"Because we see that the blood sugars are elevated, the blood pressure is sometimes going in and out of where we expect it to be. This is a question of how do we reduce systemic inflammation for that individual, and that's going to look different for everyone." - Maya Feller, RD
Shireen: Maya Feller of Brooklyn based Maya feller nutrition is a registered dietician nutritionist who is a nationally recognized nutrition expert. In her practice, she provides medical nutrition therapy for the management of and risk reduction of non communicable diseases. Welcome, Maya.
Maya: Thanks for having me. I'm so glad to be here.
Shireen: Oh, absolutely. Our pleasure is all ours. Maya diving right in, I want to learn a little bit more about what led you to become a registered dietitian?
Maya: That's a fantastic question, Shireen. So this was actually a career change and the first part of my life, I was incredibly interested in theater. And I studied the avant garde. So not like, you know, the conventional theater that people think like they go to Broadway, that type of theater, more like the surreal and, you know, interesting, the odd. So that was what I spent my time doing upon graduation. Well, so my undergrad was in theater, and then philosophy. And so I spent some time doing that. And upon graduation, I realized that I was not going to live from the avant garde as much as I wanted to, that I needed to do something else. And so I took some time in between to really think about what it was that I wanted. And that was when I fell in love with running, but like distance running and I decided that I wanted to run the Boston Marathon and I was running for charity. And so I was training with a really good friend of mine. And we would go on these incredible long runs, you know, we were running 18 plus miles, I think the longest that we did for training was 24. And we would just chat, like when I say chat, we would talk the entire time and run. And then I started musing about food, because you know, you hit a mile a team, and your carbohydrate stores are used up. And I literally was saying, what's happening with the food that I eat, and really, really funny, but I was obsessed at the time with falafel, I was a vegetarian. And so by mile 16, I would start to think about the falafel in my neighborhood. I really wanted it after my run, always. And then, you know, a couple runs, like long runs, and I was fixing what is really going on with this food that I'm eating? Where is it going? Like what's happening with the metabolism? Like how's it getting to my cells to be used for energy has my body being fueled for this, like massive, you know, period of time where I'm pounding the pavement. And I know that that sounds so silly, but then I was like, I bet you I could study that. And so I went home and I literally got on the computer and started looking around for you know, nutrition programs. And at first I thought I wanted to do a certificate. But I come from, you know, radical educators who are PhDs and certificate program for anyone that knows what it's like to be a first generation kid in this country are not a happening thing. They are very focused on getting education, you know, but with a credential. And I will never forget my dad saying, “No, you're going to go to Harvard.” It's like no, not to go to Harvard. But okay. And so I actually looked for a nutrition program. And being in New York, I was interested in Clinical Nutrition, because I wanted to have the ability to be in hospitals and work directly with people in a clinical setting. And so I applied to NYU. And that's where I ended up going for both my masters and my rotations to become an RD.
Shireen: Lovely. And so you have a unique approach when it comes to healthy lifestyle, in that you do not focus on weight specifically. So why is that? And what are some other metrics that you consider and why?
Maya: Yeah, so I think and I say this to my patients, and really anyone who comes to me that you know, weight may or may not be meaningful. And I know that, you know, in this country, we really kind of believe in diets, and that people place a lot of value on following or adhering to specific diet patterns. And what I found, especially with the non communicable diseases, is that it's more about meeting that person where they are, and creating a plan of nourishment that is sustainable and helps them express their best health outcomes. And when I say that, let's say you have somebody who comes in, and their blood pressure is on the border of, you know, being high, like they kind of toggle between, you know, within the expectations, and then sometimes moderately high and then sometimes overly high. Rather than putting them on a specific diet or saying I expect you to lose 10% of your total body weight, which is what the textbooks say, right to get that reduction in blood pressure. My question is to them, what is your life look like? How does nutrition fit into your life? How does intentional movement fit into your life? And how do you manage work life balance and stress? And then I look at those variables along with biochemical, right. So let's say that person also has elevated blood sugars, then I might say, “Okay, you know what the endocrine system is being taxed.” Because we see that the blood sugars are elevated, the blood pressure is sometimes going in and out of where we expect it to be. This is a question of how do we reduce systemic inflammation for that individual, and that's going to look different for everyone. Right? Of course, because I work with food and nutrition, I do put a priority and importance on reducing the proportion of ultra processed foods on the plate. I also talk a lot about paying attention to how added sugars, added salts and synthetic fats come into that plan of nourishment. Because one of the things that we know is that for anybody that's following the standard American diet, they're getting this over abundance of the added sugars, the added salts and the synthetic fats. And those are really endocrine disruptors, if that's the majority of what we're eating, plus being physically, you know, inactive, then the risk for developing these non communicable diseases is higher. I'm always incredibly careful, never to blame the patient. Right? So anyone that comes to me, and they are in need of my nutrition services, I never blame and I never placed judgment. The question is, how do we work together so that we can really spur a sustainable modification, right, and one that also feels good for them? where food is not a reward or a punishment?
Shireen: Mm hmm. I love that approach. So weight is only saying part of the story. There is more to be said when you're looking at other metrics.
Shireen: Interesting. And then so your practice is based out of New York, what are you seeing with patients in New York? We know, we've seen some high numbers and, you know, come out of as far as COVID is concerned, come out of New York. And of course, things are looking better. And then they, you know, it's a rollercoaster. But having said that, what are you seeing from your patients that you're seeing in New York, especially for those with diabetes?
Maya: So a lot, it's interesting. At the beginning of the pandemic, I continued to work remotely. And so every patient that I was seeing in person, I immediately emailed to, you know, check in and say, Okay, first, how are you doing? How's your family? How's your extended family? Do you want to continue remotely? Right? Do you think this is valuable? And because the majority of the people that I see are for medical nutrition therapy? They said, “Yes,” and I would say that our does, our, the way that we work together significantly shift. We really began to focus on how do we improve their clinical outcomes in light of COVID. Right? So the elevated blood pressure, the elevated blood sugar is the elevated lipids now took on a different meaning, because we saw that people who had diabetes had worse outcomes when they had COVID. And so we were really working together to kind of bring those numbers, numbers into the, where we expect them to be. You'll notice I stopped saying, or I'm not saying within normal limits. Because I think that when we talk about nutrition in general, that we put all of this kind of bias language on it. And so I've started to say things like the expectation as opposed to normal, because then that means that the person is abnormal, if their numbers are outside of it. And I want to help them also understand that there is nothing wrong with them that we really have to modify this lifestyle and behavior so that the numbers are supportive of their overall health outcomes and that we reduce the risk of comorbidities.
Shireen: I love that. I love that change in thought. Thank you. So what are some of the other things that you're seeing? So for instance, there's this level of quarantine fatigue, if you will, right now, what are you seeing with that, especially with the patients you're seeing in New York?
Maya: So in New York, because we have been quarantined for months, we're slowly opening back up. And some restaurants are opening, but many have closed. And you know, in New York, people kind of lived this fast food takeout life, where sky was the limit, especially with international cuisine, I mean, you could walk down the street, and you literally could take a trip around the globe, and get anything that you wanted. Without gluten, you know, without nuts without you name it, like in a one block radius. And for varying price points to write. So that's important to put that in there. So it wasn't just the people that were spending, you know, $15-20, on lunch that had access to this, this was also we had the food carts that you're in, I mean, could get you like an awesome $4 lunch, and be from anywhere in the world with, you know, bursting with flavor. So I say that to say that a lot of people are cooking breakfast, lunch and dinner at home, folks are tired. You know, everyone says, either I'm hand washing the plates all the time, or I'm constantly running the dishwasher. Like I am tired of being in my kitchen and also it's hot now, you know? Someone told me a friend of mine the other day, they are in Florida, and they said it was 102 degrees, right? So people do not want to turn on their ovens and make an already hot place even hotter. They don't want to turn on their stove tops. So it's like quarantine fatigue, plus heat. And it's like, What do I do? You know, they're like, I'm done with all of this. So that's, yeah, that's tough for, you know, for all of us and I would say collectively.
Shireen: And so that, and you don't have to tell me twice. We're based out of Texas, and it was 100 degrees yesterday. So a lot, it's a lot to manage for sure. So how do we take some of that pressure off? You know, how do we prioritize health in a low cost way And still, you know, have fun while doing it?
Maya: Yeah, so the first thing that I say is it's individualized, right? So depending on where you're from, you know, healthy food looks different. Um, my biological family is from the Caribbean. And in Trinidad, we have a lot of amazing curries and vegetables and you know, so that, to me, is healthy. Like, if someone makes like a potato in China curry, I'm all in somebody makes callaloo which is made from dasheen. Bush up here, people use spinach, and okra, coconut milk with pumpkin. I think that's incredibly healthy, right. So you'll see the kind of through line and all of these things, it's their foods in their whole and minimally processed form. So the first thing I say is always honor your cultural food ways. When you're thinking about how do you make healthy food, you don't have to switch over to conventional Western food to be considered healthy. If you like salads, I do listen, I love a good salad. And I will make salad for breakfast, lunch and dinner. anyone that knows me, I've been known to make a salad for breakfast and put an egg on it. You know, and I still think that that and I think that that's incredibly delicious. So I think it's about figuring out the tastes that you like, and how to simplify your interactions with them. You know, oftentimes we do this thing where we say you have to have only this type of produce. It's only good if it comes from this place. One of the things that I really like to impress upon my patients is if you live in an area where there's a farmers market, get to know Your Farmer. Figure out what time of day is best to go and when you're likely to get the best deals. Sometimes at the end of the day, there will be produce leftover, but they don't want to take back to the farm. It's been harvested, you know, in the last two days, they don't want to take it back and they're likely to give it to you at a discount. If it's a leafy green or even a cruciferous vegetable, or one of the harder ones, you can absolutely buy in bulk process at home and freeze for later. Right? So that's already a cost saving mechanism there and then you have access to the things that you like. It also allows you for some of the things that may be a bit more expensive to have them at a lower cost. So like berries, you know, they definitely don't want to take the berries back, right because those will mold quickly. But you could for example buy a flat and you'll have some for yourself if you wash dry and freeze for later. Then you've got berries for the rest of the month. So I like to suggest things like that. Also, listen, do not discount the frozen meal. I know that people are probably like what are you talking about, their frozen meals? It has great nutrition profiles. For the consumer, it's important to flip that package over take a look at the nutrition facts panel and read. What does the Daily Value say for sodium? What does it say for added sugars? What does it say for total fat? What does it say for fiber? What does it say for protein, right? Anything that's close to 5% as low and 20% as high. So it's important to take a look at that and understand what you're getting. Additionally, read the ingredients. There are a number of brands that have really tried to make frozen meals more nutritious. And they also say that it's not the main but it's an accompaniment. So you have that frozen meal, and then you put aside veggies with it. And there are so many that you can choose from. And I say for the consumer, like especially if you're experiencing fatigue, give yourself a week off, you know, like, get a compilation of some of these better for you frozen meal options. And pair them with vegetables or make a couple sides yourself that can really, you know, alleviate some of the pressure and make you feel like oh, okay, this is not so tough. I can do this
Shireen: Oh my. I want to continue the conversation. So we'll hear more from Maya and get her thoughts on mindless snacking in quarantine. After a brief message from our sponsor. We'll be right back.
Shireen: All right, Maya, so that's some interesting tidbits you shared with us and interesting ways to sort of eat healthy and still be mindful. And at the same time, make it fun and give yourself a break, because we can all use a break right about now.
Maya: Yes, we can.
Shireen: So one of the other things I want to touch upon his quarantine, fatigue, brings in some mindless snacking. So I saw that you had been, had did a segment on Good Morning America, actually talking about the root causes that varies between anxiety and boredom, and just the you know, the lack of a regular schedule that can have an impact on snacking, and more so mindless snacking. So what are some of the ways that we can swap some of that unhealthy snacks for healthier snacks?
Maya: So that's such a great question. And I say a couple of things, especially around snacking, right. Sometimes we can modify and create our own right, like, you want a potato chip, if you have an airfryer, you can make you know, your fried potatoes yourself at home, thinly sliced them little bit of oil, add some seasoning, wonderfully delicious. There are times when you say, “you know what, I really want that to Dorrito” And this is where I say, you have to ask yourself a question. Can you get a small single surf package? Sit down, actively eat it and be satisfied from it and move on? If the answer is yes, 100% do it and I say that to my patients all the time. Right? Because there are times for me, you know, full disclosure, once we were traveling back from Massachusetts visiting my family, and I just really wanted some corn curls. Like I was like, I'm gonna have corn curls. And everyone in my family was like “mom's eating corn curls!” I enjoyed that package. Right? It was an intentional choice. I got a small single serving. And it was wonderful. And then I moved on. Right? And I think that I mean, you know, I didn't create this kind of thing where the corn curl had so much power it was I want this snack, I'm going to have it, I'm going to enjoy it. And so I think there are two things, right. So I think it's modifying snacks so that you can have access on a regular basis to the better for you choices. And then deciding when you want to have the thing that you're craving, but in an intentional and mindful way. And that usually requires actually sitting down and being with it. Rather than saying like, you know, I'm going to walk and eat this, or I'm going to be on the telephone and eat this or I'm going to do this while I'm on my computer or watching TV. That's another thing, right? So all of those distractions, I say, try not to engage in them when you're snacking or eating. Because then it becomes literally hand to mouth. And you lose the you know, internal hunger, satiety checks.
Shireen: Mm hmm. And that way, even if your brain’s telling you you're full, you're not listening, because you're sort of distracted by everything else around you.
Shireen: Interesting. Well, that's great. I feel like we can keep talking here. Maya This was very, very insightful. We are going to wrap up the episode here. I want to thank you so much for your time. But before you go, I'd love for our listeners here to learn more about your work and how can they connect with you.
Maya: Thanks so much for having me. Sure and your listeners can find me on Instagram and Twitter at maya feller rd. They can also go to my website, maya feller nutrition.com. And that's the same on LinkedIn.
Shireen: Sounds great. Well, we'll throw that, those links up within the show notes so folks have access to that. Thank you once again, Maya for your time.
Maya: Thank you so much, Shireen for having me. Deeply appreciate it.