Nutrition: The Role Of A Dietitian

Nutrition, is the study of nutrients in food, how the body uses them, and the relationship between diet, health, and disease. A, Dietitian, play a really big role in people’s overall health. It’s not just about, weight loss, proper, nutrition, can reduce the burden of disease, prevent and reverse disease.

Today I interview Vanessa Rissetto, registered Dietician and co-founder of Culina Health.

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Bio

As the co-founder of Culina Health, Vanessa’s magic lies in her realistic and personalized approach to nutrition. With science as her first love, she is interested in helping clients to take an active role in their health journey with the help of her expertise: personalized lifestyle plans backed by evidenced-based, science-driven nutrition counseling, adult weight management, and building a better relationship with food. Vanessa received her MS in Marketing at NYU and completed her Dietetic Internship at Mount Sinai Hospital where she worked as a Senior Dietitian for five years.

Introduction to Nutrition

Myrna: You said science is your first love? Can you share your journey into becoming a registered, dietitian?

Vanessa:  Nutrition, is a discipline, in and of itself. And, nutrition, is a modality that elicits change. We know that anecdotally, and we are now starting to track data around that.  So a, dietitian, play a really big role in people’s overall health. It’s not just about, weight loss, I think that’s the old narrative.  A, dietitian, is not somebody who is very elite and unattainable, and unaffordable.

So, if you can’t afford, dietitian, and you’re all relegated to being, unhealthy, and that’s not the case, and we do much more than just manage some of the, weight.  Proper, nutrition, helps if you have, diabetes, if you have, kidney disease, cancer, or a nursing mother, and you want to help increase your milk supply.  All of these things, a, dietitian, can help you with. People don’t realize this and we also take insurance.

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Using Your Insurance for better nutrition

My company Culina Health does take insurance. 91% of the patients that we see all exercise their insurance benefits. So, the services of a, dietician,  is basically a luxury service that you’re not even really paying for. And using the help of a, dietitian, is going to help you with your, nutrition, will help extend your life. That’s what a, dietitian, is there for.

The physician will save your life and the, dietitian, will keep you healthy.

Myrna: That’s true, nutrition, is a big thing. I remember reading a book. I think it was Deepak Chopra’s book, Perfect Health and he was saying that everybody should have a, nutrition book, everybody should have something or someone like a, dietician, who tells them about, nutrition. I like that your specialty, or your modality is you want to call it a, science based nutrition.

That’s working with how their body processes and things, because one of the things I also learned is that the, digestive system, is just as unique as your fingerprint.

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Your nutrition is linked to you digestive system

Myrna: Everybody has a different, digestive system. So I’m sure a, dietitian, is somebody that can help you with that. I went to a, dietitian, once because my cholesterol was high. I know, nutrition, plays a big role in fighting, cancer. What made you decide to go into the, dietitian, field?

Vanessa: I studied biology in college, but I just didn’t become a doctor for whatever reason. I went to a, dietitian, myself, in college, I had gained 50 pounds, because I didn’t know anything about food. My mother wasn’t somebody who thought about calories. We didn’t have a scale in our house. And so I ate the food that my mother cooked every single day. And that was it. And I never had a problem with my, weight, and I didn’t overthink the food that I ate.

We know that soda has chemicals and copious amounts of sugar. And it can affect your, weight, in a negative way. And so I gained all this, weight, in college. For me vegetable carbohydrates worked with my, digestive system, so I lost all the weight, but I didn’t really understand how. I knew that a, dietitian, would be the person to tell me, so I went and met with a, dietitian, her name is Keri Glassman, she’s a good friend of mine to this day. And she explained, nutrition, to me in a very pragmatic way.

How food affects your body. If this is your goal, this is what and how you should eat. And so it gave me clarity on what I was doing. I went on to lose another 15 pounds, not even because I was trying, but because I started to piece together how she recommended eating. It wasn’t a restrictive prescription. It was you need to have a protein, a fat and a carbohydrate, every single meal. And I thought, wow, I could offer this service for other people. That seems very exciting and interesting. I started taking classes again and going on this journey to become a, dietitian.

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Becoming a Dietician

Myrna: That’s awesome. You know, a lot of people become life coaches, because they were, life coaching, clients. So you became a, dietitian, because you liked your, dietitian. But alright, let’s dissect that a little bit. The advice from your, dietician, was to eat a balanced meal.  She told you that you should have carbohydrates, fat, and protein at every meal.

Would that be considered, intuitive eating, or, prescriptive eating? So what I want to understand that even though we’re all different, our bodies are all different scientifically. How does one size fit all? When you talk about, prescriptive eating, which means that everybody was following the same pattern, they have carbohydrates, proteins and fats at every meal.  What does, prescriptive eating, look like?

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Prescriptive eating plans from a dietician

Vanessa: Prescriptive eating, is if I tell you how and what to eat. If I tell you how to put the pieces together, that’s going to lead you down a path towards, prescriptive eating.

Intuitive Eating, on the other hand is just knowing what works for you and only eating those foods. That works for some people and it doesn’t work for others. Some people need more guardrails like, prescriptive eating, and other people don’t. Your first experience with food depends on what on your how you were raised.

  • Did you grow up food insecure?
  • Does your mother have an eating disorder?
  • Did your parents use food to bribe you?
  • Are you constantly made to feel ashamed because you are overweight or underweight?
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The role insulin plays in nutrition

These are all the psychological factors and components that play and so, dietitians, have to understand The patient and every person is individualized. And that’s why like we at Culina Health provide, personalized nutrition. So, for example, if you were a type two, diabetic, I would counsel you an entirely different way, than somebody who comes to me and says, all I do is think about food every single day and what I’m eating like every minute of every day, I’m thinking about what I’m eating. Well, that’s, that’s an eating disorder. And so we need to deal with that in a very different way.

But if you’re a type two, diabetic, it’s completely reasonable for me to say carbohydrates, affects your blood sugar, they raise your blood sugar, they tell your liver, store fat. When the blood sugar is raised, your pancreas mobilizes insulin. Insulin helps to bring the carbohydrate in the cells, that’s a storage hormone. So that’s also going to affect your weight.

So let’s figure out how much carbohydrate you can have at every meal. How does carbohydrates affect you later on in the day. Some people have no problem eating carbohydrates at breakfast and lunch, but eating it at dinner is a problem. Some people, that’s not how it works, they need to eat their carbohydrate earlier in the day. So it just depends on your, digestive system.

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How intuitive eating works with nutrition

So even though there’s a prescription for eating, it’s still intuitive to you and your life and your cycle. You know, what is going on with you. So, let’s make that fit.

Myrna: To me, Intuitive Eating, is eating following your preferred diet and maybe tweaking it a little bit. Because either you’re, diabetic, or you’re not, or you want to build muscle, or lose weight etc. So, prescriptive eating, is what you would counsel someone to do, like a meal plan.

Vanessa: Whatever your goal is, maybe your goal is that you just want a better relationship with food. So okay. that’s different than you have type two, diabetes, and we need to control your blood sugar. So I’d probably lean more prescriptive if I need to control your blood sugar.

Intuitive eating, is just following your normal diet. If you’re from the Mediterranean or Caribbean Islands, intuitive Eating, is just honoring your body and, how you feel during the day nothing is off limits. We can eat whatever we want, we just have to understand how the food is affecting our body.

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Contemplating weight loss is not doing the work

Myrna: You say that understanding what we eat is influenced by many factors. social, emotional, and psychological. So, talk to me about that. How those modalities fit into someone’s, diet plan, for, weight loss?

Vanessa: People go between contemplative and action, they vacillate between the two often, and so it’s our job as, dietitian, to recognize that, and really meet people where they where they are.  Because if they think that they’re in action mode, but really, they’re in contemplative or pre contemplative mode, they will not be successful achieving their goals. It’s our job to help them understand where there are in the process. If I give you, diet plans, and every week you have excuses why you didn’t complete them you are in the contemplative state, so let’s step back.

Because we don’t want you to feel negatively about this experience, or that you’re not able to achieve your, weight loss, goals you’re just not ready. And that’s okay. So those are like those psychological components. And psychological and behavior, they sort of go hand in hand. And that’s a big piece of this. We need to really understand our patients, how they behave, why they behave in the way, and how we can support them, so that they can achieve success.

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Your history with food

What is your relationship with food? How were you treated as a child? How do you feel around food? How were you first introduced to food? Do you know, what are your preconceived notions about food? Those things are also important.

Myrna: So you’re talking about someone coming to see you, and they have a goal, either to be healthier, or they have an illness, like cancer, or even, something like Crohn’s disease. So there’s certain foods that they can’t eat. So, when that person comes to you, you work with them on their social, I’m assuming that social means they go out a lot, eat fast food or not drinking water. Emotional, maybe their relationships. Some people eat when they are lonely or heartbroken etc. And I guess the psychological is are you ready to do the work to make a change?

I know someone who is overweight and his wife is always trying to get him to to pay attention to his weight and food, but he’s not there yet. He doesn’t have what it takes to to make that commitment to eat healthier.

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Weight isn’t a predictor of mortality

Vanessa: Yeah, he’s not ready if people are constantly talking about his, weight, then that’s the thing for him. So this happens to a lot of people, I’m just using him because I know. But I do know that I see a lot of people that are overweight, and you’re thinking, Well, why aren’t they doing something about it?

They’ll say, oh, that’s healthy, or unhealthy? And then you’re going to get sick at some point in time? Well, I think people are not ready. I mean, we know that, weight, isn’t necessarily a predictor of morbidity and mortality, and some people choose to live in a larger body. And they’re happy with that. And so that’s that.

So we just, we recognize that and we noticed that it’s not a one size fits all. And sometimes you just have to say to people, Hey, let’s not let’s talk about the, weight. You came here because your, cholesterol, is elevated. But we have to do things to make the, cholesterol, go down. So, I want to change the way that you eat in these ways.

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Cholesterol reduction plan from your dietician

Your current diet is that you don’t eat breakfast, and then at night you over eat cookies. Let’s come up with something that you will eat that’s really easy and accessible. Let’s say it’s an English muffin with peanut butter for breakfast. You eat that for breakfast that every single day for three months and you only eat two cookies at night. I promise you your, weight, will have gone down and your lab will have gone down.

You can also lower your, cholesterol, if you had chia seeds or some berries, with almond milk, that would actually keep you full. And that’s upping the fiber content, because fiber helps to draw, cholesterol, away from the body.

Meal plan:
  • two tablespoons of chia seeds,
  • one quarter cup of oats,
  • half a cup of berries, you’d probably be somewhere in the vicinity of 15 grams of fiber. And that’s only at breakfast.
  • add vegetables at lunch and dinner,
  • and another piece of fruit paired with a fat like nuts, you would get to about 30 grams of fiber. If we focus on 30 grams of fiber every single day, that’s will lower your, cholesterol. You don’t have to eat oats, but it’s just a quick vehicle for the fiber.

Additional Resources

How to Maintain Sustainable Weight Loss

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