"Yes, so one of my most favorite recommendations I like to give to people is there is not one diet that fits all. However, if there is a dietary lifestyle that requires you to restrict certain food groups, restricts your favorite foods, doesn't take into consideration your cultural preferences and food preferences, [then] that's not the right dietary intervention for you because you're more likely to fail and it's okay to continue doing what you normally do as your eating pattern. Just watch your portion control." - Andrew Akhaphong, RD, LD, Pn1, ACEWMS, ACTION-CPT
Shireen: Andrew Akhaphong is a registered dietician and has been in the grocery retail industry for four years with six years of prior experience as a Clinical Nutrition manager, when he discovered how little there was in culturally appropriate education tools in the clinical setting, Andrew pursued the opportunity in grocery retail to bridge the gap to provide guidance on defining nutritional recommendations based on the cultural needs of consumers. Welcome, Andrew.
Andrew: Thank you very much for having me.
Shireen: It is a pleasure. So Andrew, let's dive right in. And I'd like to start up by knowing what led you to a career in nutrition and dietetics? And where does your passion really come from?
Andrew: Yes, so I would say Actually, I grew up in the Nutrition and Dietetics field without knowing it until I got older. Um, it all started when I started seeing pictures of my parents who grew up in refugee camps during the Vietnam War. And as I look through those pictures, I didn't think much about it, but their faces were sunken. And you can see their bones and the shoulders and temporal lobes on the forehead. And I thought, you know, that was a pretty normal look for them and didn't think much about it until later on. So as I got older, my parents started the first Thai restaurant in Minnesota as I was a child, and eventually it started working for them as a waiter. And as time went on, I started getting customers who asked for dietary needs, either for diabetes or kidney disease. And I didn't know much about that at first. And so when they taught me these things, I was able to educate my parents to be able to create these foods for them so that way they can eat safe and meet their health needs. And then when I started my first course in nutrition class and undergraduate at a time and then we started thinking about food groups, portions calories, that brought me back to my parents pictures in refugee camps, and realized that they were malnourished and how much they emphasized to me growing up that you gotta eat, you gotta eat. And I didn't realize that until I took that class and relating that to that picture, and so on with that history. I wanted to be able to support people in their well being and not go back to that say that my parents were experienced in the refugee camp.
Shireen: Thank you for sharing. Now, Andrew, you work at a grocery retailer. Tell us more about the work you're doing as a dietitian there.
Andrew: Yes. So of all the careers I've had, I love working in the grocery retailer setting because there is so many things a registered dietician or any other healthcare care professional could do. So I'm responsible for bridging the gap between the hospital and our air in our communities and the store and the dietitian program for my company is only about four years old, when other grocery stores in our area started hiring dietitians on site. And so one of the reasons why this company started hiring dietitians is because one of the managers went through a cardiac rehabilitation received by education, I graduated and didn't know where to go from there to continue on with maintenance. And so having me on sites, I'm able to get referrals from doctors and outpatient dieticians and they'll be like, hey, come to this grocery store. And Andrew can keep supporting you. Let's do this maintenance age, or even give you additional supports while you're with our outpatient program and kind of guide you around when what you normally eat, how you can adapt to a time using the grocery store as an educational tool. So besides consulting patients on a referral basis, I also provide grocery store tours, kids cooking classes, I do food demonstration and cooking classes, and I even help our deli and meat department with food research and development to brand new and house recipes for customers with different dietary needs.
Shireen: Grocery retailer makes it easy for people who are struggling with diet or managing chronic illness to access resources and learning opportunities. What are some important diet related recommendations you have for patients with chronic conditions like diabetes and heart disease?
Andrew: So the top resources I recommend for somebody with heart conditions, I recommend the American Heart Association and that can often tie with people who also have kidney issues on because they kind of go hand in hand. So the American Kidney Foundation is another great resource because they talk about heart health as well as guinea fowl for diabetics. I love the American Diabetes Association and diabetes living because they have a nice collective community on forums, discussing this things that people have recipes sharing and contribute on contributions from other medical professionals. One of the most common conditions I work with a lot are food allergies and people with celiac disease. So celiac foundation is a great resource for people who need to find some support group learning about their condition, understanding what gluten means and how to locate that and ingredients list. And for the allergy, there's multiple resources such as the food Marketing Institute, to pumpkin project, for example, is my most favorite one, especially for kids. And parents struggle with so many things with kids, especially when it comes to holidays like Halloween or Valentine's that involves so much candy.
Shireen: Would you just repeat that last part again?
Andrew: Yes, so so in the dairy department, I get so many different questions like which milk is the best milk. And so working in the clinical setting, I always tell about you know, if you have concerns for weight loss, such as an older person, not always the best option, if you have heart disease, like choosing whole milk, for example, will help ensure you get all those calories so that to prevent weight loss and that older person or for example, people who are allergic to milk proteins are lactose intolerant. There are also these different brands of plant alternative dairy milks. However, I tell them, make sure that they're fortified, so that way they get the similar nutrients as melt with cow's milk without getting at risk for osteoporosis and other disorders that could come about Oh, sorry, my, my work phone. So we do that. Yes. So the theory department, I get a lot of questions about what our cow milk is better, or plant based milks are better, and there really isn't any right or wrong question what I like to emphasize, especially if there's an older adult in their group, and they are at risk for weight loss or have a history of weight loss, I tried to encourage them drink whole milk because it's higher in calories to help prevent that weight loss. Now for people who choose to do plant based milks, I encourage them, make sure you read the label. This is how you look for four to five plant based milks. So that way you get enough with the calcium and the vitamin D to support your bones and not be at risk for osteoporosis or in the case of children records for the frozen department that is a little bit more difficult, especially if it's in regards to a person with chronic heart conditions. frozen foods are known for being high in calories being high in sodium, but there are ways to make them a little bit more mindful. So there's meal kits, for example that you can get are usually lower sodium because of the sauces and the greens that they come with. So to kind of help reduce the amount that a person would consume is emphasized often with adding in more vegetables, butter that's frozen, or, or canned. Or say the person doesn't know how to cook, only use the microwave and they eat frozen entrees. There are products available that are a little bit better, like the AMA bowls where they keep the entree separate from the sauce and you can choose to mix it in however, as much as you want or eat the sauce on the side.
Shireen: The next question I have for you, Andrew is that you know, now that we're in February, and people may be struggling with their new year's resolution, so ones that are still trying to keep at it and you know, stay, stay true to especially health and weight goals. What recommendations do you have for people struggling with adopting and maintaining a healthy lifestyle?
Andrew: Yes, so one of my most favorite recommendations I like to give to people is there is not one diet that fits all, which is you know, kind of general However, if there is a dietary lifestyle that requires you to restrict certain food groups, restricts your favorite foods doesn't take into consideration your cultural preferences and food preferences. That's not the right dietary intervention for you because you're more likely to fail and it's okay to continue doing what you normally do as your eating pattern. Just watch your portion control. If your brain’s telling you, you know what I'm really really craving this and I want it really bad. It's okay to give into that because one setback is not going to ruin your success on reaching your goals. And sleep is a really important factor in able to maintain wellness, especially weight management, to help reduce those cortisol levels and the complimentary markers because that can prevent you from succeeding and your interventions and preventing you from seeing your goals especially in regards to weight loss.
Shireen: Now, given your background and you know what you're doing currently, Andrew, why is it important to be culturally aware and relevant when working with Asians?
Andrew: Yes, so when it comes to food, if we look at events like birthdays, religious celebrations, fear of food is the, is the connector of everybody in the scatterings and culture as well. So like for my family Food is a community thing. It's always a big spread. And we not only invite new members to join them, but also community members, maybe we don't really talk, talk too much or not exposed too much to kind of join in and eat together and enjoy each other's company. And so in terms of culture, I consider that as like ethnicities as well as socioeconomic status. And so if I'm talking to a person of Latino, Hispanic origin, and they're eating tacos, tacos, rice torta tortillas language, which is time and I'm using educational materials that are generalized are more of the American diet and like, Hey, you know what, you need to eat two slices of bread, because that's the USDA rotation on the My bytes, for example, and they're not going to understand that because tortilla is their main, quote unquote, bread for their meals. So being able to use culturally appropriate items for those persons, it will make a lot more sense, right individual and you'll see a lot more success from that individual as well.
Shireen: The bread recommendation, but putting it within the language of what they're used to eating. And so you're instead of talking bread, now you're talking tortilla, what resources do you recommend to shoppers coming in and looking for ideas even after they leave their grocery store.
Andrew: So for heart disease, depending on the condition, say for congestive heart failure, I always emphasize to watch your sodium intake. And if you're working very closely with a cardiologist or a primary care doctor, if they have a recommendation for fluid restriction, watch that too. And both of those things are very challenging for many heart disease clients. Because numbers overwhelmed so an easy way I can get congestive heart failure patients who watch your sodium is I develop guidelines that list every product in the store and what are heart healthy In other words, like less draw sodium contents and fat content for example. And then looking for low sodium products or no added sodium emphasizing if you can't find a can product per se that has a low zoom option rented multiple times or soak it in water because salt loves water so that can help at least extract some of that sodium out from that product. For, for fluid restrictions. I have to remind them if you eat pudding, applesauce, watermelon popsicles ice cream, those are also considered fluid. it's sometimes hard to say how much fluid is in there but if you're swelling too much if you're gaining way if your voice starts to feel raspy, keep waiting down the fluid so that way you don't get those symptoms for diabetics. It depends on the person for some people depending on the diet history I get from them. If they're having trouble eating a lot of protein and protein can help slow down the digestion absorption of blood sugars, I emphasize on that and kind of teach them ways and how to increase that whether that's through snacking with nuts, which also provide fiber for fullness or slowly increasing portion so that way they start getting used to it. But my number one thing for both diabetics and heart condition heart disease patients is emphasizing fiber whether that's through food which I prefer or if they feel like they're struggling to use a fiber supplement.
Shireen: Thank you for sharing so with that Andrew, we're towards the end of the episode unfortunately, how can our listeners connect with you and learn more about you to reach?
Andrew: To reach out or have any questions and would like to learn more you can follow me on Instagram at indie rd k i n period d i hyphen rd or on LinkedIn Andrew Akhaphong, last name aka h a p h o n g.
Shireen: Thank you so much Andrew for joining us on today's episode. It was a pleasure walking through the tour, understanding sort of all these different elements that you're, that you're incorporating within the work that you're doing within the grocery store environment.
Andrew: So thank you very much for this opportunity, opportunity Shireen.
Shireen: So with that, to all our listeners, thank you so much for tuning in. Head over to our social media. We'd like to learn from you what you look at and what's important to you when you are grocery shopping. And so with that we will see you at the next one.