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.