Dr. Jen Cadenhead, a behavioral nutrition scientist and registered dietitian nutritionist, studies human diet patterns, health, and nutrition security policy. She is a Research Assistant Professor and Executive Director at the Laurie M. Tisch Center for Food, Education and Policy at Teacher College, Columbia University.

Shireen [0:32]: In today’s episode, we welcome Dr. Jenn Cadenhead, who aspires to end nutrition insecurity among American children through policy levers by 2035, while simultaneously providing nutrition knowledge to the public to lessen the impact of diet related chronic diseases. We’ll discuss her insights and food policy and education as well as the social cultural nutrition environment for minority populations. Stay tuned. Dr. Jenn Cadenhead, a behavioral nutrition scientist and registered dietician nutritionist studies human diet patterns, health and nutrition security policy. She’s a research assistant professor and Executive Director at the Laurie M. Tisch Center for Food Education and Policy at Teachers College at Columbia University. Welcome Dr. Cadenhead. 

Dr. Cadenhead [1:26]: Thank you so much. So nice to be here.

Shireen [1:28]: An absolute pleasure having you on. I do want to kick things off here by learning a little bit more about your background and your journey into this world of dietetics, and nutrition. What was that like for you?

Dr. Cadenhead [1:42]: Thanks for asking. Yeah, I’m actually a second career dietitian. And I came into the field, because I had a health scare a dozen years ago. And I realized, as I was sitting in the hospital, where I was in the hospital for over three months, that food is just crucial for everything, including being able to think. And it was something I hadn’t really considered before. And then in my journey in healing, I also recognized that I needed to change my diet in order to completely heal. And I took a nutrition one to one class. And I just realized that our food system was not as great as it could be, but also the messaging and the marketing. And the food environment that people in general found themselves in, was actually contributing to a lot of the health problems that people were having, including myself, I had gotten into the hospital with just starting high blood pressure medications. And just in that one course, and nutrition one on one, I learned how to turn my eating patterns around, and was able to not have the high blood pressure medication anymore. And I thought, wow, if it’s that powerful with just one course, imagine what it could mean for other people to be able to get this knowledge. And I wanted to learn more. And right then and there, I decided to change my career, and dedicate my life to research and to try to help people be able to understand fact from fiction, and also get to the root causes of why people were not eating as healthily as they could. And so I went back and took all my prerequisites to become a dietitian, and eventually was able to roll in a doctoral program got my postdoc, and here I am

Shireen [3:54]: Lovely. I want to get into a couple of things that you spoke about there. I do want to take a step back, though, you know, when we were researching and the work that you have done and you aspire to do, we really saw this aspiration to end nutrition insecurity among American children. A lot of focus on policy changes and this goal to do this by 2035. First, can you help our listeners understand, we’ve talked about this a couple of times before, but at least for our new listeners, help us understand what exactly nutrition insecurity is, and why is that a challenge in our society today?

Dr. Cadenhead [4:28]: Yeah, that’s a great question. And I would say people in the early part of the 19th century, were in the United States in particular, were suffering from overt malnutrition across the country. And that was because, you know, mostly it was an agricultural society. People were living mostly in rural communities. And there was an uneven distribution of food. Many people were just poor and didn’t have access to food in that way. And there was kind of an industrial revolution with machinery and people moving to more urban areas. And before, you know, sometimes people would have access to gardens. But when they moved into the cities, they had to rely on food coming into the communities. And eventually, the government decided to step in, and get more easy access to certain foods like staple foods like grains. And meat used to be a Sunday, chicken dinner was a special treat. For instance, my grandfather told me a story of when he was growing up, he and a cousin went over to an uncle’s house, and they had some chicken dumplings in the pot, because the uncle says “help themselves boys”. And when the uncle came back, the two boys had eaten all of the chicken and the uncle cursed them, because that was all the food they had, that was their only chicken, there was no grocery store to go to to get more chicken. And so we don’t have an environment like you can go to a grocery store pretty much and get a chicken. So we are not struggling with necessarily having access to food, for the most part, but there are populations that struggle with both the access of food, but also quality food. So along with that grain revolution, we can get lots of breads and rice and pastas, all that we want to our heart’s content. But we’re not eating a lot of whole grains, which have all of the nutrients in it, many that we don’t get where we find them, we are eating lots of snack foods, which again, are calorie rich, but not but our nutrient poor, we have access to lots of meats, which you know, are fine and provide nutrients. But it’s really the plant based foods that provide the bulk of the nutrition that we need to have our bodies functioning well. So with me, when I was able to reverse my high blood pressure, I just started eating more aligned with the recommendations to have three to five fruits and vegetables per day. And that in itself was part of my issue. But that’s also the issue that many Americans are facing that they’re not getting the needed nutrition through their foods they’re eating, maybe not well, because we have ubiquitous amounts of ultra processed foods out there, which are adding to calories and potentially excess weight and metabolic dysfunction. But we’re not getting those kinds of foods. So you know, lots of people like to quote that two thirds of Americans or adults are overweight, or they have obesity or overweight status. But we don’t talk about nearly nine out of 10 people are metabolically unhealthy. So you can be a, quote unquote, “normal weight person” and be metabolically unhealthy, which is the majority of Americans, in part because of our lifestyle.

Shireen [8:18]: Interesting. And so you’re saying the weight is not really measuring what is probably most important, which is quality foods and nutrient rich foods that one has access to now helping you know sort of understanding and bridging to this goal that you’ve created. What has really drawn you to this goal, and what progress have you really seen so far, we hear a lot around food insecurity. But nutrition insecurity is really that pivotal one that has this emphasis on the quality of foods, that again, if you can tell us a little bit more about like, how do we get to where we need to get to from where we are today? 

Dr. Cadenhead [8:56]: Yeah, again, thank you for that very important question. Again, my mantra was driven from me being in that hospital room, looking at a television commercial and not being able to think very well and realizing it was because I wasn’t eating quality foods, and then also getting out of the hospital and thinking about my children, and what that meant for them and then thinking about other people’s children and what that meant for the whole entire nation and beyond. I think during the pandemic, even though it was really tragic. The things that people were experiencing, what we found was that policy can make a huge difference in food insecurity and nutrition security in the lives of people throughout the country. We were able to pivot pretty much on a dime to provide support for families and that was enabling people to have quality foods. So we know it can be done. As these policy supports have evaporated, we are seeing Today there was a report saying in New York City, that one out of four children are experiencing food insecurity. Children have always been the most vulnerable because of many different circumstances. But ultimately it comes down to supporting families. And I would say it’s not that people who have children are more deserving to eat than people who aren’t with children, all people deserve access to healthy, affordable, culturally relevant foods.

Shireen [10:30]: And walk us through what is being done on the policy front today. And what is the work that is still needed to be done?

Dr. Cadenhead [10:37]: Well, the USDA has a lot of programs that do support people to be able to eat well. And I think you’ve had people on who have spoken to that. So I won’t go through all of those programs. But I will say that in terms of work that still could be done, like for instance, SNAP, the Supplemental Nutrition Assistance Program is limited on many fronts. For instance, college students who may be struggling to pay bills aren’t necessarily supported. There are many groups that are excluded unnecessarily. So the working requirements for people who are already working three or four jobs to just be able to pay the extraordinary rent that we see throughout the country are just struggling to hang on financially, makes it difficult when you’re trying to just hang on, and you have all these other restrictions. So we could take a look at how these restrictions impact people, they fail to include people like they could, again, there are many people through no fault of their own, no lack of hard work, who rely on these benefits, and they can’t necessarily get to them. And it would be great to be able to support them in that way. We can also provide support in terms of administrative support. The people in these offices are working super long hours, on very low staff to client ratios. You know, understanding how the programs are working soup to nuts, is something we could tweak and probably have much better outcomes.

Shireen [12:28]: And I absolutely love you know, a couple of minutes ago, you mentioned, you know that a lot of these efforts did go online during COVID. Now, some of the funds are drying up, which is another problem. But at the heart of it, we know that is not a logistics infrastructure problem, because that can be turned on. It has been proven during COVID. And so we really like your commentary and that, you know, we have the capability to do this, right? It’s just about driving that policy forward to be able to sustain it.

Dr. Cadenhead [12:59]: Exactly. Yeah. And having the will to do it is something we need to do. We were one of the few countries that didn’t adopt, I forget exactly what it’s called. But Eleanor Roosevelt, in 1945, I believed pushed for a human right to food. Right. The US didn’t sign on as a supporter and endorser of that. So it’s like we still haven’t acknowledged as a country that should be a basic human right. And I think going back to those days, in part that was due to the fact that some people felt that some human beings, black and brown folks didn’t deserve to eat. And so we have sort of treated this whole support system, as you know, other rising people, even if you’re not black or brown, if you are white and struggling, you deserve that support, too. So it’s like having support for everyone is something we can do. We’ve shown we can do. There’s no reason we can’t do it. We support other efforts. And imagine the savings. That’s the other thing. People will say, Oh, it’s too expensive. Well, we’re spending billions of dollars on health care as a result of this broken system. And we could put some of that cost savings, depending on how you’re calculating it. If you’re just calculating it in terms of like seven years, a seven year horizon, which I think is a shorter time horizon that the Congressional Budget Office uses then probably is appropriate for this kind of expense. If you expense it correctly, then the savings that you’re seeing from this kind of investment is just magnified. 

Shireen [14:01]: You know, there’s two things that I want to talk about next space on what you just said, you know, the first part of what you said around racial inequities there that exist, it takes me to my next question, which is, what are those gaps that you see within environmental factors that really might help determine health outcomes among different people who may not have access to proper nutrition?

Dr. Cadenhead [15:20]: Yeah, that’s also a tough and large question. So we still have a history of segregation that has fed into health crisis today, like redlining, where we had people live in one section of a city or town, and other people live in other cities. So if you go to those areas, which have traditionally been black and brown, folks, you might find the stores are different. They’re advertising products, in ways that you won’t see in other communities, you’ll see a plethora of billboards and certain communities advertising, unhealthy foods, you’ll see food swamps, which are areas where you have all of the fast food chains, there are certain areas you go to, and there’s not even a fast place, you’ll see a grocery store with affordable food and one area, it’s like we have regulations on local levels, that feed into the health outcomes of communities that increase these racial disparities. We have, even in New York City, for instance, you have higher levels of pollution in certain areas, because you allow trucking in these residential areas where you wouldn’t allow that and certain other residential areas. So you know, having that have equity lens for policy on a local and state level and a federal level was really important. I know people want to get away from regulation, but regulation is actually the thing that saves lives. 

Shireen [17:03]: And then, my second question to you from what you’ve mentioned, is really understanding the health outcomes piece, help us connect the dots between nutrition security addressing that, and then all the way through health outcomes and what you talked about even healthcare cost savings, you know, that may show up in our healthcare system, can you help us understand the connection point there?

Dr. Cadenhead [17:26]: Some people might understand this, like be a boxer, and the boxer is constantly being hit in the ear, they’ll get these cauliflower ears, right, and then, you know, maybe they’ll have to get plastic surgery, if they want to fix it. When you don’t get the right nutrients in your body, you have on a cellular level receptors. And, you know, I think you talk about diabetes, you set up the conditions in your body, so that over time, there is no point of return. I was fortunate with my hypertension that I was able to manage it through through diet, but many people, maybe they’re able to manage it with drugs. But you know, when you have diabetes, for instance, if it’s not well managed, if your HPA1C number is high for a while you’re damaging every organ in your body. And you know, your small vessels are feeding into things like your kidneys, your eyes, you know, this is why people get neuropathy. This is why people go blind. This is why people are having all these downstream impacts. And you have to have more and more medical interactions. When these things happen. It gets to a point where it doesn’t really matter necessarily what you’re eating at that point. Now, imagine someone who was able to have adequate nutrition security early on, again, a prime example. If you catch it at a point where you’re able to still reverse control it, you don’t have all these downstream effects. So that means you’ve reduce the issues with having higher medical expenses. But also like, imagine the difference in quality of life for people. You know, as that person progresses with diabetes, with type two diabetes, they become more and more disabled. You know, maybe somebody has to go on dialysis. Maybe they die from it. Maybe they go blind. I actually met a medical doctor who was at a food pantry because they had uncontrolled diabetes, developed neuropathy. He was unable to work because of the disability that they had encountered. Like, if it can happen to a medical doctor, it definitely can happen to anybody. And some of it is genetic. But a lot of it is diet related, where we have just so much refined grains and were swamped with Ultra processed foods with more than 60% of our calories, on average in our population is ultra processed. And it’s not necessarily, you know, you can add nutrients to a food, but that’s not the matrix that they were designed to be in, we need to be able to eat more minimally processed foods than we are now. And we don’t have a system built for that. 

Shireen [20:50]: And the goal there being and what you’re just touched upon there, at the end with the ultra processed food being that the more processed the food is, the more restrictive those nutrients. Hence, as you eat those foods, they’re just calories, they’re just not adding to the overall nutrition profile that you need to be consuming. 

Dr. Cadenhead [21:08]: Yes, And I would add, though, that there are a lot of manufacturers who will add nutrients to the food after they have been stripped of the matrix that they were designed to be in. And that is not the same. So you can’t just add fiber and say, Oh, it’s a high fiber food, and this is healthy for you. It’s not, I don’t believe they have a body of evidence supporting that. And I would suggest that it’s going to interact in the body differently, you’re going to have your microbes that are metabolizing it differently, and therefore the nutrients are getting into your body differently. So it’s not just strictly the nutrients in the form that they were designed to be in naturally. 

Shireen [21:52]: That’s very helpful. Dr. Cadenhead, I feel like we could definitely continue this conversation, it would be a whole nother-we could do two episodes on this. But I really do appreciate your time. And with that we are toward the end of the episode. But at this point, I would love for our listeners to know how they can stay on top of a lot of the research that you’re doing the policy issues that you’re driving forward, how can they continue the conversation with you? 

Dr. Cadenhead [22:17]: Yeah thanks for that, they can follow me on LinkedIn, they can go to our Tisch Food Center website and join our blog or our newsletter, we have a Tisch Dish which is more informal, but also updates people on different policy efforts as well. And we have lots of free resources available for anybody who wants to do nutrition education, especially educators in the K through 12 schools.

Shireen [22:44]: Perfect. With that. Thank you so much, Dr. Cadenhead. For being on this episode to our listeners. Thank you for joining another episode of the young English podcast. It has been an absolute pleasure. Head over to our social media. We do not have a question for you today, but head over to our social media. Tell us what you liked about this episode today. Again, find this podcast post and comment below to tell us what you liked about this episode. What was something new that you learned today? After listening to this episode again, head over to Facebook to Instagram, and we will continue the conversation there with that. Dr. Cadenhead, thank you so much for your time. It was such a pleasure.

Dr. Cadenhead [23:18]: Thank you for having me here. pleasures mine.</span

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