August 28, 2024 • 44 mins
In this episode of 'AI for Helpers and Changemakers,' hosted by Sharon Tewksbury Bloom, the guest, Abby Chan—a Registered Dietician and co-owner of Evolve—discusses how artificial intelligence (AI) and new technologies impact the field of nutrition and health. Abby critiques the inadequacies of traditional metrics like BMI and highlights the logistical and potential ethical pitfalls of AI in healthcare. Additionally, Abby discusses the emerging trend of personalized nutrition through genetic testing. The conversation also explores the challenges of integrating AI and technology into health practices without losing the human connection, emphasizing the importance of addressing existing biases and ensuring that tech solutions genuinely improve health outcomes.
Mentioned in this Episode:
- Evolve's website
- Abby's Mobility Flows on Evolve's YouTube Channel
- Abby's Instagram
- Sharon's past interview with Abby Chan on the Do Good, Be Good podcast
- Bloom Facilitation
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Brian AI (00:05):
/Are you not sure how to feel about the way AI is suddenly everywhere?
AI for Helpers and Changemakers isa show for people who want to do
good work and help other people.
Whether you're already using AItools and loving it, or you are
pretty sure that ChatGPT is thefirst sign of our downfall, we want
you to listen in and learn with us.
(00:26):
Your host on this journeyis Sharon Tewksbury Bloom.
For 20 years, she's workedwith helpers and changemakers.
She believes that we're about to seethe biggest changes in our work lives
since the Internet went mainstream.
We're in this together.
Join us as Sharon interviews peoplein different helping professions,
navigate what these new technologiesare doing to and for their work./
Sharon Tewksbury-Bloom (00:48):
/I'm your host Sharon Tewksbury Bloom.
My guest for today is Abby Chan.
Abby is a dietician and she is a coowner with her partner Brian of a company
called Evolve here in Flagstaff, Arizona.
With Brian being a physical therapistand Abby being a dietician and a
chef, Evolve is perfectly suited totake a holistic approach to health.
(01:11):
And they offer a range of services tohelp people either addressing health
issues or who are athletes tryingto build strength or just anyone
who's trying to get or stay healthy.
we don't go as fully in depth inAbby's views on health promotion
and being against diet culture,but she has some amazing resources.
(01:31):
She's written a lot about health onher website, as well as sharing tips
and strategies on their Instagram.
I have linked to those resourcesas well as everything else that
we mentioned in the show notes.
I hope you enjoy myconversation with Abby.
one of the thoughts that inspiredthis whole project for me was this
(01:53):
idea that we're running out of time tofigure out what it means to be human.
And I think that we often discountwhat that core humanity is that we
bring to this particular problem.
And it's something I admire in you isthat you're trying to get to the core
of Our human relationship with food,our relationship with community and
(02:13):
culture and each other and how all ofthat, you know, if someone comes into
your office and says, I want to loseweight, you're not going to take that
at that question and give them a plan.
You're going to dig into Them as ahuman in the world and how they're
making sense of themselves andinteracting with others and bring your
(02:35):
story into it and the whole thing.
And so I think that's whereyou're adding so much value
with your humanity to it that.
The AI cannot do, but I think it'simportant that we, as people trying to
do good in the world, reflect on howwe're doing that, how we're bringing our
(02:57):
humanness to it, because if we're justdoing what The computer can do, then
we're really not doing our best work.
We're not bringing our most value.
We should just leave that to chat GPT, butwe have to see like, how are we bringing
those unique human qualities to it?
Abby Chan (03:15):
Yeah.
And I think that's the most profoundaspect of any work that anyone does,
whether that be in business, inleadership, in medical care, in being a
caregiver or a parent, it's so much of.
Instead of what are we doing?
(03:35):
It's how are we actually taking amoment to pause and be and reflect not
only within ourselves, but be able toreflect and communicate effectively with
others and truly listen, because that'sagain, what all these things can't do.
They can't listen to us.
They can't listen to us, but they can'tnecessarily really take that information
in and again, boil it all down into.
(03:58):
Oh, okay.
I can see that this is reallyhard for you right now, and let's
talk about this so this maybefeels a little less hard for you.
Sharon Tewksbury-Bloom (04:08):
/Okay.
I want to make sure we also talkabout smart devices, consumer
tech that's coming into the space.
Cause I know I mentioned that I had heardabout a product that I think was unveiled
at the, big convention in Las Vegaswhere they had a tray that could measure
the calorie content in the food on it.
(04:30):
And it could also measure aftersomeone had eaten some of that
food to see the difference.
So certainly that raisedalarm bells in my brain.
But I'm curious what you've beenseeing out there in terms of actual
products and wearables and thingsthat are in your space and Where
(04:50):
your head is at on those items.
Abby Chan (04:55):
Yeah, there's a lot of tech out there.
There's a lot of options.
We could spend so much money and so muchtime diving into all of these things.
And, It first comes down to lookingat, and even when it comes to
health in general, and lookingat, let's say labs, for example,
right, they are a snapshot in time.
So we don't want to base someone'shealth on just one lab job.
(05:19):
We want to look at, what are thetrends, what's the difference?
And I think that's a beautiful thingabout tech is that it can give us trends
and it can give us aspects of, are wemaybe going in the right direction?
But they could also be anywhere from, 25to 90 percent inaccurate, depending on
the device, depending on how old it is,depending on the sensors in it, depending
(05:40):
on what data it's been compiling.
I've actually been doing my own personal.
Research on myself where I've actuallyworn 2 devices for the past month.
1 of them being a faceless 1 that itdoesn't have any numerical data on it.
And you have to use an app with it.
It's more focused on recovery basedthings and giving a little bit more data
(06:02):
there and compared to an Apple watch and.
One thing that I love about the one thatdoesn't have a face is that it doesn't
buzz at me and tell me that I need tomove or shame me into, you need to get
up now or have you closed your rings?
And there's a lot of ways youcan disable those things, but
it's actually really challenging.
I have to walk clients through often,how do we disable these notifications?
(06:24):
How do we decrease that amountfor you to close your quote
unquote rings and all of that?
And so I think they can bereally problematic because for
a lot of people, if you're more.
Let's say on the anxiety spectrum, maybeeven more in the obsessive realm of
things, numbers are something that once wesee them and hear them, they can live rent
(06:46):
free in our heads for a very long time.
So that could be your body weight.
That could be caloric amounts of food.
That could be how many calories you'regoing to burn during a certain exercise.
Like all of these numbers reallydon't tell us a lot about how do
we actually feel in our bodies.
if one of these devices tells meyou're totally recovered today and
(07:06):
you're doing great, but I'm like, Iam so sore and I am not moving today.
It's we need to look at listeninginto our bodies and maybe using this
as some other information as well.
But I think there's, yeah, so manyfitness devices out there depending
on where you wear them and howyou use them the accuracy will be
variable and also the Time and length.
(07:27):
So that's also an interesting aspectwhere buying into something and being
in the whole system of It costs money.
It costs money and it costs time And sothat's one of the things where we have
this data and we think it's so valuableand we base our lives around it But
then if it goes away, what do we do?
Oh, we have to listen to our bodies.
(07:47):
Oh my gosh That's so hard.
So I think there's some things there.
And even from the plate aspect theexample that you gave, from a one on one
individual level, from a consumer level,I don't think it's very helpful and great.
I think that could end up againsaying, here's the calories
amount that you started with.
(08:08):
Here's where you, whatyou should be eating.
Oh, you ate too much.
And then inherentlysomething's going to feel.
Bad, guilty, shameful, but from myclinical perspective, as someone who
works with eating disorders a lot, Idon't like to use a lot of serving sizes.
I don't like to give out a lot ofmeal plans or exchanges or a lot
of really strict things becausewe're, I'm telling people that we.
(08:28):
don't want to count as much and we don'twant to rely on these numbers as much.
So that could actually be a reallyinteresting tool from a provider
standpoint for the provider to have thedata to where someone doesn't have to
measure and weigh things, but maybe theprovider can get the data on the back end
and see, oh, how are we actually doing?
So I think.
It's all going to dependon, how are we using this?
(08:49):
Are we using this from a place ofone metric and not the only metric?
Are we using it from a place thatis actually to improve our health?
And also, are we still able to listeninto our bodies and continuously ask
the question of why am I using this?
And why do I feel like I haveto continuously use these
(09:10):
things and not trust my body?
Sharon Tewksbury-Bloom (09:12):
Yeah, and I think about ways in which the technology
could be used to more adeptly fit intothe ways we want to interact with our
food and our friends and all of thatso for instance, when you were talking
about it could be useful to the providerwithout requiring, maybe someone who,
(09:34):
is dealing with an eating disorder theyneed to somehow report this data back to
their provider, but if they're the oneshaving to tally everything, that might
be just feeding into unhelpful, cycle.
I was thinking about how myhusband makes fun of me because I
am one of those millennials thattakes pictures of my food a lot.
Like I love a pretty plate.
(09:56):
And so I thought, Oh, if I was workingwith a dietician, it would be helpful
if I could take a picture, which toeveryone around me would look like
just my normal behavior of I'm justthat kind of person who always loves
to take a picture of their food.
But then maybe it's, I can tag itand it automatically goes to an
app for the provider who can justcheck on it when they need to.
(10:20):
And it allows me to more easilyintegrate in those social settings.
cause one thing I've appreciatedwhen you're talking about.
People trying to make a change to theirfood is that so many people when they
make a change like going on a diet,it disconnects them from culture and
from community because they're like,Oh, no, I can't eat that thing you
(10:43):
made for me, or I can't come out todinner with my friends because there's
nothing there that fits in my diet.
Or, I.
Or I have to write down everything,and it's like this very public,
awkward thing of Oh, I gotta checkmy app before I eat that thing.
So I think ways to allow people tostill maybe get the support they need
(11:04):
from the qualified provider, but alsobe more seamlessly in their day to
day without being taken out of thoseimportant moments could be great.
Abby Chan (11:15):
Yeah, I think it's great.
And I am very much in the placewhere I don't love tracking things.
And I don't love, I don'tlove tracking workouts.
I don't love tracking food.
I will every now and again, if dependingon my training load and depending what
I'm doing, and this will also be somethingI use sometimes with my clients is where
I will track maybe one day, and I willgo in knowing that I will track it.
(11:40):
As appropriately as possible becauseoftentimes when we are tracking things,
we will typically, be quote unquote good.
And so I will try totrack it as as possible.
And that gets to be again, onething that says, Hey, okay, cool.
You're doing like, you'reat least eating enough.
I think that's where aspectsthat can be really helpful for,
(12:01):
but we need to remember that.
A, we are not machines.
Our body does not metabolize every singlecalorie and nutrient that we take in.
And it can be a helpful baselineas long as it's not something
that again, consumes our life.
So for some people I'm like, cool,maybe let's just, I can, based
on what you told me, I can gothrough and I will run that through
sometimes so that they don't have to.
And then that can help mebase some recommendations of
(12:24):
we're in a pretty good spot.
Or Ooh, we're in a big deficit here.
And I can typically with just myclinical hat, I can make pretty good
guesstimates of what we're missing.
But I think it can be areally great thing to do.
Maybe it's depending on yourrelationship with food, depending
on your relationship with dieting.
And if you know that you get reallyobsessive, that's probably not for you.
(12:46):
But for some people, especially fora lot of my athletes that I work
with, I do need to know that they areeating enough and I do need to know
what nutrients they may be missing.
But we need to come from thatfrom a very neutral standpoint.
And also knowing that is not everythingand these numbers can be skewed and that
our bodies are not going to need thesame thing every day, which is where a
(13:06):
lot of the calorie amounts come from.
people get stuck with this certain numberin their head of, I can't go over this.
And it's That's not true.
Some days our bodies need more.
Some days our bodies need less.
It totally depends.
And that's where we can use some of thedata to make sure there is enough, but
then also continuously listening to ourphysiological, mental, and emotional
cues of, hey, what do I need right now?/
Sharon Tewksbury-Bloom (13:29):
Awesome.
Anything else that you wanted toshare in terms of what you've seen
in your field with how AI is beingused or has been proposed to be
used that we didn't touch on yet?
Abby Chan (13:47):
Yeah, so there's a lot of aspects right now around personalized
nutrition, which is really thoughtof as more genetic based testing.
And I think it's really cool.
We can look at how our genetics willimpact our nutrient absorption, how it
could put us at a higher risk for certain.
Chronic health diseases, cardiacdisease or diabetes or, dementia there's
(14:12):
so many different genetic factors,but we are still learning about how
those genes interact with each other.
So we right now have data where it'sokay, we know these 2 things are
correlated, but I like to think of.
hormones and our genesas a symphony, right?
So it's not just, Oh, that one's off.
it's going to have a cascadeeffect for the rest of our body.
(14:35):
So we are not yet at the place where wecan totally use our genetics to base.
All of our nutrition information and wecan use them as one tool as well as labs
and other tests and how you feel andyour relationship to food and all these
different aspects to really pull in whatwould be appropriate for one individual.
But there's a lot of things right nowwhere it's get your genetic test done
(14:56):
to see if you have celiac disease.
It's just because you have certain genesthat may correlate, that doesn't mean
that you have an issue with gluten.
Or just because you have certain genesthat are coding for what else could it be?
Oh, certain genes that are coding forsome nutrient deficiencies doesn't
inherently mean you have those, butthere are some that we know of, hey,
if you have this genetic factor, we'rejust going to supplement with that
(15:20):
because we might as well, becauseit's a very low cost intervention.
Sharon Tewksbury-Bloom (15:23):
Yeah, and it does seem like there's a lot
of potential in the future forpersonalization And greater accessibility,
like accessibility to expertise.
But I think We're going to be ina messy middle for quite a while
where there's a lot of noise.
There's a lot of experimentation going on.
(15:45):
There's a lot of not fully testedproducts out there on the market.
Everyone's in a tech race right now.
So I think there's a lot beingunveiled and being announced
that is being hurried to market.
And it's a particularly fraught timefor things that could have a big impact.
And hopefully it doesn't take toolong until some of that shuffles out
(16:06):
and we start to see where the realopportunities are and not just the noise.
Abby Chan (16:13):
Yes, definitely.
And I think that's so much whatwe can use lived experience and
we can use research and we can usedata and compile all of that to see
how does this actually impact us.
But with those stories and livedexperience, there's so much where it's it
worked for me and it's Okay, that's great.
I am not you.
And so even when we look back at thebig popularization of the paleo diet
(16:37):
and one of the individuals who wasreally responsible for bringing it
forth, later he got his genetics testdone and I don't know what test it was
but it showed that he was actually.
Based on this test, we could alsolook at what are other tests saying,
but based on this test was betterat Processing and digesting fats and
proteins and did really well on it.
(16:58):
okay, great for this one individual youdid really well in this diet But now it
is so popularized and people believe thisas gospel as this is the only one true
way that you can be healthy And that youcan perform and it's like We again need
to always, when we're looking at nutritionrecommendations, health recommendations,
exercise, all of that, we need to, yes,take some of these stories and say, okay,
(17:21):
how can we utilize this, but also zoomout in a much bigger way and see what's
actually going on in a big picture.
What's their access to food?
What's their financial privilege?
What's their time and availability?
And we need to look at all these differentfactors of how can this apply to me?
Sharon Tewksbury-Bloom (17:38):
Awesome.
Okay.
I think this is going to besuper helpful and valuable.
Abby Chan (17:44):
This is tangential, but if you heard of the guy
who's trying to live forever,
Sharon Tewksbury-Bloom (17:49):
No.
I've heard of people who are interestedin living for as long as possible, but,
Abby Chan (17:57):
he is you don't have to include this, but God, what is his name?
He's trying to basically reverse hisbiological clock and hack his own DNA.
And he, like his supplement regimenis, but granted, okay, so he's
like tech dude, retired early.
Sharon Tewksbury-Bloom (18:13):
This the four, four hour work week guy or no?
Abby Chan (18:17):
No, it's not
Sharon Tewksbury-Bloom (18:18):
I was like, cause I know he's into a
lot of bio hacking stuff, but
Abby Chan (18:24):
now.
I want to look him up for youbecause it is fascinating He
is His name is Brian Johnson.
He's a multimillionaire millionaire dude.
I think he, his supplementregimen is insane.
I don't remember howmany capsules he takes.
It's 70 or something, and he works outand eats this really weird, obviously
(18:45):
weird diet apparently has no relationshipwith food and is fine with it.
But real problematic.
Yeah.
But thinking of the dangers ofdieting and eating disorders first and
foremost, we need to look at eatingdisorders and again, look at the data
and who's screened and who is actuallybeing cared for in these spaces.
(19:10):
So first and foremost, we always thinkof these as a thin white female disease.
That is not true because we havenot been screening people who
exist in black bodies, fat bodies,disabled bodies for the longest time.
So now we have a diagnosis that iscalled atypical anorexia, where you
don't meet the BMI criteria, butyou meet all the other criteria.
(19:30):
And that is a vast amount of individuals.
And so many times, it makes sense froma biological standpoint that if you're
trying to reduce calories to a veryminimal amount to lose weight, your body
is actually going to do the oppositebecause our bodies are made to survive.
And so you can exist in ahigher weight body and still
(19:52):
have anorexia and still have.
a variety of eating disorders.
And eating disorders are thesecond deadliest mental health
disease in the country, coming upright behind opioid use disorders.
And dieting puts you at a 18times higher risk of developing
an eating disorder compared tosomeone who's never dieted before.
It is the highest correlative riskfactor in Anything else as opposed
(20:17):
to genetics or some or say, it'ssomeone a coach who really encourages
it or encourages restriction.
It's like, dieting is going to bethe number 1 core leader between it.
And so what that ends up happening whenwe think about weight, even being a marker
of health, quote, unquote what will end uphappening is when we actually boil down.
(20:39):
All of the data and all the research,we can actually parse it out to
showing that it's actually the weightcycling that has the negative health
effects of quote unquote obesity.
So weight cycling as in yo dietingwill put you at a higher risk of
cardiovascular disease, type 2diabetes, and early mortality.
And what we end updoing is we then end up.
(21:01):
Blaming the individual who couldn'tquote unquote, lose the weight
who couldn't change their bodies.
Because again, our bodiesare made to survive.
So congratulations.
Your body's just reallygreat at being human.
And we can look at all ofthat in the broader spectrum.
And for people who do exist in higherweight bodies, they actually have.
outside of the metabolic syndromethat we talked about earlier.
(21:23):
Outside of that, they have lowermortality rates as they age.
They are going to be more protectedfrom a health standpoint because they
have a little bit more adipose tissue.
They may have more muscle massand bone density on their bodies.
And that's actually a veryhealth protective thing.
Sharon Tewksbury-Bloom (21:39):
I was talking to a friend about how much I wish I knew more
about this when I was a college athleteplaying rugby in college, because that is
probably the worst time in my life whereI went on a very restrictive diet and I
know my coach was mad at me and I wishthat she had gotten through to all of
us about why that was the exact oppositething we should have been doing as we
(22:03):
were trying to grow muscle mass and be.
Strong athletes.
So I was talking to a friend about thisand she mentioned that she has a teenage
daughter who's an athlete and how she hadfallen into the peer pressure to get into
the dieting as well, and immediately inthat season of her sport, she had ended
up developing some stress fractures, andluckily, her mom got through to her about
(22:28):
how this dieting had probably playeda role in her not being able to do the
strength building without putting toomuch, Putting those stress fasciitis in,
so she's gotten her lesson hopefully earlyin life, but yeah, those risks that come
are severe, especially for, just the waywe live our lives and the way our bodies
(22:53):
actually need that fuel and that comfortand all the things that food brings us.
Abby Chan (23:00):
yeah, and that ends up going into there's a big diagnostic syndrome
called relative energy deficiency insport, and it's, we used to think of
the female athlete triad, which islow bone density, no menstrual cycle.
Often correlated with an eating disorder,but now it's a much bigger diagnostic
(23:21):
tool and criteria, which doesn'tonly include females, which is huge.
And I think now, because that hasreally just been more prevalent
in conversation in the past 3 to5 years, coaches right now are.
still trying to keep up with that, right?
So I think coaches haveeveryone's best interest in mind.
(23:42):
I don't know if there's any coachor sport med doctor out there who's
trying to harm their athletes, butbecause there's so much of this
rhetoric around lighter is faster.
Body based aesthetic sports, andespecially when it comes to female
identifying individuals and thosewho are competing in those spaces.
Again, we don't have adequateresearch on female athletes, but
(24:03):
there's a big disservice therewithout realizing that there's going
to be a big gap through puberty.
We need to have more body fat.
On us, we need to, in order forour hormones to function and work,
there's also going to be a changein how we're relating to our bodies
during that time, not only because ofbody change, but also coordination.
And so I think it's really important forcoaches who are coaches of teenagers to
(24:26):
really just encourage them to continueto eat, to nourish their bodies, to
find rest and know that there maybe a slight decline in performance
around puberty, but if we can stayhealthy through that time period.
There is going to be a long shot of acareer in athletics and sport, and we
need to look at, it's not just aboutwhat are the effects right now, but what
(24:47):
are the long term effects and where doyou want to be when you're 60, 70, 80?
I think that's a more important thing.
Sharon Tewksbury-Bloom (24:54):
I'm going to now pivot into talking about some of the
new tech that's coming out and some ofthe both real ready right now AI and new
tech as well as what we anticipate maycome in the future but these algorithms,
many of them are powered by AI or arebeing amplified by AI and so existing
(25:15):
issues of bias and existing issuesof how the algorithms are reinforcing
systems of oppression are thingsthat we can anticipate could be just
ramped up to 11 with the power of AI.
that's the one universal theme wesee so far in this first year of
AI going mainstream is that thingsthat were already possible via the
(25:40):
existing technology are just somuch faster, broader, happening.
at such a scale oncethey have AI behind them.
So that's something I want all of usto be thinking about and be really
intentional about is okay, if itwas an existing problem that we knew
about in current society or in currenttechnology, then we need to be paying
(26:05):
close attention to how that's beingramped up now that AI is behind it.
Abby Chan (26:12):
Totally.
Yeah.
humans created AI and AI learns fromus and we are flawed individuals and
a lot of the research in general,we think of evidence based practice
in my world which is where it'sliterature and scientific research.
And while all of that is great andI am a firm believer of that, we
also need to understand the massiveresearch gap from a perspective of.
(26:38):
Actual evidence on females and whetherit be in the health space, or, financial
economic stability, all of those differentaspects, as well as anyone who is BIPOC,
like black, brown person of color as well.
So there's big research gapsthere, and that's what a lot
of is going to be based on.
(27:00):
And then, even when we start to thinkabout wearables and a lot of the data
that they're pulling into the equation.
Two wearables if you haveblack or brown skin are going
to be less effective and less.
let me back up wearables.
If you have black or brown skin aregoing to be less accurate and pull less
(27:21):
effective data because of the different.
I don't even know how to say that.
I guess it's like the wavelengths of them.
Sharon Tewksbury-Bloom: Yeah, the existing, (27:30):
undefined
Abby Chan (27:32):
that and go again.
Sharon Tewksbury-Bloom (27:33):
what I've heard and seen through, my own
research is that there's been lots ofexamples of when people tried to do
facial recognition or anything whereputting your face on camera was what
enabled you to use the technology.
Those had been developed withwhite skin as the default.
(27:54):
And when they were trying to use them,particularly with people with particularly
dark complexions then they often didn'tpick up features or they, they were
no longer accurate because they hadn'tbeen programmed with that in mind.
And I think that, especially as youstart using, I've seen a lot of use
cases put out there about using AIthat's in a phone app, for example,
(28:20):
for, telehealth and things where it willactually make certain assessments, like
I'm reading the book Girl Decoded rightnow, and she's the inventor of emotion
AI and how to read facial expressions.
And they were using that fordiagnosing Parkinson's and doing
(28:42):
early diagnostics on Parkinson'sbecause apparently your ability to
make a genuine smile is affected.
By Parkinson's and it's actuallysomething that a camera could pick up
on earlier than other diagnostic tools.
But if to the point we started with, ifthe tools were built with white faces
(29:05):
only, or if that was the dominant waythey were programmed, then that could
make a huge gap in terms of who couldbenefit from a technology like that.
Abby Chan (29:17):
Yeah, totally.
And I think there's so much inthat as well of just medical bias.
from facial recognition from skin tone,when you look at dermatology, we don't
have for the longest time, black andbrown bodies weren't even included
in how to diagnose skin conditions.
When we look at lab values, there'ssometimes different reference
(29:38):
values without looking underneathand asking the question of why are
there different reference ranges?
And it's.
When we boil it all the way back, it'sdue to, trauma intergenerational trauma,
and how that impacts our body and ournervous systems and our physiology.
Sharon Tewksbury-Bloom (29:54):
And I know one of those diagnostic tools that has
been, debunked, if you will, is BMI.
Is that correct?
And can you give, cause I feel likethat's one that I still hear a lot
of people be like, you just need topay attention to your BMI and could
you maybe give us some backgroundon that as an example of one that
(30:19):
has a problematic history and is.
Also still prevalent throughoutthe medical establishment.
Abby Chan (30:28):
Totally.
So the BMI equation was originallycreated in the 1800s by a
Dutch astronomer, physicist.
He had a bunch of differenttitles at that time.
And it was to look at his specificpopulation and to try to draw some
conclusions or see if there are anycorrelations between height and weight.
(30:48):
And if that mattered, he specificallysaid that it shouldn't be used
for an individual health marker.
ran it, the researcher Ansel Keyspicked it up in the 20th century and
popularized it and renamed it theBMI, the body mass index, because
before it was the Quetelet equation.
And so it's basically to look atwhat is the average and then start
(31:11):
to define how those deviations awayfrom the average impacted your health.
He also stated that itwas not a great measure.
For health or a great measurefor adiposity meaning body fat
percentage, things like that, musclemass, any thing in that realm.
But he still can, he stillcontinued to use it in a research
(31:34):
study, which then really.
Bracket launched it intothe use of what it is today.
It was then picked up by the insurancecompanies again to quickly assess
someone's health status so that theycould quickly give them a price for what
their health insurance plan would be.
And then the issue with it is,because again, this original
(31:55):
equation was used on white males.
It has now been amplified to be used for.
All bodies, female, black, brown,indigenous, all bodies that were never,
ever a part of this original equation.
And so I think that's what ends uphappening is that again, we come up
with this equation, or maybe we comeup with this standard in research and
not ask, why is that the standard?
(32:17):
And who made it this standard?
It was then in last year of 2023in June, the American Medical
Association they stated that BMI.
Okay.
Is not significantly correlatedwith health and that it leaves a
large population out and starts andreinforces weight stigma and anti fat
(32:37):
bias, and it should not be used asa sole criterion for any diagnosis.
Sharon Tewksbury-Bloom (32:43):
Yeah, and I've personally had many experiences
in the medical system where BMIwas used to tell me that I was
overweight or at times obese.
I have been an athletesince I was small child.
And I had a higher amount ofmuscle mass at a lot of times.
And we know that's one way inwhich the BMI quickly gets skewed.
(33:05):
Of course, I'm also a woman, havedifferent body type than the male type
that was used to create the indicator.
So lots of reasons why thisprobably wasn't a great way
to assess my overall health.
But it was used as often the solecriteria to assess my overall health and
it wasn't, it was honestly, I acceptedthat as fact and it was put into my
(33:31):
own identity as because my BMI is X,I had saved the height weight charts
in my own notebooks and had acceptedthat this was a problem with me.
for years and years.
And then it wasn't until I was in my30s and became a bone marrow donor
(33:51):
and went through extensive medicaltesting in order to prove that I was
healthy enough to donate bone marrow.
I had, EKGs.
I had blood tests.
I had all these different tests doneand when a doctor said to me, you are
in perfect health and you are absolutelythe best candidate to donate bone
(34:12):
marrow to this man to save his life.
I was like, are you kidding me?
that's the first time a doctor has told meI'm in perfect health just the way I am.
And it was such a mind blowingexperience for me that I mean
it literally changed my life.
I was there to change someone else'slife, and yet my interaction with the
medical system in this totally differentway ended up changing my whole sense of
(34:36):
self and my whole way that I approachmy body and everything since then.
It's one, it's one finite example of whatwe're talking about, of data, the way data
gets skewed, the way biases in the medicalsystem, but it's also, has all these real
human stories that come out of it as wellin the way that affects people's lives.
Abby Chan (34:58):
Yeah, and I think thanks for sharing that.
And I think it is so prevalent thatso many people base their health
on that, because that's what thesepeople in positions of power of.
medical providers, doctors, researchinstitutions are saying is the standard.
And anti fat bias and weight stigmawithin the medical and societal world
(35:20):
is real huge problems, especially whenit comes to our lived experiences.
And We often think of yes, the ways thatit deeply harms people who don't fit
into the societal thin white norm, butit also deeply harms people who maybe do
and especially from a health standpoint.
(35:40):
So there's metabolic syndrome, whicheveryone talks about, the quote,
unquote risks of being in a higher BMIcategory or being quote, unquote obese.
I don't ever use theword obese in real way.
So big air quotes there.
But, what ends up happening isthat metabolic syndrome is, insulin
resistance elevated cholesterol levels,all these different aspects, and it's
(36:01):
a collection of diagnostic criteria.
And what happens is that peoplewho are actually in a normal weight
category die at much higher rateswith metabolic syndrome than those
who exist in a higher weight category.
And those because 1,they're often not screened.
because their doctors saythey're like, Oh, great.
You're in a normal BMI category.
Cool.
(36:21):
Oh, it's just a little bitof high blood pressure.
It's just a little bitof high cholesterol.
We don't really need to worry about itbecause you're not fitting this picture
of what we think is quote unquotedangerous when in reality, those are
the individuals who are dying at muchhigher rates and have much higher risks.
Sharon Tewksbury-Bloom (36:36):
That is really important to bring up.
Thank you for doing that.
So I want to.
Take this now into the new opportunitiesand the new risks and challenges with
evolving technology, including AI.
First, since we're on it,do you have any ideas?
Has anything come to your mind interms of addressing what we were just
(36:59):
talking about of The medical bias, theanti fat bias the lack of real data
for BIPOC people in, in these studies,anything related to that where AI or
new tech could help the situation.
Abby Chan (37:17):
I think in some ways AI can be an aspect.
ways let's even back up and thinkabout ways that we're currently seeing.
AI in health and nutritionis through meal plans, right?
So you can pop on chat GBT and belike, here's what I have in my fridge.
Make me a meal plan.
And it's great at that.
(37:38):
It's awesome at that.
I think it can save people money.
It can save people from throwingfood away, which is one of the.
Hugest costs of in ourfood system in general.
So I think that's areally great use of it.
A lot of times people then go onfor specific nutrition information.
And that's where I think thewheels start to fall off.
I did a article or was interviewedfor an article on this breathalyzer
(38:01):
app called I think it's calledblue me and, it's an expensive.
device that you have to buy, and thenyou have to pay for a membership,
and then it gives you quote unquoteindividualized nutrition recommendations,
when in reality it's just a fancierversion of a low calorie, low
carbohydrate diet that you could easilyfind for free on Instagram, and that
(38:26):
brings in a lot of issues as well.
Sharon Tewksbury-Bloom (38:28):
Yeah.
One thing that I think is universal thatI'm noticing is if you know how to wield
it, chat GPT and other tools like it can.
greatly increaseaccessibility to expertise.
if you can say in your prompt, ChatGBT,please act like a registered dietitian.
(38:51):
here's the context, here's what I'mdealing with, and I'm looking for
a meal plan that hits these notes.
Then it can do an amazing job.
of pulling from all the knowledge that'salready available on the internet.
And you can ask it things like, pleasecite your sources and provide those
references at the bottom of the meal plan.
(39:12):
So that you can do your checksand balances of being able to
go in and say, okay, why is ittelling me to increase my protein?
Or why is it telling me toavoid this particular I don't
even know the right word.
like, why is it telling me toavoid grapefruit, for example?
maybe it's because you're on statins.
And so it is actually doingit for a great reason.
But you don't, you're not the expert,so you don't know why it's doing that.
(39:34):
If it's just being weirdand you're like, it's buggy.
It's telling me not to grapefruit.
Why would I not do that?
Or if it's because it's actually reallygreat at pulling this information.
So I think.
What I would love to do is help peopleunderstand how to use the tools well,
how to be able to check for the validity.
(39:54):
And this kind of goes to our existingproblem of not knowing what sources
to trust, not being able to getreliable, trustworthy information.
And so it's an existing problem that'sprobably going to be amplified by.
access to even more informationby way of ChatGPTNAI.
Abby Chan (40:14):
Yeah, and I think a lot of times, because the questions that people
are asking, because we're still in thisspace where For no matter what medical
condition or whatever is ailing you, theanswer is always weight loss where that's
Not an answer, not a helpful answer, andreally not going to lead to actual health.
But those are the questions that peopleare going to be asking CHAT GPT, right?
(40:37):
How do I go into a calorie deficit?
What a calorie restriction look like?
And it even pulls up, calculateyour BMR, calculate So your basal
metabolic rate, calculate yourtotal daily and energy expenditure.
Again, those baseline calculationsare also based on white males.
So we need to remember that.
And then it also tells us, to go into acaloric deficit of X amount of calories.
(41:02):
And those calorie drops can bepretty significant depending
on where someone's at.
And from my world, What these can't door aren't doing at this moment is also
screening for eating disorders, right?
They're not screening for what is yourrelationship to food and that's where
a I don't think we'll ever be ableto take the place Of an actual human
(41:23):
interaction to look at all the nuancesthroughout your entire Lived experience
of what was your relationship to food?
what was your food security?
What was your caregiversrelationship to food?
what did your coach tell youone day when you were 17 that?
led you down this certain path.
And so I think the AIisn't able to do that.
And I think that is what makes myclinical work as a dietician so
(41:45):
specific and so important, becausewe can pull in all of those different
aspects and really start to look at.
How is this currently impactingyour relationship to food, body and
movement here and now instead of justsaying, Oh, here's how many calories
you should decrease in your day.
Here's a appropriate amountof weight loss per week.
(42:06):
And then a lot of just the basic,I call it really tired, boring
nutrition 90s where it's like, eatnutrient dense foods, watch your
portion sizes, move, stay hydrated.
We all know what we should be doing.
So we don't need more facts.
We need to understand why are we doingthose things and how can we start to
bridge the gap and maybe change some ofour behaviors so we can learn more about
(42:27):
ourselves so that we can then carry onfuture behaviors and make change there.
But I think it has to beindividualized to an extent.
I think that AI and chat GBT and even likeGoogle AI things, all of that fascinating.
If you're like, Hey, whatdrug interactions are
there with this medication?
what do I need to learn about?
(42:47):
What do I need to know?
But it's always going back to, ifwe're thinking really big at, how
do I fix my relationship with food?
Why do I keep eating?
Why do I feel like I keep binging?
we're not at a point to where.
AI is going to be ableto answer that for us.
Sharon Tewksbury-Bloom (43:02):
Awesome.
─thank you so much for being willingto talk with me about your amazing
expertise, but also our just questioningof how new tech is going to be
entering these spaces and affectingyour work and all of our lives.
So I'm so grateful.
Thank you.
Abby Chan (43:24):
Yeah, you're welcome.
Thank you for having me.
Sharon Tewksbury-Bloom (43:26):
And how can people find out more
about what you do and if they.
do you work with people only inFlagstaff or can people work with
you if they don't live in Flagstaff?
Abby Chan (43:37):
Yes, I do work virtually.
You can find me at, I'm theco-owner of Evolve Flagstaff,
so you can find me@evolvelg.com.
And you can also find me acrossall socials at Abby, the rd.
It looks like Abby, the nerd when youspell it out, so I kinda love that.
But it's Abby, the rd Instagram,TikTok and Threads X, formerly
(44:00):
known as Twitter, whatever.
I have various amounts ofactivity on all those spaces,
but most active on Instagram.
Sharon Tewksbury-Bloom (44:05):
You also have a few very old YouTube videos
that I still go back and watch, whichare from the main Evolve channel,
where you give us the mobility flows.
So I do those mobility flowson a regular basis and I just
search for you and find them.
Abby Chan (44:22):
Love it.
Yes.
Oh, and I just started teaching yogaat Evolve, so you can come and mobility
flow with me live if you want to.
Sharon Tewksbury-Bloom (44:29):
nice, awesome.
Brian AI (44:31):
Thank you for joining us on this episode of AI for
Helpers and Changemakers.
For the show notes and moreinformation about working with
Sharon, visit bloomfacilitation.
com.
If you have a suggestion for whowe should interview, email us
at hello at bloomfacilitation.
com.
And finally, please share thisepisode with someone you think
would find it interesting.
(44:52):
Word of mouth is our best marketing.
/Are you not sure how to feel about the way AI is suddenly everywhere?
AI for Helpers and Changemakers isa show for people who want to do
good work and help other people.
Whether you're already using AItools and loving it, or you are
pretty sure that ChatGPT is thefirst sign of our downfall, we want
you to listen in and learn with us.
(00:26):
Your host on this journeyis Sharon Tewksbury Bloom.
For 20 years, she's workedwith helpers and changemakers.
She believes that we're about to seethe biggest changes in our work lives
since the Internet went mainstream.
We're in this together.
Join us as Sharon interviews peoplein different helping professions,
navigate what these new technologiesare doing to and for their work./
Sharon Tewksbury-Bloom (00:48):
/I'm your host Sharon Tewksbury Bloom.
My guest for today is Abby Chan.
Abby is a dietician and she is a coowner with her partner Brian of a company
called Evolve here in Flagstaff, Arizona.
With Brian being a physical therapistand Abby being a dietician and a
chef, Evolve is perfectly suited totake a holistic approach to health.
(01:11):
And they offer a range of services tohelp people either addressing health
issues or who are athletes tryingto build strength or just anyone
who's trying to get or stay healthy.
we don't go as fully in depth inAbby's views on health promotion
and being against diet culture,but she has some amazing resources.
(01:31):
She's written a lot about health onher website, as well as sharing tips
and strategies on their Instagram.
I have linked to those resourcesas well as everything else that
we mentioned in the show notes.
I hope you enjoy myconversation with Abby.
one of the thoughts that inspiredthis whole project for me was this
(01:53):
idea that we're running out of time tofigure out what it means to be human.
And I think that we often discountwhat that core humanity is that we
bring to this particular problem.
And it's something I admire in you isthat you're trying to get to the core
of Our human relationship with food,our relationship with community and
(02:13):
culture and each other and how all ofthat, you know, if someone comes into
your office and says, I want to loseweight, you're not going to take that
at that question and give them a plan.
You're going to dig into Them as ahuman in the world and how they're
making sense of themselves andinteracting with others and bring your
(02:35):
story into it and the whole thing.
And so I think that's whereyou're adding so much value
with your humanity to it that.
The AI cannot do, but I think it'simportant that we, as people trying to
do good in the world, reflect on howwe're doing that, how we're bringing our
(02:57):
humanness to it, because if we're justdoing what The computer can do, then
we're really not doing our best work.
We're not bringing our most value.
We should just leave that to chat GPT, butwe have to see like, how are we bringing
those unique human qualities to it?
Abby Chan (03:15):
Yeah.
And I think that's the most profoundaspect of any work that anyone does,
whether that be in business, inleadership, in medical care, in being a
caregiver or a parent, it's so much of.
Instead of what are we doing?
(03:35):
It's how are we actually taking amoment to pause and be and reflect not
only within ourselves, but be able toreflect and communicate effectively with
others and truly listen, because that'sagain, what all these things can't do.
They can't listen to us.
They can't listen to us, but they can'tnecessarily really take that information
in and again, boil it all down into.
(03:58):
Oh, okay.
I can see that this is reallyhard for you right now, and let's
talk about this so this maybefeels a little less hard for you.
Sharon Tewksbury-Bloom (04:08):
/Okay.
I want to make sure we also talkabout smart devices, consumer
tech that's coming into the space.
Cause I know I mentioned that I had heardabout a product that I think was unveiled
at the, big convention in Las Vegaswhere they had a tray that could measure
the calorie content in the food on it.
(04:30):
And it could also measure aftersomeone had eaten some of that
food to see the difference.
So certainly that raisedalarm bells in my brain.
But I'm curious what you've beenseeing out there in terms of actual
products and wearables and thingsthat are in your space and Where
(04:50):
your head is at on those items.
Abby Chan (04:55):
Yeah, there's a lot of tech out there.
There's a lot of options.
We could spend so much money and so muchtime diving into all of these things.
And, It first comes down to lookingat, and even when it comes to
health in general, and lookingat, let's say labs, for example,
right, they are a snapshot in time.
So we don't want to base someone'shealth on just one lab job.
(05:19):
We want to look at, what are thetrends, what's the difference?
And I think that's a beautiful thingabout tech is that it can give us trends
and it can give us aspects of, are wemaybe going in the right direction?
But they could also be anywhere from, 25to 90 percent inaccurate, depending on
the device, depending on how old it is,depending on the sensors in it, depending
(05:40):
on what data it's been compiling.
I've actually been doing my own personal.
Research on myself where I've actuallyworn 2 devices for the past month.
1 of them being a faceless 1 that itdoesn't have any numerical data on it.
And you have to use an app with it.
It's more focused on recovery basedthings and giving a little bit more data
(06:02):
there and compared to an Apple watch and.
One thing that I love about the one thatdoesn't have a face is that it doesn't
buzz at me and tell me that I need tomove or shame me into, you need to get
up now or have you closed your rings?
And there's a lot of ways youcan disable those things, but
it's actually really challenging.
I have to walk clients through often,how do we disable these notifications?
(06:24):
How do we decrease that amountfor you to close your quote
unquote rings and all of that?
And so I think they can bereally problematic because for
a lot of people, if you're more.
Let's say on the anxiety spectrum, maybeeven more in the obsessive realm of
things, numbers are something that once wesee them and hear them, they can live rent
(06:46):
free in our heads for a very long time.
So that could be your body weight.
That could be caloric amounts of food.
That could be how many calories you'regoing to burn during a certain exercise.
Like all of these numbers reallydon't tell us a lot about how do
we actually feel in our bodies.
if one of these devices tells meyou're totally recovered today and
(07:06):
you're doing great, but I'm like, Iam so sore and I am not moving today.
It's we need to look at listeninginto our bodies and maybe using this
as some other information as well.
But I think there's, yeah, so manyfitness devices out there depending
on where you wear them and howyou use them the accuracy will be
variable and also the Time and length.
(07:27):
So that's also an interesting aspectwhere buying into something and being
in the whole system of It costs money.
It costs money and it costs time And sothat's one of the things where we have
this data and we think it's so valuableand we base our lives around it But
then if it goes away, what do we do?
Oh, we have to listen to our bodies.
(07:47):
Oh my gosh That's so hard.
So I think there's some things there.
And even from the plate aspect theexample that you gave, from a one on one
individual level, from a consumer level,I don't think it's very helpful and great.
I think that could end up againsaying, here's the calories
amount that you started with.
(08:08):
Here's where you, whatyou should be eating.
Oh, you ate too much.
And then inherentlysomething's going to feel.
Bad, guilty, shameful, but from myclinical perspective, as someone who
works with eating disorders a lot, Idon't like to use a lot of serving sizes.
I don't like to give out a lot ofmeal plans or exchanges or a lot
of really strict things becausewe're, I'm telling people that we.
(08:28):
don't want to count as much and we don'twant to rely on these numbers as much.
So that could actually be a reallyinteresting tool from a provider
standpoint for the provider to have thedata to where someone doesn't have to
measure and weigh things, but maybe theprovider can get the data on the back end
and see, oh, how are we actually doing?
So I think.
It's all going to dependon, how are we using this?
(08:49):
Are we using this from a place ofone metric and not the only metric?
Are we using it from a place thatis actually to improve our health?
And also, are we still able to listeninto our bodies and continuously ask
the question of why am I using this?
And why do I feel like I haveto continuously use these
(09:10):
things and not trust my body?
Sharon Tewksbury-Bloom (09:12):
Yeah, and I think about ways in which the technology
could be used to more adeptly fit intothe ways we want to interact with our
food and our friends and all of thatso for instance, when you were talking
about it could be useful to the providerwithout requiring, maybe someone who,
(09:34):
is dealing with an eating disorder theyneed to somehow report this data back to
their provider, but if they're the oneshaving to tally everything, that might
be just feeding into unhelpful, cycle.
I was thinking about how myhusband makes fun of me because I
am one of those millennials thattakes pictures of my food a lot.
Like I love a pretty plate.
(09:56):
And so I thought, Oh, if I was workingwith a dietician, it would be helpful
if I could take a picture, which toeveryone around me would look like
just my normal behavior of I'm justthat kind of person who always loves
to take a picture of their food.
But then maybe it's, I can tag itand it automatically goes to an
app for the provider who can justcheck on it when they need to.
(10:20):
And it allows me to more easilyintegrate in those social settings.
cause one thing I've appreciatedwhen you're talking about.
People trying to make a change to theirfood is that so many people when they
make a change like going on a diet,it disconnects them from culture and
from community because they're like,Oh, no, I can't eat that thing you
(10:43):
made for me, or I can't come out todinner with my friends because there's
nothing there that fits in my diet.
Or, I.
Or I have to write down everything,and it's like this very public,
awkward thing of Oh, I gotta checkmy app before I eat that thing.
So I think ways to allow people tostill maybe get the support they need
(11:04):
from the qualified provider, but alsobe more seamlessly in their day to
day without being taken out of thoseimportant moments could be great.
Abby Chan (11:15):
Yeah, I think it's great.
And I am very much in the placewhere I don't love tracking things.
And I don't love, I don'tlove tracking workouts.
I don't love tracking food.
I will every now and again, if dependingon my training load and depending what
I'm doing, and this will also be somethingI use sometimes with my clients is where
I will track maybe one day, and I willgo in knowing that I will track it.
(11:40):
As appropriately as possible becauseoftentimes when we are tracking things,
we will typically, be quote unquote good.
And so I will try totrack it as as possible.
And that gets to be again, onething that says, Hey, okay, cool.
You're doing like, you'reat least eating enough.
I think that's where aspectsthat can be really helpful for,
(12:01):
but we need to remember that.
A, we are not machines.
Our body does not metabolize every singlecalorie and nutrient that we take in.
And it can be a helpful baselineas long as it's not something
that again, consumes our life.
So for some people I'm like, cool,maybe let's just, I can, based
on what you told me, I can gothrough and I will run that through
sometimes so that they don't have to.
And then that can help mebase some recommendations of
(12:24):
we're in a pretty good spot.
Or Ooh, we're in a big deficit here.
And I can typically with just myclinical hat, I can make pretty good
guesstimates of what we're missing.
But I think it can be areally great thing to do.
Maybe it's depending on yourrelationship with food, depending
on your relationship with dieting.
And if you know that you get reallyobsessive, that's probably not for you.
(12:46):
But for some people, especially fora lot of my athletes that I work
with, I do need to know that they areeating enough and I do need to know
what nutrients they may be missing.
But we need to come from thatfrom a very neutral standpoint.
And also knowing that is not everythingand these numbers can be skewed and that
our bodies are not going to need thesame thing every day, which is where a
(13:06):
lot of the calorie amounts come from.
people get stuck with this certain numberin their head of, I can't go over this.
And it's That's not true.
Some days our bodies need more.
Some days our bodies need less.
It totally depends.
And that's where we can use some of thedata to make sure there is enough, but
then also continuously listening to ourphysiological, mental, and emotional
cues of, hey, what do I need right now?/
Sharon Tewksbury-Bloom (13:29):
Awesome.
Anything else that you wanted toshare in terms of what you've seen
in your field with how AI is beingused or has been proposed to be
used that we didn't touch on yet?
Abby Chan (13:47):
Yeah, so there's a lot of aspects right now around personalized
nutrition, which is really thoughtof as more genetic based testing.
And I think it's really cool.
We can look at how our genetics willimpact our nutrient absorption, how it
could put us at a higher risk for certain.
Chronic health diseases, cardiacdisease or diabetes or, dementia there's
(14:12):
so many different genetic factors,but we are still learning about how
those genes interact with each other.
So we right now have data where it'sokay, we know these 2 things are
correlated, but I like to think of.
hormones and our genesas a symphony, right?
So it's not just, Oh, that one's off.
it's going to have a cascadeeffect for the rest of our body.
(14:35):
So we are not yet at the place where wecan totally use our genetics to base.
All of our nutrition information and wecan use them as one tool as well as labs
and other tests and how you feel andyour relationship to food and all these
different aspects to really pull in whatwould be appropriate for one individual.
But there's a lot of things right nowwhere it's get your genetic test done
(14:56):
to see if you have celiac disease.
It's just because you have certain genesthat may correlate, that doesn't mean
that you have an issue with gluten.
Or just because you have certain genesthat are coding for what else could it be?
Oh, certain genes that are coding forsome nutrient deficiencies doesn't
inherently mean you have those, butthere are some that we know of, hey,
if you have this genetic factor, we'rejust going to supplement with that
(15:20):
because we might as well, becauseit's a very low cost intervention.
Sharon Tewksbury-Bloom (15:23):
Yeah, and it does seem like there's a lot
of potential in the future forpersonalization And greater accessibility,
like accessibility to expertise.
But I think We're going to be ina messy middle for quite a while
where there's a lot of noise.
There's a lot of experimentation going on.
(15:45):
There's a lot of not fully testedproducts out there on the market.
Everyone's in a tech race right now.
So I think there's a lot beingunveiled and being announced
that is being hurried to market.
And it's a particularly fraught timefor things that could have a big impact.
And hopefully it doesn't take toolong until some of that shuffles out
(16:06):
and we start to see where the realopportunities are and not just the noise.
Abby Chan (16:13):
Yes, definitely.
And I think that's so much whatwe can use lived experience and
we can use research and we can usedata and compile all of that to see
how does this actually impact us.
But with those stories and livedexperience, there's so much where it's it
worked for me and it's Okay, that's great.
I am not you.
And so even when we look back at thebig popularization of the paleo diet
(16:37):
and one of the individuals who wasreally responsible for bringing it
forth, later he got his genetics testdone and I don't know what test it was
but it showed that he was actually.
Based on this test, we could alsolook at what are other tests saying,
but based on this test was betterat Processing and digesting fats and
proteins and did really well on it.
(16:58):
okay, great for this one individual youdid really well in this diet But now it
is so popularized and people believe thisas gospel as this is the only one true
way that you can be healthy And that youcan perform and it's like We again need
to always, when we're looking at nutritionrecommendations, health recommendations,
exercise, all of that, we need to, yes,take some of these stories and say, okay,
(17:21):
how can we utilize this, but also zoomout in a much bigger way and see what's
actually going on in a big picture.
What's their access to food?
What's their financial privilege?
What's their time and availability?
And we need to look at all these differentfactors of how can this apply to me?
Sharon Tewksbury-Bloom (17:38):
Awesome.
Okay.
I think this is going to besuper helpful and valuable.
Abby Chan (17:44):
This is tangential, but if you heard of the guy
who's trying to live forever,
Sharon Tewksbury-Bloom (17:49):
No.
I've heard of people who are interestedin living for as long as possible, but,
Abby Chan (17:57):
he is you don't have to include this, but God, what is his name?
He's trying to basically reverse hisbiological clock and hack his own DNA.
And he, like his supplement regimenis, but granted, okay, so he's
like tech dude, retired early.
Sharon Tewksbury-Bloom (18:13):
This the four, four hour work week guy or no?
Abby Chan (18:17):
No, it's not
Sharon Tewksbury-Bloom (18:18):
I was like, cause I know he's into a
lot of bio hacking stuff, but
Abby Chan (18:24):
now.
I want to look him up for youbecause it is fascinating He
is His name is Brian Johnson.
He's a multimillionaire millionaire dude.
I think he, his supplementregimen is insane.
I don't remember howmany capsules he takes.
It's 70 or something, and he works outand eats this really weird, obviously
(18:45):
weird diet apparently has no relationshipwith food and is fine with it.
But real problematic.
Yeah.
But thinking of the dangers ofdieting and eating disorders first and
foremost, we need to look at eatingdisorders and again, look at the data
and who's screened and who is actuallybeing cared for in these spaces.
(19:10):
So first and foremost, we always thinkof these as a thin white female disease.
That is not true because we havenot been screening people who
exist in black bodies, fat bodies,disabled bodies for the longest time.
So now we have a diagnosis that iscalled atypical anorexia, where you
don't meet the BMI criteria, butyou meet all the other criteria.
(19:30):
And that is a vast amount of individuals.
And so many times, it makes sense froma biological standpoint that if you're
trying to reduce calories to a veryminimal amount to lose weight, your body
is actually going to do the oppositebecause our bodies are made to survive.
And so you can exist in ahigher weight body and still
(19:52):
have anorexia and still have.
a variety of eating disorders.
And eating disorders are thesecond deadliest mental health
disease in the country, coming upright behind opioid use disorders.
And dieting puts you at a 18times higher risk of developing
an eating disorder compared tosomeone who's never dieted before.
It is the highest correlative riskfactor in Anything else as opposed
(20:17):
to genetics or some or say, it'ssomeone a coach who really encourages
it or encourages restriction.
It's like, dieting is going to bethe number 1 core leader between it.
And so what that ends up happening whenwe think about weight, even being a marker
of health, quote, unquote what will end uphappening is when we actually boil down.
(20:39):
All of the data and all the research,we can actually parse it out to
showing that it's actually the weightcycling that has the negative health
effects of quote unquote obesity.
So weight cycling as in yo dietingwill put you at a higher risk of
cardiovascular disease, type 2diabetes, and early mortality.
And what we end updoing is we then end up.
(21:01):
Blaming the individual who couldn'tquote unquote, lose the weight
who couldn't change their bodies.
Because again, our bodiesare made to survive.
So congratulations.
Your body's just reallygreat at being human.
And we can look at all ofthat in the broader spectrum.
And for people who do exist in higherweight bodies, they actually have.
outside of the metabolic syndromethat we talked about earlier.
(21:23):
Outside of that, they have lowermortality rates as they age.
They are going to be more protectedfrom a health standpoint because they
have a little bit more adipose tissue.
They may have more muscle massand bone density on their bodies.
And that's actually a veryhealth protective thing.
Sharon Tewksbury-Bloom (21:39):
I was talking to a friend about how much I wish I knew more
about this when I was a college athleteplaying rugby in college, because that is
probably the worst time in my life whereI went on a very restrictive diet and I
know my coach was mad at me and I wishthat she had gotten through to all of
us about why that was the exact oppositething we should have been doing as we
(22:03):
were trying to grow muscle mass and be.
Strong athletes.
So I was talking to a friend about thisand she mentioned that she has a teenage
daughter who's an athlete and how she hadfallen into the peer pressure to get into
the dieting as well, and immediately inthat season of her sport, she had ended
up developing some stress fractures, andluckily, her mom got through to her about
(22:28):
how this dieting had probably playeda role in her not being able to do the
strength building without putting toomuch, Putting those stress fasciitis in,
so she's gotten her lesson hopefully earlyin life, but yeah, those risks that come
are severe, especially for, just the waywe live our lives and the way our bodies
(22:53):
actually need that fuel and that comfortand all the things that food brings us.
Abby Chan (23:00):
yeah, and that ends up going into there's a big diagnostic syndrome
called relative energy deficiency insport, and it's, we used to think of
the female athlete triad, which islow bone density, no menstrual cycle.
Often correlated with an eating disorder,but now it's a much bigger diagnostic
(23:21):
tool and criteria, which doesn'tonly include females, which is huge.
And I think now, because that hasreally just been more prevalent
in conversation in the past 3 to5 years, coaches right now are.
still trying to keep up with that, right?
So I think coaches haveeveryone's best interest in mind.
(23:42):
I don't know if there's any coachor sport med doctor out there who's
trying to harm their athletes, butbecause there's so much of this
rhetoric around lighter is faster.
Body based aesthetic sports, andespecially when it comes to female
identifying individuals and thosewho are competing in those spaces.
Again, we don't have adequateresearch on female athletes, but
(24:03):
there's a big disservice therewithout realizing that there's going
to be a big gap through puberty.
We need to have more body fat.
On us, we need to, in order forour hormones to function and work,
there's also going to be a changein how we're relating to our bodies
during that time, not only because ofbody change, but also coordination.
And so I think it's really important forcoaches who are coaches of teenagers to
(24:26):
really just encourage them to continueto eat, to nourish their bodies, to
find rest and know that there maybe a slight decline in performance
around puberty, but if we can stayhealthy through that time period.
There is going to be a long shot of acareer in athletics and sport, and we
need to look at, it's not just aboutwhat are the effects right now, but what
(24:47):
are the long term effects and where doyou want to be when you're 60, 70, 80?
I think that's a more important thing.
Sharon Tewksbury-Bloom (24:54):
I'm going to now pivot into talking about some of the
new tech that's coming out and some ofthe both real ready right now AI and new
tech as well as what we anticipate maycome in the future but these algorithms,
many of them are powered by AI or arebeing amplified by AI and so existing
(25:15):
issues of bias and existing issuesof how the algorithms are reinforcing
systems of oppression are thingsthat we can anticipate could be just
ramped up to 11 with the power of AI.
that's the one universal theme wesee so far in this first year of
AI going mainstream is that thingsthat were already possible via the
(25:40):
existing technology are just somuch faster, broader, happening.
at such a scale oncethey have AI behind them.
So that's something I want all of usto be thinking about and be really
intentional about is okay, if itwas an existing problem that we knew
about in current society or in currenttechnology, then we need to be paying
(26:05):
close attention to how that's beingramped up now that AI is behind it.
Abby Chan (26:12):
Totally.
Yeah.
humans created AI and AI learns fromus and we are flawed individuals and
a lot of the research in general,we think of evidence based practice
in my world which is where it'sliterature and scientific research.
And while all of that is great andI am a firm believer of that, we
also need to understand the massiveresearch gap from a perspective of.
(26:38):
Actual evidence on females and whetherit be in the health space, or, financial
economic stability, all of those differentaspects, as well as anyone who is BIPOC,
like black, brown person of color as well.
So there's big research gapsthere, and that's what a lot
of is going to be based on.
(27:00):
And then, even when we start to thinkabout wearables and a lot of the data
that they're pulling into the equation.
Two wearables if you haveblack or brown skin are going
to be less effective and less.
let me back up wearables.
If you have black or brown skin aregoing to be less accurate and pull less
(27:21):
effective data because of the different.
I don't even know how to say that.
I guess it's like the wavelengths of them.
Sharon Tewksbury-Bloom: Yeah, the existing, (27:30):
undefined
Abby Chan (27:32):
that and go again.
Sharon Tewksbury-Bloom (27:33):
what I've heard and seen through, my own
research is that there's been lots ofexamples of when people tried to do
facial recognition or anything whereputting your face on camera was what
enabled you to use the technology.
Those had been developed withwhite skin as the default.
(27:54):
And when they were trying to use them,particularly with people with particularly
dark complexions then they often didn'tpick up features or they, they were
no longer accurate because they hadn'tbeen programmed with that in mind.
And I think that, especially as youstart using, I've seen a lot of use
cases put out there about using AIthat's in a phone app, for example,
(28:20):
for, telehealth and things where it willactually make certain assessments, like
I'm reading the book Girl Decoded rightnow, and she's the inventor of emotion
AI and how to read facial expressions.
And they were using that fordiagnosing Parkinson's and doing
(28:42):
early diagnostics on Parkinson'sbecause apparently your ability to
make a genuine smile is affected.
By Parkinson's and it's actuallysomething that a camera could pick up
on earlier than other diagnostic tools.
But if to the point we started with, ifthe tools were built with white faces
(29:05):
only, or if that was the dominant waythey were programmed, then that could
make a huge gap in terms of who couldbenefit from a technology like that.
Abby Chan (29:17):
Yeah, totally.
And I think there's so much inthat as well of just medical bias.
from facial recognition from skin tone,when you look at dermatology, we don't
have for the longest time, black andbrown bodies weren't even included
in how to diagnose skin conditions.
When we look at lab values, there'ssometimes different reference
(29:38):
values without looking underneathand asking the question of why are
there different reference ranges?
And it's.
When we boil it all the way back, it'sdue to, trauma intergenerational trauma,
and how that impacts our body and ournervous systems and our physiology.
Sharon Tewksbury-Bloom (29:54):
And I know one of those diagnostic tools that has
been, debunked, if you will, is BMI.
Is that correct?
And can you give, cause I feel likethat's one that I still hear a lot
of people be like, you just need topay attention to your BMI and could
you maybe give us some backgroundon that as an example of one that
(30:19):
has a problematic history and is.
Also still prevalent throughoutthe medical establishment.
Abby Chan (30:28):
Totally.
So the BMI equation was originallycreated in the 1800s by a
Dutch astronomer, physicist.
He had a bunch of differenttitles at that time.
And it was to look at his specificpopulation and to try to draw some
conclusions or see if there are anycorrelations between height and weight.
(30:48):
And if that mattered, he specificallysaid that it shouldn't be used
for an individual health marker.
ran it, the researcher Ansel Keyspicked it up in the 20th century and
popularized it and renamed it theBMI, the body mass index, because
before it was the Quetelet equation.
And so it's basically to look atwhat is the average and then start
(31:11):
to define how those deviations awayfrom the average impacted your health.
He also stated that itwas not a great measure.
For health or a great measurefor adiposity meaning body fat
percentage, things like that, musclemass, any thing in that realm.
But he still can, he stillcontinued to use it in a research
(31:34):
study, which then really.
Bracket launched it intothe use of what it is today.
It was then picked up by the insurancecompanies again to quickly assess
someone's health status so that theycould quickly give them a price for what
their health insurance plan would be.
And then the issue with it is,because again, this original
(31:55):
equation was used on white males.
It has now been amplified to be used for.
All bodies, female, black, brown,indigenous, all bodies that were never,
ever a part of this original equation.
And so I think that's what ends uphappening is that again, we come up
with this equation, or maybe we comeup with this standard in research and
not ask, why is that the standard?
(32:17):
And who made it this standard?
It was then in last year of 2023in June, the American Medical
Association they stated that BMI.
Okay.
Is not significantly correlatedwith health and that it leaves a
large population out and starts andreinforces weight stigma and anti fat
(32:37):
bias, and it should not be used asa sole criterion for any diagnosis.
Sharon Tewksbury-Bloom (32:43):
Yeah, and I've personally had many experiences
in the medical system where BMIwas used to tell me that I was
overweight or at times obese.
I have been an athletesince I was small child.
And I had a higher amount ofmuscle mass at a lot of times.
And we know that's one way inwhich the BMI quickly gets skewed.
(33:05):
Of course, I'm also a woman, havedifferent body type than the male type
that was used to create the indicator.
So lots of reasons why thisprobably wasn't a great way
to assess my overall health.
But it was used as often the solecriteria to assess my overall health and
it wasn't, it was honestly, I acceptedthat as fact and it was put into my
(33:31):
own identity as because my BMI is X,I had saved the height weight charts
in my own notebooks and had acceptedthat this was a problem with me.
for years and years.
And then it wasn't until I was in my30s and became a bone marrow donor
(33:51):
and went through extensive medicaltesting in order to prove that I was
healthy enough to donate bone marrow.
I had, EKGs.
I had blood tests.
I had all these different tests doneand when a doctor said to me, you are
in perfect health and you are absolutelythe best candidate to donate bone
(34:12):
marrow to this man to save his life.
I was like, are you kidding me?
that's the first time a doctor has told meI'm in perfect health just the way I am.
And it was such a mind blowingexperience for me that I mean
it literally changed my life.
I was there to change someone else'slife, and yet my interaction with the
medical system in this totally differentway ended up changing my whole sense of
(34:36):
self and my whole way that I approachmy body and everything since then.
It's one, it's one finite example of whatwe're talking about, of data, the way data
gets skewed, the way biases in the medicalsystem, but it's also, has all these real
human stories that come out of it as wellin the way that affects people's lives.
Abby Chan (34:58):
Yeah, and I think thanks for sharing that.
And I think it is so prevalent thatso many people base their health
on that, because that's what thesepeople in positions of power of.
medical providers, doctors, researchinstitutions are saying is the standard.
And anti fat bias and weight stigmawithin the medical and societal world
(35:20):
is real huge problems, especially whenit comes to our lived experiences.
And We often think of yes, the ways thatit deeply harms people who don't fit
into the societal thin white norm, butit also deeply harms people who maybe do
and especially from a health standpoint.
(35:40):
So there's metabolic syndrome, whicheveryone talks about, the quote,
unquote risks of being in a higher BMIcategory or being quote, unquote obese.
I don't ever use theword obese in real way.
So big air quotes there.
But, what ends up happening isthat metabolic syndrome is, insulin
resistance elevated cholesterol levels,all these different aspects, and it's
(36:01):
a collection of diagnostic criteria.
And what happens is that peoplewho are actually in a normal weight
category die at much higher rateswith metabolic syndrome than those
who exist in a higher weight category.
And those because 1,they're often not screened.
because their doctors saythey're like, Oh, great.
You're in a normal BMI category.
Cool.
(36:21):
Oh, it's just a little bitof high blood pressure.
It's just a little bitof high cholesterol.
We don't really need to worry about itbecause you're not fitting this picture
of what we think is quote unquotedangerous when in reality, those are
the individuals who are dying at muchhigher rates and have much higher risks.
Sharon Tewksbury-Bloom (36:36):
That is really important to bring up.
Thank you for doing that.
So I want to.
Take this now into the new opportunitiesand the new risks and challenges with
evolving technology, including AI.
First, since we're on it,do you have any ideas?
Has anything come to your mind interms of addressing what we were just
(36:59):
talking about of The medical bias, theanti fat bias the lack of real data
for BIPOC people in, in these studies,anything related to that where AI or
new tech could help the situation.
Abby Chan (37:17):
I think in some ways AI can be an aspect.
ways let's even back up and thinkabout ways that we're currently seeing.
AI in health and nutritionis through meal plans, right?
So you can pop on chat GBT and belike, here's what I have in my fridge.
Make me a meal plan.
And it's great at that.
(37:38):
It's awesome at that.
I think it can save people money.
It can save people from throwingfood away, which is one of the.
Hugest costs of in ourfood system in general.
So I think that's areally great use of it.
A lot of times people then go onfor specific nutrition information.
And that's where I think thewheels start to fall off.
I did a article or was interviewedfor an article on this breathalyzer
(38:01):
app called I think it's calledblue me and, it's an expensive.
device that you have to buy, and thenyou have to pay for a membership,
and then it gives you quote unquoteindividualized nutrition recommendations,
when in reality it's just a fancierversion of a low calorie, low
carbohydrate diet that you could easilyfind for free on Instagram, and that
(38:26):
brings in a lot of issues as well.
Sharon Tewksbury-Bloom (38:28):
Yeah.
One thing that I think is universal thatI'm noticing is if you know how to wield
it, chat GPT and other tools like it can.
greatly increaseaccessibility to expertise.
if you can say in your prompt, ChatGBT,please act like a registered dietitian.
(38:51):
here's the context, here's what I'mdealing with, and I'm looking for
a meal plan that hits these notes.
Then it can do an amazing job.
of pulling from all the knowledge that'salready available on the internet.
And you can ask it things like, pleasecite your sources and provide those
references at the bottom of the meal plan.
(39:12):
So that you can do your checksand balances of being able to
go in and say, okay, why is ittelling me to increase my protein?
Or why is it telling me toavoid this particular I don't
even know the right word.
like, why is it telling me toavoid grapefruit, for example?
maybe it's because you're on statins.
And so it is actually doingit for a great reason.
But you don't, you're not the expert,so you don't know why it's doing that.
(39:34):
If it's just being weirdand you're like, it's buggy.
It's telling me not to grapefruit.
Why would I not do that?
Or if it's because it's actually reallygreat at pulling this information.
So I think.
What I would love to do is help peopleunderstand how to use the tools well,
how to be able to check for the validity.
(39:54):
And this kind of goes to our existingproblem of not knowing what sources
to trust, not being able to getreliable, trustworthy information.
And so it's an existing problem that'sprobably going to be amplified by.
access to even more informationby way of ChatGPTNAI.
Abby Chan (40:14):
Yeah, and I think a lot of times, because the questions that people
are asking, because we're still in thisspace where For no matter what medical
condition or whatever is ailing you, theanswer is always weight loss where that's
Not an answer, not a helpful answer, andreally not going to lead to actual health.
But those are the questions that peopleare going to be asking CHAT GPT, right?
(40:37):
How do I go into a calorie deficit?
What a calorie restriction look like?
And it even pulls up, calculateyour BMR, calculate So your basal
metabolic rate, calculate yourtotal daily and energy expenditure.
Again, those baseline calculationsare also based on white males.
So we need to remember that.
And then it also tells us, to go into acaloric deficit of X amount of calories.
(41:02):
And those calorie drops can bepretty significant depending
on where someone's at.
And from my world, What these can't door aren't doing at this moment is also
screening for eating disorders, right?
They're not screening for what is yourrelationship to food and that's where
a I don't think we'll ever be ableto take the place Of an actual human
(41:23):
interaction to look at all the nuancesthroughout your entire Lived experience
of what was your relationship to food?
what was your food security?
What was your caregiversrelationship to food?
what did your coach tell youone day when you were 17 that?
led you down this certain path.
And so I think the AIisn't able to do that.
And I think that is what makes myclinical work as a dietician so
(41:45):
specific and so important, becausewe can pull in all of those different
aspects and really start to look at.
How is this currently impactingyour relationship to food, body and
movement here and now instead of justsaying, Oh, here's how many calories
you should decrease in your day.
Here's a appropriate amountof weight loss per week.
(42:06):
And then a lot of just the basic,I call it really tired, boring
nutrition 90s where it's like, eatnutrient dense foods, watch your
portion sizes, move, stay hydrated.
We all know what we should be doing.
So we don't need more facts.
We need to understand why are we doingthose things and how can we start to
bridge the gap and maybe change some ofour behaviors so we can learn more about
(42:27):
ourselves so that we can then carry onfuture behaviors and make change there.
But I think it has to beindividualized to an extent.
I think that AI and chat GBT and even likeGoogle AI things, all of that fascinating.
If you're like, Hey, whatdrug interactions are
there with this medication?
what do I need to learn about?
(42:47):
What do I need to know?
But it's always going back to, ifwe're thinking really big at, how
do I fix my relationship with food?
Why do I keep eating?
Why do I feel like I keep binging?
we're not at a point to where.
AI is going to be ableto answer that for us.
Sharon Tewksbury-Bloom (43:02):
Awesome.
─thank you so much for being willingto talk with me about your amazing
expertise, but also our just questioningof how new tech is going to be
entering these spaces and affectingyour work and all of our lives.
So I'm so grateful.
Thank you.
Abby Chan (43:24):
Yeah, you're welcome.
Thank you for having me.
Sharon Tewksbury-Bloom (43:26):
And how can people find out more
about what you do and if they.
do you work with people only inFlagstaff or can people work with
you if they don't live in Flagstaff?
Abby Chan (43:37):
Yes, I do work virtually.
You can find me at, I'm theco-owner of Evolve Flagstaff,
so you can find me@evolvelg.com.
And you can also find me acrossall socials at Abby, the rd.
It looks like Abby, the nerd when youspell it out, so I kinda love that.
But it's Abby, the rd Instagram,TikTok and Threads X, formerly
(44:00):
known as Twitter, whatever.
I have various amounts ofactivity on all those spaces,
but most active on Instagram.
Sharon Tewksbury-Bloom (44:05):
You also have a few very old YouTube videos
that I still go back and watch, whichare from the main Evolve channel,
where you give us the mobility flows.
So I do those mobility flowson a regular basis and I just
search for you and find them.
Abby Chan (44:22):
Love it.
Yes.
Oh, and I just started teaching yogaat Evolve, so you can come and mobility
flow with me live if you want to.
Sharon Tewksbury-Bloom (44:29):
nice, awesome.
Brian AI (44:31):
Thank you for joining us on this episode of AI for
Helpers and Changemakers.
For the show notes and moreinformation about working with
Sharon, visit bloomfacilitation.
com.
If you have a suggestion for whowe should interview, email us
at hello at bloomfacilitation.
com.
And finally, please share thisepisode with someone you think
would find it interesting.
(44:52):
Word of mouth is our best marketing.
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