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You’re listening to the Balanced Bites podcast episode 245.
Welcome to the Balanced Bites podcast with Diane Sanfilippo and Liz Wolfe. Diane is a certified nutrition consultant, and the New York Times bestselling author of Practical Paleo, The 21-Day Sugar Detox, and co-author of Mediterranean Paleo Cooking. Liz is a nutritional therapy practitioner, and the best-selling author of Eat the Yolks and The Purely Primal Skincare Guide. Together, Diane and Liz answer your questions, interview leading health and wellness experts, and share their take on modern paleo living with their friendly and balanced approach. Remember our disclaimer: The materials and content within this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment.
Liz Wolfe: Hey everyone, Liz here with a special guest this week that I’m very excited about. But first, let’s hear from one of our sponsors.
Liz Wolfe: The Balanced Bites podcast is sponsored in part by the Nutritional Therapy Association. The NTA trains and certifies nutritional therapy practitioners and consultants, including me, I’m an NTP, emphasizing bio-individuality and the range of dietary strategies that support wellness. The NTA emphasizes local, whole, properly prepared nutrient dense foods as the key to restoring balance and enhancing the body’s ability to heal. Nutritional therapy practitioners and consultants learn a wide range of tools and techniques to assess and correct nutritional imbalances. To learn lots more about the nutritional therapy program, go to NutritionalTherapyAssociation.com. There are workshop venues in the US, Canada, and Australia, so chances are you’ll be able to find a venue that works for you.
Liz Wolfe: Alright. Our guest today is my friend and colleague, Diana Rogers, hey friend.
Diana Rodgers: Hi.
Liz Wolfe: She is a registered dietician and a nutritional therapy practitioner. As you all know, the NTP sponsors this podcast. She’s the author of Paleo Lunches and Breakfast on the Go, and The Homegrown Paleo Cookbook. Diana’s website, sustainabledish.com, covers sustainable living, real food nutrition, her life on an organic farm, and; sorry, I’m going to tease it friend; it’s the place to watch for upcoming projects like an after 40 health lifestyle and weight loss project that promises to be amazing. You and I have had some conversations about this, and I totally probably summarized it in the wrong way.
Diana Rodgers: {laughs}
Liz Wolfe: But, that’s ok. It will be awesome.
Diana Rodgers: {laughs} Now I have to really do it.
Liz Wolfe: Yeah, you do, that’s the thing. But it’s ok, because I teased Baby Making and Beyond literally 2 years ago and it’s still not done so. {laughs}
Diana Rodgers: {laughs}
Liz Wolfe: This is; we go for long, long lead times on the podcast. So Diana is also the host of the Sustainable Dish podcast, and we’ll quickly acknowledge the fact that formerly we had a podcast together, the Modern Farm Girls podcast, which has since morphed into the Sustainable Dish podcast. And I miss it; I miss the podcast. But, we just; it was time for it to become something else, yes?
Diana Rodgers: Yes. I mostly just miss talking to you.
Liz Wolfe: I know.
Diana Rodgers: Our schedules just got kind of crazy and it was hard to collide, and I was getting so interested in interviewing people that basically that’s what the show is now. So I just interview really interesting people. And for a while, I was just interviewing farm girls, but there were so many guys I wanted to interview too {laughs}.
Liz Wolfe: Mm-hmm.
Diana Rodgers: And other experts, not just in farming and food production, but in other areas as well. So I’m interviewing a butcher coming up soon, Adam Danforth. There’s a couple of filmmakers I want to get on here, so it’s all around sustainability, healthy living, sleep experts, kind of the full gamut. So it was time, I think, to sort of branch out beyond female farmers. Who I still have tons of contacts with and lots of interview with them, as well. But I wanted to kind of broaden the show a little bit more and I love doing the interviews, so it’s all good.
Liz Wolfe: Awesome. Well, everyone needs to subscribe to that, the Sustainable Dish podcast. And I guess if you already subscribed to Modern Farm Girls, you’ll still be getting Sustainable Dish, correct?
Diana Rodgers: Hopefully, that was our goal with all the {laughs}
Liz Wolfe: {laughs} Why is it so difficult? In this day and age, to maintain a feed. I don’t even know how it all works. Thankfully we have Andy to help us with all of that.
Diana Rodgers: Yes. Yes, Liz and I had; there was a lot of frantic back and forth emails, like how do we even do this. They need to; iTunes, you need to make it easier. Or Libsyn, or whoever you are out there. It was way too complicated.
Liz Wolfe: Did you say Libsyn?
Diana Rodgers: Libsyn. Or what is it called?
Liz Wolfe: Lisbyn. You said Lisbyn.
Diana Rodgers: Lisbyn.
Liz Wolfe: Isn’t that a country?
Diana Rodgers: {laughs} I don’t know.
1. News and updates from Liz & Diana [5:18]
Liz Wolfe: It’s good. We cover sustainability and geography. It’s all good. Libsyn. Alright, so I’ll jump in with my updates, and really I just have the one. I went to; just got back last week from my trip to Washington D.C. with Beautycounter. So I think folks probably know at this point that I jumped on board with Beautycounter fairly recently. Their whole mission dovetails really well with what I’ve been doing for many years, including before I really had an online presence about it, which was to help people heal and manage their skin naturally through food and digestive health and more natural, safer, more gentle topical care. So I’ve been doing that for years now, and then I discovered Beautycounter, which kind of bridged that gap between people who are like; “yeah! I’m going to wash my hair with vinegar!”
Diana Rodgers: {laughing}
Liz Wolfe: “I’m going to use only animal fat on my face!” And the people who are like, “No. I want my high performance fancy Christian Dior dermatological type of stuff for my face because I want none of the wrinkles.
Diana Rodgers: Mm-hmm.
Liz Wolfe: So it really kind of bridged that gap, because they are very much dedicated to the science of cosmetics and formulating safer cosmetics for; well, their goal is to get safer products into the hands of everyone. That’s obviously a ways off. But they’re doing a lot in Washington D.C. to try and affect some change at the policy level.
Now, Diana, you I think understand where I’m coming from here in that I’ve never been a huge “more legislation” type of person.
Diana Rodgers: Yes.
Liz Wolfe: I kind of feel like, kind of that free market type a little bit. {laughs} And it was kind of funny thinking about that with relation to cosmetics and then dealing with TSA on my trip back and forth; just thinking, “if this institution were privatized they would be serving us instead of us serving them!” And you know. Obviously some people are going to think I’m crazy with that. But, I really do think that when it comes to cosmetics, the lack of oversight is so egregious.
Diana Rodgers: It is, totally. I completely agree.
Liz Wolfe: it’s awful.
Diana Rodgers: Especially when you look at what’s going on with our food…
Liz Wolfe: Yes.
Diana Rodgers: And then the lack of oversight with so many other industries, especially cosmetics.
Liz Wolfe: There are some big flaws… So what it kind of came down to for me. What I got to do on this D.C. trip with Beautycounter was to really see the inner workings of what they’re trying to do in Washington D.C. I was able to meet with the senate offices from my state. My sister also was able to go and meet with the senate offices from her state; really as constituents coming in and saying; “Hey look, this is a huge issue.” The head of science for Beautycounter was a researcher in endocrine disruption at Tufts, and she’s super sharp. So we are not only aware of what we’re basically starting to put on our bodies and our kids bodies from the time they’re born, but also a lot of these chemicals are also released into the environment.
So there are so, so many issues around needing more health protective laws in place; or at the very least, making noise in the place where it’s actually going to reach people on a broad scale.
Diana Rodgers: Mm-hmm.
Liz Wolfe: So you go to D.C. with 100 Beautycounter people from across the country and set meetings with these representative’s offices. We’re all walking around, looking sharp in our blazers with our little Beautycounter pins on.
Diana Rodgers: You looked super sharp. I saw your pictures.
Liz Wolfe: I’m telling you! Well, I said in the last episode or one of the last episodes that I worked in D.C. for a time, I get how it works. I’ve been there, and buzz kind of speeds around the hill pretty quick. I mean, you have all these women walking around on a beautiful day; well, and a few men as well, just kind of trying to create buzz, and it spreads really, really quickly.
So obviously there are some flaws and there are some hurdles to get over as far as how the FDA would even be able to figure out how to regulate all of these things. The current bill that folks are looking at, we’ll call it the Personal Care Product Safety Act, is asking of the FDA something that I’m not sure they have the manpower to do. So it would be a ton of revising how these things would work and how many chemicals they can actually review every year. We want more, I think the proposal is 5, and that’s just not that many. So there is a ton of ground to cover as far as actual brick and mortar legislation, and how this would even work and do we really even trust the FDA? Will they need to finance their own science?
One of the really interesting things about this is we’re asking for a voluntary reporting system, which I think is probably pretty important. Did I say adverse reaction? What did I just say, voluntary adverse reaction …
Diana Rodgers: Voluntary reporting. You just voluntary reporting.
Liz Wolfe: Voluntary reporting of adverse reactions.
Diana Rodgers: Mmm.
Liz Wolfe: Which I think is really interesting. But the real point in making change now is going to a place where people are going to really take notice and say; whoa, what is this issue? Even if there’s no legislation in place, and that’s kind of where I hope this goes from here, at least for me. Because, I mean how many of us seriously… So I’m about as excited about Beautycounter as I was when people started making tallow balm. Like, there was no tallow balm and all of a sudden there was all this tallow balm, and I was like, “Yeah! This is awesome!”
Diana Rodgers: {laughing}
Liz Wolfe: And I got real excited when I found out about what Beautycounter was doing. And of course, I had to jump right in and get involved, because I’m not going to make tallow balm, so that’s kind of like; leave that to other people. But I can get involved with this mission, and I think it’s really important. I’ve got a little bit of a precedent set in my own history for it, so it’s kind of right up my alley.
So yeah, I went to the D.C. trip with Beautycounter, it was really amazing to just see the inner workings of everything and talk to some people that are really involved in the mission, and hopefully we make a ton of change at the very least in just awareness. Because I think we’ve done that a lot in the real food world.
Diana Rodgers: Mm-hmm.
Liz Wolfe: Where a lot of things haven’t changed regulation wise, but yet there’s this huge push just from consumer pressure, right?
Diana Rodgers: Yeah. And you and I both work a lot with Farm to Consumer Legal Defense Fund, and lately I’ve been helping them out a ton. And actually there’s an event coming up in August that we’ll be promoting soon. It’s not quite all set yet. So it’s the same kind of deal. People just need to sort of get a little bit behind some of the things that they use every day and just start questioning what’s in it, who are they buying it from.
Liz Wolfe: Mm-hmm.
Diana Rodgers: With everything.
Liz Wolfe: And I really, really like the products. I love tallow balm, I’m still a total hippie on a lot of levels, but sometimes you just want to play with something that’s fun that’s also safe {laughs}.
Diana Rodgers: {laughs}
Liz Wolfe: I like makeup.
Diana Rodgers: Yeah well, I mean so the lotions are great. But the makeup is really great, too.
Liz Wolfe: Yeah, it is. And the Charcoal bar is back; do you have one yet?
Diana Rodgers: I haven’t gotten one yet. I’ve been loving the mascara.
Liz Wolfe: Yes, the mascara is excellent. You have to get the charcoal bar. I was thinking about doing some kind of promotion with it, and I just can’t get my head there in enough time to record this podcast, but it’s insane. It’s probably one of the most natural in the way we often think of it in paleoland type product that they’ve got.
Diana Rodgers: Mm-hmm.
Liz Wolfe: I did a post about charcoal and gave folks a couple of options recently on my blog, and on the Purely Primal Skincare blog, but it is insane. And it was supposed to sell out, but I believe they put a rush on the second order that was supposed to come in in June so you can still get it. It’s probably the best intro to Beautycounter you can get. Alright, people are sick of me talking about that, stop it Liz.
Diana Rodgers: {laughs} Yeah, I love the stuff too, and thank you for introducing me to it. I’m totally loving it.
Liz Wolfe: Good deal. Alright, so Diana, that was my update. What are your updates?
Diana Rodgers: Well. So I just completed my registered dietician credential, so that’s the biggest update.
Liz Wolfe: Awesome!
Diana Rodgers: It was; my gosh. It was probably, let’s see, I started it in 2011. So basically I attended NTA, I graduated in 2010. I started in 2009 with NTA. Graduated in 2010, and then started the RD process in 2011 part time. Looking at it, there are a lot of classes you have to take. It’s not really a graduate degree, it’s more like getting another bachelor’s degree, so there were a lot of classes involved, and any time I would look at this big list of classes I would get really overwhelmed, so I just sort of treated it as my hobby, and just took a couple of classes every semester. I had to start with Bio 101; they didn’t count any of my undergrad work from my college days.
So it was pretty much all consuming hobby; two classes on top of the cookbooks I wrote and having the kids and trying to run the blog and the podcast and all that other stuff. So life was really crazy, and I just, just finished. So that was at the end of April I completed it, and now I’m all done and so psyched to be all done {laughs} and ready to move on with my other thing. So I’ve set up practice, I’ve got physical offices now. I’ve got one in Concord, Massachusetts, and one in Copley Square, Boston, which is a really beautiful, overlooking Trinity Church, it’s really, really gorgeous. And I do Skype, as well, and I’ve got a few writing projects in the works, and some other fun things. I get bored easily, so {laughs} I always make sure to have a million different things going on, so it’s just perfect.
Liz Wolfe: You made me really tired just now.
Diana Rodgers: {laughing}
Liz Wolfe: I like to have one thing to do, like ever. Like, “What do you need to do today?” “Oh, I need to wash my hair.” The end.
Diana Rodgers: {laughing}
2. Diana’s RD educational experience [15:50]
Liz Wolfe: I don’t want to have a lot of balls in the air. Ok, so this is what I wanted to talk to you about, just with the meat of our show. And this is why we had you on, because we have people all the time ask us about dieticians, dietetics, holistic nutrition.
Diana Rodgers: Right.
Liz Wolfe: And all of that. So I think we often demonize conventional dietetics to the point where we think it’s completely useless, they’ve destroyed; you know, you hear about recommending a ton of simple carbohydrates to diabetics, that type of thing.
Diana Rodgers: Yes.
Liz Wolfe: So I really want to help people understand, at what point and in what circumstances this type of education is incredibly useful, and how you can help people with both the NTP and RD. So maybe we’ll do a little defending your thesis type of thing here.
Diana Rodgers: Yeah. {laughs} Ok.
Liz Wolfe: And you can kind of let me know; I guess kind of defend. Let’s talk about why this is an important thing and how you can use this education in a way that supports a whole food perspective versus what people commonly think, which is basically feedbags of you know.
Diana Rodgers: Yeah.
Liz Wolfe: Soybean oil and pea protein. I don’t know.
Diana Rodgers: Yeah, well I get where you’re going. And I think that it’s the same thing with doctors, right? There’s sort of conventional doctors that are going to prescribe statins no matter what, and then there’s doctors that maybe are a little more into functional medicine but they also have their MD or naturopathic doctor, so for me I felt like I really wanted to make change from the inside. Kind of like what you were talking about with all this Beautycounter stuff. So I had an awesome foundation with NTA, where I really learned just a fantastic overview of what real food is and why it’s so important to make your own bone broth, things like that. And how to balance fats and why healthy fats include butter and coconut oil and things like that.
Liz Wolfe: Digestive function, all of that stuff that we often don’t think about, yeah.
Diana Rodgers: All of that stuff, exactly. And you know, I’ve been interested; because I was an undiagnosed celiac until I was in my mid-20s, I’ve always been interested in nutrition even in my undergrad days when I was an art major, I actually looked at my transcripts and, surprise, surprise, I took a ton of science classes undergrad. I don’t remember taking many of them {laughing}
Liz Wolfe: {laughs}
Diana Rodgers: Because college; I was not mature enough to really be a very serious student when I did my undergrad work, which is why I was an art major.
Liz Wolfe: Who is, right? I mean, really.
Diana Rodgers: Yeah. Yeah. I was more interested in the concerts and lots of other things that were happening at UMass at the time.
Liz Wolfe: Yeah.
Diana Rodgers: Yeah, anyhow. So I’ve always been interested in nutrition, and I’m so grateful that I didn’t become an RD when I was 20, and that I did NTA first. Because it’s really hard to unlearn something, right? And so, having this foundation and being able to question thing. I’m sitting in these classes learning about the Standard American Diet, and how there’s no difference between omega-6’s and omega-3’s pretty much, like we just need to have more omegas, or we need to have a low-fat diet for this case, or whatever. All these mostly young women drinking their huge diet cokes and eating candy bars sitting around me are just diligently taking notes and not questioning anything. And I think because I went to NTA, because I was a mom and really felt like my time was very valuable, and because I was paying for this myself I sat in the front row and I questioned everything.
And, you know there definitely were times where I felt very frustrated at the professor, who was an obese vegetarian, also with a diet coke in her hand telling me what to eat. But there were a few classes that I did find really useful. I took a class on how to break down a scientific research paper, so that’s huge. So I know how to read a paper. How to look at a little bit more than just who funded it, and how to really dive into the methodology and just how the research was done to really effectively discuss it, and pull it apart, break it down, all that kind of stuff. So that was something I didn’t really have before, and I’m really grateful that I have it now.
And also just the sciences; chemistry. I didn’t have a lot of those hard sciences undergrad, so chem, anatomy and physiology, organic chem, and biochem. So understanding metabolic pathways really well is also just really useful when I read a paper or I go to one of these conferences and there’s a doctor up there talking and he’s talking about hydroxyl groups and things like that, and I know what he’s talking about. Again, before I didn’t really have a very good basis in that, and now I do. There’s definitely a lot of weight on food service. A lot of people don’t realize this, but registered dieticians are the ones who oversee food service in hospitals, most schools, most institutions in general it’s a registered dietician that’s the food service manager. So I had to know how many scoops I can get out of a number 13 can.
Liz Wolfe: What?! {laughs}
Diana Rodgers: Like, really. Oh yeah. And about a third of the RD exam and a third of the education, once you get into the program. So once you do all your science prereqs, about a third of the program is food service. So safe certification, HACCP, I mean I had questions on my exam like, if a cake has fallen in the center could it be from too much baking soda, too much sugar, too much fat {laughs} you know, things like that. I really had to know how candy was made, things like that. Just crazy stuff. Crazy stuff.
Liz Wolfe: Why is that important, and why is there not some kind of separate track?
Diana Rodgers: I don’t know.
3. Other conventional options besides RD [23:04]
Liz Wolfe: Is it not correct that a clinical nutritionist; because this is something I wrestled with before I found NTA and realized that it served my purpose very well, was clinical nutrition, registered dietician, these types of things and who is actually able to work one on one with people in different scenarios. So at this point I think there really is not a clinical nutrition degree that you can get that enables you to work with people the same way a dietetics curriculum does; is that correct, or do you know?
Diana Rodgers: There is the CNS credential that actually is a little bit more work than an RD, so you have to have a Master’s or a PhD to do it. So right now to become an RD almost all the programs do wrap that into a masters, but I purposely found one that I didn’t have to get a Masters, only because in private practice I didn’t feel that I wanted. First of all, there’s no standard program out there that I wanted to spend the money on and learn their whatever Master’s in sport nutrition where I was just going to learn about egg white protein.
Liz Wolfe: {laughs}
Diana Rodgers: And you know, whey protein powders or whatever. I didn’t want to spend the money on that, and I also just felt like a Master’s would be really good if I wanted to work in a hospital, but not so helpful for private practice. But anyway, a CNS is another alternative that also requires a lot of, a big long internship. I actually wrote; in your show notes maybe you could link to it, but I did write a very detailed blog post on all the steps I had to go through to become an RD, including all the classes I had to take. And actually at PaleoFx I’m doing a special workshop for everybody, and I go through all the different types of credentials you can get and what they mean, including just NTP and what you can do with that and all that kind of stuff.
So pretty much you’ve got to get your RD. If you want to work with doctors, get referrals, take insurance, it became pretty clear to me that getting my RD was the right way to go on top of the NTP degree that I have, or certification, because I’m really, really interested in gut health. I actually ended up doing a rotation with Massachusetts General Hospital Center for Celiac Research, and got to work under Dr. Fasano, who is like such a rock star. I don’t; probably no one knows…
Liz Wolfe: He’s like the celiac guy.
Diana Rodgers: The. Like, in the world.
Liz Wolfe: Yeah. Alessio Fasano, right?
Diana Rodgers: Yes. He, I mean people more than half the patients were flying in for the day to see him. They weren’t local Boston people. So it was really amazing to work for that team, and he’s got another great doctor that works with him too, and anyway I want to be in that. I was feeling like I was a little bit held back without that medical credential, so. And also to just to be able to take insurance. Because for people to pay out of pocket does limit my audience a little bit to people who can afford to pay out of pocket. So I’m still working on getting credentials; there’s a lot of paperwork that needs to happen, so I probably won’t be able to accept insurance for another 6 or 7 months just from what I hear with how long it takes with all the insurance companies. And it probably will only work for Massachusetts people who see me face to face, but it’s just another population that I’m able to work with. So that was important to me, as well.
4. The frustrations of RD education [26:25]
Liz Wolfe: Ok. So, tell me a little bit about what might have frustrated you about your RD curriculum, as you went through in your rotation. I don’t want you to bash what you did, but maybe your perspective on stuff and what was frustrating to you and how you got through it.
Diana Rodgers: So definitely; I mean, there was the course work and then there was an internship. So basically you have to take all these prereqs to get into a program; so you have to take all those sciences. Which is just annoying, right, but you get through it. You just memorize stuff and you get through it. And then once you're in the RD program, there’s a whole bunch of classes that you have to take that are set by the Academy of Nutrition and Dietetics; like, all the programs have to offer this set of food science, a whole bunch of classes. And then you have to do basically a one-year unpaid internship that you have to pay to do. And they’re really expensive. The cheapest ones that I was looking at were about $10,000.
Liz Wolfe: Can we just reiterate that you have to pay to…
Diana Rodgers: To work for free.
Liz Wolfe: To do free work for someone else who is benefitting from your free work. {laughs}
Diana Rodgers: Yeah. This is true. So it’s actually, getting your RD is more work than becoming a nurse, and RDs in hospitals get paid much lower than nurses, unfortunately. So, anyway. As far as the course work, there was definitely some frustration. There were definitely things that I knew to question that I wouldn’t have known to question if I hadn’t done the NTP program and knew so much about ancestral evolutionary biology all that kind of stuff from all the conferences I’ve attended. So luckily I had a couple of mentors that I was able to text when I had questions about things. Like when they would say, you know, folic acid is the best form of folate to take, instead of methyl folate. So I would take a screen shot out of the text book, and I’d be like, huh? You know, what do you think of this? So I had a few people I was able to ask questions of as I was going through the process, so that was really, really helpful.
Definitely found it frustrating, especially when the ‘everything in moderation’, which clearly doesn’t work for more than half the population. So just, pull back on calories, everything in moderation, nothing is bad, it’s just limit it. And that just doesn’t work; that doesn’t work for most people. Just because modern foods are hyperpalatable, they’re not natural, they bypass our satiety signaling, we can’t regulate our appetites very well because these foods are tricking our brains, basically. There’s no acknowledgement to that at all.
Liz Wolfe: Given that you’re a person that’s very dedicated to accuracy of information, did you say something? {laughs} Or were you just, like, put your head down and get through it?
Diana Rodgers: So, I would always start out; you know, these classes would go for a semester, and I would always tell myself; I’m just going to do it. I’m just going to be quiet, and I’m just going to sit through this course {laughs}. And then always, by one, one and a half months in, I was emailing the professors studies on the side. And you know, once in a while I’d get a professor that was receptive to it, and like, “Oh I didn’t know.” But most of the time, they were like, “No.”
Liz Wolfe: Mmm.
Diana Rodgers: You know. “No.” {laughs} And I just needed to get an A.
Liz Wolfe: No, I’m not going to read this, no this is wrong, no I don’t care, or all of the above?
Diana Rodgers: All of that.
Liz Wolfe: Yeah.
Diana Rodgers: Yeah. So that was really annoying, because I am a very passionate person, and really, really, really care. So that’s also what got me into trouble once I got into my internship. So, and I should also mention that internships are really difficult to get. I was told that you have to get an A in everything; so I got an A in every single class. I had a 4.0.
Liz Wolfe: Wow.
Diana Rodgers: Yeah. Because I heard that the match rate is only 50% to get into these internships, and here I was 40 years old with kids {laughs} you know I can’t travel. So a lot of these young RDs, they’ll go to Alaska to do their internship, or they’ll go to the University of Virginia; you know, they fly to go do these internships. I had to be in Boston, which is a really competitive market for internships because of our hospitals here. And so I got an A in all my classes. I had been a food service manager previously, so I had experience running a kitchen. I had counseling experience through; I was seeing nutrition clients the whole time during the program because of my NTA background, because I kept my practice open part time. I wrote two cookbooks, I live on an organic farm. I got rejected from the internships. For no reason; they didn’t tell me why, they just said I didn’t get matched, basically. Which was pretty devastating.
So that’s where I was last year at this time. So I was like, what am I going to do? I spent all this money; really, serious amounts of money on this program, I have no internship, and you can’t become an RD unless you’ve done an internship, and they just don’t even have enough internships for all the candidates that are coming up. Which some people could criticize heavily, and have.
Anyhow, so I ended up finding this backdoor option, called an ISPP, which is, I don’t know, individualized supervised practicum or something. Which you can only apply for if you’ve been rejected from an internship or have a PhD. So I don’t why that is, but anyway.
Liz Wolfe: {laughs}
Diana Rodgers: It worked out great for me, because basically I just got a drop box of all the things I had to do and I was sent on my way. And I was able to line up all the rotations myself. So you have to do a hospital rotation, well hospital, nursing home, and outpatient, and then you have to do a community rotation and food service. My food service was written off because of my experience as a food service manager before. I did some really cool work with a place called the Daily Table, which is in Dorchester, Massachusetts, which is a pretty rough neighborhood, and it was started by the founder of Trader Joe’s market.
Liz Wolfe: Mm-hmm.
Diana Rodgers: And basically this is a store that they get expired product or donated product from other grocery stores, other food producers, farms so actually the farm I live on, they come out and glean kale from us or whatever when we’ve got too much in the fields. They make foods with it; so they’re not giving it away they sell it at a discount, and it’s all healthy foods. So I got to do some work with them, which I love what they’re doing. And then I got to do this rotation at Mass General, which is fantastic.
But then I also saw some people during other rotations that were just there to get a paycheck, I felt very frustrated by the tools that I had to help people which was basically Ensure, Boost, and crappy hospital food, you know.
Liz Wolfe: Mm-hmm.
Diana Rodgers: To people that were clearly diabetic and the amount of carbs that were going up on their tray was insane. The standard diabetes education material that I was handed was crazy. Breakfast was; this is standard, you can find this online, coming down from the top right? This is what dieticians are supposed to recommend. Breakfast was; I should probably be accurate about this if I’m really going to make that claim.
Liz Wolfe: {laughs}
Diana Rodgers: I can’t remember exactly. I posted it on my Facebook page, but it was like, there was no protein at all and no fat in the breakfast. It was like corn flakes with skim milk, a banana, a glass of juice.
Liz Wolfe: Mm-hmm. Six different kinds of carbs, basically. {laughs}
Diana Rodgers: Yeah. Yes.
Liz Wolfe: But there’s fruit, so.
Diana Rodgers: Right. Right. And low-fat milk. Right. So that was really, really frustrating to me for sure. And just the amount of corn syrup {laughs} was really frustrating. So I definitely realized, for me, I know that emergency nutrition; like feeding tubes and IV nutrition definitely there’s a place for it. Right? Like, it saves lives.
Liz Wolfe: Mm-hmm.
Diana Rodgers: For sure. If you can’t digest your food, if you can’t for whatever reason you need to have a feeding tube, these things can help you live longer, for sure. But that’s just not where my; my passions are in preventing someone from getting there in the first place. So I’m much happier in private practice helping people that want to be helped, instead of trying to save someone who is already way down the road with tools that are not helpful.
Liz Wolfe: Mm-hmm.
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<>b5. Available options for emergency nutrition [37:00]
Liz Wolfe: So, as far as hospital emergency nutrition goes, you mentioned drinks like Boost and Ensure and things like that.
Diana Rodgers: Mm-hmm.
Liz Wolfe: Is it; so is this an institutional failing, or is it the idea that something like that is actually equivalent to real food? Because I know they talk about micronutrients and things like that, but are they really looking at this kind of overall context of what the body actually needs for a well functioning metabolism. They’re educating you on these metabolic pathways, but are they actually translating that into the prescriptive requirements for what emergency nutrition needs to contain to actually fuel a body versus just keep it alive. Does that make sense? Is it an institutional failing or is it just, the research isn’t there.
Diana Rodgers: It’s both. It’s probably a mix of all of those things. Unfortunately, for IV nutrition; in Europe, the fats come from omega-3 fats like fish oil. In the US, the fats come from soybean oil.
Liz Wolfe: Mm-hmm.
Diana Rodgers: Because it’s cheaper. And unfortunately, soybean oil is omega-6 which is highly inflammatory; and guess what happens in the US when you have someone on IV nutrition? They get fatty liver disease. So I hope to never be on IV nutrition in the US. It’s just really, really sad. And there are all kinds of other dangers with IV nutrition, because basically if you’re not using the gut then all the bacteria in the gut basically translocate and you can go septic. Which is really dangerous, of course.
With the other stuff, with the feeding tubes and these formulas, the Boost and all that other kind of stuff. You know, the hospitals are looking to save money and they basically go with whatever is the cheapest contract they can get. So the hospital that I was with; not Mass General, that was an outpatient clinic that I was working with, but the other hospital where I was doing inpatient work, they had a contract with Nestle because Nestle came in with the lowest bid. So it’s all about money. And the food service as well; so the actual food they were serving in the hospital also was just whatever the cheapest food they could get. So it has nothing to do with buying local {laughs}. I mean, that’s just silly talk.
Liz Wolfe: Right.
Diana Rodgers: We didn’t have any, even in the classes where we were learning about food service, there was no nod to sourcing anything locally, organic; nothing like that. It’s very; this is how you figure out the edible portion of the food, and this is how you get a bid from a food service provider. So the education is not there on the importance of real food, and it’s also an institutional issue. So both.
Liz Wolfe: You know what I would do, if a loved one was in the hospital on IV nutrition? I would probably rub some kind of fat soluble vitamin preparation on their skin.
Diana Rodgers: Mm. Yeah.
Liz Wolfe: Because I think you can get to like 80% absorption of FSVs in that scenario.
Diana Rodgers: Yeah, and there’s also for the feeding tube folks; so anyone out there who maybe has a loved one in the hospital facing these things, you can, there are more real food options. They’re very expensive, but…
Liz Wolfe: That was my next question. Are there options for people; and it stinks because not everybody can afford these things, but if you can, there are options.
Diana Rodgers: Yeah. For someone who’s doing like a home, like a bolus feeding where they’re basically injecting it right into their stomach, you can blenderize actual meals and do it that way.
Liz Wolfe: Ok.
Diana Rodgers: It’s a little more dangerous when you’re hanging it from a bag and it’s going in over a longer period of time, just because the food can go back and bacteria, you know.
Liz Wolfe: Yeah.
Diana Rodgers: But there are real food companies starting up that are making, for people that have to be, for whatever reason have to be on long-term feeding tube situations, Mark Hyman is involved with one. There’s a couple that are vegan, but then there are also a couple that are just real food ones that I found when I was doing the research. But of course, they’re like $8 a bag or something out of pocket. I’m not sure that insurance would cover it. Certainly the hospital; I just don’t know how all that works because that was not an option when, the makeup of the feeding tubes that I was supposed to dispense was corn syrup, soybean oil, and just a bunch of synthetic vitamins. It was, yeah. And the protein was usually soy protein, sometimes pea protein, not. You know, all of it was subpar in every way.
Liz Wolfe: I think there has to be a point at which we’re just so; I mean, we’re dug in. we’re so entrenched in; this is what we can do, these are our limitations based on the lowest bidder, the available materials, and how sick so many people are and how much of this stuff needs to actually be produced to support people who are in dire circumstances. It’s like this perfect storm of; well what are we supposed to do? How are we supposed to change this? It’s kind of like, just don’t look. Just don’t look that way. We don’t have a solution yet, so let’s pretend that we’re doing the right thing. Does that make sense?
Diana Rodgers: Yeah. I mean, I was really; I honestly went into a depression when I was going through this.
Liz Wolfe: Mm-hmm.
Diana Rodgers: Because not only was I helpless, I couldn’t help them, but a lot of them didn’t want to be helped anyway. Like, on release when I would try to tell them; ok, this is the type of foods you should be eating. They didn’t care. A lot of people that worked at the hospital didn’t care much about it. I actually wrote a post also about also end of life care and how just sad that is, and how you need to stand up for yourself. I really hope I’m not kept on all these different breathing apparatuses and everything, that I’m just ready to go. And I know for other people they may have different wishes, but those wishes need to be made ahead of time, so there are forms that people can fill out. But basically family members wanting to keep people who are not really living a life, keeping them going when there’s not much that can be done. That was also really sad for me.
And yeah, the nursing home thing was also just rough. Because I tend not to have a very good bubble where it’s just a job for me, and I really got very attached to a few patients that didn’t make it. So I’m really happy to be out; for me it’s not a good match.
Liz Wolfe: Mm-hmm.
Diana Rodgers: To be in that system. And I have so much respect for the people that are in there and that are trying to make changes and make good things happen. I think for me helping people that come to me looking for help trying to prevent disease or maybe fixing their guts, fixing metabolic issues. That’s something I know I can do, and if they actually listen to me we all have success and I feel good about it.
Liz Wolfe: Mm-hmm. Absolutely. And there are; you were saying, there are people working to change the system from the inside. I know a couple of real food oriented RDs, and I think with the speed of information now a days, the fact that everybody is on Facebook. And of course there are limitations to that too, with the throttling of information. But at this point I just don’t think things can fester as long as maybe they could have 25-30 years ago just because people get to talking about these things so quickly, and maybe the pace of change is a little bit faster, would you agree?
Diana Rodgers: I mean I think that, but I don’t know if that’s my curated Facebook feed and the newsfeed of the people I’m surrounded by.
Liz Wolfe: True.
Diana Rodgers: I want to hope that that’s happening. Yeah. I think it’s happening.
Liz Wolfe: It probably is still an upper middle class, generally privileged demographic flow of information at this point.
Diana Rodgers: Probably. Yeah, I mean it’s just like the interest in sustainability as well.
Liz Wolfe: Yeah.
Diana Rodgers: Like I think people are starting to realize that cows aren’t killing the environment, and actually can be good for the soils and things like that, but that could just be that those are the people that I talk to and hang out with more, so.
Liz Wolfe: Right.
Diana Rodgers: We’ll see. {laughs}
Liz Wolfe: We’ll see. And I’ve been encouraged lately. For example, I think General Mills bought Epic bars; Cheerios went entirely certified gluten free, I think. And who just bought Jason’s nut butter?
Diana Rodgers: Oh, I don’t know.
Liz Wolfe: It was GM or something; I don’t know who did it. General Mills or somebody. But I like to look at those things as like; oh, ok. The market is realizing what the people want and it’s kind of spreading it’s tentacles into the more conventional stuff and we’re pulling it our way. But it also very well could be “we must throw money at these people and stop them.” {laughs}
Diana Rodgers: {laughs}
Liz Wolfe: And go back to the way things were. Who knows. But I think things are probably changing at least a little bit, and that’s encouraging.
Diana Rodgers: Yeah. And actually I’m working with this really cool woman, her name is Marydale DeBor, and she has an organization called Fresh Advantage that tries to get real food into hospitals. And I’m consulting with her as her RD and also helping her work more closely with hospitals, just kind of helping her get more visibility in the Boston market. What she’s doing is super cool stuff. She goes in, she gets a chef in there, she gets them buying local, and she’ll totally transform the food service that’s going on in hospitals. So instead of working on it from inside a hospital, I’m trying to help from outside.
Liz Wolfe: Mm-hmm.
Diana Rodgers: There are definitely cool people out there doing great stuff.
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6. More advice about NTP/RD career paths [48:43]
Liz Wolfe: So let’s go back to one of the things that you said earlier, which is that when you’re talking to real foodies that want to make this into a career, you actually encourage them to do the nutritional therapy program; if they’re going to do the two programs, right, you encourage them to do the nutritional therapy program first to get that foundation because you say once you start learning something it’s hard to unlearn it unless you already have a foundation for the truth. Would you agree with that?
Diana Rodgers: Totally.
Liz Wolfe: And you’re glad you did it that way.
Diana Rodgers: Yes, totally. But you know what; I’m part of all these Facebook groups of real food RDs and other RDs that actually are trying to learn about real food, and there are RDs that are interested in doing NTA. So I think it’s really encouraging. And I think we need, hopefully one day there will be an internship program or some kind of program that incorporates a lot of what the NTA says with the RD. So it’s one thing down the road that I would love to do. And I’ve talked to; there’s a handful of other real food RDs in the Boston area, we’re hoping to come up with an internship for RDs where we’re focused on real food.
Liz Wolfe: That’s awesome.
Diana Rodgers: Yeah.
Liz Wolfe: So I think one of the questions that folks are going to have after listening to this episode is, well what if I don’t want to do; which one should I do if they’re only going to do one?
Diana Rodgers: Yeah.
Liz Wolfe: So one of the things that I would say to those folks is I have my NTA, my NTP certification. I began work on my Master’s in public health, as well; then I got pregnant then I finished a book, so that is basically on the shelf right now. I’m still working toward it, I will finish it eventually, but I’m not in a huge hurry. I’m treating it like a hobby. I like how you said that.
Diana Rodgers: Yeah.
Liz Wolfe: But what was great is doing the nutritional therapy program first, it’s a shorter program than the MPH or the RD, and you can get that foundation and start talking about things online.
Diana Rodgers: Mm-hmm.
Liz Wolfe: I think that’s my number one thing that I encourage people to do; start writing, start a blog, start putting your thoughts out there. Definitely give some thought to how much privacy you want to maintain for yourself and how you want to put it out there. But you can put your thoughts out there on the internet to help people. You’re not doing counseling in that circumstance.
Diana Rodgers: Right.
Liz Wolfe: You can start just talking about these ideas. Pondering things publicly to kind of get people on that thought train in talking about it, and that can help you as much as it can help anybody else.
But if you're wanting to, like you said, work things from the inside and help people in hospitals and with therapeutic nutrition and with cancer and all of those things, you do need to be an RD.
Diana Rodgers: Yes. Yep. So it’s really; and I also think it’s really good when you start with the NTA program to just get your feet wet with counseling people. Because maybe that’s not well suited for you.
Liz Wolfe: Mm-hmm.
Diana Rodgers: For me, I actually think I learned the most from just working with people and finding out how people like to receive information, how people like to make change. That’s all stuff that you learn as you’re actually working with people.
Liz Wolfe: Mm-hmm.
Diana Rodgers: So; I don’t know where I was going with that. Oh, yeah.
Liz Wolfe: {laughs}
Diana Rodgers: {laughing} I was going to say, if you’re a major introvert, maybe going into one on one practice is going to be so draining for you that it would be a waste of your time to become an RD if that’s what you wanted to get from the RD. So it really just depends. And I actually offer a service where people can book a one-hour with me, and I help them, you know if they want to become a nutritionist, based on exactly what they’d like to do in the future, what their time availability is, what their financial situation is, and what their background knowledge, I help them figure out; ok, do I do NTP, do I do my RD. And a lot of people are debating between IIN and NTP, so I explain the differences there and pretty much hands down it’s NTA over IIN for sure. But that is a debate sometimes with people; it’s like, RD versus NTA.
Liz Wolfe: Mm-hmm.
Diana Rodgers: Yep.
Liz Wolfe: Alright. So, what do we want to leave people with? Head over to your website, book a consult with you if people want to talk about the RD versus NTA program, kind of where they want to go with their career. And you know, it will change for people. Once you get through some of these programs, a lot of times your goals and your vision for your career changes. And for you, for example, it was definitely worth it to go through some of the frustrations of the RD curriculum because of where it stands now for you.
Diana Rodgers: Mm-hmm.
Liz Wolfe: but people can book a consult with you, talk about the career stuff. You can also go to, if you’re curious about the NTA program and what I do with that credential, you can go to http://RealFoodLiz.com and I think it’s Learn with Liz is the tab that you can check out to see what I have to say and my different projects. And you’ll definitely see, I think, the difference between what I’m doing and what Diana what you’re doing as far as consultation. You and I have some overlap ;we both are writers, we both do online programs. But a lot of your focus and the one on one is a little bit different from what I do.
Diana Rodgers: Mm-hmm.
Liz Wolfe: So to get a better picture of that you can check out both of our websites and even book a consult with Diana.
Diana Rodgers: Yeah. And my new website I’m hoping is up the day that this airs; I’m furiously working to make all the tweaks and everything, so check it out because I’ve got a lot of really fun stuff going on on my new site.
Liz Wolfe: Alright, sounds good. Well it was awesome talking to you today.
Diana Rodgers: Thanks so much for having me.
Liz Wolfe: Ok, so that will be it for today, folks. You can follow Diana at sustainabledish.com. Definitely follow her Instagram for baby goat and farm eye candy, it’s one of my favorites; and listen to the Sustainable Dish podcast as well. You can find me, Liz, at http://realfoodliz.com/ and my normal co-host, Diane Sanfilippo, is at http://dianesanfilippo.com. Thanks for listening.