Eat Right, Lose Those Pounds
Interviewed by Rasa Fournier
Wednesday - March 16, 2011
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Danielle Mccauley, RD
Registered dietitian at REHAB
Where did you receive your schooling/training?
I received my Bachelor of Science in clinical nutrition at the University of California at Davis. Then I did my internship at UC Davis Medical Center, which is a very large teaching institution in Sacramento.
Every day is a training day for me. When I see a client with a disease or a request that I’m not so familiar with, I research it. I also continually adjust and expand my counseling methods so that each encounter is personalized and effective for my clients.
Everyone asks me what is the difference between a nutritionist and a registered dietitian. A nutritionist is a self-proclaimed title, while a registered dietitian can be considered a “food doctor.” We go to school, we get a bachelor’s degree and then we do an internship similar to a doctor’s internship.
How long have you been practicing?
As a registered dietitian, I’ve been practicing for five years. I’ve worked in the nutrition industry for 10 years.
What are some of the main reasons people come to you?
The primary reason is for weight loss. That’s about 80 percent of my clients. I also get people who are tired and “don’t feel right” and they suspect that it’s related to how they are eating. I’ve had a lot of success with those clients, but I also cover the gamut. There’s a lot of disease processes with nutritional implications, whether it’s cancer, major surgery or stroke.
As part of my training at UC Davis Medical Center I focused on pediatrics for three years, a very specialized field. I often see moms who are worried that their infants have feeding problems or inadequate weight gain. There are a lot of wives’ tales about how to handle breast-feeding difficulties and how to transition from breast-feeding to regular foods. Sometimes they just need a little education to reassure them.
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Is there a formula for helping people with weight loss or is each person different?
Every person is absolutely different. Most of my weight-loss clients have tried almost every fad diet that’s been on the market in the last 20 years, in addition to taking weight-loss pills. They come to me very frustrated. As a dietitian, and often their last resort, I need to make sure I make recommendations that produce results. Cookie-cutter treatments or traditional counseling doesn’t work when someone has already seen or tried it all. I need to tailor the meal plans I prescribe to make sure that if a patient has an Asian-style diet, I’m giving them a meal plan based on Asian cuisine. Or if they’re very busy and they only eat out, I have to tailor a meal plan that includes restaurant foods. If I don’t do that, I set myself and the client up for failure. Every client has a different level of motivation and knowledge about food, so I have to cater to those differences. It’s very challenging.
Can you explain further how the meal plans work?
When constructing a meal plan, it is important that I provide food choices that are familiar, flexible and “safe.” Most people eat at restaurants and occasionally have fast food. Therefore, I provide suggestions for safe meal options for those scenarios. The meal plan is a great educational tool to show my clients what healthy eating looks like. Most of my clients have preconceived ideas about healthy eating.
I spend a lot of time debunking food myths. I get questions like: Is it OK if I don’t eat carbohydrates? (No) Is it true that water-melon has negative calories? (No) Will fruit really make me fat? (No) I have to explain that what they may have learned in the past is inaccurate, and then provide them with scientific facts to allow them to make healthier food choices.
What are some tips on preventative care?
Educate yourself and teach your kids about nutrition, about different fruits and vegetables - how to choose them at the grocery store, how to cook them. Cooking has become a lost art. Get your children involved with food preparation. Teach them now so they have the skills to be successful later.
Be active. We live in Hawaii, with some of the most beautiful beaches and mountains in the world. Take advantage of the wonderful outdoor activities available here. Make everyday activities more active. Don’t search for the closest parking spot at the store. Take the stairs, not the elevator. Get a pedometer and count your steps for the day.
Why is a dietitian often the last resort, rather than the first?
I think the major barrier is cost. Medical insurance will pay for the hospitalization for a diabetic complication like an amputation, but it won’t necessarily reimburse for the nutrition counseling to prevent those complications. That being said, I think we’re headed in the right direction. There’s at least one insurance company that will reimburse for nutrition counseling now - University Health Alliance covers most major nutrition related concerns.
Anything else you want to say about diet and weight loss?
The average American consumes 30 to 50 percent of their calories from soda, juice, deserts, pizza and high-fat dairy products. We rarely eat whole grains, fruits and vegetables. Minimizing the consumption of the most common high-calorie foods will result in weight loss. You need to cut 3,500 calories to lose one pound of fat. If you decrease your calories by just 500 a day, you can lose a pound a week.
It must be hard to get people to change their habits.
Our eating behaviors are so ingrained that dietary change is hard to accomplish alone, and will not happen overnight. That’s where a dietitian comes in. I keep people accountable and help them make lifestyle and dietary changes gradually, enough to make any weight loss permanent.
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