Selected Podcast

Nutrition at MIT

For many people, working with a registered dietitian can help them make smarter, more informed choices about their diet.

For patients who receive a referral to work with a registered dietitian, MIT Medical’s Anna Jasonides is available on campus for appointments.

Today we are speaking with Anna Jasonides to find out more about the help and guidance that a dietitian can provide.
Nutrition at MIT
Featured Speaker:
Anna Jasonides, RD., LD
Anna Jasonides has been helping patients with their diet and nutrition for more than 25 years. She joined the MIT Medical community in 1997, and has also taught classes in nutrition and diet therapy at Bunker Hill Community College. She works with patients to help with healthy food choices and to learn behavior modification around food.
Transcription:

Melanie Cole (Host): For many people, working with a registered dietician can help them make smarter, more-informed choices about their diet. For patients who receive a referral to work with a registered dietician, MIT Medical’s Anna Jasonides, is available on campus for appointments. Today we’re speaking with Anna to find out more about the help and guidance that a dietician can provide. Welcome to the show, Anna. What can a person expect to have happen when they do see a dietician for the first time?

Anna Jasonides (Guest): Well, here at MIT Medical, the first thing I would ask them is how I can help them. So, it’s patient-centered and I ask them how I can help them, and then after that I would make an assessment based on their diet history, their height, their weight, their laboratory values, their medication, their lifestyles, some of the problem areas they have. Then I would prescribe a diet if that’s what the patient was really interested in. Some are not interested in that. They might want to talk about the areas they get stuck in. So, then we would talk about strategies. I would use more of a behavioral approach. Think about goals, specific goals; come up with strategies or, like I said, I could prescribe a diet and instruct them on it and then they’re on their way. And then, I would always encourage follow-up. That’s what you can expect.

Melanie: Anna, what’s the difference between a registered dietician and a nutritionist?

Jasonides: So, a registered dietician has had a particular academic preparation and training. Usually, they are going to be doing an internship or some kind of practicum after their academic work. There’s a registration exam that’s national. That means they’ve met certain criteria, they’ve passed a test, they have to do continuing education credits. And a nutritionist could be you. You could hang a shack out your door and say you’re a nutritionist and you could be legal and you could have gotten a certificate out of a cereal box actually. So, that’s the difference between a registered dietician and just someone who calls themselves a nutritionist. There’s just one more thing. Now, we have something called registered dietician-nutritionist, which is licensure. So, if you see licensed nutritionist, I would approve. That means that they’ve had very similar training to a registered dietician.

Melanie: What kind of patients do you see most often? Is it mostly people that want to lose weight? Or, is it people that also would like to change their diet and become healthier that way?

Jasonides: Both. I mean I’m a referral service here at MIT Medical, so you have to be referred by your provider and you can ask for a referral. It’s very easy and they’ll always grant it. But, yeah, most people want to lose weight just because they want to, or many times that’s because they also have hypertension, high cholesterol, high triglycerides, fatty liver, diabetes. Those usually are the big ones that I see.

Melanie: Are there certain myths that you hear patients come in with, where they maybe think that it’s their thyroid, or it’s hereditary, or they say they’ve tried every diet in the world, and they just can’t seem to lose weight? What are some of the common myths that you hear from patients?

Jasonides: That one is probably number one — that there’s something wrong with me. But when we take a closer look as part of the assessment phase of the session, we both realize that there are lifestyle things that need to be done. You know portions are too big. Another myth, people say, “I eat the right food. Everything I eat is healthy.” They’ve got all the whole grains and lean proteins, but they forget that they’re just eating too much quantity and that will prevent weight loss. I wish it didn’t but it will. That would be the number one myth.
And another common one is, people know what to do. They know how much to eat, but they just don’t do it. So, it isn’t an issue of knowledge. So then we talk more about or I try to facilitate what’s really important to them. What do they value in their life? How do those things relate to their overweight status, if they’re overweight? Most people in this context would be talking about losing weight. We try to identify some of the barriers, come up with strategies. That’s another thing, another issue that comes up.

Melanie: And now, what do you do when someone complains that they’re trying to eat healthier food and they’re exercising a lot, but they can’t seem to lose weight? Do you look into metabolic syndrome? Do you think that there’s something wrong with their metabolism? Or, does it really usually come down to, as you say, amounts and what they’re putting in?

Jasonides: For the most part, it’s about the food they’re doing, the amount they eat, where they eat, caloric value of each item they eat. Sometimes, there’s a thyroid problem. That’s rare though and, usually, it’s diagnosed by the doctor before I’ve even seen them. But if we suspect that, if I suspect it in my assessment, then I would just quickly refer the patient back to their provider so they could get a test. So it’s easy to figure this out. It’s not a mystery.

Melanie: Anna, what’s your best motivational technique that you use for people to help them when they just can’t seem to find that motivation to stick with healthy eating? And I’m not even going to really call it a diet, but a healthy eating plan. What’s your best motivational tip out there?
Jasonides: My best tip would be, just have a heart-to-heart talk with yourself and ask what is important to you? What do you value in life and try to connect those things to the healthy eating so that you can stay on track, to say, “Oh, yeah. I’m not going to go eat a pint of ice cream tonight, because my motivator is I want to set a healthy example for my child, or I really want to reduce my cholesterol.” So, remembering the motivators, identifying the motivators first, like I said. And then second is coming up with the strategies that can help you overstep the barriers.

Melanie: Some strategies might be journaling. Are you a fan of journaling?

Jasonides: Oh, most definitely, journaling food and emotions and feelings, absolutely. Journaling is a great way to be mindful and present, which is a big issue for people who say they eat too much.

Melanie: So, give us a little example of how you would give somebody the direction to start a journal, a food journal, an emotion, what they’re feeling, when they’re maybe binge eating or doing something they know is off their diet. How would you get them started on a food journal?

Jasonides: The first thing I would say is there are so many apps out there. So, if they’re computer people and they have all -- you know, everybody has a smartphone these days, except my husband. So, there are lots of apps. You could journal right there and the information is there. You just plug it in. If you like the pen and the paper, I would just get a piece of paper and make columns and just write, “food eaten,” “amount,” “how I feel,” in the third column, and then, write that. I mean I have some forms that I give people, but it would be very simple. You just write down the food, the amount, what you’re feeling either before or after.

Melanie: It’s such great advice. And now, tell us what do you love about working at MIT Medical as a registered dietician?

Jasonides: The first reason I would give is I really like the way we collaborate as providers here, myself with the nurse practitioners, the physicians, the nurses. I think that’s great. That’s not always the case in other facilities. Second would be, I get a lot of freedom to make my own assessment about what I think would work for a patient, as opposed to having it be dictated from another provider.

Melanie: So, it’s really the multi-disciplinary approach and the way that you get to work with patients in the way that you feel the best.

Jasonides: Yes, yes. And as part of that, my freedom is I really try to engage the patient and involve them in their own treatment plan because patients are the experts in their life. I may know how many calories they need and this business about what food, but they know what’s going to work. And so, I think people forget that. They want the provider to come up with all the answers, and certainly I can help them, but I really think patients need to drive the bus and I’ll be right next to them.

Melanie: Thank you so much, Anna Jasonides. You are listening to conversations with MIT Medical. For more information, you can go to medweb.mit.edu. That’s medweb.mit.edu. This is Melanie Cole. Thank you so much for listening. Have a great day.