Blog Archive

Becoming a Registered Dietitian Nutritionist in My 50s
Tina Guadan Fogall, RDN, MS

Embarking on a new career in my early fifties wasn’t part of the original plan, but becoming a registered dietitian was a dream I couldn’t ignore. This journey wasn’t just about starting a new profession—it was about finding purpose, making a difference, and empowering others during a time of profound global and personal change.

The pandemic was a pivotal moment. Watching friends, my community, and healthcare systems stretched to their limits, I was reminded of nutrition’s critical role in resilience and recovery. That realization propelled me to pursue my dream of becoming a dietitian.

At the same time, I was navigating the challenges of perimenopause. Brain fog, disrupted sleep, and hormonal shifts tested my resolve as I tackled coursework, exams, and an intensive internship. Staying focused on science-heavy material while my body rebelled wasn’t easy. I didn’t always power through—sometimes, I hit walls. But I leaned into these challenges as reminders of my strength and adaptability, cultivated over decades of life experience.

Nutrition and lifestyle became more than a career focus—they became my personal lifeline. I applied my learning in real-time, experimenting with nutrient-dense meals, hydration, movement, stress management, and supplements to support my evolving needs. For the first time in my life, I learned to prioritize myself—above school, work, and even relationships.

Starting this journey later in life has been an asset. I’ve entered the profession with maturity, empathy, and a wealth of real-world experience that helps me connect deeply with patients and clients. Today, as a dietitian, I draw from my own experiences to guide others with understanding and compassion.

This path has strengthened my belief in the transformative power of nutrition and deepened my resolve to make a difference. As it turns out, my fifties were the perfect time to follow a dream.

Practices That Carried Me Through

Here are a few unsurprising habits that helped me manage the stress of earning my credentials and have seamlessly carried into my career as an RDN:

• Sleep: Eight hours whenever possible. Perimenopause doesn’t make this easy, but a consistent routine and occasional supplements make a big difference. On tough nights, I rely on a good book and magnesium to help me wind down.
• Movement: Yoga became my sanctuary. It offers stress relief, physical activity, and a sense of community. Finding a studio that balances strength and serenity has been life-changing.
• Snacks: I’m not one for repetitive meals, so I focus on leftovers. Extra protein from dinner often becomes my go-to breakfast or snack. We cook just enough for the next day to avoid food waste.
• Hydration: At home, I’m great at staying hydrated. When I’m out, sparkling water has become my secret weapon.
• “Me Time”: I recharge with period dramas or baking. Even an hour makes a difference. Letting go of guilt about what I “should” be doing and focusing on what truly nourishes me has been transformative.
   

Nutrition Among Asian Americans and Pacific Islanders (AAPI): Cultural Perspectives and Health Implications

Asian American and Pacific Islander (AAPI) populations represent a diverse and growing group within the United States, with distinct dietary practices rooted in a variety of cultural traditions. Understanding the nutrition-related needs of these communities is essential for addressing health disparities and promoting well-being through culturally appropriate dietary recommendations.

Cultural Dietary Practices

Traditional diets in AAPI communities are often centered around whole foods, such as rice, vegetables, legumes, and fish, with a large emphasis on plant-based nutrition. For example, the diet of Chinese, Korean, and Japanese populations typically includes rice, fish, and vegetables, while Indian cuisine incorporates spices like turmeric, which have been associated with anti-inflammatory benefits and overall health improvement (Liu et al., 2021). These traditional eating habits are linked to positive health outcomes, including lower risks of cardiovascular diseases and certain types of cancer (Mok et al., 2020).

However, as AAPI individuals come to the U.S. and adapt to a Western lifestyle, there is often a shift toward higher consumption of processed foods, sugar, and red meats. This transition has been associated with an increase in diet-related diseases such as obesity, diabetes, and hypertension (Nguyen et al., 2020).

Health Implications

Health disparities among AAPI communities are significant, with increased rates of chronic diseases such as diabetes, hypertension, and obesity in certain subgroups. For example, Asian Americans, particularly South Asians, have a higher risk for type 2 diabetes compared to the general U.S. population. This risk has been linked to changes in diet post-migration, which often includes more processed and calorie-dense foods (Khan et al., 2020). Additionally, Pacific Islanders face disproportionate rates of obesity and cardiovascular disease, which are exacerbated by dietary changes due to migration and a shift from traditional foods (Baker et al., 2021).

A growing concern within AAPI populations is food insecurity, which exacerbates the risk of poor dietary choices and the development of chronic conditions. A study conducted by the Asian Pacific Islander American Health Forum (2021) found that food insecurity rates in AAPI households are higher than the national average, particularly among low-income and immigrant groups. This highlights the need for tailored nutrition interventions that address not only dietary habits but also the economic barriers to accessing healthy foods.

Nutrition Education for the AAPI Community

To address these health disparities, it is essential to develop nutrition education programs that reflect the dietary habits and health needs of AAPI communities. Research emphasizes the importance of incorporating traditional foods and dietary patterns into nutrition interventions. For example, strategies that focus on the benefits of traditional AAPI diets, such as increased vegetable consumption and the use of heart-healthy fats, can be effective in reducing the risk of chronic diseases (Chung et al., 2021).

Moreover, healthcare providers can encourage AAPI individuals to maintain their cultural food practices while making healthy modifications, such as reducing sodium intake and replacing high-fat meats with plant-based proteins (Patterson et al., 2019). Culturally sensitive programs help foster trust and engagement, which are crucial for promoting long-term dietary changes.

Conclusion

The nutritional needs of Asian Americans and Pacific Islanders are shaped by a mixture of cultural traditions, acculturation, and socioeconomic factors. By acknowledging the dietary heritage of AAPI communities and addressing the health disparities they face, healthcare providers can develop more effective, culturally sensitive interventions. These interventions will help improve the nutritional well-being of AAPI populations, ultimately reducing the prevalence of chronic diseases and promoting healthier lives.

References:

Baker, D. L., Hu, K., & Lee, E. K. (2021). The impact of dietary acculturation on obesity and cardiovascular health among Pacific Islanders. Journal of the American Dietetic Association, 121(6), 1065-1074.
Chung, M. K., Lee, A. Y., & Lee, J. M. (2021). Integrating traditional Asian diets into nutrition interventions: A systematic review. Journal of Nutrition Education and Behavior, 53(9), 741-753.
Khan, M. A., Hashim, M. J., & Al-Raddadi, R. (2020). Prevalence of type 2 diabetes and its associated factors in Asian American populations: A review. Journal of Clinical Endocrinology & Metabolism, 105(12), 4024-4035.
Liu, Z., Han, J., & Wang, J. (2021). Turmeric and other spices in Asian diets: Benefits and potential for disease prevention. Nutrients, 13(6), 1863.
Mok, H. T., Liu, F., & Zhang, Y. (2020). The role of traditional diets in reducing cancer risk among Asian populations: A meta-analysis. Cancer Epidemiology, 66, 101707.
Nguyen, K. H., Zane, S. M., & Lopez, S. S. (2020). Dietary acculturation and its impact on health outcomes in Asian American populations. Journal of Nutrition and Health, 52(8), 938-946.
Patterson, M. A., McGown, J. R., & Lee, R. (2019). The role of culturally appropriate nutrition interventions in preventing chronic diseases in Asian Americans. Journal of Immigrant and Minority Health, 21(4), 734-742.
Asian Pacific Islander American Health Forum. (2021). Food insecurity and health disparities in AAPI communities. API Health Report, 7(2), 23-30.

Gluten-Free, But at What Cost? The Hidden Risks for Those with Gluten Intolerance or Celiac Disease

For people with gluten intolerance or celiac disease, eating gluten-free is important to stay healthy and manage symptoms. However, many gluten-free food options include a lot of processed foods, which can make up as much as 80% of what they eat compared to only 20% in regular diets (NatureDoc, 2024). These foods often use additives like preservatives and emulsifiers to make them taste better, last longer, and feel like regular foods. For example, without these additives, gluten-free bread would often fall apart, taste bland, and spoil quickly (Whelan et al., 2024).

Many processed foods, including gluten-free ones, use seed oils that are high in omega-6 fats (such as safflower, sunflower, grapeseed, and soybean oils). While our bodies need a little omega-6, having too much without enough omega-3 fats can cause more inflammation. Seed oils are often added to ultra-processed foods to improve their texture and shelf life. This can be a problem for people with celiac disease or gluten intolerance because inflammation can make their symptoms worse and has been linked to an increased risk of colon cancer

(CNN, 2024).

To feel your best, it’s a good idea to eat more naturally gluten-free foods that are high in omega-3s, like salmon, walnuts, chia seeds, and flaxseeds. Try to eat fewer processed gluten-free products and choose whole, nutritious foods instead. This can help reduce inflammation and keep your body healthy (CNN, 2024).

What Are Ultra-Processed Foods?

Ultra-processed foods are highly altered from their original form. To identify them, check how much the food has been changed from its natural state, whether it contains additives like preservatives or colorings, if it’s mass-produced instead of homemade, and if it’s designed to look better or be more convenient. You can also look for specific signs on the ingredient label, such as low fiber content (less than 1 gram of fiber per serving) or high amounts of added sugars (10 grams or more per serving) and artificial ingredients. While these products seem like quick and easy gluten-free options, they often lack essential nutrients found in naturally gluten-free products. (NatureDoc, 2024).

The Impact on Gut Health

For someone with celiac disease or gluten intolerance, relying on ultra-processed foods can harm gut health. These foods are often low in fiber and nutrients, which are crucial for maintaining healthy gut bacteria. Additives like emulsifiers can disrupt the balance of bacteria in the gut, leading to inflammation and digestive issues. Over time, this can weaken the gut lining, increasing the risk of conditions like leaky gut syndrome, which is particularly concerning for individuals with celiac disease or gluten sensitivity (News-Medical, 2024).

Boosting Gut Health with Probiotics

Probiotics can play a key role in keeping gut bacteria balanced, which is crucial for individuals with celiac disease and gluten intolerance. They help by increasing the number of beneficial bacteria in two ways. First, they grow in the gut and promote the growth of existing good bacteria. Second, probiotics compete with harmful bacteria for nutrients and space, preventing bad bacteria from spreading. Including probiotics can help maintain a healthy gut while managing symptoms (Ali & Khan, 2022). Some probiotic strains that can be especially helpful for people with celiac disease or gluten intolerance include:

• Lactobacillus acidophilus: Supports overall gut health and has been studied for gastrointestinal issues. It’s found in yogurt, fermented dairy products, and kefir.
• Bifidobacterium lactis: Helps strengthen the gut barrier and modulates the immune response, which can be beneficial for celiac disease. It’s found in yogurt, fermented dairy products, and probiotic-enriched drinks.
• Bifidobacterium longum: Maintains a healthy gut microbiota and may reduce inflammation. It’s found in miso, sauerkraut, kimchi yogurt, and kefir.
• Saccharomyces boulardii: A beneficial yeast that supports gut health and helps manage diarrhea. It naturally occurs in some kombucha drinks but is more commonly available as a supplement.

Tips to Limit Ultra-Processed Foods on a Gluten-Free Diet

While ultra-processed gluten-free foods dominate the market, there are healthier options (Suárez-González et al., 2021):

• Opt for traditional gluten-free bread: Gluten-free 7-grain and seed breads made with simple ingredients are great options.
• Focus on naturally gluten-free foods: Include lentils, beans, fruits, vegetables, meats, fish, eggs, dairy, nuts, seeds, and healthy fats like olive oil, coconut oil, and avocado oil in your meals.
• Choose better options from the gluten-free aisle: Look for nutrient-dense options like gluten-free oats, buckwheat, millet, teff, sorghum, and almond or chickpea flours. These items are often available at a lower price in the bulk section. Seeded crackers and granolas are also excellent choices.
• Bake your own snacks: Homemade gluten-free snacks are typically healthier and can be stored in the freezer for convenience.
• Bring healthy snacks with you: Carry naturally gluten-free options like dried fruit, nuts, seeds, olives, cheese, or crunchy veggies when you’re on the go.
   

Key Takeaways

Following a gluten-free diet is vital for people with celiac disease or gluten intolerance, but processed gluten-free foods can cause issues like inflammation and gut problems. Focus on natural, nutrient-rich foods like fruits, vegetables, nuts, naturally gluten-free grains, and omega-3s. Adding probiotics and avoiding additives can improve gut health and reduce risks. Smarter choices lead to better health on a gluten-free diet.

Nourishing Through the Holidays: Tips for Mindful and Balanced Eating This Season

 By Katrina Schoettler, dietetic intern with Nutrition Ink Dietetic Internship Program (NIDIP)

The holiday season can be a challenging time to stay on track with health goals. Many of us are out of our normal routines, attending events and parties or traveling to see loved ones. Our stress levels rise, workout plans give way to other priorities, and the culture around food seems to be one of indulgence. But the holidays can also be a time when we gather together, experience joy, take time off of work or school, and engage in some of our favorite traditions. It’s all a balance. Similarly, a balanced approach to eating during the holidays can help us to support our body and nervous system while leaving us room to feel joy and connection.

Here are some ways to enjoy food and all its benefits during this holiday season:

Tip 1: Practice Mindful Eating

Mindful eating is the practice of deliberately paying attention to the food you are eating and your experience with that food in a non-judgemental way. Research shows that mindful eating practices can reduce one’s tendency to overeat and reduce instances of emotional eating (1). During the holidays especially, practicing mindful eating can help us differentiate between physical hunger and psychological hunger and can help mitigate the influence of external factors, like stress, on our food choices.

To practice eating more mindfully, try these techniques the next time you sit down to a meal or snack:

● Before eating, check in with yourself to assess what type of hunger you are feeling. Is it physical hunger? Emotional? Are you eating out of boredom or stress? Are you eating to connect with the people around you? Honor that there are different types of hunger and identify yours in a non-judgemental way.

● Remove or limit distractions during mealtime (TV, computers, phones, etc).

● Pause to notice your food before you take your first bite. Pay attention to how it looks and smells.

● Take a few deep breaths before you start eating.

● Every time you take a bite, chew thoroughly and take in the flavors of your food.

● Set down your utensils after each bite or pause halfway through your meal to assess your satiety.

● End the meal with gratitude for all components of the meal and how it served you.

Tip 2: Focus on Balancing Meals and Snacks

Often during the holidays, we encounter foods that we wouldn’t normally eat the rest of the year. Instead of trying to restrict these foods, focus on balancing your plate to sustain energy and prevent blood sugar spikes and corresponding dips (aka “sugar crash”). These crashes can leave us feeling tired and foggy, with less energy to engage in fun holiday traditions. Instead, pair carbohydrates that are higher in added sugar with protein, fiber and healthy fats to slow down the absorption of sugar in the gut and help stabilize its uptake into cells (2,3,4).

Some examples include:

● Eating a small handful of nuts before enjoying a classic sugar cookie

● Adding plain Greek yogurt and some berries as a topping on your favorite dessert

● Bringing a veggie tray with flaxseed crackers, guacamole, and hummus to your next holiday party

For balancing full meals, try filling half of your plate with vegetables, a quarter with lean protein (e.g., turkey, plant-based options), and a quarter with whole grains or starchy vegetables.

Tip 3: Make Some Swaps to Feel Your Best

Maybe there are certain holiday staples that no longer sound appealing or make you feel bloated or sluggish. Swap these foods out for alternatives that are lower in saturated fat, added sugar, and sodium.

Here are a few examples:

●      Use plain, non-fat Greek yogurt instead of sour cream

●      Use canned coconut milk instead heavy cream if you are sensitive to dairy

●      Use avocado or olive oil in place of solid fats (butter, margarine)

●      Use unsweetened applesauce or mashed bananas instead of sugar or oil in baked goods

●      Opt for whole foods over processed foods as much as possible to reduce sodium and inflammatory oils

Tip 4: Honor Enjoyment and Tradition (and Ditch the Guilt)

Food is an important part of our cultural traditions around the holidays. Honoring that food serves more purpose than just fueling our bodies can help us enjoy holiday treats without the guilt. One of the dangers of overly restricting food during this time is that it could lead to emotional overeating later on (5). Instead, recognize that having a slice of your grandma’s pie fulfills a different type of hunger that is just as important to our overall well-being.

The holiday season can be challenging in many ways, but it is also a time for us to foster connections and honor our traditions. Food can be an important part of that. With a mindset of balance, mindfulness, and self-compassion, you can support your health goals and still enjoy all that the season has to offer!

Katrina Schoettler is a recent graduate of Bastyr University’s Master of Science in Nutrition with a Didactic Program in Dietetics (MSN/DPD). She is now completing her dietetic internship with Nutrition Ink Dietetic Internship Program (NIDIP) and hopes to become a Registered Dietitian Nutritionist. She is passionate about integrative and functional nutrition that seeks to target the root cause of illness through diet and lifestyle change.

Sources:

Warren JM, Smith N, Ashwell M. A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: effectiveness and associated potential mechanisms. Nutr Res Rev. 2017;30(2):272-283. doi:10.1017/S0954422417000154
Russell WR, Baka A, Björck I, et al. Impact of diet composition on blood glucose regulation. Crit Rev Food Sci Nutr. 2016;56(4):541-590. doi:10.1080/10408398.2013.792772
Müller M, Canfora EE, Blaak EE. Gastrointestinal transit time, glucose homeostasis and metabolic health: modulation by dietary fibers. Nutrients. 2018 Feb 28;10(3):275. doi: 10.3390/nu10030275. PMID: 29495569; PMCID: PMC5872693.
Rehfeld JF. Cholecystokinin – from local gut hormone to ubiquitous messenger. Front. Endocrinol. 2017 Apr 12;8:47. doi.org/10.3389/fendo.2017.00047
Reichenberger J, Schnepper R, Arend A-K, Blechert J. Emotional eating in healthy individuals and patients with an eating disorder: evidence from psychometric, experimental and naturalistic studies. Proceedings of the Nutrition Society. 2020;79(3):290-299. doi:10.1017/S0029665120007004