Why is Nobody Talking About Social Determinants of Health? W/ Your Nutrition BFF

Jess Jones: Before we get into this week's episode, I have a new venture that I am so excited about. I've not been as excited about anything in a really long time, and I wanna quickly share it with you. So I have started a newsletter on, it is called Internet Elder, and you can find [email protected]. Basically, the newsletter is about how in a world obsessed with staying young, I wanna talk about getting older.

I am an internet elder. I am an elder millennial. I'm turning 40 this year, and I wanted a place to process and also connect with other geriatric millennials like me. I started internet elder as a platform where I could look back to look forward and share my reflections on everything from modern marriage to girl boss burnout and how my approach to all the things like food, money, friendships.

Style and decor has evolved over the decades. I'll also interview friends and older role models living unapologetically in their second chapters. So with a combination of personal anecdotes, practical advice, lessons learned, embarrassing throwbacks and recommendations. This is gonna be a community where we can celebrate our collective experience as the last analog generation, and also explore new ways to navigate this next half of our lives.

I'll be releasing new pieces of content every single week. So whether it's an article, I'm getting back to my journalism and writing roots, or a voice note or a video or a curated list of recommendations. There'll be something every week, and I think you're really gonna like it. So if this sounds like something you're into, head on over to internet elder.subs.com.

That's internet elder.sub.com. All right, let's get to the episode. Welcome back to another episode of the Food Heaven podcast. Today we are having a conversation with somebody that I've been dying to have on this podcast for a really long time. Her name is Clara Nasik and she runs the popular Instagram account.

Your nutrition B F F. Clara is an outpatient registered dietician by day and a content creator slash internet troll by night. This is her bio I'm reading, by the way. Her love language is memes and infographics, and she loves to listen to audiobooks at 1.2 Speed. We're gonna be chatting about social determinants of health, which is something I always see Clara post about on her Instagram account because she is very social justice oriented in the work that she does as a dietician.

For those of you who have not heard about social determinants of health before, you're not alone. That's why we're doing this podcast episode. But briefly, they are economic and social conditions that influence individual and group differences and health status. So a lot of times people like to blame the individual like, oh, you're not eating enough vegetables or, You should be exercising more without pulling back and realizing that we have these social determinants of health that really play a big role in our health status.

So we're gonna dive into that today with Clara. Some of the things we talk about are why these determinants of health matter when it comes to what we eat and how we live, how the healthcare system can fail us. She is an outpatient dietician, as I mentioned, so she's gonna share some of her stories and insights, working with patients directly and kind of what has been helpful and how she's able to incorporate information regarding the social determinants of health to the work that she's doing, and just her thoughts on how we can actually try to make.

Things better and promote health equity. We also get into culture and how that has a huge impact on how we view food and how she tries to make sure to consider cultural differences when working with clients. As a dietician, we get into healthy eating on a budget, how chronic stress and trauma can affect health in a lot of ways, and how we can prioritize our health without getting caught up in diet culture.

Clara also shares her favorite wellness practice that is absolutely free. This episode is full of a lot of gems, and if you're someone who has not heard about social determinants to help before, you definitely need to stay through this conversation, even if you had, it's a great conversation. Now, before we jump in, I want to read a listener review.

This one says, hesitant. Ooh, and it's from, I have everything I need and they write. While I've been having a hard time for the last few months, I've been pushing myself to get back into wellness and improve my mood, physical, mental, and emotional health. Overall, the task has felt daunting. However, listening to your podcast has helped me lean into the areas where I seek improvement in a way that feels real and far less intimidating.

Thank you. Food Heaven. And then they left a sunflower. I love that review so much and appreciate you for taking time out of what I know is a busy day and giving our podcast a chance because it sounds like as many people are just in general with podcasts, you are hesitant at first. I know there's so many pods and it's hard to know what's worth listening to, so we appreciate that you gave bars a chance and left that really kind review.

If you have not already, you know the drill, just head on over to iTunes or Spotify and leave us some stars. Drop a review. We will most likely read it on this podcast. The reviews are the highlight of our day and we read every single one of them, and it really helps to keep us going. Now, with that, let's jump into the episode.

So if people don't follow you on Instagram, they should, because in my mind, you are the meme queen, and I'm curious, where do you get the inspiration to create all these great nutrition memes? And does it come naturally to you or is it, I don't know. I just feel like you do such a good job at it.

Clara Nosek: My God, thank you.

It comes from my over consumption of television and social media. I am what some may call chronically online, so I am like always consuming content, which I'm trying actually. I'm really trying not to as much anymore or being more mindful of how I scroll. But I think that the communication part of it comes really from being a parent.

So I think about how I communicate things to my kids. Hmm. Like really complex cuz my daughter will ask me like the craziest questions and I really wanna honor her curiosity. And so I try to bring that same energy to my content because it's like, how can I explain this very complex thought. In a very concise, humorous way, so that way it will be more well received generally.

Cause sometimes it's, I get in little tiffs here and there. Yeah.

Jess Jones: Are like with the RD community or.

Clara Nosek: Yeah. RD community. Sometimes it's just people passing through. Okay. But if it is a thought that goes against current thought that you might have any biase you might have in place, anything that you currently know, having something question that can be jarring.

And so I'm not averse to being met with like resistance and like kind of having to walk someone through that thought process. And so, which is why I feel like I've really embraced infographics. Yeah, because it kind of is like a very easy, simplistic way, which is funny because like that is kind of how I see it in my brain before.

So like sometimes I'll like have an idea and I'll just like brain dump it this mess onto a piece of paper and then from there I can like take out what I need and like make a pretty graphic on Canva. Yeah.

Wendy Lopez: And put Real Housewives on it,

Clara Nosek: right? I think it's like little razel dazzle, little razel dazzle, little spice.

Wendy Lopez: I mean, yeah. Make it a little more

Clara Nosek: interesting. Make it relatable. Yeah.

Wendy Lopez: Yeah. That sounds like a great marketing tactic. And like you need to do all of our graphics. We need help in that department. So we're gonna talk about social determinants of health, which is a very complex. Topic. Mm-hmm. And I'm happy that we're bringing you on to talk about it because there's like a lot of nuance there and I don't even know that I fully understand social determinants of health.

So I think it would be good to start at like, what does that even mean and why does it matter when it comes to the food that we're

Clara Nosek: eating? Yeah. Okay. So social determinants of health. They're basically like all the things in your life that can affect your health. So like where you live, where you work, where you play, where you learn any of those things in conjunction with like your genetics and how that impacts your health outcomes.

So if say a person lives in a neighborhood without access to things like fresh fruits and vegetables, They might not have access to all the nutrients that their body might need. Yeah. I love

Jess Jones: that answer. Very straightforward. What about, okay, so with the healthcare system in general, I think a lot of times the healthcare system can fail us when it comes to social determinants of health because they make things so simple and one dimensional like.

You have diabetes, so therefore you need to cut out all these things and eat this and it's gonna be solved. Do you feel like the healthcare system contributes to inequalities when it comes to health outcomes? And how do you kind of see that play out as a dietician who works in in healthcare?

Clara Nosek: Yes. Okay.

So I think of it very much. Did you guys watch Clueless? Like the movie? Of course. Okay, so you know that line as if literally, so like the healthcare system in America is like a full on Monet, right from far away it looks good, but like up close. It's a big old myth, right? So a lot of those factors that are considered in social determinants of health that are outside of the medical system can negatively impact a person's health outcomes.

And then when you combine that with. The racism, the discrimination, the biases that are not checked within the healthcare system. It kind of compounds those inequities and makes it more difficult for people, specifically those in marginalized communities to have access to higher quality healthcare. And so like you get people who.

Either can't afford it, right? So like Bipo folks are most more likely to be uninsured or underinsured, which means they can't afford to get the healthcare that they need. And then when they do seek the care, when they're like, all right, fine, it's time to go. It's often met. With those biases, those unchecked internalized biases, racism, discrimination from the providers, which ultimately then will perpetuate that harm right then that they're like, I'm not gonna listen to this person.

They don't get me, they don't see me, they're not listening. What's the point of going? And so it kind of is just like this vicious cycle of like a state of unwell and. It's like so much more than just the healthcare system. So those communities are more likely to be food deserts or in food apartheid and where they don't have access to like fresh foods, fruits and vegetables, proteins like that are readily available.

For them. They're usually places that are in higher polluted areas. They might be unsafe in the, in terms of like just the area. They might not have areas for like sidewalks for walking, right? So a lot of the times you get this recommendation, right? The American Heart Association recommends 150 minutes of moderate activity daily or not daily, weekly.

How can you do that if where you live is unsafe? How can you do that? If you don't have access to parks to walk around, you don't have sidewalks to safely walk on the street. You don't live in an area that like feels safe enough to walk around in. And it's kind of like all these little things tend to build up and so it's working as it's supposed to.

I think a lot of Western medicine treats symptoms. And so if you think of medicine in that lens, then it's working because it's a lot of these are your symptoms. Let's treat that, no problem. But there's no real getting to the root issue of a lot of these health outcomes that we're seeing. Yeah, and I feel

Wendy Lopez: like food and exercise are usually at the forefront of the recommendations that are given.

It's like, eat all of this stuff, and it's like, yeah, these conversations about access are always overlooked. I'm wondering with social determinants of health, like what are some things that. You think should be considered that maybe a lot of healthcare providers, including dieticians might not look into that could impact our eating choices.

I know you mentioned food access being like a really big one where you live, poverty, things like that. But what are some other things that might be a little

Clara Nosek: more nuanced? I think that it would be really great to assess. Like make it part of the intake to assess history or current status of food insecurity.

Hmm. Right. So even if you're not currently facing food insecurity, if you had food insecurity as a child, if you faced it in early adulthood, like those adverse life effects events, yeah. Could have ripples, right, that you might not like consciously be aware of, but it could show up in the way that you choose to eat food.

And so a lot of the times you see healthcare professionals kind of with a sweeping recommendation to avoid all breads, rice, pastas, tortillas, any of those. Staple foods and it is in that recommendation that there is that triggering of restriction where there's not a physical restriction, but you'll still have that like mental thought, that anguish and feel kind of that same insecurity that was there before.

So I think like assessing for that is really important. Assessing for safe housing. Are you employed? Are you, do you have transportation? And I think they do that. Now, maybe, maybe not. But yeah, so I think doing those, so like I work in the health education department at my hospital and we have a long list of community resources, but I think a lot of other departments might not be aware of those.

And so I think it's really important for clinicians to kind of have. That connection with their local community to know like, where are the food banks? Where are the assistance programs? Where are the job training programs? Or at least know where to direct patients to. I also think that we should really start addressing health literacy as well as digital literacy.

So it might not necessarily have to be a healthcare issue. It might, right? Because everything is digital now. You have a lot of your doctor communications like from your phone, but like helping patients learn how to read all, like do they know how to read labels? Do they know how to build a meal? Do they know how to navigate healthcare systems?

We're all supposed to be keeping a cu up on ethics. Right as dieticians, I think including a required CU on patient-centered care, like at least trauma informed care is really important as well, because I think a lot of those. Life events really play a important role in the way that a person lives their life.

And so like if we are looking at a person and trying to provide them medical nutrition therapy, trying to provide them healthcare, we have to like really take a look at the whole person. Yeah. As opposed to just like the symptom that's like on the surface level. Right, and

Jess Jones: I feel like that's what usually happens is it's just the surface level symptoms or I think it's doctors making a lot of assumptions about people based on their biases or just stereotypes and not even really taking the time to understand, like you're saying, who this person is.

What is our health literacy. Digital literacy too, I think is so important. I, those are all really great tips. So let's take it more to a personal lens. So let's say somebody's listening or they have a family member who doesn't have food security, and maybe it's not easy to make nutrient dense food choices.

There are a lot of barriers in the way, like I said, not having access. What are some things that you recommend people get started with if they're feeling like access is the primary issue that's keeping them? From eating a more nutrient dense

Clara Nosek: diet. So I always like start with level one as like eating is something, something is always better than nothing.

And that's like literally like the hardest part, right? Because a lot of the times I. You're getting a lot of this food is toxic, this is poison, this is bad, this oth carbs are bad, fats are bad. Protein's bad for your heart. And like all of these conflicting messages, and then it's time to eat. And it's like, well, I don't know what to eat, so I'm, I'm not gonna eat anything.

And that is like, step one, something is always better than nothing. And then step two is what I like to, I'll call, I'll call it their besties. So your protein and your carbohydrate, those are the besties. And once we can get in the habit of like, breakfast is a protein and a carb, lunch is a protein and a carb dinner is a protein and carb, then I'm like, I'm like, okay, let's ramp it up.

Right? And then I kind of bring in like the plate method, and then that's when I really heavily, heavily, heavily emphasize the joys of convenience foods, frozen fruits and vegetables, canned fruits and vegetables. Dried grains, beans, PEs, legumes, all of those. So a lot of those are very budget friendly.

There's a, a question of whether or not there's a place to safely store them when we talk about like frozen or perishable goods in that capacity. But typically you can either do like a dried good or anything like that. So then that's when I kind of bring in, I love the plate method, so then I kind of do like, okay, can we get half a plate of vegetables?

Can we get a palm size serving of a protein and then another fist or a cupped hand of a carbohydrate? I'm like, and I don't, I don't really care what kind of carbohydrate is it is because like a lot of the times people come in, they're like, my doctor told me I can't have white rice anymore, but I don't like brown rice, so I'm just not gonna eat anything.

And it's like, so they've been eating nothing, right? They've been eating veggies and a protein, and they're like, I'm so tired all the time. And they're like, you know, I, I just drank coffee. And so then. It becomes like breakfast is coffee, lunch is a fart and a salad, and then dinner is the entire pantry.

And it's this vicious cycle of like, how can you undo that? So if you want to eat in a health promoting way, really working through. Knowing that eating something is better than nothing. Pairing your carbs and protein and then trying to use things like the plate method will be e. Very easy, sustainable, flexible ways to go about eating and really leaning heavily on convenience, processed foods, frozen fruits and vegetables.

Canned fruits, vegetables and proteins, dried grains, legumes, these peas, lentils, all that fun stuff, and really working towards supporting your body and getting to a place then where you can feel like you have energy to like, okay, let me try all these other dishes. Let me add the spice at the variety, at the, the little razzle dazzle of like, whatever.

But it doesn't have to be like a strict, avoiding all foods and not, and like not every meal is gonna look like that. Right. So it's like removing kind of that pressure to eat perfectly all the time and just knowing that like you are supporting your body in that moment is really like all you can ask another person to do.

Yeah,

Wendy Lopez: yeah. Similar to like people having that all or nothing approach to like, if it's not completely. Healthy, whatever that means, then I'm just not gonna eat at all. I feel like people do that a lot with fruits and vegetables. I was just having this conversation with someone yesterday where she's just like, if it's not the best quality then you know, it's like what's the point of even eating it?

And so when you talking about like buying frozen buying can for people who have that. Thought process. What are some conversations that you have with them to kind of like destigmatize process plant foods, because that's something that comes up a lot I think for people trying to eat healthier. They're like trying to do it the farm to table way, even though that's not very like practical

Clara Nosek: for most people.

Yeah, oftentimes like frozen produce is picked at the peak of ripeness and then preserved flash frozen in that state, so it has all the nutrients. And typically I think when you bring home fruits and vegetables, oftentimes you get salad soup in the back of your fridge or. It might be a little bit wrinkly because you let it sit in the CRISPR for a little too long if you're not using it right away.

They essentially are losing nutrient value, and I think that stems really from this place where we always feel compelled to optimize everything in life, right? You wanna like optimize your time, you wanna optimize your nutrition, optimize your health, and it puts a lot of responsibility on the individual.

And so just knowing that like you don't have to do that, and that is literally just capitalism reaching into your life, just trying to add to stress, add to the stress of life, and it doesn't need to be there. Like those fruits and vegetables are great options. They're great time savers. If we're thinking of it in terms of like ways to add nutrition, those are a hundred percent great ways to do it.

Yeah,

Jess Jones: those are all great ideas. So let's talk about chronic stress and trauma, right? So many of us have experienced that and we all know that it can impact our health in a lot of different ways. Or actually sometimes people may not even realize how closely those things can be aligned with their health and health outcomes.

What are some things that people can do to take care of themselves? And heal from trauma or just feel better. They don't have anything to do with the food that they're eating because I think we often put all this pressure on food, but there's so many other things that we can do that would be helpful. I

Clara Nosek: think it really starts with if you are able really setting and practicing boundaries.

I'm working on mine, my own boundaries, but I really think that moving away from screens like less screen time is huge. So before I got sick this week, I was really working through like those like low dopamine mornings. So like my alarm will go off, I won't touch my phone for like at least two hours. I'll do a lot of other things.

I'm really working on Monotasking, so I watched, I think it was a TikTok. I was reading an article which on TikTok, and they were talking about how like our brains are not meant for multitasking. We're not supposed to. And how like that can contribute to underlying stress as well. Stress and anxiety. Just having to always be in so many different places mentally.

So like I really have been consciously trying to monotask, trying to have those like very. Concerted screen time, time zones in my day. I think that getting outside, if it's available to you, the vitamin D, there's a like grounding standing in grass. There's something about like just being outside and. Yeah, just kind of like protecting your peace, like if it's available to you.

Just having a lot of those, like if it's not a hell yes, it's like a no. Yeah. For me, a lot of the time I think of it like, what was I doing before the internet? Right? Like very much early nineties, what was life? Mm-hmm. And like trying to coplay was like early nineties core, pre-internet core. Let me go outside.

Let me like paint a picture. Let's just like do stuff. Yeah. But yeah, speaking to like the stress and all that stuff, like, I always talk to my patients about how like, you know what, if you are stressing about everything that you're eating, That will play a role in the way your body digests the food. Like there was that research article like people who are in a calm state and eating will absorb their foods much better than someone who's like in a heightened state of stress.

Yeah. And so if you are like, oh my God, what I'm eating is poison, then it's like, ugh. You're gonna give yourself bubble guts. Yeah. Every time everything is gonna hurt your tummy. Everything is gonna not sit well. And it has nothing to do with like what you're having. It's just the fact that you're already ramping up yourself to not absorb any of it.

And so I think really working towards like being conscious with what you're consuming, not just food, like the internet, social media, the radio. People who are like, this is toxic. This is toxic. Just adding to your stress, if that is not sitting well with you until you can like really heal. That like energetically be in a place of calm, I'm really big on like, let's not consume that.

I remember like in early pandemic, I was like, mm, I'm just gonna delete Facebook. I don't need to see any of this. I'm just

Jess Jones: gonna not, nothing happening over there. Yeah.

Wendy Lopez: You haven't missed

Clara Nosek: out on anything.

Wendy Lopez: No. I feel like no one is using Facebook anymore. It's a thing of the past. I wonder if Instagram will get there one day.

I think so. I think it's headed there. Yeah. I think it's getting there, getting old. It's, yeah. So for listeners who wanna learn more about the work that you're doing and want to stay up to date with all of your great memes and infographics, where can they find you?

Clara Nosek: So you can find me on Instagram and TikTok mostly at your dietician, B f F, or you can subscribe to my [email protected].

I think that's pretty much it. Yes. Keeping it low key. Yeah.

Jess Jones: Yeah. Keeping it low key in 2023. That's my motto. Thanks so much for listening to another episode of the Food Heaven podcast. If you haven't already, make sure to connect with us online. We're most active on the gram at Food Heaven, but we're also on Facebook and Twitter at Food Heaven show.

If you like this podcast, make sure to rate, review, subscribe, and share with a friend. Yep.

Wendy Lopez: Our podcast is released every Wednesday and each week we take a deep dive into topics like health at every size, food and culture, intuitive eating, mental health, and body acceptance. If you're looking for a sustainable and inclusive path to wellness, come hang out with us to learn how to take care of yourself from the inside out.

We'll catch you next time. Bye.