Centered on Health 8-21-25 - Misconceptions about malnutrition and malnutrition awareness with Monica Loughmiller, Registered Dietitian at Baptist Health Floyd.
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Speaker 1 (00:01):
It's now time for Centered on Health with Baptists Health
on use Radio. Wait forty WYJS Now, here's doctor Jeff Tubble.
Speaker 2 (00:11):
Good evening, everyone, and welcome to tonight's episode of Centered
on Health with Baptist Health here on news Radio eight
forty whas. I'm your host, doctor Jeff Tublin. We're joined
by our producer mister Jim Fenn, who's waiting to take
your calls at five oh two five seven one eight
four eighty four. That's five oh two, five seven one
eight four eighty four. In twenty twenty three, thirteen point
(00:33):
five percent of households we're low on food security and
five point one percent were very low. And in Kentucky
food security is considered above average in the nation. September
is the month that includes malnutrition awareness. Tonight, we're talking
to Monica lock Miller, who's a registered dietitian and nutritionist.
She's a graduate of LSU in Baton Rouge, Louisiana, where
(00:55):
she received a Bachelor of Science in Nutrition and Dietetics
and went on to reci EVA master's degree in nutrition
and Dietetics. Her experience in Louisiana and here has included
almost twenty years of experience in every capacity diabetes coordinator,
very action coordinator, and lead dietitian. She is serving on
the board of directors for Louisville Association of Nutrition and Dietetics.
(01:18):
Welcome to the show.
Speaker 3 (01:21):
Thank you, I'm glad to be here.
Speaker 2 (01:23):
Yeah, we're very excited to have you. And I know
that September is a big month because it's Malnutrition Awareness
Week and it's a big week for you this week
with an article that I know you're being featured and
published this week, so we're going to hear about that.
But I want to congratulate you on that and welcome
you to our show. And maybe you could just start
off by telling us about how you got interested in
(01:44):
being a dietitian.
Speaker 4 (01:47):
Yeah, so I knew at a very young age I
wanted to be a dietitian. I had a grandmother who
was severely diabetic and really came from a place of
food and security and lack of nutrition education, and so
she did not take care of that properly. She didn't
care for herself, didn't take her medicines the way she
(02:07):
was supposed to do.
Speaker 3 (02:07):
So as a young.
Speaker 4 (02:08):
Child, I saw how nutrition could affect quality of life,
very very directly, and so it just was always an
interest of mine that what we ate could make such
a big deal in our health, in our wellness and
the way we did pretty much everything. So I started
on that path, did a lot of nutrition quiz bold
(02:30):
type things growing up with four H associations, and then
decided that route in college.
Speaker 2 (02:38):
Yeah, and it's so important to develop those understanding of
food and health young. So it's so interesting that that
had such an imprint on you. What in general is
the difference between a dietitian and a nutritionist and how
would somebody decide, you know, who they needed to see.
Speaker 3 (02:58):
That's a great question. We get that question a lot.
Speaker 4 (03:00):
So a dietitian is the leading professional on nutrition. So
dietitians are licensed that we are regulated with the title.
You cannot say you're a registered dietitian if you don't
keep up your license.
Speaker 3 (03:15):
So we go through.
Speaker 4 (03:16):
A licensure board, through a federal regulation agency, and then
also each state, so you have to be licensed in each.
Speaker 3 (03:26):
Specific state that you practice.
Speaker 4 (03:28):
A nutritionist is not really regulated, so a lot of
times a dietitian is also a nutritionist, but a nutritionist
is not necessarily a dietitian.
Speaker 3 (03:37):
Uh, Nutritionists just kind of.
Speaker 4 (03:40):
Give general wellness, overall health guidance, health coaching, I guess
is a better term for it. Dietitians are going to
be the ones that do like the medical nutrition therapy
we're in a hospital, it's going to be a dietitian.
They're the ones that are you know, have you have
to have a bachelor's degree and go through an internship
(04:01):
and actually that's changing now to a master's degree.
Speaker 3 (04:05):
To be a dietitian.
Speaker 4 (04:06):
We have to do so many like a thousand supervised
hours of an internship.
Speaker 3 (04:10):
We have to take a registration.
Speaker 4 (04:12):
Exam like many health professionals have to do, and keep
up so many education hours every year.
Speaker 3 (04:18):
Things like that.
Speaker 4 (04:19):
So the dietitian is going to be the one that
is generally the leading professional if that makes.
Speaker 2 (04:25):
Sense, makes it? Yeah, it makes a lot of sense
and definitely a lot of experience there. So it might
have gotten cut off in my introduction. I think we
had a little technical thing. But we're talking tonight about malnutrition.
But that's double sided, right, that doesn't just mean under nutrition.
Tell me what your definition of malnutrition is and how
(04:45):
you approach it.
Speaker 4 (04:48):
Yeah, So malnutrition is not necessarily just meaning underweight. There
malnutrition can be double sided. So generally what we are
what we think of as malnutrition is undernourished, not getting
enough nutrition for the body, which shows up in various ways.
(05:09):
But also you can be malnourished in the way of
getting too much nutrition, which presents as obesity.
Speaker 3 (05:18):
Both of those things can.
Speaker 4 (05:19):
Cause great health disparities, cause issues in the way that
your body functions regularly. So malnutrition as an undernutrition is
generally a more acute condition because obviously we're getting a
lack of the es central vitamins and minerals your body
needs to process to live day to day life, to
carry out normal functions. So that's going to be something
(05:42):
that we need to fix. On the acute side, over
nutrition or obesity is going to be excessive intake of calories,
of fat.
Speaker 3 (05:51):
Of nutrients in general.
Speaker 4 (05:52):
That's when you get weight gain and increase risk of
health issues on that side.
Speaker 2 (05:58):
And what are some of the signs that someone might
be malnourished other than just being skinny.
Speaker 4 (06:06):
Yeah, So for one of the things that I do
talk about in the article that'll be coming out in
Southern Indiana Living Magazine, is malnutrition in older adults because
they tend to be at higher risk just because of
various things in their life. So one thing that you
can tell like or certain ways you can tell and
to monitor for malnutrition. For instance, I see people that
(06:32):
are still technically considered overweight have a body mass index
that is above what the average ranges. And ways that
you can tell that they are becoming malnourished is if
there's unintentional weight loss. If they are losing weight more
than five percent of their body weight in.
Speaker 3 (06:51):
A month, that's a sign of weight of malnutrition.
Speaker 4 (06:55):
Clothes fitting more loosely, if things that they've worn for
years are all of the sudden kind of sagging off
of them, that's a sign that they are losing muscle
and fat, fatigue, low energy that.
Speaker 3 (07:07):
Is different than normal.
Speaker 4 (07:09):
If they're getting sick, often getting infections, often if they
don't really want to eat, they're skipping meals or only
eating small bites, kind of moving their food around the
plate instead of actually eating it. If they get a
wound or any kind of injury, if it heals poorly
or slowly. Things if they're bruising or skin is you know,
(07:34):
just kind of brushed and it comes open and those
wounds are acquired easily obvious signs of weakness, things like
that just can't pick up or move things the way
you used to struggling with basic day to day life activities.
Speaker 2 (07:51):
Well, I know that you have this article coming out,
and I do want to talk a little bit about more,
a little bit more about that. We're going to take
our first break here, and I want to let every
you know that you are listening to Centered on Health
with Baptist Health here on news radio eight forty WHAS.
I'm your host, doctor Jeff Tublin. We're talking tonight with
Monica Lochmiller about malnutrition and we will be right back.
(08:23):
Welcome back to Center on Health with Baptist Health here
on news radio eight forty WAJS. I'm your host, doctor
Jeff Tublin, And if you're just joining us, we're talking
tonight with Monica lock Miller, who is a registered dietitian
who's talking to us tonight about malnutrition and malnutrition awareness,
which is in September of this year. Our phone number
is five oh two, five seven one, eight four eight
(08:45):
for our producers on call to take your calls and Monica,
welcome back. We actually do have a caller for you.
Wallace is on the line and he has a question
about certain types of foods that he wants to ask
you about. Wallace, welcome to the show.
Speaker 5 (09:00):
Hey, thank you, Hey, hey, thank you so much. So
right now, as far as fruit, really my soul, fruit
in my diet daily or every other day are frozen
organic blueberries. I try to maintain a variety of vegetables
every day.
Speaker 1 (09:20):
I have a.
Speaker 3 (09:21):
Lagoon some type of bean every.
Speaker 5 (09:23):
Day, cruciferous vegetables. But I was wondering, can you can
you get what you need out of vegetables that you
would depend on fruits for it?
Speaker 3 (09:36):
What do you mean?
Speaker 1 (09:41):
Yeah?
Speaker 5 (09:41):
Are there a variety of vegetables that have the same
minerals and vitamins that fruit would have. But I'm trying
to just avoid too much sugar calories.
Speaker 3 (09:52):
Got it.
Speaker 4 (09:53):
Yeah, So some fruits and vegetables generally, there are some
overlap in the new trans provided in the vitamins and minerals.
Speaker 3 (10:02):
You are gonna get some more of those vitamins in the.
Speaker 4 (10:05):
Fruit that you're not necessarily gonna get in the vegetables.
But it's kind of everything within regulation. So you don't
want to what That is one thing that people don't
think about. So I'm glad you brought that up. That
fruit does tend to have sugar content because it does
have fruit toast, which is natural occurring sugar that comes
(10:25):
from fruit. That's why somebody with diabetes can't eat as
much fruit as they can vegetables. It will raise your
blood sugar. So if you're eating fruit and moderation, what
I mean by that is paying attention to serving sizes.
If it says, you know, half a cup is a
serving size, stick with half a cup.
Speaker 3 (10:43):
I would not recommend trying to completely cut.
Speaker 4 (10:45):
Out fruit and get that just from vegetables because it's
gonna have there are gonna be the vitamins that you're
gonna want. There are some overlap, for instance, with like
leafy greens have some of the vitamins that you would
get from fruit, but overall you kind of want to
balance it both.
Speaker 3 (11:04):
That's fair.
Speaker 5 (11:04):
Thank you so much.
Speaker 2 (11:06):
Well, thank you for calling in being a part of
our show. So Monica, thank you for answering his question.
And before we went to break, we were talking about
the article that you have coming out in Southern Indiana
Living Magazine next month. Can you tell us about some
of the highlights of that article, what the take home
points you want our audience to know.
Speaker 4 (11:27):
Yeah, so in general, So, Malnutrition Awareness Week is September
eighth through twelfth, and the whole point of that is
to just bring awareness to people that there may be
some of your people in your life, loved ones, people
that you're caring for, that are gonna be malnourished and
you might not notice because one of the.
Speaker 3 (11:46):
Main focuses is that.
Speaker 4 (11:50):
Malnutrition is generally associated with someone who's very frail, or
very weak, or in situations of extreme poverty or starvation,
and that's not necessarily true. So it focuses on older
adults primarily, is what the article focuses on, but just
different things that can contribute to malnutrition. And then also
it goes into kind of what we discuss things to
(12:11):
monitor for and then just ways to support better nutrition
in everyday life. To not have to make this a
big deal, it doesn't necessarily have to be just kind
of an inevitable part of aging to be malnourished. We
think that, you know, as people get older, they're just
gonna be these teeny tiny.
Speaker 3 (12:30):
Little elderly people. And that's not true. We don't have
to have that.
Speaker 4 (12:33):
You can be well nourished and not just see that
that as an inevitable part of aging, but realize that
part of aging are these symptoms that come up that
tend to increase risk of malnutrition.
Speaker 2 (12:48):
And clearly in that article it seems like the focus
is on sort of the older adult at risk, but
what other populations or groups of patients can be rich
for malnutrition.
Speaker 4 (13:03):
So anybody that is really could be at risk for malnutrition,
people that have signs of eating disorders that are keeping
themselves from eating large amounts of a certain nutrient or
of calories in general, if you're withholding food. A lot
of issues with TikTok and social media and all the things,
(13:25):
are these images of what nutrition and health look like
that aren't really real, and so that is causing younger
populations to want to be an image that is actually unattainable.
So because of that, malnutrition is more prevalent, probably now
because we have all these standards put out there for us. Also,
(13:47):
people in pregnancy, anyone that is struggling from health disparities,
So if you have wounds, if you have surgeries, anything
like that, that is going to increase your metabolism. It's
going to increase your demand for calories and protein, and
(14:07):
which comes along with that a greater risk of malnutrition.
Speaker 2 (14:13):
And so one of the things I feel like comes
up a lot is, you know, somebody might want to
eat healthy, and then so many of these healthy fruits
and vegetables, they're so very expensive. So for somebody who
might be in a situation where they want to be
well nourished and healthy, but they're kind of on a budget,
(14:35):
how do you recommend they approach their shopping.
Speaker 4 (14:40):
Yeah, So for that, Unfortunately, the healthier foods tend to
be the foods around the outside of the grocery store,
where you start in the produce, go around to the
fresh meats and fish and seafood.
Speaker 3 (14:54):
Dairy products, things like that.
Speaker 4 (14:55):
Those tend to be the foods that are better for you,
which also comes with higher costs. So when you're trying
to eat healthy, I recommend trying to balance diet overall,
so trying to have a little bit of all those things,
but not get caught up in the brand names or
(15:20):
the certain features that are listed. Look at the actual
content of the food, and you can get a store
brand of something that's just as good as the name brand.
Just because the package is flashier or prettier doesn't mean
that it has more nutrition. If it has these buzzwords
on it that are trying to get your attention that
(15:43):
will say natural or things like that, it's generally going
to be more expensive, but not necessarily any better than
the store brand who didn't use all their money in advertising.
Speaker 3 (15:53):
To give you the same food.
Speaker 4 (15:54):
Also, frozen fruits and vegetables, you can get a lot
of nutrients out of those. Most of those are flash
frozen pretty quickly after being after being picked and being harvested,
so you can get those nutrients from those.
Speaker 3 (16:10):
But also it increases their shelf life. So you you know,
we've all done it.
Speaker 4 (16:16):
We buy the thing of strawberries or whatever and put
it in the fridge and three days later they're no good.
So buying frozen things pervent that, which also makes it
where you're not spending more money to go buy something
that went bad very quickly.
Speaker 2 (16:33):
You know, you took the question right out of my
mouth about if frozen was as good you know, for
people to get those nutrients. Tell us a little bit
about malnutrition awareness. What does that really mean in terms
of what you do in your career and what September
is for. Is this going out into schools? Is it
(16:54):
TV commercials? Like? How does one increase awareness?
Speaker 4 (17:00):
Well, the way that we in in the Baptist facility
that I work for, we have all dieticians that each
of the Baptist facilities have appointed a Manutrition Awareness Week ambassadors,
so them and I work for Baptist Floyd, so I'm
the person here, but we are doing different things in
(17:21):
each area to promote malnutritions just so people are aware
that it doesn't have to be something that goes untreated.
Speaker 3 (17:30):
Also, in order to treat it, you need to detect it.
Speaker 4 (17:33):
So just what the signs of malnutrition are kind of
getting that out there, letting people know these.
Speaker 3 (17:40):
Are the signs of malnutrition. If you see these in
people you you.
Speaker 4 (17:44):
Care for or are in your life, or even yourself,
dieticians are available to help you get control of that.
There's so much information out there and also with malnutrition
leads to increase of mortality in to or it leads
to for recovery if you have anything else going on
(18:07):
health wise. So we just want people to know that
it isn't something that we just kind of have to
let stand where it is.
Speaker 2 (18:16):
Well, we do have another caller on the line. I'm
going to ask if that if our caller could hold
on till after this commercial break and we will start
with your question right after the break. We are talking
tonight with Monica Loch Miller about malnutrition and her being
a registered dietitian with Baptist Hospital Floyd. You are listening
to news radio eight forty wahas Centered on Health. I'm
(18:37):
your host, doctor Jeff Tublin, and we'll be right back
after these words. Welcome back to Center it on Help
with Baptist Health here on news radio eight forty wahas.
I'm your host, doctor Jeff Tublin, And tonight we're talking
(18:59):
with Monica Miller about malnutrition and she is a registered
dietitian with the Baptisployd Medical Group. And we're talking tonight
and we have a caller on the line, Jennifer, who
has a question about protein needs. And Jennifer, if you
are with us, you are on with Monica.
Speaker 5 (19:18):
Hi.
Speaker 1 (19:18):
Thanks Monica, I have a question for you. A bunch
of my friends have started talking about being in their
late forties, early fifties and premenopause and post and in
menopause and talking about the role of protein. So can
you talk about how much protein a woman in those
ages needs to be having and what specifically they should
(19:40):
be eating if they're a vegetarian. And then a secondary
question to that is does it kind of lack of
protein impact like tightness in your muscles and things.
Speaker 3 (19:52):
Yeah, that's a great question.
Speaker 4 (19:53):
I'm always pumped to talk about women's health. And so
with menopause, your protein intake does probably need to increase
a little bit if you're just kind of eating regular
and not really watching your protein. You know, if it's
a woman who's already watching her protein, working out a lot,
that sort of thing, it can probably stay about the same. Usually,
(20:15):
we the general recommendation for protein is about zero point
eight grams of protein per kilogram whatever you weigh of
your body weight. So when you're in menopause, usually that'll
bump up on on average kind of perry menopause, it's
probably one to one point two, so not much. But
then when you're active menopause, it actually goes up more
(20:37):
and you need probably closer to two grams of protein per.
Speaker 3 (20:40):
Kilogram in that active time.
Speaker 4 (20:44):
Mainly because you're really trying to combat muscle loss decrease
muscle mass you. It also helps regulate blood sugar levels. Protein,
along with things like vitamin D and calcium, will help
prevent osteoporosis, which is more common in menopause and after menopause,
(21:07):
so we want to make sure to do that. So
all those numbers kind of can get jumbled. What that
means is generally around twenty grams of protein a meal
is probably good. Usually on what you're eating, you can
kind of find the grams of protein pretty easily, So
if you kind of keep it twenty to thirty grams
(21:27):
of protein per.
Speaker 3 (21:28):
Meal, that'll give you what you need. And in that
time of life.
Speaker 4 (21:33):
Usually what I recommend, honestly to any of my patients,
with the exception of if you have some sort of
condition with kidneys or something like that that you need
to restrict protein, I recommend that every time you're eating
a meal or a snack, make protein the star.
Speaker 3 (21:49):
So have protein with something else.
Speaker 4 (21:52):
If you're going to be eating carbs, make sure there's
a protein paired with it, and that's going to get
you enough protein throughout the day.
Speaker 3 (21:59):
So things that you can do with that doesn't necessarily
just have to be meat.
Speaker 4 (22:03):
Obviously, lean meats are better chicken, turkey, fish. Your white
meats are gonna be the leaner ones that aren't gonna
give you as much of the cholesterol and the extra
fat and things like that. Dairy is a great source
of protein. One of my favorite things is Greek yogurt.
I find all of these recipes on the internet that
you can use Greek yogurt to make everything, like I
(22:27):
make this dough out of Greek yogurt. So that's a
great source of protein. Eggs are a good one too.
Legumes like lentoles, chickpeas, hummus, and any kind of like nuts, seeds,
things like that.
Speaker 3 (22:43):
Also, soy products have protein and.
Speaker 4 (22:49):
Tofu if you like tofu, and then you can always
drink like a protein shaker supplement as well if you're
struggling to get that protein in.
Speaker 3 (22:59):
Was there another part to the question? Did I answer
all of that?
Speaker 1 (23:02):
You answer that? And then I was just wondering if
could a lack of protein like cause muscle discomfort or
it's only that protein just helps build muscle, not decrease muscle.
Speaker 4 (23:15):
Yeah, so a lack of protein can cause muscle loss
or a decrease in muscle mass, and so you want
to make sure you're getting enough protein because just day
to day activities and then exercise especially on top of that,
are going to break down some of those muscles, and
so you want your body's constantly rebuilding that muscle tissue.
(23:35):
And so if you're not getting enough protein, it can't
rebuild that muscle tissue. Also, when you are getting an
increased amount of protein, fluid is key. You want to
make sure you're getting fluid with that protein or you'll
have issues with things like that with muscle tightness, also
with making frequently cause constipation if you're getting too much
(23:56):
protein and not enough fluid with it. It Just being
hydrated helps digestion altogether all the time.
Speaker 3 (24:05):
So yeah, is good.
Speaker 4 (24:07):
Not enough also causes loss of the things we want
our bodies.
Speaker 3 (24:11):
To hold on to.
Speaker 2 (24:12):
Thank you so much, Jennifer, thank you for calling in.
Have a good rest of your night. So Monica, talking
about over nutrition or obesity for just a minute. I
know we've done shows specifically on that, but having you
here as a dietitian, what are the things that you
use to monitor the health in terms of weight are
(24:35):
you a BMI user, Do you use other markers of
waste circumference or skin What are the things when you
assess the patient that help you identify the patients at risk.
Speaker 4 (24:48):
Yeah, so in the hospital we do use BMI often
just kind of as a screening measure.
Speaker 3 (24:54):
For that kind of thing.
Speaker 4 (24:57):
Usually, we try to get away from the super diet
culture now, just because there's so much negativity with that
in the media on social media. There is a lot
of research that shows that being obsessed with losing weight
can make it go the other way and then you
(25:18):
lose too much weight in you and it causes anxiety
and depression and all these things afraid of getting it back.
So the main thing that we try to do is
promote balance. If you're eating a balanced diet and getting
in all the essentral food groups every day and making
sure that you are watching your portion size as being
(25:41):
mindful of what you're eating. If your body needs to
lose weight, it will lose weight if you're doing that,
and it will maintain weight if you're not needing to
lose weight.
Speaker 3 (25:54):
Does that make sense?
Speaker 4 (25:56):
Kind of just overall being healthy and mindful of what
you're eating. Now, we do you Obviously, if somebody is
very overweight and needs to lose weight, then we create
a program with them that.
Speaker 3 (26:07):
Provides exactly what.
Speaker 4 (26:08):
They need based on their body to lose the weight
that they need to lose in a healthy timeline.
Speaker 2 (26:15):
And we hear a lot about you know, we need
to drink enough water. I mean you mentioned it just
recently just before with the protein intake. What's a target
for most people? You know, we see everybody's carrying around
their their water bottles these days and drinking water all day.
What are we aiming for? What's a good healthy amount
of water to be drinking a day.
Speaker 4 (26:36):
A kind of baseline marker amount is one one milliliter
per calorie that you need a day, So usually the
average two thousand calories about the average women are going
to need a little less than that. It's based on
the amount of exercise. So if you that's kind of
(26:59):
a good a good marker. A lot of times, an
easier way that I tell people is one you need
to have one millilater for every kilogram, so that way
you're getting exactly what you need today. Honestly, I say,
listen to your body.
Speaker 3 (27:17):
Your body is going to tell you when you need to.
Speaker 4 (27:20):
Have those things when you need more liquid, when you
need less. If you're sweating a lot, obviously you are
going to need more.
Speaker 3 (27:29):
If it's coming out of your body.
Speaker 4 (27:31):
If you're sweating perspiration, that is, you're losing fluid, so
you're going to need to gain fluid back.
Speaker 2 (27:39):
So in your practice, when you're assessing patients, do you
use skinful measurements or waste circumference or do you take
a different approach when it comes to evaluating a patient.
Speaker 4 (27:52):
So, to evaluate a patient for malnutrition, we use what's
called a nutrition focused physical exam, and so we look
for muscle and fat wasting on a patient. We feel
different areas of the body, mainly in the bony prominences.
We start kind of at the temple and the orbital
(28:12):
regions of the face, and then we kind of look
at the clavicles, the shoulder area. We go down the
sides and if there are certain markers, there's actually diagrams
that we've been trained with that tell us certain things
that we see in those areas tell us if a
patient is malnourished, and then also what level if it's
moderate or severe.
Speaker 3 (28:33):
Things like that.
Speaker 2 (28:36):
Well, we are talking with Monica Lock Miler tonight about
malnutrition and her being a registered dietitian with the Baptist
Floyd Medical Group. We are going to take our final
break here, and if you missed any part of the
show or want to hear all of this excellent information
in its entirety, I want to encourage you to download
the iHeartRadio app. It's free, it's easy to use, and
it gives you access tonight's show. We will be right
(28:57):
back here listening to Centered on Health with Baptist Health
here on news Radio eight forty whas. Welcome back to
(29:17):
star It on Health with Baptist Health here on news
Radio eight forty whas. I'm your host, doctor Jeff telblonan Tonight,
We're talking about malnutrition and we're talking with registered dietitian
Monica Locke Miller, who is teaching us all about healthy nutrition.
Remember to download the iHeartRadio app to listen to this
(29:38):
or any of our previous segments, and to have access
to all the other features that the app has to offer.
So it's interesting that the statistics say that there's actually
an inverse relationship on social media between the representation of
actual diet registered dietitians providing information and the accuracy of
(29:59):
the information that's being provided. So I thought, you know, Monica,
while we had you here, we could talk. You know,
so many people get their information from from social media
and people that they follow, that maybe we could talk
a little bit about trends and diets and myths and
misconceptions and you know, maybe get through as many of
them as we can with the time that we have.
(30:19):
So starting with just sort of some of the trends
that are out there, what are the things that you're
seeing and what should we be looking out for. So
some of the ones I came across were, you know,
fiber maxing or one meal a day or oh mad
or you know, things like that. What are your thoughts
about some of these trends that are out there?
Speaker 4 (30:43):
So I feel like all of it, there's there's good
and bad with it. Some of it is great because
people are giving new ideas for things, and then some
of it is.
Speaker 3 (30:53):
Just not realistic.
Speaker 4 (30:55):
We have these people who are paid to represent a
certain image or a certain personality or a certain version
of things, and so they have so much pressure that
they're representing things that they may not or they may
or may not even believe in, or we see these
like one meal a day things where it promotes, hey,
(31:16):
if you follow this, you're gonna look like me. But
that's just not we're seeing one snapshot of their entire day.
We don't know that they're not showing this, Oh I
eat this one meal a day.
Speaker 3 (31:29):
And then going home and eating.
Speaker 4 (31:33):
Half a bag of Dorito's, or struggling with an eating
disorder or what they're The real life is behind that.
So I think we just have to look at all
these things as what they are. You think about when
you post a picture on social media, you post what
you think is the best version of yourself or even
ideal self. So we're not necessarily getting reality. And so
(31:55):
I think that we have to just have a clear
mind when we see these things and filter them through,
ask questions, talk to professionals things like that before we
just blindly follow what we.
Speaker 3 (32:10):
See on the internet. You know.
Speaker 4 (32:11):
And a lot of times these things come with severe,
severe calorie restrictions that no one should be on unless
they're being followed by a doctor and a dietitian, you know,
a medical team that is monitoring these things, and they can.
Speaker 3 (32:24):
Cause these.
Speaker 4 (32:27):
Severe reactions in their body by getting too much or
too little of something that they didn't even realize they
were doing to themselves.
Speaker 2 (32:36):
So I think you, you know, you really touched on
a lot of these actually, just through our conversations about
some of these mix of misconceptions. I went through and
I wrote down some of the ones that I came across.
You've answered actually quite a bit of them. I mean,
you've told us about how to get protein if you
don't eat meat, and you've talked to us, talk to
us about the fresh produce versus frozen and stuff. But
(33:01):
what about some of these myths that you know, if
you eat carbs you're going to gain way that carbs
are bad for you.
Speaker 4 (33:08):
Yeah, so I feel like carbs are the villain of
the of the net.
Speaker 3 (33:16):
Yeah. Yeah, carbs are always the villain.
Speaker 4 (33:20):
But so with carbs, the problem is there's something that
are they're so easily abused. They they tend to be
our comfort foods. They tend to be the things that
you can acquire very quickly.
Speaker 3 (33:32):
When we go to a restaurant, what do they bring
you out? First? They bring out a basket of bread,
or they bring.
Speaker 2 (33:38):
Out chip hopefully. Yeah.
Speaker 4 (33:41):
Yeah, so those are the carves the carbs are cheap
and you can eat a lot of them. But the
problem is with that is there a lot of times
empty calories. So we're eating these things that have the
high calorie content, but yet they give us no fill,
they give us no real benefit in the quantities that
(34:01):
we're eating them. And so that's why, Sure, carbs can
make you gain weight, but too many calories of anything
can make you gain weight. So once again, it all
goes back to balance. It goes back to balancing your diet.
Carbs are good if you eat them correctly and you
eat whole grains and things like that.
Speaker 3 (34:22):
Your body actually needs them for energy.
Speaker 4 (34:24):
It's the main source of energy and the easiest source
of energy for your body. And if you don't get them,
then you struggle with blood sugar dropping low or things
like that. So it just goes back to self control,
mindful eating, and you know, moderation balance in all things.
Speaker 2 (34:43):
What about the myth or the concept that eating late
at night causes you to gain weight? Is that true?
Do you recommend a certain time cutting off maybe piggyback
and remittent fasting into your answer? What are your thoughts
about that eating strategy?
Speaker 3 (35:03):
Yeah?
Speaker 4 (35:03):
So, eating later at night can lead to waking and
the reason for that is your metabolism slows down. So
in the morning is when your metabolism.
Speaker 3 (35:14):
Tends to be highest.
Speaker 4 (35:16):
So that's why the whole breakfast is the most important
meal of the day. That's where that phrase kind of
comes from. Your metabolism is highest in the morning, and
so your body's gonna barn more. So if you're snacking
late at night, your body's just kind of storing most
of it.
Speaker 3 (35:31):
It's not really using it for anything.
Speaker 4 (35:33):
Also, when we tend to eat late at night, we're
not really doing anything usually right, maybe like thumb on
the remote kind of exercise, and that's about it. So
that's where we're eating late at night comes from. And
normally we're doing it just because we're bored or we're tired,
or you know, not really because our body's hungry. It's
(35:55):
more than emotional comfort kind of eating. And so it's
usually not foods that are good for you. I mean,
nobody's really getting up and eating you know, a handful
of veggies at eleven thirty at night, you know. So
usually it's foods that are like the things that we
shouldn't be eating that much of and we just kind
of like lose all inhibitions when it gets late.
Speaker 3 (36:16):
Usually a good cutoff.
Speaker 4 (36:19):
I usually try to say, don't eat after nine pm.
In an ideal world, it would be a you know
a little earlier than that, but the way the world
now is, I know, like I'm a parent and sometimes
my kids don't get home from their extracurriculars till that time,
So just kind of cutting it off, like after dinner,
if you have to have a snack, have a small
(36:40):
healthy something with a protein and maybe one serving of
carb as a snack.
Speaker 3 (36:45):
But other than that, try to cut it off. With
intermittent fasting.
Speaker 4 (36:50):
There's so so much contradictions between what people put out
there for that. If you're doing an inter mint ormitt
and fasting diet, I recommend just being followed by a
dietitian to set that plan.
Speaker 2 (37:06):
Well, I have about fifty seven other questions that I
want to ask you, So we're definitely going to have
to have you back because that is going to do it.
For tonight's segment of centered on help with that this
health I want to thank you our guest Monica for
joining us tonight and talking to us about these mixed misconceptions,
understanding about malnutrition, and certainly letting everybody know that September
(37:31):
is Malnutrition Awareness Month. I want to thank our producer
mister Jim Fenn and our callers and tonight join us
every Thursday for another segment, and I hope everybody has
a healthy and safe rest of your week and a
great weekend. Thanks for joining us. This program is for
informational purposes only and should not be relied upon as
(37:54):
medical advice. The content of this program is not intended
to be a substitute for professional medical advice, dieti dignosis,
or treatment.
Speaker 4 (38:01):
This show is not designed to replace the physician's medical
assessment and medical judgment.
Speaker 2 (38:06):
Always seek the advice of your physician with any questions
or concerns you may.
Speaker 4 (38:11):
Have related to your personal health or regarding specific medical conditions.
Speaker 3 (38:15):
To find a Baptist health provider, please visit Baptist Heealth
dot com
It's now time for Centered on Health with Baptists Health
on use Radio. Wait forty WYJS Now, here's doctor Jeff Tubble.
Speaker 2 (00:11):
Good evening, everyone, and welcome to tonight's episode of Centered
on Health with Baptist Health here on news Radio eight
forty whas. I'm your host, doctor Jeff Tublin. We're joined
by our producer mister Jim Fenn, who's waiting to take
your calls at five oh two five seven one eight
four eighty four. That's five oh two, five seven one
eight four eighty four. In twenty twenty three, thirteen point
(00:33):
five percent of households we're low on food security and
five point one percent were very low. And in Kentucky
food security is considered above average in the nation. September
is the month that includes malnutrition awareness. Tonight, we're talking
to Monica lock Miller, who's a registered dietitian and nutritionist.
She's a graduate of LSU in Baton Rouge, Louisiana, where
(00:55):
she received a Bachelor of Science in Nutrition and Dietetics
and went on to reci EVA master's degree in nutrition
and Dietetics. Her experience in Louisiana and here has included
almost twenty years of experience in every capacity diabetes coordinator,
very action coordinator, and lead dietitian. She is serving on
the board of directors for Louisville Association of Nutrition and Dietetics.
(01:18):
Welcome to the show.
Speaker 3 (01:21):
Thank you, I'm glad to be here.
Speaker 2 (01:23):
Yeah, we're very excited to have you. And I know
that September is a big month because it's Malnutrition Awareness
Week and it's a big week for you this week
with an article that I know you're being featured and
published this week, so we're going to hear about that.
But I want to congratulate you on that and welcome
you to our show. And maybe you could just start
off by telling us about how you got interested in
(01:44):
being a dietitian.
Speaker 4 (01:47):
Yeah, so I knew at a very young age I
wanted to be a dietitian. I had a grandmother who
was severely diabetic and really came from a place of
food and security and lack of nutrition education, and so
she did not take care of that properly. She didn't
care for herself, didn't take her medicines the way she
(02:07):
was supposed to do.
Speaker 3 (02:07):
So as a young.
Speaker 4 (02:08):
Child, I saw how nutrition could affect quality of life,
very very directly, and so it just was always an
interest of mine that what we ate could make such
a big deal in our health, in our wellness and
the way we did pretty much everything. So I started
on that path, did a lot of nutrition quiz bold
(02:30):
type things growing up with four H associations, and then
decided that route in college.
Speaker 2 (02:38):
Yeah, and it's so important to develop those understanding of
food and health young. So it's so interesting that that
had such an imprint on you. What in general is
the difference between a dietitian and a nutritionist and how
would somebody decide, you know, who they needed to see.
Speaker 3 (02:58):
That's a great question. We get that question a lot.
Speaker 4 (03:00):
So a dietitian is the leading professional on nutrition. So
dietitians are licensed that we are regulated with the title.
You cannot say you're a registered dietitian if you don't
keep up your license.
Speaker 3 (03:15):
So we go through.
Speaker 4 (03:16):
A licensure board, through a federal regulation agency, and then
also each state, so you have to be licensed in each.
Speaker 3 (03:26):
Specific state that you practice.
Speaker 4 (03:28):
A nutritionist is not really regulated, so a lot of
times a dietitian is also a nutritionist, but a nutritionist
is not necessarily a dietitian.
Speaker 3 (03:37):
Uh, Nutritionists just kind of.
Speaker 4 (03:40):
Give general wellness, overall health guidance, health coaching, I guess
is a better term for it. Dietitians are going to
be the ones that do like the medical nutrition therapy
we're in a hospital, it's going to be a dietitian.
They're the ones that are you know, have you have
to have a bachelor's degree and go through an internship
(04:01):
and actually that's changing now to a master's degree.
Speaker 3 (04:05):
To be a dietitian.
Speaker 4 (04:06):
We have to do so many like a thousand supervised
hours of an internship.
Speaker 3 (04:10):
We have to take a registration.
Speaker 4 (04:12):
Exam like many health professionals have to do, and keep
up so many education hours every year.
Speaker 3 (04:18):
Things like that.
Speaker 4 (04:19):
So the dietitian is going to be the one that
is generally the leading professional if that makes.
Speaker 2 (04:25):
Sense, makes it? Yeah, it makes a lot of sense
and definitely a lot of experience there. So it might
have gotten cut off in my introduction. I think we
had a little technical thing. But we're talking tonight about malnutrition.
But that's double sided, right, that doesn't just mean under nutrition.
Tell me what your definition of malnutrition is and how
(04:45):
you approach it.
Speaker 4 (04:48):
Yeah, So malnutrition is not necessarily just meaning underweight. There
malnutrition can be double sided. So generally what we are
what we think of as malnutrition is undernourished, not getting
enough nutrition for the body, which shows up in various ways.
(05:09):
But also you can be malnourished in the way of
getting too much nutrition, which presents as obesity.
Speaker 3 (05:18):
Both of those things can.
Speaker 4 (05:19):
Cause great health disparities, cause issues in the way that
your body functions regularly. So malnutrition as an undernutrition is
generally a more acute condition because obviously we're getting a
lack of the es central vitamins and minerals your body
needs to process to live day to day life, to
carry out normal functions. So that's going to be something
(05:42):
that we need to fix. On the acute side, over
nutrition or obesity is going to be excessive intake of calories,
of fat.
Speaker 3 (05:51):
Of nutrients in general.
Speaker 4 (05:52):
That's when you get weight gain and increase risk of
health issues on that side.
Speaker 2 (05:58):
And what are some of the signs that someone might
be malnourished other than just being skinny.
Speaker 4 (06:06):
Yeah, So for one of the things that I do
talk about in the article that'll be coming out in
Southern Indiana Living Magazine, is malnutrition in older adults because
they tend to be at higher risk just because of
various things in their life. So one thing that you
can tell like or certain ways you can tell and
to monitor for malnutrition. For instance, I see people that
(06:32):
are still technically considered overweight have a body mass index
that is above what the average ranges. And ways that
you can tell that they are becoming malnourished is if
there's unintentional weight loss. If they are losing weight more
than five percent of their body weight in.
Speaker 3 (06:51):
A month, that's a sign of weight of malnutrition.
Speaker 4 (06:55):
Clothes fitting more loosely, if things that they've worn for
years are all of the sudden kind of sagging off
of them, that's a sign that they are losing muscle
and fat, fatigue, low energy that.
Speaker 3 (07:07):
Is different than normal.
Speaker 4 (07:09):
If they're getting sick, often getting infections, often if they
don't really want to eat, they're skipping meals or only
eating small bites, kind of moving their food around the
plate instead of actually eating it. If they get a
wound or any kind of injury, if it heals poorly
or slowly. Things if they're bruising or skin is you know,
(07:34):
just kind of brushed and it comes open and those
wounds are acquired easily obvious signs of weakness, things like
that just can't pick up or move things the way
you used to struggling with basic day to day life activities.
Speaker 2 (07:51):
Well, I know that you have this article coming out,
and I do want to talk a little bit about more,
a little bit more about that. We're going to take
our first break here, and I want to let every
you know that you are listening to Centered on Health
with Baptist Health here on news radio eight forty WHAS.
I'm your host, doctor Jeff Tublin. We're talking tonight with
Monica Lochmiller about malnutrition and we will be right back.
(08:23):
Welcome back to Center on Health with Baptist Health here
on news radio eight forty WAJS. I'm your host, doctor
Jeff Tublin, And if you're just joining us, we're talking
tonight with Monica lock Miller, who is a registered dietitian
who's talking to us tonight about malnutrition and malnutrition awareness,
which is in September of this year. Our phone number
is five oh two, five seven one, eight four eight
(08:45):
for our producers on call to take your calls and Monica,
welcome back. We actually do have a caller for you.
Wallace is on the line and he has a question
about certain types of foods that he wants to ask
you about. Wallace, welcome to the show.
Speaker 5 (09:00):
Hey, thank you, Hey, hey, thank you so much. So
right now, as far as fruit, really my soul, fruit
in my diet daily or every other day are frozen
organic blueberries. I try to maintain a variety of vegetables
every day.
Speaker 1 (09:20):
I have a.
Speaker 3 (09:21):
Lagoon some type of bean every.
Speaker 5 (09:23):
Day, cruciferous vegetables. But I was wondering, can you can
you get what you need out of vegetables that you
would depend on fruits for it?
Speaker 3 (09:36):
What do you mean?
Speaker 1 (09:41):
Yeah?
Speaker 5 (09:41):
Are there a variety of vegetables that have the same
minerals and vitamins that fruit would have. But I'm trying
to just avoid too much sugar calories.
Speaker 3 (09:52):
Got it.
Speaker 4 (09:53):
Yeah, So some fruits and vegetables generally, there are some
overlap in the new trans provided in the vitamins and minerals.
Speaker 3 (10:02):
You are gonna get some more of those vitamins in the.
Speaker 4 (10:05):
Fruit that you're not necessarily gonna get in the vegetables.
But it's kind of everything within regulation. So you don't
want to what That is one thing that people don't
think about. So I'm glad you brought that up. That
fruit does tend to have sugar content because it does
have fruit toast, which is natural occurring sugar that comes
(10:25):
from fruit. That's why somebody with diabetes can't eat as
much fruit as they can vegetables. It will raise your
blood sugar. So if you're eating fruit and moderation, what
I mean by that is paying attention to serving sizes.
If it says, you know, half a cup is a
serving size, stick with half a cup.
Speaker 3 (10:43):
I would not recommend trying to completely cut.
Speaker 4 (10:45):
Out fruit and get that just from vegetables because it's
gonna have there are gonna be the vitamins that you're
gonna want. There are some overlap, for instance, with like
leafy greens have some of the vitamins that you would
get from fruit, but overall you kind of want to
balance it both.
Speaker 3 (11:04):
That's fair.
Speaker 5 (11:04):
Thank you so much.
Speaker 2 (11:06):
Well, thank you for calling in being a part of
our show. So Monica, thank you for answering his question.
And before we went to break, we were talking about
the article that you have coming out in Southern Indiana
Living Magazine next month. Can you tell us about some
of the highlights of that article, what the take home
points you want our audience to know.
Speaker 4 (11:27):
Yeah, so in general, So, Malnutrition Awareness Week is September
eighth through twelfth, and the whole point of that is
to just bring awareness to people that there may be
some of your people in your life, loved ones, people
that you're caring for, that are gonna be malnourished and
you might not notice because one of the.
Speaker 3 (11:46):
Main focuses is that.
Speaker 4 (11:50):
Malnutrition is generally associated with someone who's very frail, or
very weak, or in situations of extreme poverty or starvation,
and that's not necessarily true. So it focuses on older
adults primarily, is what the article focuses on, but just
different things that can contribute to malnutrition. And then also
it goes into kind of what we discuss things to
(12:11):
monitor for and then just ways to support better nutrition
in everyday life. To not have to make this a
big deal, it doesn't necessarily have to be just kind
of an inevitable part of aging to be malnourished. We
think that, you know, as people get older, they're just
gonna be these teeny tiny.
Speaker 3 (12:30):
Little elderly people. And that's not true. We don't have
to have that.
Speaker 4 (12:33):
You can be well nourished and not just see that
that as an inevitable part of aging, but realize that
part of aging are these symptoms that come up that
tend to increase risk of malnutrition.
Speaker 2 (12:48):
And clearly in that article it seems like the focus
is on sort of the older adult at risk, but
what other populations or groups of patients can be rich
for malnutrition.
Speaker 4 (13:03):
So anybody that is really could be at risk for malnutrition,
people that have signs of eating disorders that are keeping
themselves from eating large amounts of a certain nutrient or
of calories in general, if you're withholding food. A lot
of issues with TikTok and social media and all the things,
(13:25):
are these images of what nutrition and health look like
that aren't really real, and so that is causing younger
populations to want to be an image that is actually unattainable.
So because of that, malnutrition is more prevalent, probably now
because we have all these standards put out there for us. Also,
(13:47):
people in pregnancy, anyone that is struggling from health disparities,
So if you have wounds, if you have surgeries, anything
like that, that is going to increase your metabolism. It's
going to increase your demand for calories and protein, and
(14:07):
which comes along with that a greater risk of malnutrition.
Speaker 2 (14:13):
And so one of the things I feel like comes
up a lot is, you know, somebody might want to
eat healthy, and then so many of these healthy fruits
and vegetables, they're so very expensive. So for somebody who
might be in a situation where they want to be
well nourished and healthy, but they're kind of on a budget,
(14:35):
how do you recommend they approach their shopping.
Speaker 4 (14:40):
Yeah, So for that, Unfortunately, the healthier foods tend to
be the foods around the outside of the grocery store,
where you start in the produce, go around to the
fresh meats and fish and seafood.
Speaker 3 (14:54):
Dairy products, things like that.
Speaker 4 (14:55):
Those tend to be the foods that are better for you,
which also comes with higher costs. So when you're trying
to eat healthy, I recommend trying to balance diet overall,
so trying to have a little bit of all those things,
but not get caught up in the brand names or
(15:20):
the certain features that are listed. Look at the actual
content of the food, and you can get a store
brand of something that's just as good as the name brand.
Just because the package is flashier or prettier doesn't mean
that it has more nutrition. If it has these buzzwords
on it that are trying to get your attention that
(15:43):
will say natural or things like that, it's generally going
to be more expensive, but not necessarily any better than
the store brand who didn't use all their money in advertising.
Speaker 3 (15:53):
To give you the same food.
Speaker 4 (15:54):
Also, frozen fruits and vegetables, you can get a lot
of nutrients out of those. Most of those are flash
frozen pretty quickly after being after being picked and being harvested,
so you can get those nutrients from those.
Speaker 3 (16:10):
But also it increases their shelf life. So you you know,
we've all done it.
Speaker 4 (16:16):
We buy the thing of strawberries or whatever and put
it in the fridge and three days later they're no good.
So buying frozen things pervent that, which also makes it
where you're not spending more money to go buy something
that went bad very quickly.
Speaker 2 (16:33):
You know, you took the question right out of my
mouth about if frozen was as good you know, for
people to get those nutrients. Tell us a little bit
about malnutrition awareness. What does that really mean in terms
of what you do in your career and what September
is for. Is this going out into schools? Is it
(16:54):
TV commercials? Like? How does one increase awareness?
Speaker 4 (17:00):
Well, the way that we in in the Baptist facility
that I work for, we have all dieticians that each
of the Baptist facilities have appointed a Manutrition Awareness Week ambassadors,
so them and I work for Baptist Floyd, so I'm
the person here, but we are doing different things in
(17:21):
each area to promote malnutritions just so people are aware
that it doesn't have to be something that goes untreated.
Speaker 3 (17:30):
Also, in order to treat it, you need to detect it.
Speaker 4 (17:33):
So just what the signs of malnutrition are kind of
getting that out there, letting people know these.
Speaker 3 (17:40):
Are the signs of malnutrition. If you see these in
people you you.
Speaker 4 (17:44):
Care for or are in your life, or even yourself,
dieticians are available to help you get control of that.
There's so much information out there and also with malnutrition
leads to increase of mortality in to or it leads
to for recovery if you have anything else going on
(18:07):
health wise. So we just want people to know that
it isn't something that we just kind of have to
let stand where it is.
Speaker 2 (18:16):
Well, we do have another caller on the line. I'm
going to ask if that if our caller could hold
on till after this commercial break and we will start
with your question right after the break. We are talking
tonight with Monica Loch Miller about malnutrition and her being
a registered dietitian with Baptist Hospital Floyd. You are listening
to news radio eight forty wahas Centered on Health. I'm
(18:37):
your host, doctor Jeff Tublin, and we'll be right back
after these words. Welcome back to Center it on Help
with Baptist Health here on news radio eight forty wahas.
I'm your host, doctor Jeff Tublin, And tonight we're talking
(18:59):
with Monica Miller about malnutrition and she is a registered
dietitian with the Baptisployd Medical Group. And we're talking tonight
and we have a caller on the line, Jennifer, who
has a question about protein needs. And Jennifer, if you
are with us, you are on with Monica.
Speaker 5 (19:18):
Hi.
Speaker 1 (19:18):
Thanks Monica, I have a question for you. A bunch
of my friends have started talking about being in their
late forties, early fifties and premenopause and post and in
menopause and talking about the role of protein. So can
you talk about how much protein a woman in those
ages needs to be having and what specifically they should
(19:40):
be eating if they're a vegetarian. And then a secondary
question to that is does it kind of lack of
protein impact like tightness in your muscles and things.
Speaker 3 (19:52):
Yeah, that's a great question.
Speaker 4 (19:53):
I'm always pumped to talk about women's health. And so
with menopause, your protein intake does probably need to increase
a little bit if you're just kind of eating regular
and not really watching your protein. You know, if it's
a woman who's already watching her protein, working out a lot,
that sort of thing, it can probably stay about the same. Usually,
(20:15):
we the general recommendation for protein is about zero point
eight grams of protein per kilogram whatever you weigh of
your body weight. So when you're in menopause, usually that'll
bump up on on average kind of perry menopause, it's
probably one to one point two, so not much. But
then when you're active menopause, it actually goes up more
(20:37):
and you need probably closer to two grams of protein per.
Speaker 3 (20:40):
Kilogram in that active time.
Speaker 4 (20:44):
Mainly because you're really trying to combat muscle loss decrease
muscle mass you. It also helps regulate blood sugar levels. Protein,
along with things like vitamin D and calcium, will help
prevent osteoporosis, which is more common in menopause and after menopause,
(21:07):
so we want to make sure to do that. So
all those numbers kind of can get jumbled. What that
means is generally around twenty grams of protein a meal
is probably good. Usually on what you're eating, you can
kind of find the grams of protein pretty easily, So
if you kind of keep it twenty to thirty grams
(21:27):
of protein per.
Speaker 3 (21:28):
Meal, that'll give you what you need. And in that
time of life.
Speaker 4 (21:33):
Usually what I recommend, honestly to any of my patients,
with the exception of if you have some sort of
condition with kidneys or something like that that you need
to restrict protein, I recommend that every time you're eating
a meal or a snack, make protein the star.
Speaker 3 (21:49):
So have protein with something else.
Speaker 4 (21:52):
If you're going to be eating carbs, make sure there's
a protein paired with it, and that's going to get
you enough protein throughout the day.
Speaker 3 (21:59):
So things that you can do with that doesn't necessarily
just have to be meat.
Speaker 4 (22:03):
Obviously, lean meats are better chicken, turkey, fish. Your white
meats are gonna be the leaner ones that aren't gonna
give you as much of the cholesterol and the extra
fat and things like that. Dairy is a great source
of protein. One of my favorite things is Greek yogurt.
I find all of these recipes on the internet that
you can use Greek yogurt to make everything, like I
(22:27):
make this dough out of Greek yogurt. So that's a
great source of protein. Eggs are a good one too.
Legumes like lentoles, chickpeas, hummus, and any kind of like nuts, seeds,
things like that.
Speaker 3 (22:43):
Also, soy products have protein and.
Speaker 4 (22:49):
Tofu if you like tofu, and then you can always
drink like a protein shaker supplement as well if you're
struggling to get that protein in.
Speaker 3 (22:59):
Was there another part to the question? Did I answer
all of that?
Speaker 1 (23:02):
You answer that? And then I was just wondering if
could a lack of protein like cause muscle discomfort or
it's only that protein just helps build muscle, not decrease muscle.
Speaker 4 (23:15):
Yeah, so a lack of protein can cause muscle loss
or a decrease in muscle mass, and so you want
to make sure you're getting enough protein because just day
to day activities and then exercise especially on top of that,
are going to break down some of those muscles, and
so you want your body's constantly rebuilding that muscle tissue.
(23:35):
And so if you're not getting enough protein, it can't
rebuild that muscle tissue. Also, when you are getting an
increased amount of protein, fluid is key. You want to
make sure you're getting fluid with that protein or you'll
have issues with things like that with muscle tightness, also
with making frequently cause constipation if you're getting too much
(23:56):
protein and not enough fluid with it. It Just being
hydrated helps digestion altogether all the time.
Speaker 3 (24:05):
So yeah, is good.
Speaker 4 (24:07):
Not enough also causes loss of the things we want
our bodies.
Speaker 3 (24:11):
To hold on to.
Speaker 2 (24:12):
Thank you so much, Jennifer, thank you for calling in.
Have a good rest of your night. So Monica, talking
about over nutrition or obesity for just a minute. I
know we've done shows specifically on that, but having you
here as a dietitian, what are the things that you
use to monitor the health in terms of weight are
(24:35):
you a BMI user, Do you use other markers of
waste circumference or skin What are the things when you
assess the patient that help you identify the patients at risk.
Speaker 4 (24:48):
Yeah, so in the hospital we do use BMI often
just kind of as a screening measure.
Speaker 3 (24:54):
For that kind of thing.
Speaker 4 (24:57):
Usually, we try to get away from the super diet
culture now, just because there's so much negativity with that
in the media on social media. There is a lot
of research that shows that being obsessed with losing weight
can make it go the other way and then you
(25:18):
lose too much weight in you and it causes anxiety
and depression and all these things afraid of getting it back.
So the main thing that we try to do is
promote balance. If you're eating a balanced diet and getting
in all the essentral food groups every day and making
sure that you are watching your portion size as being
(25:41):
mindful of what you're eating. If your body needs to
lose weight, it will lose weight if you're doing that,
and it will maintain weight if you're not needing to
lose weight.
Speaker 3 (25:54):
Does that make sense?
Speaker 4 (25:56):
Kind of just overall being healthy and mindful of what
you're eating. Now, we do you Obviously, if somebody is
very overweight and needs to lose weight, then we create
a program with them that.
Speaker 3 (26:07):
Provides exactly what.
Speaker 4 (26:08):
They need based on their body to lose the weight
that they need to lose in a healthy timeline.
Speaker 2 (26:15):
And we hear a lot about you know, we need
to drink enough water. I mean you mentioned it just
recently just before with the protein intake. What's a target
for most people? You know, we see everybody's carrying around
their their water bottles these days and drinking water all day.
What are we aiming for? What's a good healthy amount
of water to be drinking a day.
Speaker 4 (26:36):
A kind of baseline marker amount is one one milliliter
per calorie that you need a day, So usually the
average two thousand calories about the average women are going
to need a little less than that. It's based on
the amount of exercise. So if you that's kind of
(26:59):
a good a good marker. A lot of times, an
easier way that I tell people is one you need
to have one millilater for every kilogram, so that way
you're getting exactly what you need today. Honestly, I say,
listen to your body.
Speaker 3 (27:17):
Your body is going to tell you when you need to.
Speaker 4 (27:20):
Have those things when you need more liquid, when you
need less. If you're sweating a lot, obviously you are
going to need more.
Speaker 3 (27:29):
If it's coming out of your body.
Speaker 4 (27:31):
If you're sweating perspiration, that is, you're losing fluid, so
you're going to need to gain fluid back.
Speaker 2 (27:39):
So in your practice, when you're assessing patients, do you
use skinful measurements or waste circumference or do you take
a different approach when it comes to evaluating a patient.
Speaker 4 (27:52):
So, to evaluate a patient for malnutrition, we use what's
called a nutrition focused physical exam, and so we look
for muscle and fat wasting on a patient. We feel
different areas of the body, mainly in the bony prominences.
We start kind of at the temple and the orbital
(28:12):
regions of the face, and then we kind of look
at the clavicles, the shoulder area. We go down the
sides and if there are certain markers, there's actually diagrams
that we've been trained with that tell us certain things
that we see in those areas tell us if a
patient is malnourished, and then also what level if it's
moderate or severe.
Speaker 3 (28:33):
Things like that.
Speaker 2 (28:36):
Well, we are talking with Monica Lock Miler tonight about
malnutrition and her being a registered dietitian with the Baptist
Floyd Medical Group. We are going to take our final
break here, and if you missed any part of the
show or want to hear all of this excellent information
in its entirety, I want to encourage you to download
the iHeartRadio app. It's free, it's easy to use, and
it gives you access tonight's show. We will be right
(28:57):
back here listening to Centered on Health with Baptist Health
here on news Radio eight forty whas. Welcome back to
(29:17):
star It on Health with Baptist Health here on news
Radio eight forty whas. I'm your host, doctor Jeff telblonan Tonight,
We're talking about malnutrition and we're talking with registered dietitian
Monica Locke Miller, who is teaching us all about healthy nutrition.
Remember to download the iHeartRadio app to listen to this
(29:38):
or any of our previous segments, and to have access
to all the other features that the app has to offer.
So it's interesting that the statistics say that there's actually
an inverse relationship on social media between the representation of
actual diet registered dietitians providing information and the accuracy of
(29:59):
the information that's being provided. So I thought, you know, Monica,
while we had you here, we could talk. You know,
so many people get their information from from social media
and people that they follow, that maybe we could talk
a little bit about trends and diets and myths and
misconceptions and you know, maybe get through as many of
them as we can with the time that we have.
(30:19):
So starting with just sort of some of the trends
that are out there, what are the things that you're
seeing and what should we be looking out for. So
some of the ones I came across were, you know,
fiber maxing or one meal a day or oh mad
or you know, things like that. What are your thoughts
about some of these trends that are out there?
Speaker 4 (30:43):
So I feel like all of it, there's there's good
and bad with it. Some of it is great because
people are giving new ideas for things, and then some
of it is.
Speaker 3 (30:53):
Just not realistic.
Speaker 4 (30:55):
We have these people who are paid to represent a
certain image or a certain personality or a certain version
of things, and so they have so much pressure that
they're representing things that they may not or they may
or may not even believe in, or we see these
like one meal a day things where it promotes, hey,
(31:16):
if you follow this, you're gonna look like me. But
that's just not we're seeing one snapshot of their entire day.
We don't know that they're not showing this, Oh I
eat this one meal a day.
Speaker 3 (31:29):
And then going home and eating.
Speaker 4 (31:33):
Half a bag of Dorito's, or struggling with an eating
disorder or what they're The real life is behind that.
So I think we just have to look at all
these things as what they are. You think about when
you post a picture on social media, you post what
you think is the best version of yourself or even
ideal self. So we're not necessarily getting reality. And so
(31:55):
I think that we have to just have a clear
mind when we see these things and filter them through,
ask questions, talk to professionals things like that before we
just blindly follow what we.
Speaker 3 (32:10):
See on the internet. You know.
Speaker 4 (32:11):
And a lot of times these things come with severe,
severe calorie restrictions that no one should be on unless
they're being followed by a doctor and a dietitian, you know,
a medical team that is monitoring these things, and they can.
Speaker 3 (32:24):
Cause these.
Speaker 4 (32:27):
Severe reactions in their body by getting too much or
too little of something that they didn't even realize they
were doing to themselves.
Speaker 2 (32:36):
So I think you, you know, you really touched on
a lot of these actually, just through our conversations about
some of these mix of misconceptions. I went through and
I wrote down some of the ones that I came across.
You've answered actually quite a bit of them. I mean,
you've told us about how to get protein if you
don't eat meat, and you've talked to us, talk to
us about the fresh produce versus frozen and stuff. But
(33:01):
what about some of these myths that you know, if
you eat carbs you're going to gain way that carbs
are bad for you.
Speaker 4 (33:08):
Yeah, so I feel like carbs are the villain of
the of the net.
Speaker 3 (33:16):
Yeah. Yeah, carbs are always the villain.
Speaker 4 (33:20):
But so with carbs, the problem is there's something that
are they're so easily abused. They they tend to be
our comfort foods. They tend to be the things that
you can acquire very quickly.
Speaker 3 (33:32):
When we go to a restaurant, what do they bring
you out? First? They bring out a basket of bread,
or they bring.
Speaker 2 (33:38):
Out chip hopefully. Yeah.
Speaker 4 (33:41):
Yeah, so those are the carves the carbs are cheap
and you can eat a lot of them. But the
problem is with that is there a lot of times
empty calories. So we're eating these things that have the
high calorie content, but yet they give us no fill,
they give us no real benefit in the quantities that
(34:01):
we're eating them. And so that's why, Sure, carbs can
make you gain weight, but too many calories of anything
can make you gain weight. So once again, it all
goes back to balance. It goes back to balancing your diet.
Carbs are good if you eat them correctly and you
eat whole grains and things like that.
Speaker 3 (34:22):
Your body actually needs them for energy.
Speaker 4 (34:24):
It's the main source of energy and the easiest source
of energy for your body. And if you don't get them,
then you struggle with blood sugar dropping low or things
like that. So it just goes back to self control,
mindful eating, and you know, moderation balance in all things.
Speaker 2 (34:43):
What about the myth or the concept that eating late
at night causes you to gain weight? Is that true?
Do you recommend a certain time cutting off maybe piggyback
and remittent fasting into your answer? What are your thoughts
about that eating strategy?
Speaker 3 (35:03):
Yeah?
Speaker 4 (35:03):
So, eating later at night can lead to waking and
the reason for that is your metabolism slows down. So
in the morning is when your metabolism.
Speaker 3 (35:14):
Tends to be highest.
Speaker 4 (35:16):
So that's why the whole breakfast is the most important
meal of the day. That's where that phrase kind of
comes from. Your metabolism is highest in the morning, and
so your body's gonna barn more. So if you're snacking
late at night, your body's just kind of storing most
of it.
Speaker 3 (35:31):
It's not really using it for anything.
Speaker 4 (35:33):
Also, when we tend to eat late at night, we're
not really doing anything usually right, maybe like thumb on
the remote kind of exercise, and that's about it. So
that's where we're eating late at night comes from. And
normally we're doing it just because we're bored or we're tired,
or you know, not really because our body's hungry. It's
(35:55):
more than emotional comfort kind of eating. And so it's
usually not foods that are good for you. I mean,
nobody's really getting up and eating you know, a handful
of veggies at eleven thirty at night, you know. So
usually it's foods that are like the things that we
shouldn't be eating that much of and we just kind
of like lose all inhibitions when it gets late.
Speaker 3 (36:16):
Usually a good cutoff.
Speaker 4 (36:19):
I usually try to say, don't eat after nine pm.
In an ideal world, it would be a you know
a little earlier than that, but the way the world
now is, I know, like I'm a parent and sometimes
my kids don't get home from their extracurriculars till that time,
So just kind of cutting it off, like after dinner,
if you have to have a snack, have a small
(36:40):
healthy something with a protein and maybe one serving of
carb as a snack.
Speaker 3 (36:45):
But other than that, try to cut it off. With
intermittent fasting.
Speaker 4 (36:50):
There's so so much contradictions between what people put out
there for that. If you're doing an inter mint ormitt
and fasting diet, I recommend just being followed by a
dietitian to set that plan.
Speaker 2 (37:06):
Well, I have about fifty seven other questions that I
want to ask you, So we're definitely going to have
to have you back because that is going to do it.
For tonight's segment of centered on help with that this
health I want to thank you our guest Monica for
joining us tonight and talking to us about these mixed misconceptions,
understanding about malnutrition, and certainly letting everybody know that September
(37:31):
is Malnutrition Awareness Month. I want to thank our producer
mister Jim Fenn and our callers and tonight join us
every Thursday for another segment, and I hope everybody has
a healthy and safe rest of your week and a
great weekend. Thanks for joining us. This program is for
informational purposes only and should not be relied upon as
(37:54):
medical advice. The content of this program is not intended
to be a substitute for professional medical advice, dieti dignosis,
or treatment.
Speaker 4 (38:01):
This show is not designed to replace the physician's medical
assessment and medical judgment.
Speaker 2 (38:06):
Always seek the advice of your physician with any questions
or concerns you may.
Speaker 4 (38:11):
Have related to your personal health or regarding specific medical conditions.
Speaker 3 (38:15):
To find a Baptist health provider, please visit Baptist Heealth
dot com
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