As a registered dietitian, Elizabeth has spent the last decade in various nutrition-related roles ranging from patient counseling to employee well-being programming to teaching. She is drawn to the many disciplines that share intersections with food – culture, sustainability, politics, and socioeconomics just to name a few. She started Communal Table Wellness as a way to explore all those intersections in her work with individual coaching and organization consulting.

Shireen [0:32]: In today’s episode, we are talking to registered dietician Elizabeth Lee. We’ll explore with Elizabeth the intersection of nutrition research and coaching the non judgmental environment vital for holistic nutrition coaching, and discuss what culturally inclusive nutrition coaching looks like. Stay tuned. As a registered dietitian, Elizabeth has spent the last decade in various nutrition related roles ranging from patient counseling to employee well being programming to teaching. She is drawn to the many disciplines that share intersections with food, culture, sustainability, politics, and socio economics just to name a few. She started communal table wellness as a way to explore all those intersections in our work with individual coaching and organization consulting. Welcome, Elizabeth.

Elizabeth [1:26]: Thanks for having me, Shireen

Shireen [1:28]: Such a pleasure having you on. So first things first, Elizabeth, our first question usually is what led you to this? Can you share a little bit more about what drew you into the field of nutrition and coaching to begin with?

Elizabeth [1:41]: Yeah, absolutely. As a whole Nutrition has been something that I didn’t quite think about going into until I was well into college. My path was going to go into med school, and I was interested in pediatrics. But after organic chemistry, I realized that that was probably a time point that I should rethink my decision. It was not my greatest accomplishment in terms of classes. And around that time, I went to a career panel that was hosted by my university, UC Santa Barbara, a shout out to my alma mater. And there was a dietician who was there speaking on careers are related to health, but not going into medicine, nursing. And that really piqued my interest. And as far as what about coaching and research that I’m interested in coaching is something that’s been part of my career for some time, I started out in community nutrition, working for a headstart program. And after that a number of roles I’ve had really involved one on one coaching or group counseling. It was not a career path that I had planned, but I ended up really enjoying it, I really enjoyed the interactions with the individuals. So it’s something that I kept on pursuing. And as for research, it’s a little bit more of a happenstance, I was involved in a course that was headed up by Dr. Christopher Gardner at Stanford, and an opening came up in his lab group to help with the research that we’re conducting. So I came on board as a health educator for his lab group. And it really piqued my interest because it is still counseling to an extent, but very much so done in a different setting with a different population I haven’t worked with before. So that’s kind of my path. That’s how I landed in my current portfolio of experiences, if you will.

Shireen [3:35]: Is this an interesting pathway? You know, you talked a little bit about sort of navigating your way through, you really gain diverse experiences across teaching, research, counseling, coaching, and then you know, all of this being around nutrition? How do these three different avenues sort of shape or even inspire your understanding of nutrition? 

Elizabeth [3:56]: Yeah, I think they really feed into each other. So in teaching, I often have discussions about myths and half truth with students because they’re exposed to them and are curious about them. I think it is somewhat interested in nutrition or just eat food in general, which is, many of us, all of us. were exposed to some of those myths and half truths on a regular basis. And I think these often really mirror the questions that my own clients have naturally. And another big topic of discussion and nutrition classes is correlation versus causation, which is very much related to research. So being part of the research group has really brought into my understanding of study design, participant recruitment, and data capture. And I think it’s human nature to want to draw a straight line between cause and effect. So my experience in research there has really been a helpful reminder to myself, but also something I can bring into teaching and coaching to say, Hey, slow down. Let’s look at the science and beyond the headlines to see like What is really going on? So for all of those things that kind of come together, I think they really feed into each other and continue to shape and inspire my understanding of nutrition. 

Shireen [5:10]: Interesting. My next question to you is around some of the coaching work that you do, what really led you to establish that, in fact, you have an initiative called “Communal Table Wellness”? Can you tell us a little bit about that, and also strategies that you implement to achieve some of these initiatives? 

Elizabeth [5:27]: Yeah, so Communal Table Wellness is my business that I started a couple years ago. And it really started as a combination to meet a couple of my own. I wanted to put some fun back into food because I think food has really gotten serious and clinical. And food is really a symbol of culture. To me, it’s a token of care. It’s a really potent connector. And all of that seems to have kind of been stripped and distilled into nutrition science. And for that, that’s why I think it’s gotten serious and clinical. And then there’s also this desire of mine to speak to the missing or muted East Asian culture representation that I’ve been seeing in nutrition. So when I first started thinking about starting a business, I had been away from nutrition coaching for a few years. And I sort of missed it. But I knew I didn’t want to go back to it in the same way that I was doing patient counseling years ago. So leading up to starting the business in 2020 2021, there was a lot of conversation about cultural representation that made me examine my own identities and culture, and especially in the context of food and my profession. And at the same time, I saw a lot of very innovative and original ways that artists, advocates, writers, they were building community and teaching very interesting, virtually. So all of it really got me thinking about how I can be creative about nutrition education and coaching, where people will feel included, seen and walk away with not just useful information, but practical skills. So communal table wellness really was born with the intention of not just offering one on one coaching, but also some virtual and in person workshops that are centered on conversations and connections,

Shireen [7:16]: You know, when you talk about culturally inclusive is what you said, yeah, when you’re talking about a term like that, you know, it can seem very layered. There’s a lot within that that needs to be taken into account. I would like to get your perspective as you’re an RD to really understand what does sort of general coaching and I say, General, with air quotes here, but what does sort of this general coaching look like? And then what does culturally inclusive coaching look like? How’s it different or even similar for that matter, in terms of tools or resources that may intersect across both ways of providing coaching?

Elizabeth [7:52]: Sure, and you’re so spot on about it being a layered concept. And I just want to put out the disclaimer that I’m not an expert on this whatsoever, there’s still a lot to learn. And there’s still a lot that I don’t know. But for me, what culturally inclusive coaching looks like is if a client comes to us as dieticians, that we understand what some of those foods might hold for them in terms of cultural meanings. So for example, I’ve worked with a number of clients who are from the East Asian background. And oftentimes, there’s a conversation about, well, if I don’t finish certain things that are put in front of me, that would be very disrespectful. But they don’t want to maybe eat certain things or cannot finish, certain portions that are given to them, because it doesn’t align with their health goals. So how to understand that. And I think having that kind of understanding as a dietitian, is really important. And I think this is why it’s so important to have diversity in our field, in terms of just different cultures being represented in our profession, because then that way, our clients and our patients can pick and choose who they want to work with, and who seem to understand and who gets them. I think at the end of the day, that’s what it is. So while there’s a lot of overlap, like the nutrition science concepts, doesn’t really differ based on the individual per se. There’s a lot of broad things that just apply to all of our patients and our clients. But in terms of resources, for example, if I’m working with somebody who has diabetes, and I just give them kind of a run of the mill type of handout that doesn’t have a lot of the foods that they typically eat, it might seem kind of discouraging to them, like okay, well no, no, the foods that I eat are on here and also Are you telling me that I need to completely switch what I’m eating, what my diet looks like. So I have to Read it some handouts, I’ve created some resources for my clients. But also, I think there’s a lot of dietitians out there who’s done a phenomenal job and putting out resources. So we don’t have to reinvent the wheel. And then some health organizations have done that. And so as well, so that’s been really helpful. So hopefully that chips at the question, the very layered concept of what cultural inclusivity looks like, in my practice for you 

Shireen [10:25]: Absolutely needed. The reason I also asked that question is, because that’s a lot of what we see in the definition, sometimes I’m so glad you brought up some of the other definitions of what culturally inclusive work and look like because I feel that an English to another language translation is not culturally affirming. We need to think beyond those translations. And the reason why I say that is, even in the work that we do at Yumlish today, we’re very focused starting out in the Hispanic community. But I know at the same time when people will even introduce my work, they’ll say, oh, you know, they do Spanish work. And I was like, Okay, it’s a little bit more than Spanish, because it’s culturally affirming So I think there’s something around the definition of that, broadly, people are still understanding as to like what it means to be culturally affirming, and you know, just a plain sort of language translation. Not to discount that a translation is probably appropriate in certain instances, but culturally, you know, affirming or culturally inclusive, goes far beyond them. Yeah. And I like that, as a dietitian, you are so focused on including some of those things within the work that you do. 

Elizabeth [11:37]: Yeah thank you. And I think you bring up a great point that translations language is just one part of it. But there’s a lot more to the culture besides just the language. So how the culture perceives the food like how historically maybe food has been used, how it may have some traditional holds like certain place and traditions, for different populations, I think that’s also a big part of it. And in my practice, I have tried to refer coaching clients to another practitioner at times, when I don’t feel like I am the best fit for them. Whether it is the area of expertise that they’re seeking out, or the culture is not necessarily in misalignment, I just feel like there might be somebody else better in my network, who can speak to them speak to their culture that I can. And I think having those kinds of connections that they can have right off the bat with a dietitian, it just makes for a much more enjoyable coaching experience. And it’s almost like a shortcut, like they don’t have to explain so much. And they don’t have to give like an entire Wikipedia page, to the context that they’re trying to explain, which I think is really beneficial for the clients.

Shireen [12:59]: And I think there’s also the element that helps overcome some of that muteness to you know what the individual’s needs are. So I’ll speak to an example, one of the things that we hear through the work we do are things like, Oh, my doctor told me to stop eating rice or stop eating tortillas. It’s like, that is a big part of someone’s culture. I myself am a South Asian descent, rice and roti. And those things are a big part of it. And I know that anyone in my family, if they’re ever told to stop eating rice, they will leave the doctor or the dietician before they leave the rice. So how do you deal with some of those challenges, and really helping people one, overcome some of those recommendations, we will call them that they receive in a way that is safe and inclusive for them.

Elizabeth [13:47]: Yeah, that resonates so much, because as a East Asian rice is also big in our culture, so I would not advocate for my clients who are from those backgrounds to have to ditch the things that mean so much to them, that brings so much enjoyment to them. So for me, I typically start with explaining the nutrition science concept, like why did their doctor for example, advise them to not eat certain things, rice, rotate tortillas, for example, and start from there to give them the information of where that recommendation was coming from. And then from there, because they have the information there’s a gained understanding from where the rationale is, they can start to tell me like okay, well, if it is really trying to get at reducing my carbohydrate intake, can we work on something else that will achieve something similar in reducing the carb intake without having to take away the things that I enjoy the most? So that oftentimes is my first place to start with My client’s, and then you know, we can identify the things together in a typical day or in their eating pattern that will fit that requirement. And so we can still achieve the same outcome. So for example, if they’re eating a lot of fruits as well, instead of taking away the rice, which may mean a lot to them, and it’s a staple in our household, we can start with moderating the amount of fruit intake that they have to reduce the carbohydrate intake. Or if they’re snacking on something that has a lot of added sugars, refined sugars, that would be another place that we can work on instead of taking away that tortilla that may mean so much to the client.

Shireen [15:40]: I love that approach. You know, looking at some of the work that you’re doing with communal table wellness, we can see that an aspect of this is really that non judgemental, right? Why is having this nonjudgmental environment really important when it comes to nutrition? And how do you see it benefiting individuals?

Elizabeth [16:00]: Yeah, so it’s really important for me, and also, I think it really empowers my clients. Or I try to empower my clients to create that non judgmental environment or approach for themselves for a couple of different reasons. One is because again, going back to how food holds a lot of different meanings and significance for each one of us. To put myself as an example, I grew up in Hong Kong, and there are these delicious custardy egg tarts. That’s one of my favorite favorite foods. And so if somebody judges me for indulging in them, because they’re unhealthy, that wouldn’t really make me feel good, because I feel like my own history with that food with the place, and the memories that go along with them are being criticized. And then another reason is that I think food is a big part of most people’s identity. And increasingly, it has become people’s social identity as well. And so social identity is more like a membership in a social group. And so traditional social identities revolve around class, race, gender, religion, sexual orientation, sports teams, even. And I think these identities provide a sense of belonging, and also pride and self esteem. But how nutrition is perceived now and talked about, I would make a case that social identity now really includes people’s nutrition approach, and dietary preferences. And so the way that we eat the eating pattern that we follow, they aren’t just mere habits and practices, some people identify very strongly with those things and take them on as identities. And so related to that, how a person eats has really become a proxy of how they perceive themselves and how they want the world to see them potentially. So I think we’ve all witnessed people who follow certain diets. And they are very strong about that being a part of their identity. And they will go back and forth with people who don’t agree with their approach, using articles and documentaries as their ammo. And so I think because social identities are so important for how we make sense of ourselves, our belonging, get, we can feel like we’re under attack, when somebody disagrees with, or judges our identity, and dialogue and progress are really hard to get to when we feel like we’re being attacked. So all that to say, this is why I think a non judgmental approach is really important to me and my clients, and the work that we do.

Shoreen [18:31]: Can you speak to an example or certain successes or memorable folks that you have worked with, that you’ve seen the impact of some of this that you’re referring to here, within their outcomes?

Elizabeth [18:43]: Yeah, so I think, not quite successful or unsuccessful, but definitely memorable cases. And these examples, I will share really hinge on why context matters. And I think in today’s age, like context is a little bit hard to come by. There’s a lot of content everywhere. But how to make sense of it all really is a key to what we do as dietitians. I think he’s been just a key to being human beings. So there was a memorable case where I was working with a patient who has been going through bariatric surgery, she had come to our clinic for pre surgery work, just to get herself ready for the surgery, but also post operatively. We’re working on monitoring her intake and making sure that she doesn’t have any nutrient deficiencies. And I was very fortunate enough to work on a team where there was also a psychologist. And so we really work with tandem and collaboration. And so, in a lot of the interactions that we have with the patients, things are tangentially related to food comes up and family dynamics often comes up. And she was mentioning how she felt like her family and friends were sabotaging her. Because she’s had the surgery, she cannot eat the same foods as before. But seemingly people are just presenting her with all these things that she can’t eat in portions that were very inappropriate. And this was quite a few years back. So I was at a less mature understanding of like, well, why would that be? Like? Why would somebody who’s you know, considered a family member or friend be actively sabotaging somebody’s efforts to become healthier. And so it came to light that my patients body size, kind of served at some kind of yardstick for the family and friends. And so when she was no longer at that size in that larger body, they felt just confused. They didn’t know what to do. And they just wanted to make sense of well, she always serve as that yardstick as that barometer for us, like, as long as we were not larger than her, we were okay. And that really kind of blew my mind in a sense that oh, okay. It’s not just what my patient knows how to take care of herself. And it’s not even about helping her family and friends understand what is the dietary pattern that she needs to follow now, but that social context, that familial context of family dynamics of social dynamics really come into play. And so that was a really long conversation. But that was a very memorable case.

Shireen [21:45]: Thank you so much for sharing that, Elizabeth. Unfortunately, we are toward the end of the time on this episode. At this point, I would love for our listeners to know how they can connect with you and learn more about your work. 

Elizabeth [21:57]: Yeah, so folks can learn more about my work at communal table.co. And folks will find links to how to book a coaching session, browse my selection of cookbook recommendations, and much more there. And I also write a monthly ish newsletter called Hey-Hey, for anyone who’s interested in curated list of recipes, musings about food culture and general wellness, the link to sign up is at communal table.co/newsletter. But also you can find the link to the newsletter signup on my website.

Shireen [22:34]: Okay, that is helpful. Thank you so much for that, Elizabeth. It’s been such a pleasure talking to you here today. To our listeners It is that time again, head over to social media, and answer this quick question. What are some unique

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