Shireen: Kim Rose is a Florida based registered dietician nutritionist who specializes in health and wellness concerns for underserved populations. Her inclusive approach and philosophy revolve around making nutrition easy and attainable, especially for people with diabetes. Welcome, Kim.

Kim: Thank you so much for having me on the show. I'm honored to be here today.

Shireen: An absolute pleasure having you on. So diving right in Kim, what led you to work within nutrition and with a specific focus on diabetes care?

Kim: So I'm going to give you the cliff notes version, the condensed version. So I was born in Jamaica, and I came to the United States at a very young age. But you know, that did not mean that I still didn't grow up in a traditional Jamaican household. So being raised in a traditional Jamaican household, I was always expected to go off and be a nurse or a doctor or even an engineer. So when I finally started my schooling to become a dietitian, my parents were like, Diawara who like what, what is that? So you know, I realized within the field, all my classes, I was the only person of color, or I was one of two people of color. So I decided, I said, You know what, this field does not really seem to be diverse at all. So let me stick with it. And let me see where it would lead me. And then with the topic of food, food is so interesting, because I tell everyone food is so bipartisan food, it doesn't matter if you're Democrat or Republican, which we're not going to get into today. It doesn't matter if you're from the east, or if you're from the west, it doesn't matter your gender, we all need food in order to survive and live and eat. And in my family, I realized that type two diabetes was just running rampant. And I realized it was running rampant because of the foods that we were consuming. So typically, in my culture, my Jamaican culture, we do adhere to a lot of root vegetables, and root vegetables aren't bad, but too much of them can cause your blood sugar to get a little high. And I remember an uncle of mine who was around the same age of my mother, it's actually my grand uncle. He died due to complications with type two diabetes, avoidable complications, that, that. So I realized to myself, you know what, I'm going to stick to the field, I'm going to specialize specifically in diabetes, because diabetes also costs the healthcare system so much money, and it's something that can definitely be controlled through diet as well as lifestyle.

Shireen: Very true. And so your broad focus has been on inclusivity, as well as simplicity when it comes to diet and nutrition. How did you really get there? And how has this really become your mission?

Kim: Oh, well, you know, I get so passionate about these topics, I'm trying to get excited, trying to keep my excitement and trying to contain it. But during my schooling, to become a dietitian, I noticed that a lot of the clients and patients that I interact with, were just very hesitant to want to know how to eat better. And a lot of them would say to me, for lack of better words, that I'm going to quote them specifically, this, what you're telling me to do is, quote unquote, white people's food. And, you know, speaking to communities of color, I realized it was very important for them to still hold on to their traditional foods, but make it in such a way that it is healthful for them. Additionally, with that, even before getting into the nitty gritty of what the diet should entail, I realized that there was just this mental block about them. They didn't want me to speak to them about diabetes, I guess they thought that I was the food police per se. So I said, you know, it's, it's not difficult at all. It's quite simple. And once you know, the barriers were broken down. And they allowed me to give them food and nutrition related education. Then they looked at me and they're like, Oh, well, that that wasn't so bad. I'm like, No, it's not bad at all. It's just a little modification here and there, and you can still enjoy the things that you're used to eating. There's no such thing as a diabetic diet, or any you guys can't see me, but I'm throwing air quotes for those of you listening to this podcast, but everyone's diet is individualized. And we have to make certain carbohydrates that we're used to in our culture, proper for the diet.

Shireen: When you start looking at making food relevant, and you talked about being culturally relevant when talking about food. Why is that important to why is that important to consider when talking to patients?

Kim: Sure. So that's important to consider. Because of ethnocentrism. So by definition, ethnocentrism is when one culture views another culture as subpar, or sub optimal. And because of that ethnocentrism, the person or the individual or the client that you may be speaking to, may become offended, and then they lose trust in you as a provider. So case in point, I was speaking to a good friend of mine, she is a dietitian in Canada. And she shared with me that her parents were diagnosed with diabetes. And before she became a dietician, her parents were sent to a dietician for their, their food and nutrition education. And they were told to start eating a salad with every meal. The problem with that, and the Chinese culture from what my friend was explaining to me is that not they do not eat raw vegetables, their vegetables have to be cooked. Another case in point A friend of mine, her father's from Africa, there's a traditional staple dish called Fufu, which is very starchy in nature. So the dietician that he went to see asked him to trade out Fufu for asparagus, and this is a man in his 60s, he's never consumed asparagus in his life. So he was like, Well, what is this burger, so it's important to be culturally sensitive. Because when you are culturally sensitive, then you're able to break down those barriers, you're able to teach your patient, you're able to teach your client why it's so important that you need to increase fruits, increase vegetables, what is a carb? Why is meal timing so important? Why are my medications important because medication compliance plays into that factor as well. So it's really about building a relationship with your client, not necessarily being their dietician, or being their provider, but being an ally in their corner. So if they don't understand something, they can come to you, and ask questions on how they can improve their overall health, which impacts the health of the nation.

Shireen: Now, Kim, you wrote an article where you were featured, in fact about plant based eating, tell us about the importance there and the impact it has on brain and body.

Kim: Sure. So with plant based eating, for those of you who do not know, it's basically there's many terms for it, it could be vegan, it can be pescatarian, it can be lacto, ovo vegetarian, so forth, and so on. So plant based eating what I like to promote is increasing your fruits, increasing your vegetables, increasing your nuts, increasing your lagoons, and increasing your whole grains. And the society that we live in now, especially seeing that everyone is social distancing, and staying indoors, I'm realizing that the refined grains and the refined snacks and the sugary and the salty foods, that is a comfort food, quote, unquote, you guys can't see but I'm throwing up all of these air quotes. But too, with that, that actually has an impact on our health as well. So when we eat all of these refined foods, what happens is our blood sugars spike, and because of our blood sugar spikes, that causes our organ in our body by the name of the pancreas, to release insulin, and then insulin has to do their job to stop effectively to bring down the blood sugars. So this is actually promoting a can be a promoting factor to obesity. And when someone does gain that unintentional weight and does enter into that obesity status, studies are showing that they do enter into insulin resistance as well. And insulin resistance is a proponent for type two diabetes. And as I mentioned earlier, it is something that is so avoidable, simply by the foods that we choose to put into our mouth, and also our lifestyles. So with a plant based diet, the plant based diet actually has not only nutrients in them in the forms of vitamins and minerals, but it also has a, another nutrient, which I think is of great importance called fiber. And what fiber actually helps to do, it helps to slow those blood sugar spikes. So instead of it being a roller coaster, as I like to call with the highs and the lows and the dips, it's more of a gradual, equal up climb of that blood sugar so that your pancreas doesn't really have to work so hard. So that is the importance of a plant based diet on the overall system, when specifically focusing on the brain. Now let's talk about the nuts. Let's talk about pistachios. Let's talk about walnuts. So these have healthy fats in them and these healthy fats are in the form of omega three and omega six fatty acids, which actually do help our memory, they help us to retain information. I know a lot of people say that you know brain cells don't grow. That is not true. As an undergraduate I did graduate studies in that and it just helps your brain cells overall. So it is, it's not only a heart healthy diet, it's a brain health diet. It's a pancreatic healthy diet, it's a long healthy diet. And for individuals at this time, I'm seeing patients in the hospital because I am a clinical dietitian that do have the COVID-19. And even if you're not diabetic, we're finding that the blood sugars just really high, it's really high. That's the process of the disease. So it would really behoove us to eat a wholesome, healthy plant based diet. So that just in case, we do contract the COVID-19, we give ourselves a fighting chance.

Shireen: What has been, when you're looking at the plant based diet overall, what has been the overall impact on one c levels? You talked about blood sugars? And I'd love to see sort of, what does that impact look like on, look like on one c levels?

Kim: So this is a great question. And I think it was about a week ago, or maybe a week and a half ago, I was speaking to an endocrinologist in Texas at that, and she was a plant based practitioner as well. And she was telling me, in her private practice, she sees a 1% to 2% reduction in one. So I know these numbers may seem small, but let me tell you the significance of that. uncontrolled blood sugars can lead to a whole slew of complications, you can have vision problems, your fingers and your toes can get really numb, your kidneys can start to fail. And these are only a few of the little things. So a plant based diet, a diet that is high fiber, high in those vitamins and minerals called micronutrients can cause a reduction in a once, you which will improve the quality of life.

Shireen: So that's great to hear, Kim. Now, one of the interesting things is that you're based out of Florida. And we know that we've seen cases in the past, at least with Florida, Florida really being that hotspot for COVID-19 cases, how has your work been affected by the pandemic, particularly for your patients with diabetes.

Kim: So with my patients with diabetes, I'm finding it much harder to control blood sugars. I work in the ICU setting, I work in the med search floor, which is non critical care. But for that critical care patient who is on a breathing machine, and who has to be fed through a tube, I'm finding it much harder. So I know a lot of my physicians, they're contacting me and they're saying, Kim, we have, we have the medications on board. But for some reason their blood sugars are too high. So that is something that I'm currently battling with. And it's not only myself, the other dieticians that are caring for their patients that are in the ICU setting, they're battling the same thing as well. And these individuals, some of them have diabetes, and some of them do not have diabetes. So currently, at this time, I'm working very close with my pharmacist to try to properly dose that insulin because in the ICU setting, even if you're someone that do that does have diabetes and you're not on insulin, you're going to be put on insulin because it's just critical care that we need to get those blood sugar's down, because when those blood sugars are so high, then your body doesn't heal itself, those white blood cells that are trying to fight off this virus is not going to fight as effectively and efficiently as they would if the blood sugars are low. So that is a problem that we see all across the board, not just in Florida, but for every, every practitioner dealing with the COVID-19 virus and their patients with high blood sugars.

Shireen: You have this podcast episode about what you need to know about COVID-19 and diabetes. I'm going to do a quick plug for that episode to get more information on that. Which leads me to your podcast. It's called nutrition lifestyles with Kim and Joanne. So many awesome episodes, by the way, covering a variety of topics. Speak to us about some of the, the reason why you've created this podcast, the, the type of work that you're doing, what you're hearing from it.

Kim: Sure. So thank you for that plug. I appreciate that. So the reason why we decided to create that podcast is because currently in the field of dietetics over 70% of dietitians are Caucasian dietitians. And the less than 15% are dietitians of color. So we decided to create a podcast to speak to individuals as well as not only colleagues but more so our patients and clients that are of color. So specifically on that episode, what you need to know about COVID-19 that episode is heavily scientifically based. And we're seeing on the news where it says if you're obese If you have diabetes, or if you have a slew of other things, that you're more likely to get the COVID-19, which is not necessarily true, according to the American Diabetes Association, your risk is higher, not that you're necessarily going to contract it. So on that episode, it's really an episode to encourage as well as empower you to take charge of your health. And also to be knowledgeable to know your numbers. I know many clients that I meet, they don't know what their blood sugar numbers are. And I always say what you don't know can and will hurt you. So you have to realize that you're the bus driver, the doctors, not your bus driver, the dietician is not your bus driver, you make the decision, what you choose to put into your mouth, you make the decision, if you're going to prick your finger and see the results of that blood sugar, you make the decision when you're going to call your doctor and ask for a follow up appointment. So it's really about taking charge of your health because you live within your specific body. We don't live within your body, we don't know what you're feeling. So it's really about during this time where the pandemic is just especially in Florida, where it's just spreading to become an informed consumer.

Shireen: I love the, the overlap between our work, Kim. So when you talk about bringing diversity into the dietetic space earlier, when you spoke about culturally relevant nutrition and the impact of that on diabetes and diabetes management, I think we're so aligned on our mission there, for sure. So with that, we're unfortunately toward the end of the episode. At this point, I'd love for listeners to learn more about how they can connect with you, follow your work, stay updated. What can they do there?

Kim: Sure. So the easiest way to connect with me is on my website, Kim Rose dietitian.com. And I'll be free to help. I'll be happy to answer any questions you may have. 

Shireen:  

That's lovely and can folks… what about your social media and your plugs there?

Kim: So with my social media, it's still Kim Rose dietitian throughout all my social media platforms, I try to keep it pretty consistent with the exception of the podcast.

Shireen: And what we'll do is we'll throw links up for that for your social media and your website within our show notes. So if you'd like to connect with Kim, you can do so just follow the show notes to get you there. So with that, Kim, thank you so very much for your time, it was an absolute pleasure having you on and learning more about your work. And again, like I said, just I love hearing of diverse voices within the dietetic space and who are working to understand that that cultural nuance that is so important in providing nutrition therapy, and I love the work that you're doing for sound bites included, of course, but I love the work that you're doing. Thank you so much.

Kim: Thank you for having me.

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