Ep. 25 | Anna Scott, Dietitian, SGMC Health

Transcript

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- Welcome to another episode of What Brings You in Today.

- I'm Erika Bennett.

- And I'm Taylor Fisher.

- And we just wanna start off by thanking everyone for tuning in to our podcast, what brings you in today, and for subscribing and just tuning into all the different episodes.

- Yeah, this is exciting 'cause this our second full year of recording. So we're excited that you guys have supported us for a whole year. And if you have topics or questions that you wanna hear us talk about, you can submit those at sgmc.org/podcast.

- And today we are here with Anna Scott. And Anna is a dietician at SGMC Health. And so Anna, what brings you in today?

- Well, I've come in to see how the patients are doing with their meals, provide them with information that'll help them in their journey for a better nutritious life and to take care of the ones that are unable to feed themselves and are critically ill.

- Yeah, I think when you think about a health system or a hospital in general, dietary needs are probably like one of the last thing that a just a come Joe thinks about when coming to the hospital. Like

- Yeah, you think more about medicine and you know, getting them well, but you don't really think about how they get fed usually.

- But it plays a big role in a patient's recovery. Right?

- We certainly think so. Patients a third or more that are admitted to the hospital are considered malnourished by specific kind of criteria. And when patients come in already malnourished, it extends their length of stay, it complicates wound healing, it creates more readmissions kind of thing. So it can make caring for the patient harder by all the disciplines that are involved. Wow. Yeah.

- I wouldn't thought about that. And they say food is medicine. Yeah, I have heard that term before. Yeah,

- It is. It is.

- Well, tell us about your role to become or your journey to become a dietician. Like what does that look like? And then how did it land here in a, did you always know, like in the end, did you always know you wanted to work for a hospital or kind of what you maybe thought you wanted to

- Work for? No, I kind of started, I come from a family of teachers and so I kind of already knew that I might go into a role that was a teaching kind of heavy. But I started off doing more of an international relations thinking I would go in the Peace Corps and help people help themselves in other countries, you know, build wells or something. I didn't know. But then I had the family member that got really ill and had to deal with medicine a lot. And I then went back and decided to do something in the health field, figure out where I wanted to be in the health field. Quickly realized after volunteering it was not gonna be medicine or nursing, but that diet and nutrition and food is everybody's life. Yeah. You know, we've been eating a certain way since we were a year old, you know, or more, you know, so there's just habits that are ingrained from culture and from growing up in a certain community hardships. Yeah. And so I kind of went into public health and then added the dietician license stuff onto it to make it more specific.

- Yeah. Yeah. So that's, that's interesting. It is interesting speaking of like habits and I mean eating is something we do every day, but I, I mean it's such a mind mindless task I guess you would think. Like, I don't know that how many people are very mindful about what they're putting into their bodies, what the impact that it has on their health and wellness and just how they feel overall.

- Yeah, yeah. Including those of us that are in the field. You know, just being a lot more conscious.

- Yeah.

- Is is a, is a big step.

- Okay. Well what do you recommend, what's your first the easiest thing to, if you're wanting to kind of change, especially in the new year, you know, hear a lot about New Year's resolutions and everyone always wants to lose weight. It's usually their number one goal, but they're not always willing to change their diet and stuff. But if, what's the simplest advice you give, especially to patients? 'cause I imagine they're going through a lot of changes already. How do you encourage them and anyone to kind of take their nutrition more seriously?

- Well sometimes when you see a patient that has just been through a traumatic experience, which could just be a heart cath with a stent because they had some shortness of breath or chest pain, they can be a captive audience where they're a lot more willing. Or you've got those that are, you know, maybe just not as willing and just wanna come in and have somebody give them a medicine and fix it that way. But I try to meet the patient where they're at and when we walk into a room, a lot of times the patient will look at us and just know that I'm going shake my finger at 'em and tell them to stop doing something. And I really try to not give them that satisfaction. Maybe it's my stubborn streak, but I'm gonna win you over.

- Yes. - So I try to figure out, well what are you eating? What do you drink? What do you think you're not doing right? And then maybe what could you replace it with and more of let's add a fruit and a veggie because that's gonna help you maybe decrease your sodium intake and increase your potassium intake, which will help that cardiac inflammation. So it's maybe, maybe we wanna add something or try something new or get up and walk five more minutes a day. I mean these little tiny changes

- That makes asking, sometimes it just asking them where, what their understanding is is something that I hadn't thought of. 'cause not everyone has the same understanding of help. So asking them what do you think you're not eating? Right.

- Yeah.

- Is an interesting,

- I mean if we were to ask all of us here in the, you know, right here in this room, we all know what we could do better. Right. We all have an idea of what's not the best thing and what's what we could do better. So sometimes having them identify it and then see if they can, you know, do something just a little different. I have a lot of people that love their sweet tea and, and love sodas. I mean they grew up that way, but maybe just changing one or two of them out. Yeah. For a carbonated water or something. You know, just try something different.

- Or just keeping track. Make it more adventurous. Because I know when I started to actually look at the sugar content of certain things that I was consuming, especially drinks because those are very sneaky. You don't realize how much sugar you're drinking. That's just kind of like empty calories or empty sugars. So I think that's another good way is just to keep track of things for a little while.

- Yeah. Yeah. If that, that person's willing to, right. Exactly. Yeah.

- Yeah. How much does education truly play a role? Because you know, sometimes you can educate. I mean you don't know what you don't know and you can't change what you don't know. So if you're educating people, like you said about the sugar content, I mean really how many people do you come across that are just unaware of how they're eating and how that's like contributing to their health? Or do you think people ultimately know and they're just kind of been putting it off into a significant event happens that lose them in the hospital? They're like, okay, I need to make a change.

- It can be combination. Yeah, it can be a combination. 'cause I think a lot of people they don't necessarily know when they're just drinking their calories for per se. Hmm. Until you point it out on a food label. You know what, what if you just put down two of these, you're down 500 calories in a day.

- Yeah. - And then others just need that cheerleading.

- Yeah.

- You know, just that kind of marketing or just that, hey, this is not that hard if you just think about it in this one little way of put down, instead of doing french fries with every meal twice a week, change it to a fruit cup. You know, or something like that. Just little simple things that just opens their eyes that, oh, that could really make a difference. Yeah. It really

- Can. Thinking about it differently too, I like how you said, how can we add things to your meals versus like, okay, we have to cut this in half. And you have, you can only have, you know, like restrictions and people really don't like things to be taken away from them that they may like. So they may come, you know, defensive or, so I like that

- We all deal with this. So speaking about, you know, taking things away and restricting, what are your thoughts on, you know, these hardcore de detox diets or you know, switching all the way to keto from eating? What are your ideas on these different fad diets?

- Those are, they are not sustainable. I mean any of them. So when you're thinking if you need a jumpstart sometimes and people may need a jumpstart just to get them motivated to see a really fast result. Those can, those can be helpful 'cause you see that, but there's certain medical conditions where they really don't even go, need to go near those, you know, diabetes or kidney disease or liver disease. Maybe some age related frailties, detoxing. I mean the best way to detox detox is just to drink, drink water, drink fluids. Yeah. But you know, and put some more, I hate to harp on fruits and vegetables, but the antioxidants in those foods, really that's what they're for. They help to combat

- What's - In our system that that might be doing harm. So it can give a little boost, but I never ever say to eliminate anything from your diet. And keto does that. Keto tells you to eliminate foods.

- Well and so many things di in the diet world in that, you know, they, they say consult your physician before you start. But how many people actually call their doctor? I'm like starting this diet. Let me see if it,

- Yeah,

- No, you're not doing that.

- So yeah, I've just always thought they, they couldn't possibly be sustainable long term. So really if you just do that and then go back to eating the way you were, you've really done nothing except for torture yourself for a little while.

- For calorie restriction. The more you restrict your body, it's gonna change your metabolism to only burn the calories you're putting in.

- Yeah. - So it's gonna really decrease your calorie burn. Mm. So once you then start eating more again, it's gonna store, right? Yeah, yeah, yeah. So it kind of messes things like that up metabolism. Yeah. Everybody's is different.

- Yeah. And it's crazy how you can change your metabolism. Like you're saying, how your body changes it based on what you're eating. And I mean the average person I don't think understands that and the impact that that has on

- Yeah. Some people think you're born with it or you're not. Yeah. But Right. Your body is made to, it wants to survive so it's gonna change its needs based on what you put in it

- For average person. Let's talk about maybe you're not in the hospital now, you're your home. How can we prevent ourselves from landing in in the hospital room? What is the recommended meal, I guess you should say, like how should you make your plate? What are you thinking or what are you, what are you wanting to make sure you include every day?

- Well first off I would say people need to eat more than one time a day. There's a lot of people out there that

- Don't One of that intermittent fasting stuff too.

- Yeah. And there's some intermittent fasting which has its place, but people are in the habit sometimes of just getting up, go, just go, go, go, go, go. And then all of a sudden, alright, it's time for lunch or it's time for dinner, you know, or I'm suddenly starving and then they get all of their calories plus in one meal. And that's hard for your body to, to digest sometimes and assimilate the nutrients. So I would say for one, try to eat multiple times a day. Not necessarily the six that or six to eight, but try to eat in the morning and then every four or five hours after that have something look for variety. So if you're eating kind of a meal, try to have at least a couple of different nutrients on it. Like a, a fruit and a dairy. Or if you're having a whole big meal, a, a protein, a starch, a pro, you know, and a vegetable and, and using kind of a, the plate method which says half of the plate needs to be produce and then a quarter protein and a quarter starch is kind of a, a guideline that's known in our industry. But not everybody wants to eat those, all those foods at the same time.

- Yeah.

- So like with me personally, I will kind of keep track of my head or on paper or somewhere that what I've had in the morning. So if I've had cereal and fruit this morning, then I know at lunch I need to have a little more protein of vegetables and try to look at it throughout the day to make sure my plate's being filled in that 12 hour period that I'm eating or something like that. Does

- That, yes. And talk about portions.

- Okay.

- Because I think we overserve ourselves a lot. We can. So what is like the recommended portion size that you should be eating at? You know, say lunch?

- Yeah, if you think about a half a cup in a sense some things are more like a quarter cup or a third of a cup for a portion. Especially if you're managing like glucose people that have, that are have, that have diabetes and are having to watch their carbohydrates. You've gotta be a little more specific and got with those serving sizes. But a, you know, a quarter cup, a third of a cup of certain foods for starches, two to three ounces of meat, which can be, you know, a palm vegetables kind of are unlimited in a way

- Depending on what

- You've put on them. I think. Yes, probably like a half a cup cooked or a cup raw is sort of the the guidelines. But half your plate. So

- You mentioned tracking, I know there's several apps out there now. You know, you have like the MyFitnessPal, there's all kinds of different apps that you can utilize to help you track what you're eating. And then I've also heard a lot of like counting macros and d different things which that can be over. And it seems so overwhelming to someone who doesn't understand anything about that. Is there some, is there a to, how does someone figure out what is right for them without like cons having to pay a lot of fees for someone that's figured this out and telling you what you should do?

- I mean they can always come to me of course. Okay. You know? Yeah. They can always come see a dietician or call one up, you know, you can find them online and even look at certain websites such as the Mayo Clinic or National Institutes of Health, you know, something reputable. Generally if we, that's a hard question to answer. It's because it's the hardest, it's so individualized. Right. Yeah. But, but I mean we can figure it out based on what's maybe their ideal place to be with their weight.

- Right. Kind what their goals are,

- Where they're at currently and their activity level. And then we've got some ratios kind of maybe 25 calories per kilogram is kind of a general, but not everybody thinks

- About kilograms. But I think there are calculators, like you said on May office. I think I've seen that before. A calculator of like calories versus you know, what you burn and it kind of helps you with that.

- Yeah. Using some site like that. And then usually about half your calories at least 40, no none less than 40. 40 to 50% should come from the carbohydrates, the starches and 20% from protein and less than 30 from fats. So those are kind of some general ratios.

- Well what about, you know, we have a lot of different people that listen. You know, we have busy, you know, like nurses, moms, people that are you know, very busy running out of the door. What about meal prepping? Do you have any tips for how someone can meal prep when they're on a busy schedule like that so they're not breaking down at the end of the night and eating something super unhealthy? Gosh, I'm right there with them. I

- Know, right? I really am. I struggle. Y'all have probably heard out there that just knowledge and behavior, they just don't always match up. Oh yeah. So it's hard. It is hard. And I struggle with that too. I, I, when I grocery shop and I usually try to grocery shop once a week or more and then I spend a day, you know, we usually all will have at least a day off during the week. Hopefully I'll try to get some ideas together where I'll have certain things available in the kitchen, certain things I know I can always grab apples, carrots, cheese, nuts. We'll you know, those are just those quick things. Peanut butter and crackers are always something easy to have in a desk drawer meal. Prepping wise, it's good to think about maybe when you're doing your grocery shopping, having a meal or two in mind that you wanna have like I'll cook on the weekends and then we eat some leftovers throughout the week, you know, and then I always have sandwich stuff, salad stuff, something I can pull out of the freezer a soup. So I, I do a lot of make a meal and try to then extend it Or get a rotisserie chicken and have some vegetables in the, the freezer that I can then microwave real fast.

- Yeah. I think the key there, what I'm hearing is being intentional. Being intentional about what you're going to make for the week, what you're gonna eat, how you can maybe, how it can maybe last a little bit longer if it is something that's better for you, but you're having to think you have to prioritize

- It. You do have to yes.

- If

- You're serious about

- It and don't do it when you're hungry. Don't grocery shop when you're hungry.

- That's hard. It is hard. But right. Having that, that intention to have a meal or two made and then always have something that's a go-to, that's a decent choice. You know, kind of like last night it was busy for me and I just was able to make a Turkey sandwich, you know, had the stuff there that I always can just get a quick Turkey sandwich in.

- Yeah. It doesn't have to be some elaborate like meal with a meat and

- Several sides. And that's kind of what I do. What me and my husband do is we buy, you know, a certain amount of meats and then we're like, we buy all these different vegetables that will go,

- You know, and we just kind of decide, hey, you know, we'll make this and have leftovers

- Keeps you out of the drive through.

- Right, right. And people that are doing drive through life, that's, you know, that's, that's their life. I'm not gonna criticize anybody's the way they have to live, you know, with, with trying to work and go to school and things. But then having those, being able to say no to certain, you know, go for the grilled a few times rather than the fried or always have like an apple or things in the car that you can have and then say no to the, to the fries a couple times. So it's,

- Yeah, that's what I was like, especially if you are at a desk and you to go ahead and buy snacks that you can have that have, are high in protein, things are gonna fill you up but also be healthy so you don't feel tempted or you don't find yourself like, oh I'm starving and you don't have any good options. So you end up taking the bad option.

- Yeah. Yeah. You feel better. Yeah, you feel better. So

- Is there, so tell us about feeling better and, and when you are eating, is there anything, I mean what, what makes that, is it just all the benefits that come with eating healthy?

- I think it, some of it is, some of it when you know you're making a good choice, you feel better about yourself. I mean just emotionally, but then getting enough hydration, you know, hydration is is big and if, if you're drinking a lot of caffeinated drinks, I mean usually it's alcohol and caffeine that are the dehydrating drinks. So if you're choosing a lot of caffeinated drinks throughout the day, going less, less caffeinated for one, just choosing a a caffeine free soda is gonna help. You know, just feeling hydrated. You feel more clearheaded getting a variety of foods then hits helps you to hit all those nutrients that you'd need. All the, the B vitamins and the antioxidants that help your body fight off inflammation and make you think a little clearer. So, and just outside of nutrition activity. Yeah, I mean if someone's not even ready to make a change really with their diet yet, if they're willing to just do something extra 10 minutes a day, I encourage that. And sometimes then that'll lead to, oh I've, you know, I've walked an extra 10 minutes and I got a little bit hot. I think water would be good right now to, you know, rehydrate and then there's two good decisions.

- So, so don't overcomplicate it. You don't have to make it. It seems overwhelming sometimes when you're thinking about I need to change my entire, this diet, I need to get active, I need to do all this. Almost to where you feel like you can't do it because it seems like a lot. It's so just take baby steps.

- Yeah. I don't think it's a good idea to make, make all the changes at the same, just

- Go ahead and drink that glass of water. Why add more stress to your life? Yeah. Yes. Yeah. Coy, we enough of that glass of water get outside but yeah, one or two little changes. Exactly. Yeah. Make it easy. And then you can build from there

- And they compound, like you said, exercising and then wanting to eat healthier. And I definitely see that in myself and I see the reverse too when I'm not active. How I tend to, I mean I just, I just tend to eat worse. I don't know what it is. Well you're just

- Like, what the heck? You know, I'm already, I'm already not doing anything. I've already thrown this

- Day away.

- You know, you kind of get that

- Mindset. Yes you do. Yeah. And these last few months, you know, since Halloween, I always say Halloween basically through the Super Bowl.

- Yes. That is a good analogy because all the sweets and stuff that are around all the, all the meals, all the holidays

- Stuff you kind of get in that group and everybody's doing it so

- Well they say that, you know, you make your New Year's resolutions and I think like two weeks in then it's like national quit day where everyone has already given up on the rest. Yes.

- Is it like this Friday today maybe?

- I think, I think it's, people have already quit, so guess what I did? I'm not starting till after the national quit day that way I'm not even gonna be tempted by that. So I'm gonna start, we're gonna procrastinate. Yes. There we go. I'll just procrastinate.

- Alright, well I decided to call mine goals instead of resolutions. I set goals because I don't do resolutions either. Well I, I have already set some goals that I'm already on track with. Good. I've been to the gym four times this week. I get it four times back to back. So I'm very proud. But I, it's like you said, building on those successes I think so once you're successful at one thing then you think, oh I can do this. I'm gonna try this other thing. And then I think you kind of, it motivates you and gives you more confidence

- That adventurous spirit kind of. I think it's seeing, it's a curiosity rather than something negative. Let's just see,

- You know, I feel like I'm a a mother, two kids husband job, you know, doing all the things and I kind of feel like I get, the last thing I wanna do is think about what I've got to eat like at the end of the day and even throughout the day like I just feel like I don't have time and so then I tend to neglect it because

- Yeah,

- It's whatever I, I've often said I wish I could just take a pill that would like give me my all my nutrients from a meal worry make you feel satisfied. And because I'm telling you any mom or wife on this, the dreaded term when you get off of work is when your spouse or significant others like

- I get that phone call too. What's for dinner? It's like are you not

- An adult? Is that not the most unnerving question you've ever been asked?

- You see that's why you need to have already meal plan and wrote it on the fridge. I write it on the fridge so they know what's for dinner but my husband doesn't call me and you better not call me and ask me what dinner don't start. We're not

- Recommending it. And if there are any husbands that are listening right, just stop that. Call her and say Babe this is, I'm making this or we're going to get this because you're gonna get I don't know what And

- She What

- Do you want for dinner? Browning points right there. Yeah. And now we have you, you know we have ideas of how you can even make that dinner. Yeah. Bonus points if you make the dinner. If you make the dinner it's right there in the refrigerator or a crockpot or something. Talk, I mean crockpot. Oh yeah. I hear a lot about that. I don't even know where to start though. Although I know that get a crock pott. I have a crock pott.

- Yeah. Or an instant instant pot. I have an instant pot that can act as a crock pot. And that's always, I will say that's where you can get the less expensive, tougher cuts of meats and things and just cook it all day and it gets nice and tender and it's not fatty and it's healthy and then you get there and Right. Throw in some veggies for those last 30 minutes. Exactly. Good idea. And it

- Feels year

- This time like

- A good year. Yeah.

- But you have to get up and get it going

- And you do have to plan plan. You gotta plan that one little bit. That's my problem. That's why I haven't started a crockpot yet. 'cause I have been good at the free plenty

- Yet you could put this stuff in there the night before. I've done that. And then the next morning just plug it in and turn it on. You might have to cook it a little longer 'cause it might be cold.

- Right.

- But I've done that before it

- All day. Put it in the pot and just put it in the refrigerator and then take it out, unwrap it.

- Or you can cook it all night and

- Then

- That's true. Yeah. I don't like to smell food cooking overnight though. Yes.

- Seems a little weird in the morning time when you're getting your coffee. But that's idea like that roast smells delicious. Then you have it for breakfast

- Then your whole day. Yeah.

- That's kind of counterproductive.

- So at the end of our podcast I usually ask what people like to eat in the cafeteria or in the spice. So I'm very interested to hear if you ever eat here. I do. And do what you have to say. So what's your favorite meal that we have?

- I like the, I love some, some beans like with the the taco Tuesday I will sometimes get like the taco salad with lots of beans. 'cause in my family I'm the only one that eats beans so I have to eat it here. And then at the spice, I love their grilled chicken sandwich or just their tuna sandwich on the jalapeno cheddar bread and all the veggies. I make a dab wood kind of sandwich with all the veggies on the top of it.

- And that's salad bar they have. And the All spice is amazing because they have so many different things. If you're talking about color, you can make a very colorful getting salad.

- Yeah. Make it look like Erika's dress. Make it look.

- Yes. There you go. In there. Those are two dancer I don't think we've had before. So it's interesting that we get a lot of different things and then we have a couple that people tend to repeat, but I just, you know, was curious to hear what you thought. Yeah. But I think both of yours are pretty healthy. So

- Yeah, I'm not surprised. And the cafeteria, just to put a plug in for food service that we're changing up a lot of our recipes, well I shouldn't say recipes, but we're having kind of a meal menu refresh coming up in the next couple months for retail and for patients it's gonna be, it's just some new ideas, new things, ways to throw veggies in in a different way, to different ways to cook meat, different flavors from different cultures. We see how it

- Goes. I mean you just don't think about that. Again, going back to my very first comment is in a hospital, it's interesting, you know, we have a whole team that work to make it really good, as best as it can be for our patients while they're here and to meet their needs. And that's something people wouldn't really think about. But we thank y'all for all your hard work and hopefully we don't have to be in the hospital, but if we do, we know that we'll get,

- You'll get well taken care of if we want patients to eat and enjoy it. Yeah. Yes. It's not hospital food, it's

- Nutritious. Right. Exactly. Medicine, food is a recurring theme in our podcast because we ask that question at the end of every podcast. So food services gets a shout out every time. Yay. We love it. Well thank you for joining us today.

- Thank you for having me. It's been great.

- Yes, and thank you everybody for listening. Please like, subscribe, rate our podcast and we'll see you next time. Thank you.