Beyond the Scale: What a Dietitian Can Do for You

Intro: This is Weekly Dose of Wellness, brought to you by Memorial Care Health System.

Scott Webb (Host): If you've ever wondered what a dietician can do for you in terms of eating better, feeling better, losing weight, and more, you pressed play on the right podcast today as I'm joined today by Heather Hendron and Bianca Heilman, both of whom are registered dieticians with Memorial care.

It's nice to have you both here today. We're going to talk about how a dietician can help folks. And I've wondered, how can a dietician help me? So, it's good to have you both here. And Heather, I'm going to start with you. What can someone expect during their first session with a registered dietician and how do you tailor the experience to their unique goals or, let's say, dietary preferences?

Heather Hendron: Yeah. So at the first visit, it really is all about information. We're going to be asking questions to better get to know you, your nutrition history, what your focus and your concerns are, your routines, for example. This allows us to really see the big picture. From there, we're going to go ahead and take that information, provide a tailored education to you, and start highlighting those potential areas that we want to work on. Then, we take that education and we break it down even further into our initial goals that we're going to work on at our next visit and future visits as well.

Host: Well, sure. Yeah. Bianca, I think a lot of us think of dieticians-- maybe this is kind of old school-- but as weight loss coaches, right? So, what are some unexpected ways that you support mental health, chronic conditions, and just overall well-being?

Bianca Heilman: Yeah. So, a lot of patients will walk into a dietician appointment expecting a meal plan, a list of foods they can and cannot eat in a preset calorie limit. And while diet is a large part of the conversation, we also place emphasis on stress management, sleep, self-care, and movement that is both realistic and enjoyable.

Our objective is to set our patients up for success. We start with small goals and gradually build upon them. Patients are often surprised that they don't have to exercise five days a week or go cold turkey on their favorite snack foods. As dieticians, we know all-or-nothing doesn't work, and instead, aim for sustainable changes that include small indulgences, movement that is intuitive, and self-care practices that prevent that burnout and support our overall well-being.

Host: Right. Yeah. And Heather, I think a lot of us did some emotional eating. I mean, speaking for myself, I did a lot of emotional eating during COVID, you know? At least that's my excuse. And I know it's often tied to stress and mental health. So, how do you help patients recognize these patterns and develop healthier coping strategies around food?

Heather Hendron: Oh, my gosh. So, my approach to emotional eating is very much an inquisitive one. So if you see, me be prepared. I will be asking why or what a lot. The reason I lead with that is, with high stress and strong emotions, it can be very challenging to separate how our physical body is feeling from our emotional state. So, an example of one of my questions would be: What are we feeding? Like, hunger, emotion? Why did you want that particular food? Was it comforting and nostalgic?

The biggest thing is we're all very busy. So, sometimes my questions can even be as simple as, "Did you even have more than coffee all morning?" We are all very much weak to sometimes just having a cup of coffee and then getting distracted. So, it's very much a conversation of the fact that people are very quick to blame that lack of willpower, so to say, for not being able to say no to those foods.

But really, we kind of look for the fact that our body is trying to find something it's not getting. So once we separate that and recognize what those feelings are and the sources for them, we can focus next on that redirection. So like, what are things we can do to meet that need that we're not getting? So, they could be relaxing in different ways that we prefer, could be being creative. It could be eating earlier, or even seeking some support from friends, family, or mental health professionals to walk us through some of those stress.

Host: Sure. Bianca, let's talk about nutrient deficiencies. And I know they're commonly linked to mental health challenges. So, how do you help patients identify and address them through a more personalized nutrition approach or personalized nutrition plans?

Bianca Heilman: Yeah. So, not everyone realizes this, but mental health and nutrition are closely tied. And having these deficiencies in any of these nutrients can contribute to that low mood, anxiety, trouble sleeping and others. So, some of the important nutrients we want to look out for, include things like omega-3 fatty acids. So, these healthy fats help to reduce inflammation and support brain function, and you'll find them most commonly in fatty fish like salmon, sardines, mackerel. But you'll also find in more plant-based sources like walnuts, chia seeds, flax seeds, as well.

Another one is vitamin D, also known as the sunshine vitamin. Vitamin D is not only important for our bone health and immunity, but really important for mood regulation as well. So, we see a lot of deficiency amongst our patients due to lifestyle habits that limit sun exposure, like working inside all day.

Host: Sure.

Bianca Heilman: So, you can boost your levels through that sunlight, but also having whole eggs, mushrooms, bone and fish or supplements can help to reverse that deficiency as well. And if you're curious about where your vitamin D level stands, your doctor can order a simple blood test to see if you have that deficiency. And if you need a supplement, that doctor can recommend an appropriate dosage for you.

And then lastly, I'd like to focus on magnesium as well, because it's another common nutritional deficiency. So, magnesium's known for its calming effects. It can help ease anxiety, promote sound sleep. So, we find it largely in dark leafy greens. We'll see it in nuts and seeds and even dark chocolate. So, possible deficiencies can be seen through simple diet recall provided by your dietician. And again, we can also get a blood draw from our doctor, and supplement with a supplement as needed.

Host: Right. Yeah. And Heather, I know that our needs, our nutrition needs, if you will, shift, you know, during our lifetime. So, how do you adapt your guidance to support patients through those key transitions, childhood, adolescence, pregnancy, aging, all of that while still promoting sustainable habits for long-term health?

Heather Hendron: Yeah. So, our basis or what I tend to encourage is kind of that flexible thinking. When we hit those different life stages, we're kind of learning a different body than the one that we were in before. We kind of can get stuck. So, calorie needs can change, protein needs can change, amounts and types of exercise can change and so forth.

So when people get stuck in that, what worked before, which is one of the biggest challenges I tend to see, you know, it probably did work before because you were in a different body. That was you at a different stage in your life. And that's fine. But then, when it comes to our guidance, it's kind of like we're reorienting you to what your body's actually needing right now. And then, we direct that towards establishing healthy habits that will grow with you and have that flexibility to keep adjusting.

Host: Yeah. You're so right. We change, right? I liked the 25-year-old version of me, you know, physically better than I like this version. And I have to adapt and accept, you know, what I am today and, you know, possibly work with someone like yourself to make sure that I am eating right and getting the right nutrients and all of that.

And, you know, Bianca, I think one of the things that's hard for me as the primary shopper in my family is just how overwhelming food labels can be. So, I guess I'm just wondering like, what are some of your top tips for decoding, if you will, those food labels and just making the smartest grocery choices we can?

Bianca Heilman: Yeah. So, you're not alone there. So, food labels can definitely be tricky and many people feel overwhelmed trying to make sense of them. That's why I make it a point to walk every patient through how to read a nutrition label properly. So first, I always suggest ignoring any flashy claims on the front: phrases like organic, gluten-free, or made with whole grains, because they don't tell the full story and they're usually there to distract.

So, the real information is hiding on the back. So when we look at our nutrition facts, labels always start at the top with the serving size. So, this is your reference point for portion. Recognizing if you eat more or less than that amount, all those listed nutrients scale up or down accordingly. From there, I'll help patients understand how to interpret calories, carbs, fat, and protein based on their individual health goals.

So for example, I often recommend aiming for at least 5 grams of protein at snack, and 20 grams at a meal. Though again, this varies greatly from person to person. Fiber and added sugars are two other areas to watch out for. So generally speaking, more fiber is better and less added sugar is recommended. But again, context matters. So, no fiber doesn't mean bad, and no added sugars doesn't necessarily mean good either. We want to look at our nutrition labels holistically and consider all that goes into our food, including those ingredients.

So regardless of your disease state, sticking to minimally processed whole foods sources like fruits, vegetables, whole grains and legumes, some unsweetened dairy products and proteins like eggs or ground meat will provide you with the best nutrition and overall health benefits. And after meeting with a dietician, if nutrition labels still confuse you, a safe bet is always choosing foods that don't even come with a nutrition label. So, sticking with your fruits and veggies and the produce aisle, and you're sure to be in a good place.

Host: Right. Yeah, for sure. Well, you know, Heather, it feels like I used to hear more about eating disorders years ago. It seems like it was talked about more in the news, social media, maybe there's just so many other things going on, but I know they still exist. Folks still suffer from eating disorders, anorexia, bulimia, binge eating, so forth. So, how do you support patients in healing their relationship with food amid these rising mental health challenges?

Heather Hendron: Yeah. I mean, eating disorders, I would say, are still very much under-discussed and under-supported. When it comes, I know it's heartbreaking, honestly.

Host: Right. I mean, I'm glad of course we are talking about it today. But I feel like in general, we don't talk about it enough. So, I'll leave it to you, but let's get the word out there.

Heather Hendron: I mean, the biggest thing I want to start off with is anyone who's working with a dietician, we're going to definitely be recommending also establishing with some mental health professionals as they are really vital for the recovery. It's definitely a team approach to have the best success with that recovery period.

When it comes to us and specifically what we do, we're going to be evaluating the nutritional status and needs. So, we're going to look at what nutrition that person is getting right now. So, what are they currently eating? What are they potentially missing? And we're going to kind of guide them through where and how we can add that. We're also going to be kind of identifying and helping to redirect some of those disordered eating behaviors. We can guide exposures to challenges and overall just provide some nutrition education to round out their work with that therapy team.

But there is one other eating disorder that I really would like to call attention to. It's orthorexia. Now, I know it's not as commonly heard one. But with orthorexia, one may be concerned with the healthfulness of foods. Now, we think, "Okay, that's good, right? We want to be concerned." But when it gets to the point where it's really affecting someone's physical and mental health, so it's very all-consuming, not, "Hey, I want to make some changes for my health," but it's all you can think about and it's affecting your day-to-day life, then we definitely encourage addressing that as a concern. So if you know someone or their loved ones, you notice your loved ones are experiencing that significant anxiety over foods and eating, we always encourage people to reach out for that support and really be mindful of the effects that social media is having on how we interact with food, our body, and our health.

Host: Hey, that's so true. I think we could do an entirely separate podcast just on, you know, what to be prepared for when we open Instagram. Everyone is making themselves look, you know, thinner and more beautiful and all of that. And that's a separate podcast. But you're so right that, you know, help is available. And sometimes it's just a matter of reaching out or having someone reach out on our behalf.

And I'm wondering, Bianca, like when we think about working with a dietician, is it short term? Is it an ongoing partnership? Like what's your perspective and what does that journey look like over time?

Bianca Heilman: Yeah. So, the end of working with a dietician really depends on the patient. It's not a one-size-fits-all timeline at all. So, some people will come in for short-term support, while others benefit from that ongoing partnership that evolves with their health goals and as their life changes.

So typically, the first session, as Heather mentioned earlier, focuses on understanding the patient's medical history, their lifestyle and goals, along with providing that foundational nutrition education. Follow-up visits are used to track progress, troubleshoot challenges, and adjust the plan as needed. And then, once that person feels confident managing their nutrition independently and is in a stable place, we may begin to space out those appointments or just wrap up care altogether. But the door is always open. Patients can return anytime their needs shift, or they just want a little bit of extra support.

Host: Yeah. That's nice to hear. And it's been good having you both on. We were just sort of saying we don't talk about some of this stuff enough, so it's good to do that. I want to finish up with you, Heather. Let's just say we're ready to take the next step, right? You've convinced me. The both of you sold me today. All right, let's go. Let's get that next step. How do we connect with a registered dietician through Memorial Care?

Heather Hendron: Through Memorial Care, as long as you have a Memorial Care primary care doctor, it's a really easy referral. You can send a message or at your next appointment, address those concerns. Be like, "Hey, I would like to have a referral to see one of the dieticians." And within a couple days after that referral's put in, we're going to be reaching out to you and trying to get you scheduled.

Host: That's awesome. Well, it's been great having you here. I love podcasts like this where I feel like we're really helping people, educating them, putting positive information and positive vibes into the world. So, thank you so much.

Heather Hendron: Thank you for having us.

Bianca Heilman: Yeah. Thank you. This has been great.

Host: And if you'd like to speak with a registered dietician, talk to your primary care physician about being referred to a registered dietician. And if you enjoyed this episode, please share it on your social channels and check out the entire podcast library for additional topics. This is Weekly Dose of Wellness, brought to you by Memorial Care Health System. Thanks for listening.