just… I love talking to my guests and I kind of eat out on my guests.

Mathea Ford: [00:29:35] Yeah! I find, I agree. You have to love to talk to be a podcaster and just have to have a natural interest in people. Sounds like you do. So, what’s your most popular episode podcast episode topic that you talk about?

Melissa Joy Dobbins: [00:29:51] So my podcast is a variety of topics. Anything from diabetes to agriculture to… I dabble a little bit and like mindful eating, body image but there’s so many podcasts so late about it that I don’t really get too much into that. I talk about fertility, farming, food myths and fads, celebrity, pseudo science. I really tend to gravitate toward the like consumer insight and basically just helping people think about something differently. You know you’ve heard about sustainable seafood you know like there’s something wrong with farmed fish but really you’ve got it backwards. So, it’s like the pesticides in produce. And like you know you might hear these scary headlines but here is actually the science. So, with a variety of topics. My most popular episode like I’ll do a survey every year and different people like different episodes. But as far as downloads most recently I interviewed Dr. Julie Miller Jones about grains and here I’m thinking “I didn’t even know grains can be you know controversial in the media as far as like paleo or gluten or…

Mathea Ford: [00:31:13] Keto.

Melissa Joy Dobbins: [00:31:14] Yeah! You know all the fad diets that I have to cut grains out but ultimately I kind of like whole grains seems like such a boring topic. I hope people will listen to this show. And Julie Miller Jones I mean I could listen to her for like all day. And so I was really excited to see that that episode got a lot of downloads because I feel like the first blush people are kind of like they either think “grains are boring. I get it. I need to get fiber. I need to get whole grains. What are you going to tell me that’s new? Or I don’t do grains because I’m keto, paleo or whatever. So, I just buy.” Who’s going to be open to this topic and I’m so so excited that it’s been one of the most downloaded episodes. Another popular one is that I interviewed Timothy Caulfield. He was A health law professor in Canada and he is like totally doing a smackdown on celebrity pseudoscience. I saw him speak at a conference and he started a TV show that is not airing in the US yet but it’s called Cheating Death and he has several books his first book was titled Does Gwyneth Paltrow Have It All Wrong? So, he’s been you know kind of getting on her case for a while. So, he’s got some amazing work and that’s also been really popular episode. .

Mathea Ford: [00:32:38] If we think about everything we’ve talked about. A lot about media training, podcasting, being out in the public, what are some ways that listeners who are dietitians, healthcare professionals and regular individuals can use this information in like their daily life? How do they implement some of what we’ve talked about?

Melissa Joy Dobbins: [00:32:58] Just like you wouldn’t hopefully do your own taxes or cut your own hair or whatever I don’t know. You know a dietitian can really help and if you go to eat breakfast or there’s a button or a tab that helps you find an expert not only in your area but one that specializes in whatever that you need help with like diabetes or cholesterol. I even recently took my husband to a dietitian because his cholesterol has been high for 10 years and you know I can tell him to eat more oatmeal and get more exercise but you know eat more fish. But what else is there? Like I don’t know the specifics like I would if it was diabetes. So, you know you can definitely get a lot of good support from the dietitian. And for the dietitians and health care professionals, my advice is you know follow your passion, take as deeper dive as you can in whatever areas interest you and find a way to communicate more whether it’s doing more speaking or writing or you know social media. Just find a way to communicate more within your area of expertise and network with dietitians and other health care professionals. I find social media a great way to do that. That’s the workshop that I did where we met Mathea was you know find ways to get involved in social media that are enriching and not stressful for you. Like I meet the most interesting people on Twitter. And as much as I would I don’t spend very much time on Twitter but I love it because of that. And you know when you when you find somebody who has a common interest and you see articles or videos or information that they’re sharing that you didn’t know about. It’s just really exciting. So, follow your passion and find a way to communicate your area.

Mathea Ford: [00:34:56] So, what about dietitians who work for a hospital or don’t own their own business aren’t necessarily entrepreneurs. What do you say to them how they can implement it?

Melissa Joy Dobbins: [00:35:07] Yeah. This is like my favorite example because I say “Okay, even if you are a clinical inpatient maybe dialysis dietitian wouldn’t it be great if the local media knew that you were an expert in that area?” So, let’s say a celebrity that particular disease, you can speak to it. So, it doesn’t have to be the every dietitian to do you know on camera TV interviews but it could be the newspaper where you talk to them and you share the science in a way that people can understand which we do that with our patients and clients. We’re not using a ton of jargon and technical information. We’re explaining it in ways that people can understand so it’s the same with the media.

Mathea Ford: [00:35:57] Yeah! I also think you’re not always going to have that job. And if you have it out there in the public that you’re an expert in a certain area and you want another job or somebody is looking for someone as an expert in that area you can have more opportunities that way too.

Melissa Joy Dobbins: [00:36:14] Yes and definitely building your communication skills is one of the best if not the best thing you can do for your career because they’re always inside communications, external communications. You know even negotiating a raise or you’re presenting to your team you know writing an email, boosting your communication skills is really a great way to enhance your career and get more visibility and more success.

Mathea Ford: [00:36:48] I love it. So, Melissa I always ask my guests what’s your favorite food?

Melissa Joy Dobbins: [00:36:54] No! What’s the toughest question? You know I could say pizza or chocolate. The funny thing is I’m more of a liquid. Okay, my favorite food is soup because it’s liquid like my friends and family know like right now, I have a glass of water, a decaf coffee and a diet soda in front of me. I usually have several beverages at a time. Yes. So, I don’t know I love all food but probably my favorite food is soup.

Mathea Ford: [00:37:29] Any particular soup or just cream soup or…?

Melissa Joy Dobbins: [00:37:33] I love my mom’s chili. I love Italian Wedding Soup. I have a great recipe from Jada that if you even make your own meatballs which sounds so hard but it’s actually very easy. More probably like broth faced with with like lots of stuff in it.

Mathea Ford: [00:37:49] Yeah. I love soup too but I can imagine living in Chicago. There’s a lot more opportunities to eat soup. Well, Melissa 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 media given that there being more public and just making sure expertise is known. So, if listeners want to connect with you what’s the best way to do that?

Melissa Joy Dobbins: [00:38:18] Yeah! They can find me online my website is soundbitesRD.com and I’m on Twitter and Instagram @MelissaJoyRD. I’m on Facebook Melissa Joy Dobbins and The Guilt Free RD Soundbite. Also obviously my podcast and you can find my podcast on iTunes, Stitcher anywhere you consume podcasts. Sound Bites two words with Melissa Joy Dobbins and definitely check it out if you like podcasts. Hopefully, you’ll like mine and Mathea thank you so much for doing your show and for elevating the visibility dietitians and supporting dietitians.

Mathea Ford: [00:38:59] Thank you! Well guys, this has been another great episode of 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 28 Functional Nutrition And Healthy Guts with Sara Korzeniewski, RDN

November 12, 2018 by matheaford Leave a Comment

Sara is a registered dietitian, certified LEAP therapist, and functional diagnostic nutrition practitioner. She suffered with hormone and digestive symptoms for years with little recommendations for relief. Being in the wellness field she knew there had to be more going on and was determined to find a solution. She started studying functional medical nutrition therapy and through functional lab work, nutrition, and lifestyle was finally able to find a long term answers to her symptoms. Now she helps busy women dig to the root cause of their health issues. Using proper testing, science based education, and lots of support, she empowers women to take back their health and gain back energy and vitality!

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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 Sara Korzeniewski on the show today. Welcome to Nutrition Experts. I’m excited to have you on the show and share your expertise with my tribe. So, Sara tell my listeners a little bit more about you and what you do.

Sara Korzeniewski: [00:00:56] So, I am a Registered Dietitian. I’ve been a Registered Dietitian for about 13 years now. I’m also a functional diagnostic nutrition practitioner as well as a certified LEAP therapist. So, I help busy women dealing with hormone imbalances, digestive issues kind of get things back on track. I don’t just treat symptoms but really help clients get to the root of their symptoms. I’m all about you know getting to the root cause and not just managing symptoms, you’re trying to cover them up. I use functional lab work to find hidden internal stressors and dysfunctions to really help provide clients with resources and information to be able to rebuild their home.

Mathea Ford: [00:01:39] Okay. Can You talk a little bit more about your credential as a functional diagnostic nutrition practitioner? And why would a dietitian want or need that additional training?

Sara Korzeniewski: [00:01:49] Sure. So, you know as a registered dietitian you know going through school you know we get a lot of the conventional training and you definitely get a lot of resources to talk to clients about food. But as I was really working through my practice come to the realization that food is just one piece of kind of the health puzzle and didn’t really want to just have people come to me and say “Okay. Well, tell me how to eat?” And there’s just I think such a need out there for supporting women in getting to the root cause of their symptoms. I dealt with it a lot myself. You know I think a lot of people become nutritionists or become dietitians or health coaches because you know they’ve dealt with maybe a health concern themselves. And so then they become you know super interested in it. Well for me it was kind of the opposite. So, you know I had been interested in nutrition from a very young age you know since the seventh grade and became a dietitian and you know like a lot of people started out in the clinical setting and wasn’t super fulfilled in that. About halfway through my career kind of decided and learned a lot more about Functional Nutrition and Functional Medicine and kind of realized there was a lot more information out there than really what I had been taught. So, started to do a lot more digging on my own a lot more reading, a lot more research and started to kind of realize that I was actually having symptoms that weren’t normal and that there was probably a deeper reason for that. And so started to get into the functional realm world and came across the FDN program and what the FDN program you know they really teach you not just you know about nutrition but really about lifestyle as well and also being able to use functional lab work to help people get to the root of their health concerns because you know we don’t diagnose, we don’t treat diseases but we really help people look for areas of opportunity for healing and that’s exactly what I was looking for. So, I was able to do some some lab work on my own on myself first and actually realized that there was more going on inside than I had ever thought. And so I was able to use that information to really help heal myself from the inside and help eliminate any symptoms I was having at the root. You know I was having just the symptoms bloating, constipation, hormone imbalances, I had you know really irregular periods, you know developed a fibroid, you know things like that. I was dealing with acne especially you know hormonal acne around chin. Was realizing that there was something going on inside that was contributing to those. So, being able to kind of figure that out myself I was like “Wow! This is really interesting you know this disclose a lot deeper than just what we’re eating.” You know we also have to take everything else going on in our lives into consideration as well as you know what’s going on internally and the only way to really figure that out is with good functional testing. You know we could guess all day long and I definitely did plenty of that.

Sara Korzeniewski: [00:05:07] You know trying probiotics and digestive enzymes and you know eating fermented foods and you know all of the things that we know as a basis for good digestive health. But it was until I did lab work and found there were some infections and there were some imbalances in my gut bacteria going on that I was able to really address it and be able to eliminate you know the symptoms that I have so now that’s really why I like to help my clients do that.

Mathea Ford: [00:05:35] I think that’s a great example of you know we get so generalized information in our internships and that’s the purpose is to get a broad swath and then you kind of specialize, specialize, specialize but how is it different from normal medicine? The functional work that you do to with a patient because it sounds like there’s some you know fact basis, there’s some labs. But how is it different than what you would do as a dietician without this training, without this credential?

Sara Korzeniewski: [00:06:11] The FDN program has allowed me really to have access to more labs to be able to run with clients. As a dietitian, there are some labs that we are able to order and it kind of depends on what state you’re in as well. Certain states allow for you to be able to do more so for my state here I use Dutch testing which is a urine based hormone test so I can definitely do that on my own as an RD but I wasn’t able to run a GI map which is the stool test that I like to run with clients. It’s a DNA based stool test so with the FDN program, we also have access to what they call a Medical Director program. We can basically request labs through their doctor who’s the director and you’ll be able to use that to be able to get that testing out and available for clients because these functional tests that I have seen because you know I’ve run a few different labs on myself. I did traditional blood testing for hormones which of course you know oftentimes I hear even from clients you know it comes back and the doctor says “Oh! Everything looks normal right?” It looks like everything’s fine even though you’re like fallen down with symptoms as long as labs look fine you’re fine right? But in the functional world you know we look at things in a much tighter range than in the conventional world you know as long as you fall within between A and Z, you’re fine even if you’re at B you know. So, in the functional world we’re much tighter there but we also take the client into account to what symptoms are you having and use that to correlate. You know listening to you and what’s going on with you not just reading the labs. That has really been a catalyst of what FDN has taught me to do to is to being able to use and have access to labs but also reading them and looking at them from a functional perspective and also then taking the client and what they’re dealing with into account too. With Conventional Medicine and honestly I see this happen sometimes within the functional like naturopathic world. There are definitely plenty of great doctors out there but it’s all too about kind of what they’ve been taught you know and then conventional world they’ve been taught “Okay, if someone comes in with this. This is what you do. And then if that comes back fine then this is like the medication you give them” because they’re really just trying to help manage symptoms. They’re not really taught to get to the root. And you know even in an ad for profit world you know sometimes you’re in the case where you know they’ll get a bunch of labs done even if they’re really good labs and then they might just be told “Okay, well here take these 10 supplements and you’re be good.” But you know the healing process isn’t just about food, it isn’t just about taking supplements but it’s about lifestyle too. “How are you managing your stress? Are you sleeping? You know are you supporting your liver? Are you removing as many toxins from your life as possible?” You know these it’s looking at the person as a whole because your body doesn’t work as individual system. So, oftentimes like someone will say “I went to the doctor and they tested my hormones and they said I was low in progesterone so they just gave me some progesterone.” And I said “well, that’s great! Because that might help you feel better. But I want to know why progesterone is low. I want to dig deeper and figure out what’s causing. Is it a digestive issue? Is it a stress issue? It could be a combination of both. Are you just you know nutrient deficient which is preventing you from being able to you know make certain hormones? Is it inflammation that’s causing that?” So you know you really want to be able to work with somebody that’s looking at the full picture and I see that missing in especially the conventional medicine world.

Mathea Ford: [00:09:55] What are some things that people might consider normal that are actually signs or something to be concerned about?

Sara Korzeniewski: [00:10:03] Yeah! So, I think the biggest things that I see with clients constipation you know I would say a good 80 to 90 percent of clients I deal with have constipation and sometimes they don’t even realize that they’re constipated. I’ve heard of “Oh! I went to my doctor I told them I only poop three times a week but that’s how I’ve always been and they said ‘Oh well that’s probably normal for you'” Sorry but it’s not. Even if it’s something you’ve been dealing with for your whole life. That doesn’t make it normal. You know we need to be able to poop daily to be able to get rid of toxins and get rid of excess hormones and things like that. So that’s a sign. So, even those that are maybe going on a daily basis. Does it look like little balls? Do you feel actually like you’re eliminating fully? If not then that’s still a sign of constipation. I had to write a post a blog post about what healthy poop looks like because people don’t know you know looking at that old Bristol School chart to see kind of where you fall there. I also know a lot of people women are dealing with PMS. You know premenstrual syndrome whether it’s cramping you know, whether it’s bloating, irritability, you know irregular periods – those types of issues. And we think it’s so common. I mean gosh every time I watch TV or commercial and I see them talking kind of joking about PMS you know and like every time I see that I’m like “That’s not normal!” You know it means there’s a hormone imbalance going on that needs to be addressed. We shouldn’t have to deal with those types of things. So, I would say those are really the two top problems that women come to me with that they don’t really always realize is an issue. But you know I deal a lot with low energy, you know fatigue. Some people are like “well, I have three kids.” So yeah you know the doctor says “Well, of course your fatigued you know because you’re dealing with three children” but that’s not always the case. You know that could definitely be a symptom of something going on. I see a lot of anxiety as well. You know depression and that is another sign, it’s a symptom of something going on deeper and you know that’s kind of one thing that I like to educate the public on is to what things to look for that aren’t normal and just about any symptom you can think of. Something that I think we know ourselves enough to know when something’s off or when something doesn’t seem right and you know we just want to be able to acknowledge that yes there’s something going on you know that we can address and we can look and investigate to see what’s going on that’s contributing to it and that there are answers out there.

Sara Korzeniewski: [00:12:37] And so if you go to a practitioner and you know they do testing on you if you’re lucky enough to kind of get that and they say “Oh! Everything looks fine, you’re fine!” but you don’t feel fine then don’t take that as the end-all- be-all. You need to find somebody who really understands this whole process and how the body works together as a whole to really help you figure out what’s causing the symptoms.

Mathea Ford: [00:13:03] Okay. So, You also mentioned that you are a LEAP therapist? L-E-A-P. So, what is that and how does that fit into your practice?

Sara Korzeniewski: [00:13:12] Yeah! So LEAP MRT testing is a food sensitivity test that’s a blood test. A lot of food sensitivity testing out there is just IgG using IgG antibodies to look for food sensitivities which are different than food allergies. Food allergies or IGE testing and food sensitivities are much more common. LEAP really goes above and beyond just looking for IgG because there’s multiple ways that your body can react to certain things. So, I find a lot of clients that I work with. You know we do stool testing. We look for it. We’re looking for gut infections, we’re looking for bacterial imbalances, you know things like that but oftentimes stress. These pathogens you know we’ve been on antibiotics a lot maybe even birth control pills that are potentially contributing to gut bacterial imbalances. You know birth control pills aren’t dealing with the problem. They’re not dealing with the root problem of hormones that are just cutting your own hormones off and you’re getting synthetic. But ultimately that can do a lot of damage on the inside as well. And I know because I was on it for a long time and had some issues with it.

Sara Korzeniewski: [00:14:22] But these things cause damage to the lining of the digestive tract and can contribute to what a lot of people know as leaky gut or intestinal permeability. And so then when you’re eating foods even if you’re eating really healthy foods, those if you have leaky gut then those foods the particles those proteins go out into your bloodstream where they’re not supposed to be and then you have a lot of immune cells floating around your bloodstream looking for things that aren’t supposed to be there. So they might come into contact with these food particles and say “wow! I need to help her fight this off. There’s something here that’s not supposed to be here. There’s a foreign invader here.” Your immune system sets these alarm bells off. Your whole body kind of kicks into gear trying to get rid of this stuff but you’re constantly eating those foods right? You’re always exposing your body to that. So, you go from you know acute inflammation which is normal. That’s a normal process that your body uses to help you deal with something like maybe a cold virus. But if you’re chronically exposing your body to these particles and you have a leaky gut. Now, you can develop chronic inflammation which is at the root of our lot of our modern day diseases. So, by using food sensitivity testing you all good food sensitivity tests we can kind of get an idea. Now, no test is really going to be perfect but it’s a tool. Testing is a tool. You know they’re not absolute.

Sara Korzeniewski: [00:15:46] So, we can use that information to kind of pinpoint where some food sensitivities might be and what foods might be contributing to inflammation in an individual because that’s going to be very different from person to person. You know there’s so many clients that come to me that have you know maybe are suffering from digestive issues, suffering from hormone issues and what’s the first thing they tend to do they start eliminating every food they can think of that could be contributing to it. Right? And they start eliminating maybe gluten and dairy and eggs and all this stuff and then they don’t necessarily feel like it’s helped as much as they would have liked. So, what they end up doing is they start cutting even more foods out and be like “oh! It’s got to be the food. It’s got to be the food.” Right? And then by the time they come to me, now they have this horrible relationship with food you know and they’re afraid to eat and they think every food is going to cause issues. They don’t want to go out to eat at restaurants with their friends because they’re afraid they’re going to eat something that’s going to cost them. And at the end of the day it isn’t just about the food. But that definitely is a piece of the puzzle right? It’s one factor. So, by using testing you know we can kind of get a better idea of what could be causing more inflammation and potentially more symptoms in that person so that they don’t have to spend months and years in agony trying to cut out all these things that they’re thinking is contributing to the problem. So, it kind of helps ease that process a little bit.

Mathea Ford: [00:17:18] I can see how that all goes together with what you’re doing. So, I know you’ve talked a little bit about this but what are the most of the people or the women you talk to have issues with and how do those show up in their lives?

Sara Korzeniewski: [00:17:32] Like I mentioned kind of PMS, irregular periods. I see a lot of people with PCOS polycystic ovarian syndrome or suspect you know that they have PCOS just based on symptoms that they have you know acne, hair loss, dark hair growth on like their you know neck or chest things like that. You know a lot of anxiety sometimes issues with sleeping, low energy, you know fatigue, they feel like they sleep throughout the night but they wake up still tired. You know the constipation, bloating you know that’s another huge one. A lot of uncomfortable to ask and these are definitely symptoms. These are things that are not right. It’s your body’s way of telling you something is wrong. It’s kind of your body’s way of screaming out for help right? Symptoms are typically the last thing that pop up. When a symptom is is there that usually means something has been off for a while. Right? It can show up kind of random time. You know sometimes I hear people tell me “Oh well! I felt fine and then this one thing happened and then all of a sudden like I had all these symptoms” and they get very confused by that you know they’re like “well, I was doing really well and now I’m not and I don’t know what happened.” And for some people it’s one stressor. Right? And what I tell clients is that stress can come from hundreds of different places and a lot of them can be hidden internally.

Sara Korzeniewski: [00:18:57] You know food sensitivities, blood sugar dysregulation, gut infections – these are all stressors that you may not really realize are issues because they’re going on inside you know. Some people are like “well, I don’t feel like I’m stressed like I don’t feel mental, emotional stress” but that’s just like one area of stress. And I think in our world today it’s impossible to avoid all stress. You know it’s like unless you’re living on a deserted island and you’re independently wealthy you know you probably have some form of stress. It just kind of comes with the territory here. You kind of got to think of your body as like filling up a cup with water you know. Your body can handle so much water until it starts to overflow because it just can’t handle it all anymore. So, it kind of becomes this domino effect of starting out with one stressor and then if that doesn’t get resolved it can kind of start to move into other areas of your body and create more symptoms more issues and then before you know it you wake up and it’s like “oh! I have five symptoms where as a couple months ago I maybe just didn’t feel so good and now I’m like now I’m constipated, now I’m bloated and it kind of becomes this” you know just this overflow that your body can’t handle anymore. And so now it turns into other things.

Mathea Ford: [00:20:10] Yeah! That makes a lot of sense because your body does work so hard to maintain that homeostasis that it does all these other things to compensate. Yeah. And then one day it just breaks down.

Sara Korzeniewski: [00:20:22] Yeah! When you’re under stress your body puts priority on that. It could care less about helping you maintain your estrogen and progesterone levels or maintaining your thyroid levels or you know making sure you’re adjusting properly because it’s trying to help deal with what it considers most critical.

Mathea Ford: [00:20:38] So, you mentioned hormones a little bit too. Can you talk about what types of hormonal issues women tend to have?

Sara Korzeniewski: [00:20:47] It definitely can vary a lot. I mean that’s why I love testing because you know I don’t want to guess what’s going on. And I’ve kind of seen it all. You know I’ve run hundreds of different hormone of the DUTCH test in particular which I love because it doesn’t just look at hormones like it’s not just testing estrogen, progesterone, testosterone but we’re looking at how your body’s actually making them and how you’re processing them, what pathways they’re going down and that’s really important information as well. So, I mean I’ve seen everything from you know high estrogen which is causing estrogen dominant symptoms which is you know can cause heavy bleeding, the PMS and the breast tenderness and you know the fibroids and things like that. You know I’ve seen a lot of PCOS which can be low progesterone you know high testosterone levels. I’ve seen a lot of adrenal issues right? Because we also get to look at cortisol and see how that’s working. I’ve seen high, I’ve seen low, I’ve seen a mixture of both. Part of testing is to try to figure out why those things are off not just that they’re off. You know how is the liver processing hormones? Is it because the liver’s clogged up and it’s not really even processing and that are all that causing them to be higher in the system. Are you under so much stress? You have lots of adrenal issues and cortisol dysregulation that’s down regulating your ability to make your estrogen and progesterone or are you under a lot of stress, have a lot of inflammation going on in your body? Inflammation hugely impacts your ability to make hormones. You know your immune system is in your gut. You know 70 – 80 percent of it and any inflammation in the gut can disrupt all of your hormones. If you’re constipated you’re not eliminating those hormones properly they’re getting recirculated in your body and then they’re getting reactivated and then you end up with higher amounts and your digestive system is also a place where a lot of the nutrients get absorbed that help you actually make hormones. You know in the first place you need those building blocks. So, you know when I test women I like to also run the stool test at the same time because the hormone testing can be really helpful. You know seeing the patterns there but like if I see on the hormone test or it looks like you have what inflammation it doesn’t really tell us where that inflammation is. So, that’s why we typically need to look at the whole picture.

Mathea Ford: [00:23:08] You talk about eating real food on your blog. And I was wanting to know kind of what do you define as real food? What do you think of when you say the word real food because you can be literal is the food actually there or not? But there is a difference that you define as real food.

Sara Korzeniewski: [00:23:27] When I’m talking to clients you know I’m not expecting perfection here. We want to kind of see you know you make progress to try to eat more real food than processed food because that’s going to provide you with more nutrients. It’s going to decrease stress on your body. So, the kind of easy definition there for me is is it coming from a farm or is it coming from a factory? Right? Does it sound like food? If you’re reading the label and it looks like you can’t even pronounce half ingredients then it’s probably not real food. It’s probably synthetically made in a factory by a scientist. And you know real food is providing your body with a lot of nutrients which are the building blocks of how your body functions in the first place but it’s also those extra toxins that you’re then providing if you eat a lot of processed foods or a lot of more chemically induced foods then that becomes an added stress on your body like we talked about before. And you know your liver gets burdened by it your body doesn’t really know what to do with it. And sometimes these chemicals can also disrupt hormones and kind of turn on certain hormones and then you have excess hormones. So, just kind of starting with the basics and just trying to eat food that sounds like food.

Mathea Ford: [00:24:43] So, what are some of the biggest mistakes that people make when they’re just eating their regular diet that you usually advise your clients to change?

Sara Korzeniewski: [00:24:51] Typically, I think it’s really easy to get in the trap especially of like let’s say you know gluten free. Going gluten free is kind of the big thing these days. Right? Or at least trying that first but then they get into the trap of kind of gluten free junk food. You know it’s like they’re now they’re eating all the gluten free cookies and stuff like that. But still if you read the label has 20, 30, 40 ingredients in them and a lot of them don’t necessarily sound like real food. So, it’s like well yeah great you’re eating you know gluten free but you’re still kind of in the processed food category there.

Mathea Ford: [00:25:27] How does processed food affect your body differently than real food so to speak? What types of things is it doing differently in your body?

Sara Korzeniewski: [00:25:35] Yeah! I think the biggest thing kind of touched on this before is just that anything that goes through your body has to go through your liver. Anything that you put on your body right gets absorbed in your skin and goes through your liver. Your liver’s like the filter of your body. And so when you’re eating foods that your body doesn’t recognize you know it has to get processed and it can kind of cause more stress on your liver which can ultimately impact a lot of other things too. Your digestion you know your liver is part of your digestive system and even your hormones because sometimes your hormones get put on the backburner while your body processes these other toxins. And then it can get recirculated reactivated. Also you’re not feeding your good gut bacteria. You know when you’re eating, we’re eating we should be eating to feed our healthy bacteria because our gut bacteria does a lot for us. You know helps us break down food, helps us make certain nutrients, helps us make short chain fatty acids that help keep us in a good mood. Help keep bad bacteria from being able to get into the system and take hold. And so when you’re not feeding your good gut bacteria with low fiber diets right? We see that a lot. Then, your gut bacteria starts to kind of eat away at the mucus layer that protective layer that’s in the lining of your digestive system. And then it does that to kind of feed itself and then once that’s gone that bacteria can start to die off and then fast forward due time and you’ve got digestive issues because you haven’t been feeding that good bacteria with nutrient dense foods.

Mathea Ford: [00:27:12] So, what are some tips or some things that they can do to use this information that you just gave us which was great in their day to day life?

Sara Korzeniewski: [00:27:21] I think for a lot of practitioners you know this process for us we should never stop learning. Even if you don’t pay to go through a program. You know there’s so many different resources out there. Go to the library get some good books, podcasts right? They’re free. They have a lot of great information on them and also just being open to new things. Things you may not feel like you understand now but don’t dismiss it before you get a chance to kind of look into it because ultimately at the end of the day you know I’m here to work for other people and to help them and the same thing for doctors you know even if you’re being paid by insurance companies you know you still work for us.

Sara Korzeniewski: [00:28:01] And so the the thing that always pains me the most is when someone comes to me and says “I tried to go to my doctor. I maybe even tried three, four, five, six different doctors and nobody would listen to me or they would dismiss me or you know tell me it was in my head or you know say ‘well, oh! I don’t think you should do this or I don’t think that’s what it is.'” And you know stuff like that but really working with your client as a team and being on their side and if someone comes to you you know saying “hey I’m really interested in running this house or I’m really interested in knowing more about that.” If you don’t know it or don’t understand it tell them that and say “well, let me get back to you let me look into it more.” And don’t just dismiss them because this is kind of a crisis situation that we’re in right now. I mean I had someone the other day who told me who you know he was having a lot of digestive issues and he couldn’t even get into the GI doctor for another two months. And that just kind of shows you how busy these doctors are because these things are so prevalent now. If we truly want to help people and heal people then we need to be open to that and be open to learning new things even if it’s not something that maybe you were taught when you were getting your education. And so just really make sure you’re also very sympathetic with these people that are going through a lot. I mean for a lot of people they’ve been dealing with these things for so long that they just started looking for someone to really listen to them and realize that there’s something going on and take them seriously. So, you know that’s kind of what my hope is for other practitioners moving forward. And so if I can kind of shed light on that and maybe even something that I mentioned make someone think “oh! Ha! Maybe I should go look at that or look at that test” or you know “hey! If someone comes to me with this issue, now I know I don’t just dismiss them or just give them the medication but I want to kind of figure out what I can do to help them” and if you don’t feel like you know then you know refer them to somebody who you do think will help. You know I know a lot of doctors don’t get a lot of nutrition you know in school. So, have a dietitian on your team or somebody that you can then refer them to be able to help them through that process because I still hear people doctors tell people that nutrition doesn’t matter or “oh! You know you don’t need to change your diet because it does not going to impact you” but it does right? We know it. We see it. We can prove it. So, be open to that.

Mathea Ford: [00:30:32] In a little lighter note, I always like to end with asking my guests “What is your favorite food?”.

Sara Korzeniewski: [00:30:40] Yeah! You know if you were to ask me that ten years ago I probably would’ve said something with sugar in it. Ice cream or whatever. And I asked my husband that all the time. Sometimes we go out and you know there’s there’s people that ask and he’ll say “salad.” As boring as that is, it’s kind of true. It’s like a really good salad though not just I’m not talking about some lettuce thrown into a bowl or whatever but like a nice homemade dressing with some good roasted veggies on there. Maybe some nuts or trunks, some good healthy protein something like that. I’m kind of one of those people that if I haven’t eaten vegetables in too long. I’m like give me a sprout, where’s the nearest salad that I can get my hands on? And after I eat it I’m just like “oh yes! You know. That was what my body needed.”

Mathea Ford: [00:31:30] Wow! Oh that’s great! Yeah. I love salad too and I love just yeah! It can’t be plain it needs to have a few other things like maybe some pears, maybe some roasted walnuts something like that.

Sara Korzeniewski: [00:31:43] I mean that’s just kind of goes to show you how kind of changing yourself over the years can make your taste buds change too.

Mathea Ford: [00:31:53] Well, Sara 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 gut and hormone imbalances and about your FDN credential. I think that’s really something that dietitians need to know about at least. If listeners want to connect with you what’s the best way to do with that?

Sara Korzeniewski: [00:32:13] I do have a website. It is theorganicdietitian.com and that dietitian with D-I-E-T-I-T-I-A-N. You know I know what people felt with the C but that’s not the right way. And you can also find me on social media with the same name The Organic Dietitian over on Instagram. That’s where I had to do a lot of posting and also on Facebook as The Organic Dietitian as well.

Mathea Ford: [00:32:39] 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 27 News Edition, Holiday Eating, Losing Weight, Eating Healthier with Janet Brancato

November 5, 2018 by matheaford

The past 15 years she has worked at a local hospital in NJ as an outpatient dietitian and community health speaker.

Janet is also a food blogger, you can check it out on her website www.mynutopia.com.

Follow her on social media:

Facebook – @Nutopia, LLC
Twitter/IG – @janetmsrd

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 Janet Brancato back on the show today. Janet welcome to Nutrition Experts.

Janet Brancato: [00:00:45] Hi Mathea! It’s so nice to be back here again.

Mathea Ford: [00:00:47] Yeah I’m excited. We’re going to talk. This is our news podcast so it’s episode number 27 and we’re going to talk about some things that are important at this time of year. So, it’s November and we have Thanksgiving coming and we have Christmas coming and Hanukkah and all the different kind of holidays that involve getting together with families and eating. So we’re going to go over some different topics that we felt would be good to remind you of this time of year. So, let’s get started. I thought we’d start with talking about good snacks to take with you on the go. So, you may be traveling either in the car or on a plane. Other ways buses whatever. And going somewhere to visit family or whatever. So, what are some good snacks that you could take with you that are healthy that are easy to travel? Obviously yogurts not going to last very long in your purse. So, Janet did you have any thoughts on that?

Janet Brancato: [00:01:52] Yes! I always try to bring snacks whether I’m going on a long distance trip or even a short trip, traveling on the car, in the air. I always try to plan for a snack. Something that’s going to be easy and portable like you said. Doesn’t need refrigeration and something that’s going to really fill me up and hold me. So, I always try to pair of fiber and a protein together. The fiber comes from the plant based foods. So, maybe a fruit or vegetable or some kind of whole grain, whole grain bar or crackers or something like that along with a protein, a simple easy protein could be like a nut butter or some nuts or seeds. I find that those are easy to sort of bring about on the road. They really fill me up and hold me and also give me energy because the longer the time you want to keep your energy up, mental alertness, you know stay well hydrated definitely bringing water on the go as well.

Mathea Ford: [00:02:52] Yeah I love the idea of whole fruits. You can buy I’m usually in the airport or whatever but you also can see a lot of times at gas stations or whatever they’ll have some whole fruit at the counter but obviously even easier is just to bring some with you. Bananas, oranges as long as you have a little bit of wipes to keep your hands clean. Sometimes we don’t think about this. My kids hate it when their sandwiches are soggy but if we’re traveling you can bring you know kind of the components separately. So, you bring bread or crackers like you said and then maybe some peanut butter and jelly or some other things that you want to put on those crackers, hummus. I know hummus isn’t always as portable. But also I love the idea of nuts. Like you said it got fat and they’ve got protein and that’s going to really hold you over for a longer period time specially between meals. And I just think sometimes we snack a little too much. So, I always try to make sure and do a double check and do I really want some water. Do I really just need some fluid. We tend to not drink as much while we’re traveling and I think it’s because it’s less convenient. And it’s a little bit harder to manage but just make sure that if you’re snacking and you think you’re hungry. Check “Okay, when was the last time I ate? Maybe I just need a little water.” Any other thoughts on that?

Janet Brancato: [00:04:17] I mean I look at companies now are coming up with these little nut butter packets it’s much more portable. And even the little hummus cups. Again they’re small sort of portions size even a little guacamole are made to be very portable and snack size which is great because you can take one of those. And like you said pair it with like a fruit or vegetable or a little baggie of crackers. So, those little packets are definitely helpful even a little oatmeal pack. Do that in hot water in the airport or on the plane and then you have a quick little you know nice little oatmeal there or the little trail mix you could actually make your own or you can buy a trail mix all the way together. It’s about the drive through usually a nut or a seed. Sometimes you can get a roasted bean in there. Those are really good and nice and filling.

Mathea Ford: [00:05:11] Yeah! I love dried fruit too. There they can be a little calorically dense but just a few of them gives you that sweet instead of buying a candy bar. Have a little bit of that. So, that’s a good point. Okay. So, those are some of our ideas for you to you with travel and we all know what’s coming up at the end of this month that’s the big meal that everybody either loves to get together with their family for just gets together with their family for Thanksgiving. I wanted to just talk about kind of the calories that are in the Thanksgiving dinner and how we can make a Thanksgiving dinner a little bit healthier. And I think you’ve got to start with your plate when you go through the first time I just grab a little bit because there’s always plenty of food. If there’s not plenty of food then that’s a different story. But usually there’s an abundance of food. So, I just grab a little bit of everything and I want to try. Broccoli Bacon Salad, a little bit a turkey, a little bit of gravy, a little bit of potatoes and then I get a little taste of everything. And I get a chance to sit there and talk with my family and munch and then not too many snacks beforehand. You know usually there’s maybe some snacks out our appetizers while everybody’s waiting for the food to finish but I try to manage that just that way and then go back and get a little bit more of the things that I really like. And I also try to remember that there’s always dessert – a special in Thanksgiving.

Janet Brancato: [00:06:44] Exactly! And just don’t stress out you know enjoy the holiday. I know a lot of people eat or skip meals you know to save up for the Thanksgiving meal. They’re not eating breakfast and denying lunch. What happens is that really does backfire because at some point the hunger is on it again and then it gets to lose control. So feeding regular breakfast have something for you. Well, don’t stress but stay mindful. Like you said you know stay mindful of how much you are putting on your plate. You know depending upon whether you’re the host or you’re going to the celebration you know you can have a little bit of control of what’s there. So if you are the host you could again try to make sure there’s a lot of those nice healthy colorful vegetables on hand. If you’re going to the celebration you can bring a veggie platter or you could bring a fruit ball so that you know there’s going to be some options for you to go to. So, yeah definitely you know stay mindful with your portions but enjoy yourself. I mean it only comes once a year and there might be foods that you only eat on Thanksgiving. So, again you know maybe start with a smaller helping but try a lot of different things and then eat it nice and slow. Really enjoy.

Janet Brancato: [00:08:03] I think a lot of us are so hungry and are so excited that we eat so quickly. We feel like “oh! I feel I didn’t eat anything. I know they want to go back for more so I think like slowing down and really savoring even that first plate is really kind of a good strategy as well.

Mathea Ford: [00:08:21] Yeah! And if you’re the host or hostess. Good idea is to think about the serving spoons that you use. So, if you put that big huge serving spoon in the mashed potatoes everybody’s going to grab that much and put it on their plate. But if you maybe use some smaller utensils or even just offer them they’re at the place then people can take a little bit of everything, you can let everybody know hey you know just grab a little bit of everything you want and come back and get whatever you know you liked the best and get a little more of. But you’re right there’s things we only eat at Thanksgiving that we only put that effort into eating of that time a year. Other things are, I feel that way when I go to a new place I’m always like I don’t want to go out to dinner at a place that I’ve already been if I can unless I really really want something from there. So, if you can get a dinner roll any time of the year then I would skip the dinner roll but you can’t get necessarily candied yams anytime of the year. Candied sweet potatoes or maybe your mom’s grooming casserole. So, do enjoy that at that time but it’s not required that you take a little bit of everything. You know it’s not that way. So, you can really eat just a dab. And so I think we forget that it is about gathering and about being with your family.

Janet Brancato: [00:09:45] Exactly! Yeah! Focus on the people. You know there’s some things you can do like go a little lighter on the gravy you maybe it was a little drizzle vs. weeding out a drenching something in it or leaving the skins off the turkey. Like all those things can really help too.

Mathea Ford: [00:10:02] And with your dessert you can go have these so maybe they cut the pumpkin pie piece eight to a pie. Find somebody that wants to maybe go half and half maybe you want some pecan and some pumpkin. And we used to do this when I worked at the V.A. hospital for Thanksgiving dinner we would do just half slice each of a pumpkin and a pecan so that everybody got a little taste of each but we weren’t given them two whole slices of pie. And so think about maybe cutting your desserts a little smaller so that people can get more like a taste. If we’re the host, we tend to do a lot of the work and we’re exhausted. So make sure that you’re inviting other people to help. People will offer to bring things and I just encourage you to let them.

Janet Brancato: [00:10:48] Yeah! Yes! Definitely get them involved with preparations and then even helping you you know with clean up or that type of thing. It shouldn’t be all on one person you should be able to enjoy yourself as well.

Mathea Ford: [00:11:03] Yeah. My husband got a new grill this year which is it’s an indirect heat. I don’t know if it has these wood pellets but the guy who was selling it to them looks at me and he says “well, he can cook the Thanksgiving Dinner Turkey on this grill.” And I was like “I’m all for that.” So, this year we’re going to try it out with my husband took the turkey on his grill. Anyway it’s more like a oven. It’s kind of a weird setup but I’m like I’m so excited because now I get the oven back to cook a few other things. So…

Janet Brancato: [00:11:34] Beans, ram, shallots is delicious!

Mathea Ford: [00:11:36] Yeah it’ll be a little interesting taste but Thanksgiving, Christmas this applies to any of those things we’ve kind of gone over so when you got a Christmas dinner do the same thing. Cut your desserts in half. Try to just take a little bit of everything if that’s what you want and not overdo it. There was an article that just came out that talked about nutrition and exercise and bone strength. So, I wanted to talk about that a little bit because I’ve always thought weight bearing exercise is really what helps with bone health. I mean I know you need to have the vitamins and the minerals as long you have a healthy diet but this one asks the question: Exercise or Nutrition, which one has a bigger positive impact on bone strength? And the result that they came up with is that nutrition has a greater impact on bone mass and strength than exercise. And they said even after the exercise training stopped the mice that they were looking at this in mice. The mice retained bone strength gains as long as they ate a mineral supplement diet. So, this was from University of Michigan and it was dated October 17th. So, you have any thoughts on that Janet?

Janet Brancato: [00:12:53] This was something new. I mean I knew these minerals are so important for bone health but you know I didn’t realize that the nutrition kind of outweighed the exercise is actually something that I thought was very interesting. It wasn’t just the calcium but it was the phosphorous too so it’s really all those minerals sort of working together that seems to be you know like you said even more so than…. The exercise is important too but this sort of is more of a longer term solution and works even without the exercise. Yeah this was great to know that you know having that diet with all those minerals is so beneficial to own mass, bone density and strength. That was something new for me but I think that’s very good to know.

Mathea Ford: [00:13:41] Well, I think we’ve known for a while that bone mass kind of gets to its peak when we’re young, 20s or whatever. This just reminds me that it’s super important to make sure that our kids are getting a variety of food that you don’t have a lot of control over or when they go out on their own not necessarily college but that’s the peak bone time and we need to make sure that they’re either getting foods with lots of calcium and phosphorus in them. You know that obviously begins early but making sure that our young teens and early 20s we’re encouraging them to make sure they get that healthy diet. And I know we do some but we always kind of I mean I always kind of thought “well, they have to get their exercise soon. And I think exercise is definitely important but it’s one of those things where it’s like “wow if I make sure that they have a good basis in their diet, they’re getting all these vitamins and minerals that’s can also make sure that that happens.”.

Janet Brancato: [00:14:44] Yeah. Well you know when they’re young they’re at their highest calcium needs. And I know a lot of kids kind of stopped drinking milk at a certain age. They don’t like it. So, it’s always that challenge of getting in the calcium. Some of them don’t eat green vegetables that are also its source of calcium like the Kale you know or broccoli you know but we want to try to see where we can maybe entice them by you know me making a smoothie or doing something with a yogurt Parfait or just finding ways to get those calcium and phosphorus rich foods into their diet young like you said they’re in a bone building phase though it is sort of a key component of their eating. We want to try and make sure that we’re being tuned into that.

Mathea Ford: [00:15:27] Yeah I think they tend to move towards the phosphorus dense beverages like sodas or diet sodas which then can deplete that calcium because our body has a very extensive mechanism to manage the calcium, phosphorus levels in our blood.

Janet Brancato: [00:15:44] Throws off that balance.

Mathea Ford: [00:15:46] Yeah. So, I just wanted to kind of talk about that little because I think it’s new information and obviously it’s an animal study and it doesn’t translate automatically to humans. But as we learn more, I think it’s important to just start thinking in that direction. It just reinforces what we already knew that nutrition is important especially at that stage in life. And like you said plant based diet can get plenty of calcium. You don’t have to necessarily be eating or drinking those beverages so… I saw this other article that was posted and I’m trying to see the date on it. It said it was from March early this year. Broiling, barbecuing, grilling a roasting to prepare beef and chicken increase the risk for Type 2 diabetes. And this was information from the Nurses Health Studies and the Health Professionals Follow Up Studies which was 289 men and women. So, it’s a big study. And I’m sure they looked at food frequency questionnaires then correlated they said fish was not related to this but the chicken and the beef. So, I just want… It says it who frequently ate meats and chicken cooked at high temperatures were one and a half times more likely to develop Type 2 diabetes compared to those who ate the least. There was also increased risk of weight gain in developing obesity in the frequent users of high temperature cooking methods which may have contributed to the development of diabetes. I think we’re discovering more and more that obesity is almost a precursor to especially type 2 diabetes. So, did you have any any thoughts on that Janet?

Janet Brancato: [00:18:11] Yeah! I Mean I saw that it said too that it had a lot to do with if it was well done or the charred well. The more charred, the more of an increase risk vs. if it was lightly browned so that seemed to be a little bit of a difference there. And there seemed to be a connection between those chemicals coming from the heat contributing to an increase in inflammation which we know is sort of a root cause of a lot of chronic conditions. So, it’s a little bit better to use a slower cooker method so cooker, baking, steaming, stewing or even a stir fry. It’s not really on the high heat for long. We don’t want to encourage people to under cooked chicken for sure. But you know you want to cook that chicken fully but… So, some other options, my thoughts were you can do to grill marks ahead of time if you’re concerned about this you do on the grill quickly just to put in the grill marks and then bake the chicken you can again just bake it. You have the option to do some blackened type of things which is more of a spice not necessarily a charring. As we learn more there’s a lot of conflicting information too. You know obviously but I think there’s that link between the obesity and the diabetes that while they found these people were more likely to eat you know red meat and chicken that were cooked on a grill. They also said that they tended to have more issues with the obesity which I believe may be of good factor in there too that they obviously said is a factor but they didn’t necessarily measure how much. So…

Janet Brancato: [00:19:59] Right! And it could be a portion control thing too. Maybe just eating less of that you know animal source as well. I mean you know they’re recommending just not keeping it on the high heat that long. Like you said you want it to be cooked through but maybe just initially putting it on there and then finishing it off in a slower cooker method putting it in oven in or in your crackpot or something like that you could finish it off and then maybe most of the meal are more plant based. So, kind of balance things out a bit more.

Mathea Ford: [00:20:29] Yeah! I think we are finding very clearly that plant based diet whether they’re purely vegetarian or just emphasized the plants on the plate vs. the meat is leading to better outcomes is making people healthier. Obviously lower a little bit lower fat but also just not processed. So, they said in this that to lower diabetes risk it’s important reduce red and processed meat consumption which like you said can be replaced by chicken, fish, plant protein foods. I would say that if you’re concerned about diabetes you definitely need to manage how much of this especially red meat and processed meats that you’re eating. You know they also again I’ll go back. They said the weight was also a factor. So, as long as you’re getting exercise and doing those things that we know altogether combined make you healthier then that’s going to lead to a decreased risk as well.

Janet Brancato: [00:21:31] And that those player base foods are also anti-inflammatory so they can really help sort of counter that inflammation as well.

Mathea Ford: [00:21:40] So, inflammation your body you want to talk about for the listeners maybe they don’t know what that is. Would you kind of talk through them a little bit?

Janet Brancato: [00:21:47] You know something that’s more of inflammation is when your body gets some sort of trauma to it like you got a cut or a bruise. Obviously, there’s a short term inflammation going on the body so your body sort of heals and repairs it. This is talking a little bit more of a chronic inflammation where there’s sort of an underlying invader sort of you know in the body that your body is sort of like fighting against and it’s causing you know other reactions in the body that might be causing you know blood sugar to rise or you know other sort of chronic conditions sort of as a way of a defense mechanism or is this inflammation of that kind of makes sense. But it’s sort of something that’s a little bit more chronic versus a short term response. It can like you said diet is a part of it. Also weight gain or obesity could be part of it too. You know causing certain chemicals to get released in the body and can cause other ripple effects in the body. Maybe a little more insulin resistance could go on or you know things like that might happen a little more long term obviously not in the short term but it could be more of a root cause of things.

Mathea Ford: [00:22:56] So, if you think about when you have like a cut in that area it gets a little bit swollen and it gets red, it gets kind of puffy your body has a reaction where it goes in there and starts to clear out those cells.

Janet Brancato: [00:23:09] Yeah! your immune response.

Mathea Ford: [00:23:10] Right! So, imagine that happening kind of chronically in your body and so your body is constantly kind of at that irritated state and that’s not healthy for us. So, the things we can do to lower that inflammation are important. And you’re right those eating more plant based foods are definitely lower inflammation. So, we’re getting close to the beginning of the year. And while we don’t want to think about a diet and I don’t like the word diet. Well, I like the word diet as far as a diet is the food that I eat every day. It’s not necessarily a change that I make for a couple of days to lose weight. So, if you think about healthier overall diet a report I saw said that the Mediterranean and the DASH diets are kind of the top ways of eating. I see it summarized a lot as W-O-E way of eating. So, the Mediterranean and the DASH diet are the best overall diets for 2018 at least that they were measuring. And I wanted to talk about. So what is the DASH diet and what is the Mediterranean diet? So the DASH diet is an abbreviation for Dietary Approaches to Stopping Hypertension but basically it’s more plant based. It has lots of fruits and vegetables, a little bit lower sodium, lower protein but it was a study that showed that when people ate that way, that their blood pressure was naturally lowered and I do a lot of counseling with people, educating people with kidney disease especially Stage 3, Stage 4 but when people who have stage 1 or stage 2 kidney disease, if their doctor actually told them. I always encourage them to follow a DASH diet because it is it does help lower their blood pressure and it kind of puts them on a little bit more plant based diet. So, Janet do you want to talk about what the Mediterranean diet is?

Janet Brancato: [00:25:13] You know pretty much stems from that area of the world. The Mediterranean countries which of course has those influences and definitely there’s the plant based you know a lot of plant based foods as well as fish. So, fish a big food on the Mediterranean diet you know. So, in those Mediterranean countries they eat a lot of fish and olive oil is their main source of fat which we know is a very healthy type of fat. The mono unsaturated fats it also has those healthy omegas, a lot of the antioxidants. So, it’s really been known. Lots of research with olive oil being not only heart healthy but good for the brain and the joints. So, it’s overall very healthy type of fat. They also eat beans and nuts and seeds. So those are also a big part of the diet as well. Definitely you know those plant based foods are a bigger amount on the plate. Obviously, you know there’s some grains too in those countries they eat them in smaller portions. You know they’ll have maybe some bread or the pasta or maybe a couscous or some type of Mediterranean grain but it’s also balanced with fish and the plant based foods, the vegetables or fruit and that olive oil on top. So, this diet for really centuries has been shown to increase longevity and decrease chronic conditions. It’s a heart healthy. So, a lot of these countries have been studied and they have low incidences of heart disease in this Mediterranean region of the world.

Mathea Ford: [00:26:55] I think sometimes we think fat is bad or we’ve taught people, recent cardiac guidelines that fat was bad. And I know that the American Heart Association changed their recommendation to not necessarily say a specific amount but more just like you said the healthier fats so the mono and polyunsaturated, the olive oil. And I just want encourage people that fat is not necessarily bad in our diet. It actually helps us to feel full and is able to eat a little less even though the calories might be the same but there it’s healthy for our hearts and our brains. The reason they stated that they liked the DASH and the Mediterranean diets the bests was because they felt like they were more sustainable. So, I know in the past we talked about intermittent fasting and the Keto diet and they just felt like those were more short term diets and really it’s easier just the sustainability of like a DASH diet or a Mediterranean diet is higher because it doesn’t necessarily you know restrict an entire category of food. It’s just more about portion and about the amounts and the types of food that you eat the majority of. But again there it is plant based and both of those are really heavily based in fruits, vegetables, grains, beans type diet that work over a longer period of time.

Janet Brancato: [00:28:25] Exactly! And they’re you know they’re well-balanced. You know they fill you up, they satiate and their food quality you know the quality of foods. High nutritional quality and they’ve been effective. They’ve shown to be very helpful in the long term. So, like you said it’s a long term solution not really a short term solution.

Mathea Ford: [00:28:45] I think we forget sometimes when we lose the same. Losing, regain the same ten pounds that we really don’t get any further ahead vs. even if we weighed the same if we were eating a healthier diet that’s not as like we talked about inflammatory for our bodies and helps us to all of those healthful benefits we’re better off than if we can go back and forth on some different fad type of diets. So, yes! Food quality is super important. And kind of to end the podcast, I wanted to go over this talking about some different things, foods, ingredients that we like to use in this time of year because it’s the fall and we like “If you’re like me like your sweaters” and you’re kind of that fall feeling. Oh! When I flew somewhere last week and I flew through Denver and they had snow and I was like “oh I’m so excited to see snow. Even I really didn’t want to go out and be in it because it was cold. So, some different ingredients we use a little more this year. Cranberry. So, any ideas for using more Cranberry in our diet?

Janet Brancato: [00:29:59] Yes. I love cranberry. And it’s really so personal adds a little bit of sweetness but it’s got those antioxidants in it and fiber. So, I usually top it on my salad. I put a full cranberries on top on top and it really adds a nice flavor. You could put it in your oatmeal or your yoghurt or you could bake with them. A lot of great… They’re very versatile.

Mathea Ford: [00:30:21] Yeah! We are talking about Thanksgiving a little bit before and I know cranberries, jelly or whatever is one of the things we do but we could put cranberries like you said on a salad. I love them on steel-cut oats. They’re delicious and it does give that little bit a sweet without being sugary. So, what about garlic? I know a lot of people that love garlic. So, how do we use garlic a little more?

Janet Brancato: [00:30:44] Ohh garlic! I use garlic on everything. I’m Italian. I love garlic. It’s very versatile and it will really add a lot of flavor. And it has a great health component and its been shown to lower cholesterol, lower risk of cancers so you could really chop it up. You know you can either buy the already diced if you really don’t have time to do a lot chopping and throw it into vegetables or if you’re doing a stir fry, if you’re making a sauce. You know you could just grate a little bit over dishes. Keeping it on hand to add flavor if you’re cutting back on salt or sodium you know adding herbs and spices and garlic is a great way of adding flavor and nutrition.

Mathea Ford: [00:31:29] Yeah! And you dont have to add a ton but definitely if you’re cooking like if you’re doing a dish where you have a little bit of onion that you’re sauteeing you could throw some garlic in there and sautee it at the same time and it makes it really that flavor come out.

Janet Brancato: [00:31:44] Soups. It chops these and you can add it to soups.

Mathea Ford: [00:31:47] So, cinnamon. Cinnamon may help lower blood glucose level in people with type 2 diabetes. But we love adding cinnamon this time of year. So adding it to coffee, adding it to on top of all desserts or hot or iced tea. What other ideas?

Janet Brancato: [00:32:06] I love to just springkle it on my apple. It’s a great combination if you slice up an apple and you just sprinkle a little bit of cinnamon on top. It’s a great flavor. I also like to put it on my yogurt, my plain Greek yogurt. A lot of people say well it doesn’t have a lot of flavor, it’s tangy. If you add that cinnamon it actually adds a little sweet flavor to it. Oh I like to do that as well.

Mathea Ford: [00:32:29] A couple of my favorites that I love to use I’m probably going say this wrong. So apologize ahead of time. Turmeric. I call it tumeric but turmeric and then ginger. I love both of those. I love adding them to it. It’s got that warm flavor. I’ve loved Ginger since I was pregnant because I used to eat I used to buy pickled ginger in the Asian markets and I would buy a pickled ginger and I had a lot of stomach upset with my daughter and so I would chew on it but I just loved ginger grated and things or a little bit of spice and the turmeric is that warm, it gives warm flavor to me. So…

Janet Brancato: [00:33:15] You know those are great and turmeric adds nice color too. You can put it on your vegetables and then you roast them like a cauliflower. I like to add ginger, turmeric to a stir fry, to your salad dressing. Ginger adds a nice little flavor.

Mathea Ford: [00:33:31] Yeah! A little garlic, a little ginger in that salad dressing. And Asian dishes for those. You know I just remembered I was thinking about this when I was little we used to put a little bit of cinnamon on rice when we would have a little bit of milk and rice for breakfast. And I love a little bit of cinnamon on rice just like you said kind of gives you that warm feeling.

Janet Brancato: [00:33:54] Right! And you can put a little in Chile. Seen that in recipes too.

Mathea Ford: [00:33:57] Well I think Janet, that’s about it for this week. So, thank you so much for being on the podcast today. It was a pleasure to have you on the show. I know our listeners love listening to us just chat about the news that’s going on in nutrition. So…

Janet Brancato: [00:34:12] It was great. I really enjoyed it.

Mathea Ford: [00:34:15] Well guys, this has been another great episode of the Nutrition Experts Podcast. Janet, if listeners want to connect with you what’s the best way to do that?

Janet Brancato: [00:34:23] You can find me on my web site mynutopia.com. I have a virtual web site. Virtual practice working with pediatrics and adults and I also have a food blog as well so I’d love to connect with you.

Mathea Ford: [00:34:35] Okay, so this is the podcast that’s all about learning more so you can do more with nutrition in your life. Have a great week and talk to you next week.

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