Shireen: Jamie Freier is a registered dietician nutritionist and licensed dietitian with a BS in Nutrition Focus in Dietetics, and a BA in Psychology with a Social Justice minor, all from the University of Minnesota Twin Cities She's currently working as a registered dietitian at St. Joseph's Minnesota is COVID Hospital along with St. John's and Woodwinds hospitals. Thank you so much for joining us, Jamie. How are you doing?

Jamie: I'm doing great. Thanks for having me.

Shireen: An absolute pleasure. So let's just dive right in. I'd love to learn more about what brought you to a career as a registered dietitian.

Jamie: Okay, well, it's kind of a personal and silly story. But um, I was originally going for psychology, and then I decided I didn't want to be a psychologist. It wasn't my cup of tea, I do appreciate the field. But I didn't know what a registered dietitian was at the time. And during my break and finding my passion. I was studying nutrition, but also my grandmother had passed away of six different kinds of cancers. And I was really she was my, my number one, you know, and I one late night, I left the TV on and an infomercial popped up. And it was like, Oh, you can prevent cancer with fruits and vegetables and all this. And I was just like, Oh gosh, like, I don't want to listen to this. That's not true. Like, how can they even say stuff like that, um, but then when I looked into it, it's true that cancer is one of those diet related diseases, at least a couple different kinds of cancers. So it was something that really kind of pushed me into learning more about what diet can do for people's health and chronic illness.

Shireen: So one of the recent things that we heard of is that the USDA put out new dietary guidelines. And by the way, these guidelines are going to be linked in our show notes. So what aspects of the USDA new dietary guidelines Do you think can be helpful to those living with chronic illness?

Jamie: I really believe that pretty much all of them. So what these dietary guidelines do that is really helpful as it goes through the lifespan starting from infants all the way to older adults. And at each one of those life stages, there are tips in there to help prevent chronic diseases. And although the guidelines aren't meant to treat them even following as closely as you can, to those guidelines will help them there are things that you can do to customize your guideline, like customize the guidelines to fit more your personal, like if you are dealing with a chronic illness, to tailor it to what you need to do to help your personal self become more healthy, in relation to those. 

Shireen: In what capacity can those living with chronic illness really utilize these guidelines?

Jamie: I would say using the guidelines as kind of like the backbone. So if you if you haven't been able to focus your complete dietary pattern around these guidelines that fit your current life stage, trying to hone in on those things first, before moving on, and really trying to make specific changes for whatever disease state you may have. Because those are even more specific and harder to follow. But the guidelines are meant to be realistic and achievable for any Americans. So I think just really focusing on one guideline and sticking to that as much as possible. If it doesn't work, move on to the next one and keep like ,really trying to follow them. And I think that might help her any kind of disease that you may have. But to also keep in mind that those will need to be tailored if you are to see better results depending on what your diseases are. 

Shireen: Would you say there are any limitations to these guidelines, especially for those with chronic illnesses?

Jamie: I would say though, um, I know like the sodium recommendations are pretty, it's 2300 milligrams for sodium. And in the hospital, what we usually recommend for people who are having, like hypertension or some cardiac related diseases is to have it be less than 2000 milligrams a day, and that's even the 2300 milligrams is significantly lower than you might think most people give far over that just eating really in America. So that could I mean, it's a good guideline to follow but just to know that for specific diseases, you will want to tailor those things. The other thing that I noticed in the guidelines is although they do mention dietary fiber as being helpful, dietary fiber is so so important. We're all disease risk factors and having more of a concrete goal to getting more dietary fiber will probably benefit everybody. So and they don't have a concrete recommendation around dietary fiber, but increasing dietary fiber has been known to reduce mortality and reduce the risk of multiple diet related diseases. Absolutely. And it does mention that in the guidelines as well that to tailor it to your personal, your personal lifestyle, your health and all of that. So and that's a big upgrade from the last guidelines where it gave you the guidelines and told you like what you should and could and need to be doing. Where this one is more mindful of the diversity within our country. So I think that is definitely an upgrade from the last one. And hopefully it will continue to be, so.

Shireen: What do you think, within the newest guidelines, they omitted a recommendation from the advisory committee to reduce the added sugars intake to 6%. and choosing to keep it instead at the previously recommended 10%? What do you think is the effect of this?

Jamie: Well, they were trying to be inclusive of everybody. So the calories are for each individual person are using an equation to come up with a recommended calorie for that. And some people need more, and some people need less. So the current nutrition food label uses 2000 calories as the, the average that an American should have. And that's more geared toward the males and the females, because females would probably be closer to about 1800 calories would be like a pretty big goal. Though already using 2000 calories at 10% is a little bit higher than what, what we should be getting. But in order for them to include everybody from the people who need 2000 calories all the way up to 3000 calories. They, they kept it at 10%, where ideally, having less added sugars, just in general is more helpful. So I think they were trying to be more inclusive to try to not leave everybody out. But really it's giving people that extra like oh, I can have like they might try to get 10%, when really it's less than 6% is actually helpful for their health. So in my personal opinion, I feel like the more we stick closer to the science and what is actually needed to prevent chronic disease, the better off the American people will be. 

Shireen: What do you think of the newest guidelines that emitted a recommendation from the advisory committee to reduce alcohol intake to one drink per day and choosing to keep it at the previously recommended two per day for men.

Jamie: So I also feel like it's along the same lines with the added sugars like less is more. And it says that in the dietary guidelines that even if you have just a small trace amounts of alcohol, like you might find enough kombucha or some fermented food, that is enough to have health benefits where you actually were having a full drink of alcohol daily isn't and they did keep it at two for men and one for women. And that could be from the previous evidence that men just metabolize alcohol differently than women and that type of thing. But the current science really does show that less is more. So I think they're trying to not push too much into people too fast, especially in some of the higher drinking state, and in the Midwest, that kind of thing. But it is if you can do it, try to limit it as much as possible and don't start it if you haven't.

Shireen: So, do you have any alternate recommendations of these guidelines?

Jamie: Similar to what I said before, you know, really focusing on the dietary fiber. So a good example of that would be rather than drinking a fruit juice, because it's recommended only four ounces of juice in a day, you could have a whole fruit and then you're getting that fiber and the benefits of the juice at the same time I'm choosing and the recommendation, the guidelines do say to have half at least half of your grains be whole grains, well, I would recommend pushing that to try to make all your grains, whole grains, and then just being around and in life, you were bound to get some of the non whole grain grains. So just kind of pushing yourself as much as you can to try to follow those guidelines, but doing it in a way where it does work for you, but also is really a step towards the right direction. And their slogan with these guidelines is every byte counts. And I think that is so neat. And I love that because everybody does count. So yes, you could choose between having a whole group or a juice, but just know that if you have the whole group, that bite is way more beneficial for your health in that group. So there's that, the fiber piece, but then also, I would say, considering our environment and what's going on in the whole world today. We do know that the impact of red meat consumption is not only detrimental to our health, I definitely to the environment. And I think that trying to follow a more plant based eating pattern is just entirely beneficial all around though that would be my personal recommendation is look for those different ways to get in your protein besides the red meat. Red Meat is just not good for our health and it's not good for the environment and trying to limit orders to maybe specialty occasions would be just helpful all around. 

Shireen: You had mentioned on your social media that you feel the USDA and Department of Health and Human Services should review and adjust the Dietary Guidelines more frequently than five years. What is your recommendation on it and why?

Jamie: Well, ideally I'm maybe I'm too much of an idealist is it would be nice to have these guidelines be kind of more of an ongoing improvement. So if a giant systematic review came out and some information was like found that this guideline might not quite meet the current recommendations or if there's things that could be changed, then those, I think that should be included almost right away. I don't think we should have to wait five years before we start following those new guidelines. The other views that I think about, especially now that they added the earlier life stages in the infants and toddlers, and those were years ago, they were in the guidelines, and now they're back. But after five years, those that life stage is over with, and we're on to the next life stage. So we would need to review this kind of more frequently. At the same time, it takes time to come up with these guidelines. And the review process is really intense and significant. And it takes a lot of people and to figure out what the best way is. And I just hope that the same amount of time and is that is needed to come up with these guidelines would be accounted for in that though a lot wouldn't have to come into my head or the guidelines to be reviewed more frequently. But if there's time to do it, I would say have this just be an ongoing and unlike an open book type of ongoing improvement, will the American people can start improving their lives sooner than later. That makes sense.

Shireen: Where do you feel like aligners for both healthcare practitioners and lay individuals of staying up to date with nutrition information without being at the whim of every single study?

Jamie: Oh, goodness, yes, that is, that's important. And that's why these guidelines are so helpful, because it is a way for all bodies of the government, as well as like our schooling and just everything. As far as delivering nutritious food options to our people is that we need to make it realistic and understandable and not overwhelm people who may not be really that interested in nutrition and the science behind that. 

Shireen: And going through a health practitioner can help understand all of that for you is probably the best way.  So it's like I love the guidelines, they're absolutely amazing for helping people kind of follow them without needing to know all the backstory, even though they do provide an extensive amount of information in them as well. But um, yes. So I think I think as healthcare professionals, we, we have all that knowledge. And if you want to know it, we can deliver that to you, if it will help you get closer to the guideline. But otherwise, you can, you can trust that the guidelines are pretty much spot on almost closer than maybe a dietitian might agree with but you can be, you can be safe and knowing that following the guidelines will definitely help improve your health. Oh, great. So then talking about the lay person, what small simple steps do you feel like the average individual can implement to lead a healthier life? I really agree with the MyPlate. So it mentioned setting the guidelines like making half your plate fruits and vegetables, a quarter of your plate or maybe a tiny bit less of a protein food. So that would include the meeting the food, eggs, those things and then having only a quarter of your plate, the grain. So if you think about it, eating a full plate of spaghetti spaghetti, that's not following the guidelines, the tomato sauce, that's not half your plate, you know, so you have to look at every plate that you may and try to stick with that my plate pattern, go half your plate, fruit and vegetable after plate protein, and gray. And then those are all whole grains and you're getting all that fiber. If all those fruits are whole fruits, you're getting more fiber and just helping improve your health now and for the long run.  So with that, Jamie, unfortunately, we're towards the end of the episode. At this point, I'd love for listeners to connect with you and learn how they can, you know, connect with your work?

Jamie: Oh, yes, absolutely. So the best way to get a hold of me is via LinkedIn, though, if you just search Jamie fryer on LinkedIn, so it's linkedin.com forward slash in or just slash Jamie dash wire, you'll find me and I am pretty good about answering my messages might take me a couple of days that I'm busy at work. But yes, absolutely. That's the best way to get hold of me. And we will, by the way, for all the listeners, we will link everything up in our show notes. So you can click on it and go directly to Jamie's LinkedIn page.

Shireen: So to our listeners here, I would like to ask what role does a dietary recommendation play in your life? reach out to us on social media and submit your response? And we'll, we'll address it on social media. With that. Jamie, thank you so very much for being on the podcast with us today. Really appreciate your time and helping us understand these dietary guidelines really been in the context of our care and that it really, the, my takeaway from this is that the dietary guidelines are not the end all be all there's a lot of contextualizing that needs to be done for an individual's health. And so there's, there's still work to be done.

Jamie: Yes, absolutely. Thank you so much for having me. It was a wonderful opportunity. 

Shireen: Thank you.

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Email: jamieraefreier@gmail.com

Resources mentioned:

USDA New Dietary Guidelines

Department of Health and Human Services 

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