Shireen: Sheena Jaramillo is a registered dietician nutritionist specializing in eating disorders and plant based nutrition. She focuses on helping patients make behavior changes to facilitate progress towards health and wellness goals. She has three bachelor's degrees in psychology, anthropology in nutrition and dietetics. She has a master's degree in sports, nutrition and human performance. Welcome, Sheena.

Shena: Hi, Shireen. Thanks so much for having me today. 

Shireen: Absolutely. So Sheana, let's just dive right in. We'd love to learn a little bit more about your background. What led you to become a registered dietician? And then further to that, how are you working to solve for health disparities and speak to some of your work within eating disorders?

Shena: Yeah, yeah, absolutely. So my first two degrees were actually in psychology and anthropology, where I really fell in love with behaviorism and cultural anthropology. So examining cultures and how we exist within that culture, and form our behaviors. And then I started delving a little bit into nutrition, honestly, just purely out of curiosity. So I really started falling in love with the clinical science behind nutrition and specifically regarding eating disorders, because there is so many cultural and behavioral components surrounding that. So that's really where I developed my love for that focus, regarding health care disparities, and resources for say, low income individuals, minority groups, LGBT communities. I really became interested in that because it is such an underrepresented group. And I feel like there really isn't any nutrition therapy or medical nutrition therapy without first understanding what goes into caring for these populations.

Shireen: So with that, you know, when you're talking about, specifically for health disparities in the nutrition solutions for this group, what are some basic staples that folks should have in their pantry? Some good foods to sort of keep on our grocery list as we navigate our way through COVID-19, and make sure to support people who are going through health disparities along the way? 

Shena: Yeah, absolutely. So some really good, great staples to keep in your pantry would be things like rice, beans, these are also very affordable staples and they offer a good source of protein. Keane was a good one, buckwheat is a good one. I also like to encourage less traditional items like canned or condensed milk, coconut milk, cashews, things, nuts, seeds, things that we don't typically think about all the time. But they can be really affordable solutions for individuals, and they keep really well. So we don't need to make quite so many trips to the grocery store, in order to be planning and planning out our meals and making sure that we are keeping nutritional adequacy up through this difficult time.

Shireen: And then how can people really shop in grocery stores and still be mindful for people who are on food assistance?

Shena: This is an excellent question. I think this has really kind of got pushed under the radar with this whole COVID-19 thing. A lot of individuals are saying, you know, limit your trips to the grocery store or purchase foods through an online shopping app where those groceries can be delivered. But what a lot of individuals aren't recognizing is sometimes individuals on say, food assistance or snap, can't actually utilize those resources. They're not allowed to use their snap cards on some of these platforms where you might be able to order your groceries and these are also some of the individuals that are most at risk for contracting COVID-19. So individuals with say diabetes or COPD, where they might be at a higher risk, and yet they're forced to go out to the grocery versus being able to get their groceries delivered like other individuals might be able to do.

Shireen: Now, how does it happen? There's a hoarding mentality in place. But how does hoarding or stockpiling a lot of this? How does that play into the purchasing needs for people on food assistance?And then what can we do to sort of change that? 

Shena: Yeah, that's a great question. So when we hoard foods, I mean, first and foremost, it takes foods off the shelves, so if an individual is going to the grocery store, especially if they're immunocompromised, now they're not able to access the foods that they would normally have. Milk has been one that's been out a lot. Dairy, cheese, dried goods, all of these items where an individual might be able to stock up a little bit extra, if they are immunocompromised, now they're no longer able to acquire those foods. Also, a lot of individuals that are going out and stockpiling these foods really don't have a plan for these foods, they don't know how to utilize these foods. And a lot of these foods might actually perish before they're even put to use. And yet we're taking them off the shelves for other individuals.

Shireen: And the the sad part about this is when you see waste coming out of this because we're we're buying, let's say produce, and it has a certain shelf life, and then we don't use it, and then it's going to waste, right, that's like taking it from someone who truly needs it. Because you know, you can, you can afford to buy it or you're there because the supplier was there at the time, and you shopped it, and you took it off of somebody else's plate, literally. But you didn't end up using it, which is so unfortunate, with all the other ways coming out of this.

Shena: Yeah, that's absolutely correct. And it's very unfortunate, because I think we get this mentality where you know, we just need more, because we went to the grocery one time and we couldn't find dairy on the shelf. And so then we end up with two to three gallons of dairy. And we think that we're going to suddenly use that when that's not part of our normal routine and we don't have the household size to support that. And yet, like you mentioned, we are taking that off of somebody's plate, maybe a snap recipient or maybe perhaps a WIC recipient, and now they're no longer able to get access to high quality, nutrient dense foods.

Shireen: So speaking about that, I want to talk a little bit about the women infant children program, which is known as the WIC program. So WIC families are reporting shortages in staples, like you mentioned, like eggs, milk bread. I know my local grocer, I have to go there at a certain time or else the eggs are gone. That's pretty much how this is working for me. But when we're looking specifically for these families, we're hearing of some WIC substitutions that are starting to be allowed in certain programs. Can you speak to some of that?

Shena: Absolutely. Well, this is going to vary a lot depending on your state and the regulations on your state. Some of the variations that you might see now being allowed that might not have been allowed previously might be if there was a certain percent milk that you were previously permitted to buy, now you might be able to buy 1%, fat free milk or whole milk. Just because that might be the only thing that's on the shelf, it might be variations in the types of breads and grains that you could buy. So white bread might be allowed where it might not have previously been allowed, because that's all that's on the shelf. So they are making exceptions in some ways in some states, but that's really going to vary depending on your state. And you'll have to ask for guidelines from your specific WIC location.

Shireen: And then what should people be sort of mindful for when they're to prevent really these shortages? What can the ordinary consumer really do to be mindful of making sure that they one don't stop fire and to don't take those resources away from someone who truly needs it?

Shena: Well, my first advice for this would be really think about what you need, maybe make a meal plan, maybe determine a grocery list where you can collect what you need for that week, even if you're doing a little bit extra. A lot of times you'll find that when you stick to a grocery list or when you stick to a meal plan, you're still buying less than what you would normally purchase if you're just going into the grocery store, frantic thinking that you're going to run out of everything in your house essentially, and then utilize what you purchase. So a lot of individuals might purchase buckwheat and quinoa because it's what they find on the shelves and they think that it's safe because it's shelf stable. But then they go to their homes and they don't know how to utilize any of these products. And so therefore again, it's just taking it off the shelf for another individual that might utilize that in their meal plans.

Shireen: From here I want to talk a little bit about the current state of affairs given COVID-19 which is a evolving situation. But we're starting to see governors, you know, sort of lift the stay at home orders that were put in place not too long ago, and state by state. I know I'm in Texas and some of those orders have, are being lifted. How does anxiety poor eating all of that play into this uncertainty of sort of lifting that stay at home orders? People aren't certain about what that means for them? Are they going back to work or not? How much can they really go out? What kind of interaction they can have? How does all that play into eating habits? And then even health outcomes such as someone with a chronic illness like diabetes?

Shena: Yeah, absolutely. So I think the main thing with this is that the fear is still there, right. So even if we're allowed to go out, permitted to go out, it might not necessarily be safe with somebody, for somebody with COPD, with diabetes with a terminal illness or something along those lines to be regularly shopping in a grocery store. So while they are permitted to go out, they still might have specific health concerns that they might be identifying with. So we still need to follow the guidelines of getting what we need shopping with that grocery list, shopping with a meal plan in mind. And also, even though restrictions are lifted, we are still going to see that fear for quite some months to come. Because individuals aren't certain of what's going to happen. A lot of individuals think that there's going to be a second wave of COVID-19. And so actually, it might even height in some of this frantic purchasing, because they're preparing for this second wave. So the really important lesson is basically, don't do that as much as possible. Really, just try to purchase what you're needing. It's okay to stock up a little bit extra, it's okay to really think about those non perishable items like grains in the form of qinhuai, or pastas or things like that. Frozen, veggies, canned veggies, canned goods, but you don't need as much of pasta as possible every time you go to the grocery store.

Shireen: And then how does this, the, just the anxiety of it all? How does that play into our eating habits? And sort of even as much as we want to plan and plan ahead and, you know, sort of prepare ahead of time? How does all that play into the overall state of our health and well being?

Shena: Yeah, absolutely. So one of the biggest things to remember is that stress has one of the big biggest influences on our eating behavior that there is. So especially for an individual trying to control blood sugars and trying to manage carbohydrates or something along those lines. If we're constantly in this state of stress, and we're constantly feeling like we're going to be in a food shortage that's going to influence our eating behavior. So stress is going to produce more cortisol in the body, it's going to make us crave more high fat, high calorie foods, those sweet foods, those foods that are going to be more comfort foods. So we're responding to that stress versus responding, responding to internal cues like hunker. So that stress is going to play a big role. So just kind of thinking about that, before you're even starting with your day, it's always a good plan to do some meditation or stress reduction technique. So that way, you're able to kind of go about your day and go about your shopping and your eating with a little bit more levelheadedness.

Shireen: 

There's something to be said, For with this new lifestyle. I have you know, I'm working for home, as I'm sure you are. When we do that, and you know, having access to the kitchen, and just being able to walk in, I feel the refrigerators looking at me all day long instead of me looking at it. But given that, how much are you seeing that people are sort of giving into or not having as much willpower when it comes to eating? Well, you know, and eating right for themselves?

Shena: Absolutely. So access is definitely going to be one of the biggest influencers surrounding our food behavior and when individuals are going to a workplace. Oftentimes, we would see a lunch pack, or at least a plan for lunch, or at least a time for lunch. Whereas now we're seeing those habits that might have been a little bit more prevalent on, say, a weekend where we're snacking on the first thing we see on the counter are now emerging into our everyday lifestyles. So this is causing some individuals, you know, a lot of stress, they're not really, they're not really sure when they're going to have their meals. They might have more irregular eating patterns, because we're grabbing just that cracker or that piece of cheese versus actually sitting down to have a meal. And then it also can impact energy levels pretty significantly if we're not eating on regular schedules that can influence our mood. So there's lots of things that can help happen with that when we are constantly having that access to food. So I would definitely recommend for individuals that are experiencing this just really trying to stay on that segment meal schedule as much as possible, planning out meals, if that's something that they're feeling like would be beneficial for them. And really just having a little bit more routine, focusing on that meal routine a little bit more frequently.

Shireen: And then what are some good habits to have in place to sort of keep us on track? Who do you recommend? writing it all down? Or, you know, how do you recommend sort of creating that new routine?

Shena:  Well, that's a great suggestion, writing everything down. I mean, in a perfect world, I think we would all write down everything that we're planning to have for our families for meals every single day. But now we've got work thrown in there, we're homeschooling kids. So we have to be realistic about what is actually feasible. I always recommend individuals maybe plan out at least one meal, if you know that you're struggling to get dinner on the table every evening in a structured way, maybe that's something you're planning out. But maybe it doesn't need to be every single meal every single day. A better way to maybe maybe manage this is to do a little bit of batch cooking. So maybe you're roasting up some vegetables at the beginning of the week, you're cooking up some chemo that you can have in the fridge. And then that way, meal planning and prepping can become a lot easier and more realistic, especially with all these added responsibilities in the home.

Shireen: When you were talking about it just a few minutes ago, we were talking about having some staples on hand. I want to talk specifically for people with diabetes, and to switching gears, what kind of staples would you recommend for them to have on hand and, you know, again, not to not to hoard and keeping all that in mind, but just having certain things on hand, what would you recommend to that?

Shena: So absolutely, with diabetes, we do have a lot of the same nutrition requirements as somebody that is non diabetic. So we are going to still want to have those fruits and vegetables, I would definitely encourage stocking up on the frozen and the canned. Even if sodium is a concern for you, veggies are still an excellent source of nutrients, but you can rinse off about 40% of that sodium. So that's a really good thing to keep in mind, you can always add those veggies to a meal as well. I'm still needing the grains. So you still do need, you know, whole wheat bread and qinhuai and rice and all in pastas. Trying to really go for those whole grain products, we still are going to need those, we're just going to utilize them a little bit differently in our homes at our mealtime. One thing I would definitely encourage for a diabetic is just making sure that we're not having goodies and pastries and all those things lingering on the counters. I know this can be a really tempting time to stock up on those items. Because we are, I think all of us are feeling a little bit more food insecure at this time. So those things are the things that don't perish. So a lot of individuals are wanting to stock up on those and where they end up lingering is on the counter the perfect candidate for somebody to just linger into the kitchen on their work day and snack on, and that can be really problematic for a diabetic. So if you do purchase these purchases in moderation and give them a spot in your kitchen, put them in a cupboard where they're not lingering.So literally out of sight, out of mind, out of sight out of mind. So you have to really make the choice to have that. 

Shireen: Love it. Okay, so with that we're coming toward the end of our episode here, Sheena, can you tell us a little bit more about how people can connect with you and learn more about your work?

Shena: Absolutely. So I do run a plant based blog at www dot peace and nutrition.com You can also work with me one on one, you can book an appointment at that website or you can email me at Shena at peace and nutrition dot com. Or I do also run an Instagram page as well as a Facebook page @peaceandnutrition. So any of those platforms you can follow me at I do plant based recipes, guidance for body trust. So those are all places where I'm accessible.

Shireen: That's great. And we're gonna have links for all of that in the show notes as well as on our website so folks can access that there. Perfect. So with that, thank you so much enough for your time, truly appreciate having you on.

Shena: Absolutely thanks so much for having me, Shireen.

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