What is your exact job title?

Outpatient Clinical Dietitian

What is the description of your job and how are you

impacting childhood obesity?
I provide 30-60 minute nutrition assessments and counseling education classes to a
low-income population in Houston at two clinics within the city. One clinic is
primarily children, and I primarily educate/counsel children who are overweight. I
first provide the child and parent with basic nutrition education that describes what
defines a low calorie, high calorie, nutrient dense food vs. nutrient dense poor
(sodas, hot Cheetos, chips, fruit juices of any kind, fast food) and emphasize the
importance of portion sizes of each food group. A large barrier is often that many
kids are picky eaters and dont like vegetables. I often describe the connection
between eating vegetables and how it prevents heart disease by preventing
inflammation in the arteries (the first step in CVD development). Then I tell kids
that it is scientifically proven that you must try a food 8-15 times before your taste
buds/brain will determine if it likes it or not (which is true, and most kids have only
tried their disliked vegetables 1 time.)

What inspired you?

Growing up, my grandparents and father had diabetes and heart disease. My mother
changed our diet to a healthier one when I was about 10 due to my fathers
development of diabetes. His disease progression has always inspired me to live and
promote a healthy life since LIFESTYLE MODIFICATIONS are the biggest variable to
diabetes and heart disease prevention.
Also, when you see these childrens lab values being worse than my mothers, I often
cringe and foresee that they will have a rough life filled with diabetes, heart disease
complications if we do not do something to reverse the damage as much as we can
and get these kids back to a healthy weight and diet.

What is your experience working with obese children?

I work with them 2 days a week and help them lose the weight slowly and with
healthy practices such as 1 hour of aerobic-like exercise every day, eating nonstarchy vegetable servings on each dinner meal (ex: NOT peas, corn, potatoes, sweet
potatoes, cooked carrots, must count these as carb foods and take off bread/dessert,
etc.). I often have to educate and counsel mom/dad about their familys overall diet
so its often the unhealthy lifestyles of the parents that are driving their childs
unhealthy eating, but strangely not always. I would say a large portion of childhood
obesity is LACK of EXERCISE. Kids today are so sedentary and live on their smart
phones, tablets, computer, and TV screens. They simply need to get active and stop
drinking all sweetened beverages (juice included). Another portion of childhood
obesity lies with psychological issues that are outside the realm of my practice.

Many kids are depressed, have anger problems, anxiety, and or have severe ADHD.
This is why the facility I work at tackles this with a multidisciplinary approach.
There is a weight management doctor and psychologist that are pulled in on cases
that require a multidisciplinary approach and we all try to educate patients
comprehensively. We share information and needs or anything we noticed that
needs attention by the others specialty. It is really a great way to tackle childhood
obesity.

In your opinion, what is the major problem?

Like I said above, it is misinformation/ignorance by parents regarding nutrition,
childrens dislike for vegetables (i.e. low calorie/high nutritious foods), major lack of
exercise/physical activity, and psychological problems that has caused child to
resort to eating for whatever reason.

Do you believe our culture has an effect to our childrens

lifestyle?
YES! For example, there is research that states if a child comes from a family whose
parents are overweight, they are more likely to be overweight, and their perception
of a healthy weight is usually distorted. Even in my own practice, I catch myself
looking at a kid and thinking to myself they are at a healthy weight since most kids I
see now are very large. Then I catch myself and remember all of the health
consequences this child is having in their body and remember that just because this
childs weight is the norm it is not normal.

Do you believe cost of food and family schedules

contribute?
Oh yes! This is often the biggest barriers. A lot of time is spent teaching parents
ways to eat healthier with low-cost options which involves cooking with is
constrained by time. It is a huge part of it, and I always make the point to state that
time and money must be given to your health (I say you are worth it!) A side note
here, often these money constrained individuals come in with nails done and
coach purses so it is more to do with money management and being selfish, frankly.
The biggest part of it is to make sure they understand their money needs to be spent
on whats important first which is nutrition since it ultimately affects the well-being
of their children.
PE needs to be every day in school, more low income sports activities/gym access,
gardening programs and nutrition education within our schools, parenting classes
on nutrition/cooking/money management, and mental health available to all (Im
looking at you Bobby Jindall, lol).

What can parents, educators, and community do to help

these children?
Parents and educators need to get healthy themselves and be good role models for
these children. The community needs to come together to provide an environment
conducive to physical activity (walking/biking trails, community activities to be
physically active) Vegetable gardens need to be learned by all. Parents should cook
with their children and get them excited about healthy eating by letting them help
prepare food (if they are old enough.)

What resources are available that you know of for

families?
www.eatright.org
www.myplate.gov
www.cdc.gov
www.usda.gov

What services do you offer?

I offer nutrition education services to low income people of all ages.

What is the cost of your services?

Depending on insurance, I have saw some people only having a $3 copay to see me
to as much as $50. Some doctors offices are including dietitian services as a free
service in their offices to attract more patients.
How do you think as a nation we could do to decrease the cost of assistance for
those less fortunate?
I think we could provide edible landscape which would basically mean keep up
gardens around low-income areas so people have access to fruits/vegetables.
I think the food stamp program (SNAP) needs major reform and only allow people
to buy certain healthier items to eat (no sodas/chips/candy at the least).