EP134 Mission Nutrition with Rachel Ryan

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EP134 Mission Nutrition with Rachel Ryan

Aman: Folks, welcome back to another episode of the "I AM GPH" podcast, and today we have Rachel Ryan with us. Rachel is a visiting assistant professor in public health nutrition here at NYU GPH. She graduated from NYU Steinhardt in 2022 with a PhD in human nutrition and also holds a master's in health education from the Teacher's College at Columbia University. What's really interesting is that before immersing herself into the world of nutrition, Rachel was a crypto logic linguist for the US Air Force, and also holds an associate of arts degree in the Arabic language. Just like you all are very curious to learn about this journey and how someone even gets into the world of nutrition, we're so excited to hear about all the insights facing public health when it comes to nutrition and how you're even transitioned into this. Rachel, welcome to the "I AM GPH" podcast.

Rachel: Thank you. Thank you for having me. It's a pleasure to be here.

Aman: I mean, I'm so excited to talk to you because I've never really seen a, out of all the people I've interviewed, a journey like this and a transition that's happening. So why don't we start over there, right? Like that transition you talk about. Maybe let's talk about nutrition.

Rachel: Okay.

Aman: What was the turning point for you that moved you into this world of nutrition? How did the passion for nutrition begin? We don't speak to many people in the world of nutrition or people who teach nutrition apart from, you know, diet people or gym people, at least in my world. So what does nutrition mean to you? What was that turning point for you?

Rachel: Yeah, so I've always had some interest in nutrition. When I was in high school, I actually thought, I was like, “Okay, maybe I will go on and get a degree in dietetics” but I decided I didn't wanna do that at the time and I ended up joining the Air Force as you brought up my background. And so it was during my time in the Air Force that I got pregnant with my first child and that was actually the turning point for me. And it's a little bit of like a classic textbook, like example of we have these different kind of intervention points where we might be able to facilitate behavior change easier. And this is a time for some people like myself, where I was like, oh my gosh, I'm gonna be a parent and now I need to take things seriously. You know, I wanted to, as a first time mom, I was very much like, okay, I need to do everything right, everything that I can to start setting my child up for success. And that started with, you know, nutrition during pregnancy. So before that I was like, I had this kind of idea, maybe I was just trying to not face reality, but that, you know what? As long as I'm like a healthy body weight, it doesn't matter what I eat, you know, I'm just gonna kind of do what I want and eat whatever I want. But then I guess I confronted reality when I got pregnant and I was like, you know, it's more than just about body weight. I think it's important to try to stay within a healthy body weight, but our diets, they also influence our health separate and apart from our body weight. And so when I was pregnant, I was like, okay, let me do what I can. So that was kind of when I got back into the idea of nutrition, but it wasn't for a couple years later. So I was in the Air Force when I had my son and I didn't get out until a few years later. And that was the point at which I decided I would actually pursue a career in the field of nutrition.

Aman: So it was your experience for setting your… you had an inclination with nutrition before joining the Air Force, it was like you always had that interest beforehand?

Rachel: Yeah, just I thought it was interesting, but I wasn't really passionate about it. It was just something that I was like, hey, this is, you know, could be kind of fun to be in the field of nutrition. But like I said, I was kind of just doing other things, pursuing different things and wasn't very serious about college at the time.

Aman: Yeah.

Rachel: And so it wasn't until later that I got more serious about it.

Aman: And it was mainly the first child that during pregnancy that I want to set up. I wanna give the best environment. And that's where health starts in with regards to nutrition and what you put in your body as well.

Rachel: Yeah. I also had like a little scare. They do a test in pregnancy, they test for gestational diabetes and so they do this glucose test, and I failed the first one, so it was my glucose was high, and then you come back for one that's a longer one. So where you've had like more time to fast and to get a more accurate reading of your blood glucose. But it scared me because my mom had a history of gestational diabetes with an older or a younger sibling of mine. And so that I was like, oh my gosh, I'm gonna have gestational diabetes. I'm gonna have to watch so closely what I eat. But I went back and I didn't. It was, you know, it was just, it was standard. I had to get the second test and I didn't have it, but it got me thinking like, okay, this is serious and I wanna do what I can to promote my own health and that of my child's.

Aman: Wow. I mean, that's reminding me of my family as well.

Rachel: Oh really?

Aman: Yeah. Some similar stories and I've heard this, I really admire this, you know, how you take care of yourself and it has a long-term impact, longevity in those things. You know what? I wanna dive into nutrition, but there's something very interesting before nutrition is this Air Force experience, right? So, you know what? I understand now why you moved into nutrition, but what made you join the Air Force? Was it a path that had taken? Because I really want to learn about how you got into Arabic, how you got into the Air Force. Can you tell us more about that?

Rachel: Yeah, sure. So I'm from a rural area in Pennsylvania, a really small town. And where I'm from, people mostly grow up and they live there. They continue to live there. They don't move to other places. So almost all my family's in Pennsylvania, but I wanted to do something different and I thought that the Air Force would be a good way to do that. You know, I wanted to also serve my country, but also to get the experience of doing something different, of moving somewhere else. The first time I was on an airplane… so I joined the Air Force, and the first time I was on an airplane was when I flew to basic training in Texas.

Aman: Wow.

Rachel: But I knew there's-

Aman: I joined the Air Force before I've been on an airplane.

Rachel: Right. Well, and it's funny 'cause I say Air Force and people automatically think like flying, but they do these physical examinations when you're joining the military to make sure you are physically able to, you know, to be in the military. And one of the tests that they do is, they test your ears. So it has to do with pressure. You hold your nose and you blow and then they look and like the popping of your ears or whatever. And I failed that test, so I could not have a flying job in the Air Force.

Aman: Wow.

Rachel: So there are a lot of jobs where you're not gonna be flying. And so that was me and there. Yeah, so I knew my job before I went to basic training, I had to take this very weird test. So if you were interested in being a linguist, there's a certain test that you take that's supposed to measure your aptitude for being able to learn another language.

Aman: Okay.

Rachel: And so I took that and passed it. And so I had some people go in, I believe it's called like “open general” and you don't really know what your job's gonna be when you get in, you find out at the end of basic training. But I knew I was gonna be a linguist. I didn't know what language I was gonna be assigned. And I remember looking at this pamphlet that had like, the different languages that you might be assigned and they're divided into categories based on how difficult they are for an English language speaker to learn. So like in category one, I think it is like Spanish, German, maybe French. Two, I don't know all the categories, but category four is the hardest and includes Arabic. And I remember being like, I hope I don't get, you know, one of these harder languages. 'Cause you have, you can put your preferences, I don't remember even what I put first, but it was not Arabic and I did not get my preference. But it was such an amazing experience. There's what's called the Defense Language Institute and it's in California and it's where all of the military members, 'cause there are linguists in all the different branches, so they all go to the same base and learn foreign languages. And so, you know, I was learning Arabic and it was a year and a half program. It was just Arabic all day, every day, we would be at a table this size and there would be like four other people and a teacher, you know, native Arabic speaking teacher who's very good. We had a whole team of teachers and it would be like six hours of these small classrooms of Arabic every day. And so it was really a phenomenal learning experience, like I said, where I was from, there's just not a lot of diversity. And so it was really my first time really meeting people from just all kinds of walks of life. And so it's funny 'cause you bring up the Air Force and it feels like such a distant history to me and doesn't feel very relevant to what I'm doing now. But, you know, all of our experiences cumulatively make us who we are. And it was definitely an influential time in my life, I really changed a lot during that period.

Aman: Well, that moved me. So you knew you wanted to do linguistics or because you took the test and then you passed it. They said, all right, I'm gonna do it. Was it kind of like that?

Rachel: You know, I think I was definitely influenced by my mom. She wanted me to do something that was maybe a little bit more intellectual than, you know, some of the other… you know, like mechanic or something that I might have ended up doing. But I guess it appealed to me, you know, on some level. But part of it was just passing the test, but I had to elect to take the test in the first place. You know, not everyone takes the test. I went and did that and yeah.

Aman: You still speak Arabic fluently?

Rachel: So unfortunately, I've forgotten a lot.

Aman: Yeah.

Rachel: And also our training was mostly in reading and listening.

Aman: Okay.

Rachel: We did do speaking, but it was always what I was kind of like the worst at. And I don't know if it's typically like harder to speak language than it is to like read it, or write it, or listen to it. But in any case, like the speaking is hard and there's certain sounds that aren't, that we don't use in English. And so, you know, sometimes the pronunciation of those can be a little bit rough when I'm trying to do that. It was actually kind of funny, 'cause I would speak to the Arabic teachers at the school. They would understand me. And then sometimes, like when I would get a chance, if I encountered someone, this is maybe like after the Air Force that spoke Arabic, I would like try to speak to them. And I realized how accustomed our teachers were to hearing English speakers speaking Arabic. And I was like, okay, not as good as I, you know, maybe thought I was because it was much harder for them to understand me. And then it's also kind of complicated by the fact that I learned modern standard Arabic. Which is kind of like the more formal version of Arabic. It's like what's on the news and stuff. But there are so many dialects and so people don't really speak to each other in modern standard Arabic. And I don't really know any of the dialects, so…

Aman: That's impressive. So you can still understand it and things, or is it?

Rachel: A little bit, it's definitely something that I want to refresh and I would love to travel to the Middle East and kind of do it that way at some point in my life.

Aman: How lovely.

Rachel: Just not now.

Aman: How did that transition happen now? So you finished this part of your life at the Air Force, and then where did the world of nutrition come in? You're deep in the world of nutrition now, so.

Rachel: Yeah.

Aman: How did that transition happen for you?

Rachel: Yeah, so after I got out of the Air Force, I came to New York for school pretty much. It was both my husband and I, and he had different interests, so we wanted to have a lot of options in terms of the colleges and universities and what was offered. And then also our families are both kind of from the Northeast. So we moved here and I decided that I wanted to, you know, pursue nutrition and dietetics. And I would say that also like one thing that facilitated me being able to do that was the GI Bill. So being able to have funds for education, for pursuing higher education. But again, it was just kind of getting back to what I was interested in. When I was in the Air Force, I was stationed at Fort Meade, which is in Maryland, and it's like jointly located with the National Security Agency. So my job was more like intelligence gathering and people would, you know, some people would get out of the Air Force or, you know, or stay in and keep doing that, but some would get out and just move into like the NSA or kind of like an adjacent field. And I was just like, “This isn't for me. This isn't, you know, what I'm passionate about.” So originally I did think like, “Oh, I'm gonna wanna build on sort of some of these things that I've learned while in the Air Force, either like the Arabic or the intelligence part of it.” But just, it wasn't for me. And I wanted to do something that I was actually gonna be interested in and passionate about, so that's what, you know, brought me back to nutrition.

Aman: Wow. Okay. Well, since you have been in the world of nutrition for almost a decade now, would you say it's been a long time.

Rachel: It has been a long time, yeah. Oh, I mean…. yeah, almost.

Aman: So perhaps let's start, because I want to introduce all the listeners to your commitment to nutrition. So that's why I want to start by asking the most common facts and myths that you're asked about nutrition.

Rachel: Yeah. I don't know what some of, I don't know what the most common are, but one thing that I definitely come across that I try not to be, I don't want to be like obnoxious with correcting people, but you also don't want people to be confused about what's true and what's not. And just hearing a lot about carbohydrates… carbohydrates are bad, you know, limit your carbohydrates. And it's really an oversimplification of how we think about carbohydrates, right? So carbohydrates are a macronutrient. They provide energy for our bodies and that's their primary role is to provide energy for the body, so really important role. And within carbohydrates, they're very different types of chemical structures. So you can think of it broadly as like sugars, starches, and fiber. And so this is where it gets more, a little bit more meaningful. Like we can then look at sugars in particular, added sugars be like, yes, this is something that we should keep an eye on and limit because too much added sugar is, you know, detrimental for our health. But conversely, fiber is very beneficial for our health. And you know, I think people automatically think maybe of, you know, refined white bread or french fries when we think of carbs. But what I think of with carbs are like our fruits, our vegetables, you know, whole grains, legumes, like, there's so much in there that's so good for us. And so I think that one thing that I want people to know is that carbohydrates as a whole nutrient group, they're not bad, they're an important nutrient for our bodies, but we do want to be careful about, you know, which type of carbohydrates we're consuming. You know, we do want to limit the really refined and process carbohydrates, because they've had like the fiber stripped from them and we're not getting that benefit then, or they've had the added sugar put in them. But I think maybe just a little bit of a more nuanced understanding of carbohydrates would be helpful for people.

Aman: I have one side tangent question Some people oftentimes have allergies, right? Are those simply genetic? Is there actually, is it because of the way the food is constructed in the world? Or how do these, like celiac disease perhaps, or even shellfish allergies, whatever it may be, that people have all kinds of allergies. Are they born with it? How do these allergies happen?

Rachel: Yeah, I think that the allergies usually develop over time. Like I know for example, with peanut butter, the guidance or peanuts, the guidance has changed that we're actually doing earlier introduction of peanuts. So now I believe the recommendation is that like, starting at around six months when you introduce solid foods to infants, you actually, unless you have like maybe family history of allergies, or some reason to believe your child might be at a higher risk of allergies, then we're actually introducing them earlier in, you know, small amounts to try to prevent the development of allergies. But I don't actually know, you know, how much of it is genetic versus environmental. I know that there's been some interesting studies in the past that have looked at like, if children grow up on farms, or around animals, that can actually decrease the risk of the development of allergies, but yeah.

Aman: I mean, we can talk about multiple different things, facts and myths forever as well.

Rachel: Yeah.

Aman: Perhaps let's transition it since I'm curious to know what is something that we should prioritize in the world of nutrition right now? There are so many things that people focus on, right? But what is the biggest priority you see as you're teaching nutrition, as you have invested your time into it, what is the main thing to be focusing on in the world of nutrition?

Rachel: Yeah, so I would first qualify my statements by saying, you know, most of my training and research has been focused on the US. So when I'm speaking, I'm taking more of a US perspective rather than a global perspective, 'cause it's just what I can speak to. But something that I've become increasingly interested in or feel that is really important relates to our, you know, facts and myths, which is nutrition communication, how we are communicating information about nutrition to the public. And it's tough. I definitely don't have, you know, all of the answers, but I think that it should really be a priority is, you know, simple, clear and consistent messaging that is getting to the public about, you know, what they should be eating. And, you know, then of course people get information from outside of like the experts, or dietary recommendations. And that's a whole different, you know, I'm not really sure how we deal with , you know, incorrect information that's coming from different sources, but I feel like at the very least there should be some good consistent messaging, you know, kind of as a field as a whole that we're giving to the public and trying to limit this perception that we're always changing our minds. You know, people feel like we're flip flopping based on what's reported in the media. And you know, at its core we just, there are basic recommendations that we're pretty confident in, you know, that we have strong scientific evidence to support and maybe it's a little bit boring and people don't like to hear boring, but, you know, so much progress could be made in the diet of American people just by like focusing on increasing, like fruits and vegetables. And we're kind of notoriously bad at not meeting the recommendations for, in particular like vegetable intake. And so, you know, I don't think it's as interesting to people, you know, they would rather figure out maybe should I get the yogurt with probiotics or not? You know? But what's really gonna move the needle on our health are these kinds of bigger shifts, you know, increasing our whole grain consumption, and eating more legumes, our beans and peas, and, you know, increasing our fruit and vegetable intake. So I think that's one big area I would focus on. And then secondarily, I think that, you know, knowing about nutrition is one thing and is important, but what is really influential on our food choices are like the environments that we're in, you know, what is easy to get, what is accessible? What can I afford? What are, you know, the cultural norms? What's being served in my school? And I think that anything we can do to make them more nutritious options, like the default option, the easier option, that will really help us more so than focusing on what is the right thing to eat, because that's easier to tell people. What's really hard is actually then putting that into practice.

Aman: I mean, how does one even influence these things, right? Who's leading this? How does information go out there? It's so varied and it totally makes sense that people are flip flopping. Everyone has different opinions, there's multiple channels for information as well now. How do you influence that correctly? What is the most accurate form? What is the most important?

Rachel: Yeah, I'm not sure. You know, one of our primary ways for communicating nutrition information to the public is through the dietary recommendations by way of like MyPlate, which you, you know, might have seen. It's like, you know, it has a little plate and it shows how much you should eat of, you know, your fruits, vegetables, proteins, grains. But you know, there was recently some research that was asking Americans about their awareness of MyPlate, or whether or not they've tried to follow it. And it's pretty low, you know, people, I guess maybe not too surprisingly, they're not like going to a government website to get their dietary recommendations. I do think that there's maybe a lot of good education that happens through like federal programming because that's the, you know, MyPlate is really used a lot through these federally funded nutrition programs that are aimed at increasing nutrition education. But it's definitely a challenge. And I don't know how we bring about these kinds of bigger system level changes, but I think that there does need to be some sort of concerted effort by the field to make nutrition communication a priority and try to answer some of those questions.

Aman: I love it. It's very true as well. And even in different parts of public health with the people I've spoken with, like information sharing the correct jargon, making it easily accessible is so difficult. And it's been a challenge in the world of public health. So you did nutrition at Steinhardt… human nutrition stuff. How did the GPH-Steinhardt balance come in? So what are the differences that you notice as you have moved into teaching here? You have moved from Steinhardt to global public health. Are they similar over here? What's it been like for you?

Rachel: Yeah, so I really like being a GPH because it's kind of brought together the different parts of my past education. So at Teachers College I did the degree in health education, which I don't think is like a very common degree. I'm not exactly sure what I was thinking. But now that I am at GPH and see the curriculum, not just in nutrition, but other things as well, there were a lot of similarities in my training in health education that you get in an MPH degree. So like, you know, focusing on the social determinants of health. And I learned a lot about health behavior, theories for changing behavior, that sort of thing. So kind of a bigger picture perspective on nutrition, taking into consideration all these different factors. I mean, it wasn't even nutritional, it was health education, but I always applied it. I, you know, always did my projects and stuff on nutrition related topics. And so I have kind of that background. And then, yeah, I did my PhD at Steinhardt in the nutrition department there. And I guess I would say the primary difference between here and there is their programs, or their degrees in particular, like their master's in clinical nutrition. Some of their programming is focused more on like training clinicians. So a lot of the people that go through the program end up becoming registered dieticians. And so there's a little bit more of a focus on the individual versus like the population, and everything is like nutrition there. Whereas here, you know, students are getting an MPH degree first, and then they have this concentration in nutrition. So we have a limited number of courses where they're still getting, you know, a good amount of information about nutrition, but it's more thinking about, it's like through a public health perspective, thinking about more at the population level, less so than like the individual. Like, I'm not having students in my classes make a meal plan for someone because we're thinking more about, you know, what they can do in the community, or policies that influence nutrition, or looking at the data on what Americans kind of as a whole are consuming, that sort of thing to try to help, you know, prepare them for maybe roles in government, or nonprofit organizations. And I think it's broader, you know, it gives a little bit more opportunities to… I don't know, Steinhardt is a little bit more clinically focused and like you're then an RD, but that also opens up opportunities. Like you can work in a hospital as a renal dietician or whatever it is. And then the beauty of it is, you know, we're at NYU and we collaborate. And so some of our students, they actually do the courses at Steinhardt that are required to become a registered dietician. So they extend their program, and it usually takes about three years for those students, but they do specific courses that are required to become a registered dietician. So when they finish here, they'll have the MPH with the concentration of nutrition, but they'll also have what's called a DPD verification statement, which will allow them to do a dietetic internship. It's a whole process.

Aman: Wow.

Rachel: And then sit for, and formally become a registered dietician. But I think that's an awesome pathway you have then.

Aman: Yeah.

Rachel: Kind of feels like the best of both.

Aman: I mean, folks, there's endless paths. You can hear like how many options there are, and I'm sure you have formed a student's path right now if they're listening to this podcast.

Rachel: Yeah.

Aman: And I want to take your class. It's so cool. Let's ask this final question, you know, to conclude it, because we can go, I can talk to you for two hours straight. There's so many questions I have. I think this is a great final direction for, we have some people that come into GPH or even students, people that watch this podcast, that have a deep interest in nutrition. And you know, there's like interest that students lean towards. How do they find their interest in nutrition? Because I know, remember when I was researching about all the publications you have, you have had, it's been based on your environment, the things that have surrounded you that really interested me that how it wasn't a higher level thing, it was a direct impact thing based on what I saw. How can students find that in their own life? You know, what are the common perspectives that everyone can have that they can leave with through you? How can they find their path in the world of nutrition?

Rachel: Yeah, I mean, I think one thing that is interesting is like we, I teach about the scientific method, right? And like, kind of the first step of that is like, make an observation. And in some ways I think it feels like a little bit antiquated, or like, oh, is that actually the first step? Or how people are coming to their research questions? But truly my research questions for my dissertation came about through both my personal experience, but also through making observations. So I was in all of these Facebook groups because I was trying to recruit people for a research study. And so I joined all these groups and they were for people who are breastfeeding, or parents or mother, so all these different ones. And I started to see just like so many posts about how people were trying to increase their milk supply. And so this is what I ended up doing my whole dissertation on. But they were, you know, looking at, or they were trying all of these different like foods, oatmeal, lactation cookies, there's a whole market around them. And I could go on forever. I'll stop there. But the point being, I saw this and I was like, this is something that people are doing and it seems like a lot of people are doing. And I went to, you know, look at the research. I went to PubMed and I was like, what do we know about this topic? And it was like very, very little.

Aman: Wow. 

Rachel: And so I had the combination of like, kind of my own experience with breastfeeding and knowing a little bit about that topic. I had the observation that like, people were recommending to each other, just like they do for diets, or what you should eat, you know, it's like people are giving each other advice online. Oh, this worked for me, this didn't. And I was able to conduct research to document, you know, this high prevalence of use of all these different things to increase milk supply, most of which don't really have any research to back them up. So for me, it was kind of this, it ended up being this perfect, you know, there was no research on it, and it was something that was interesting to me, and it was from an observation that I made. So I think just, you know, keeping your eyes open, what's going on around you, it can relate to your own experiences. It might not, but I think that, you know, with science, with research, we're kind of investigators. We're looking at what's going on around us and you know, reading up on what we already know about topics and try to find what don't we know and what interests me, what do I want to know? And then that's something that you can learn more about.

Aman: I mean, that's what you did. What don't we know? What's interesting?

Rachel: Right.

Aman: What can I learn about it and how can I influence it? It's wonderful just presenting that idea. There's all the information's out there that exists. How can you enhance that information? And that's kind of what you're doing. And you're such a great example for the world of nutrition, therefore, you're teaching it and pioneering new areas of it.

Rachel: Yeah, it's exciting. I like being in my position here at NYU I, you know, since I was a student very recently myself, I just, I feel like I'm in such an influential role and I definitely had, you know, professors who are role models to me. And they impart, you know, influenced me being here right now. And so I recognize, you know, that I am also a role model for students and, you know, just try to do my best to help them along and share my own experience. Everyone's experience is different, but people find their own paths.

Aman: I mean, you have had a very interesting one. I've been fascinated listening to the entire thing. Thank you for exposing all of us to the world of nutrition and everything it entails, and what we can do in the world of nutrition. We link all your publications down below as well, so people can learn more about all the cool work you're doing. And I'm sure a lot more is going to go there. Thanks for coming on the podcast.

Rachel: Yeah, thank you so much for having me.

Aman: All right folks. That was Rachel Ryan, and we'll see you on the next episode. Comment down below if you have any questions, or comments about nutrition. We'd love to hear them.