How to nourish yourself in college with Wendy Sterling, RD
Alyssa Herrera-Set: Good morning! Hi Nadia, hi Wendy!
Wendy Sterling, RD: Hello!
Alyssa Herrera-Set: We are so excited to have you here today, Wendy. Wendy and I have worked together in the San Francisco Bay area on efforts to keep gymnasts healthy and so I'm really excited to have her on the podcast today. I'm going to introduce her and then Nadia has a few questions addressing some of the stuff we talked about in an earlier podcast about eating healthy in college and diet culture in college and also Eating Disorders. Let me start by introducing Wendy: Wendy Sterling is a certified eating disorder registered dietitian and a board certified specialist in sports dietetics. She specializes in Sports Nutrition, eating disorders, and utilizes a non-diet health at every size approach in her practice. Wendy maintains a private practice in the Bay Area California and sees clients virtually throughout the country. Wendy is an author on multiple books that focus on eating disorders and Body Image. Her latest book publishes next month and is called How to Nourish Yourself Through an Eating Disorder. in addition to working with local high schools and colleges, she has consulted with professional sports teams including the Oakland A's, the Golden State Warriors, the New York Jets and the New York Islanders .Wendy received her degree in dietetics and nutritional Sciences from Cornell University. She earned a master's degree in nutrition education at teach college at Columbia University, where she also completed her dietetic internship. Wendy is a former competitive dancer and All American cheerleader. Welcome Wendy!
Wendy STerling: Thank you. Thanks to you both for having me this morning!
Nadia Herrera-Set: Of course! My first question: a lot of uh our listeners are college students who are trying to decide what career they want to pursue. I wanted to ask you if you could tell us a little bit about how you decided to become a registered dietician ,and what the difference is between a registered dietitian and a nutritionist?
Wendy Sterling: Yeah, good question. so I picked nutrition um as my major literally out of uh a catalog. My sister was a Psychology major and I was very interested in that too. But as younger sisters will do, I wasn't going to do what she did. She was at Cornell at the time, and I fell in love with the college. And so I was looking through that big red book that came in the mail and I stumbled upon nutrition and I was like “wow you know this is awesome!” I was really attached to the Sciences I was really kind of nerdy that way. I loved chemistry and biology and I I really didn't want to give that up you know for example if I went into psychology. I loved the idea of working with people. I was a dancer, I was doing that ever since I could walk and so the idea of being able to fuel people, educate them, while also keeping the Sciences? Tt just seemed like a perfect fit. As for your second question about the difference between a dietitian and a nutritionist, really anyone can call themselves a nutritionist. There's not really any regulation. When you use the word dietitian, you're referring to a registered dietician which has certification and certain schooling and requirements, plus a uh formalized dietetic internship program that you apply for and get training in various categories like clinical nutrition and some food service and Community rotations. There's like a structure in a program. Finally, you'll take a test to become a registered dietitian. When you see a registered dietician we know that it is certified, whereas when we see nutritionist, we don't know what that means. Like anyone at the gym could be a nutritionist, or you know the person at the grocery store could be like “oh yeah I'm a nutritionist.” And so sometimes people use the word nutritionist because it more casual, but I think when you go through the schooling, you know, we tend to prefer registered dietician.
Nadia: Yeah, it's definitely interesting if people can just offer their advice and because they have the title of “nutritionist,” people will just end up believing them when they might not have the education for that.
Alyssa: I've actually like, as a physical therapist, when I have um athletes come in at the On the Move PT clinic, I encourage them to get some specialty advice regarding nutrition. Oftentimes, they reach out to a nutritionist and I get a little bit concerned because I don't know what their educational background is. So I really wanted you to be able to answer that question for our audience because I don't think the average person realizes that there's a difference between registered dietitian and nutritionist.
Wendy Sterling: And I'm sure there are really educated nutritionists out there who have done a ton of work and can give you some great information. But there are also some that just carry the title “nutritionist” and put it after their name because you know they've done some weekend work or they care about it a lot or whatever, but don't have a lot of scientific background necessarily behind their advice. I think it's really important for young folks out there, for everybody out there, to understand the difference. And I guess while we're on the topic, I might as well add that there are lots of influencers on social media who have hundreds of thousands of followers and often don't have any credentials as well, right. And they will interact very intimately with their followers and provide lots of really beautiful videos, and are very seductive in their messaging. But often the messaging that they're giving is not accurate for, let's say, a teenager. Or not accurate for the person who's listening. And so we always will also say “hey, who are you following?” and like “are they reputable?” and “do they have the appropriate credentials?” just to kind of make sure. Because a lot of times, people are taking the material that they're getting from social media as face value. And often, they don't have access to a registered dietitian and that is the only information they're getting.
Nadia: Yeah that's, I mean, that's very important to hear. Personally on Tik Tok I get those videos all the time: people offering like dieting or food advice. And obviously there's people that are taking their advice but you never know what intentions they have and if it even like can be applicable to the person watching.
Alyssa: On a previous episode we talked about parents who incentivize their kids to not gain the Freshman 15. What are your thoughts on that?
Wendy Sterling: Oh you can't imagine how much I hate that. I'm really sorry for anyone who has had that happen to them. I mean, I really felt, when I like saw that you might be asking that, I — my heart just felt really broken at the thought of that. I think what that says to the kid is “gosh, you know, your weight is so important to me that I am going to pay you to stay at this weight.” And kids don't forget that. That stays with them forever. And not only does it stay with them forever, but the weight at which they were paid to stay at also stays with them forever. So that should they exceed that weight, which by the way most likely they will because the weight at which they are as a freshman in college is not meant to be their forever weight (there's no forever weight bodies are changing, especially as a freshman you know our our bodies and hormones and our you everything is just evolving right), but when they when they exceed that weight they remember “gosh I was this number when I was younger and it causes a lot of shame and it causes a lot of body image dissatisfaction. It’s also sending the message that should my body change, my family won't approve of me. And so it's a really unfortunate paradigm that a family would set up for their kid upon going to school. There seems to be so many more important things to be thinking about with your kid as they are leaving for college… Alcohol, for example, might be another one. Or safety, you know?
Nadia: Yeah, yeah I definitely, I mean my freshman year of college which was just last year it's very hard to be living away from your parents and having to choose your own food to begin with. So I can't imagine like having to think about “oh if I'm eating this I might you know… thinking about my weight and all this because I'm just trying to like not be hungry all day”
Alyssa: Totally. But yeah, on that note it's tough for a parent to figure out when to keep their mouth shut when they think that their offspring, their adult child, is making unhealthy decisions whether that's eating unhealthily or not sleeping well or partying too much, making some questionable friends all those things. Like as a as a parent of a kid who's just like gone to college, you don't know when to speak up and when not to, right? So um what are your thoughts about the communication between a parent and a child regarding healthy eating once they're in college? Like how much should we be saying? I mean actually I'll give you a personal… can I share Nadia? can I share our experience? Okay so, one time I was telling Nadia I was like oh so you know we had this conversation and it was probably right before lunch and I was like “so um you're living in the dorms, what did you have for breakfast this morning?” and she's like “um I had apples.” and I was like “oh, where did you get that from? Did you get that from the the dining Commons or from Trader Joe's?” and she… I don't remember what she said. And then I was like “okay… and where are you off to now?” she's like “I'm off to lunch.” she's like “I'm gonna go get Popeye's fried chicken sandwich.” and I was like hmmm. she's like “I'm going to do a meal exchange at popeye's for a fried chicken sandwich.” I'm like “Is that really the healthiest choice?” and she's like “I don't need to tell you everything I'm eating.” so I was like oop. I went a little bit too far. so I guess yeah, so that's my question… Like how would you navigate that?
Wendy Sterling: Yeah, parents almost always say too much. And you know the the focus ideally you know, it's tricky. I think when kids are probably out of the house because you're not seeing everything. Like in in the case with Nadia, I'm sure she's not going to popeye's all all the time every day is probably my my guess. And you know so I think it's a little trickier for parents commenting. Your adult kid is reporting one thing and then you're reacting, but you don't see what's happening every day. It's hard not to react because sometimes you get tidbits of information and then it feels a little bit provocative, and you want to say something. But what you don't know is the rest of the seven days: the seven breakfasts, whatever else she had for lunch. So sometimes you can just get curious rather than being reactive like “oh like you know Popeyes? Like where else do you go with your friends?” or “Do you go to the dining hall?” or like “what do you are you eating in the dining hall?” You know? You can ask some more questions. That might be one thing, but I think as it pertains to the kids who are in the house more, parents almost always say too much. And what we really want to do is to try to create this peaceful relationship with food and body where where all foods and all bodies really are welcome. But instead there does tend to be a lot of scrutiny where comments about what kids are eating and how much they're eating. And the reality is like no one else could know how much you need or how much another body needs. Appetites vary day-to- day and it even varies meal to meal. So even in that example you know with Nadia, like she didn't have much breakfast and most likely she needed a much bigger lunch because she was probably really hungry. So if someone observed her at lunch and made a comment about what she was eating volume wise, they would have not known that she was really hungry because she didn't have morning snack and she didn't have breakfast. We often see parents coming in in the middle and kind of then saying things like “wow do you need all that?” or like “you have such a big appetite” and this really discourages kids from satisfying their full hunger and can alter the course of the rest of their day because maybe then they don't finish what they actually needed or they restrict or causes a lot of guilt and shame. And then you know this idea of like oh these are good foods and then these bad foods, it can then create guilt or shame because then it feels like I'm eating the wrong thing or I ate a bad thing. But really if like all food was just okay and neutral, then it would really lead to a lot more peace. But we see it trickling into body image because if somebody ate the wrong thing or bad thing that's deemed that way in a parent eyes, then all of a sudden you start to feel really dissatisfied and uncomfortable in your body.
Alyssa: I mean I think that's what we tend to do. It's very complicated. I'll keep my mouth shut more (laughs).
Nadia: I mean I personally don't remember that conversation but it really stuck with her.
Alyssa: It did. I was like oh this is was like a red flag this is going in the wrong direction, I need to change course I need to change the way that I'm communicating with my daughter. I'm glad it didn't stick in your mind.
Nadia: I must have been having a bad day. My next question: like myself, kids who do high school School sports often see a huge decline in the amount of exercise they get in at the start of college and even throughout college. Do you have any nutritional tips for transitioning away from a 10 to 20 hour like exercise routine per week to just working out a few hours a week on your own?
Wendy Sterling: Yeah, the biggest thing is that nutritional needs most likely in that scenario will decrease and the frequency with which somebody is taking their pre and their post-workout fueling snacks and the composition of one's plates are going to shift in terms of how we're recommending the macronutrients on the plate, in terms of the volume of carbohydrates are going to shift to a different kind of plate. When the intensity, the frequency, the duration of one's training changes that way. What we want to kind of begin to coach our athletes on is their hunger and their fullness as well. I think a lot of times when somebody's training and training intensely they really can't necessarily, they don't necessarily feel their hunger. Sometimes the hunger levels are suppressed with really intense training. I think when training decreases to kind of a low to moderate level it's maybe easier to feel hunger and so we begin to say like hey are you hungry? Are you full? Where is your hunger level, where is your fullness level? So we'll begin to coach them on that. Then something else that I see happening when people are transitioning out of their sport is actually that people start picking up other sports and I think sometimes they don't realize that even though it's not their main sport, there's a significant impact potentially in their new set of training. In the types of training that they're doing. So for example, a gymnast might decide that he or she or they like running and all of a sudden, they never ran before it wasn't part of their training, but now there's a significant impact that their running has on their energy needs. And even though it's not 10 to 20 hours it's quite possible that there's a significant energy cost associated with that training. And sometimes our athletes get into a state of energy deficiency even post-retirement. Like in retirement, and that always surprises them. And we see that a lot actually, it's actually called relative energy deficiency in sport. The acronym is called REDS and it can happen in season like in the height of their sport and it can also happen in retirement as people all of a sudden become cyclists out of the blue, or they start training for a marathon, or they start training for something else um they just don't they don't account for things that actually aren't making them sweat the same way they used to sweat. For example walking the dog for three to four miles they're like “ah it's not exercise it's not movement doesn't really count” but actually if you're walking the dog three to four miles and then you're running later that day and then you're also walking to the supermarket, all of these things actually need to be accounted for um with your food.
Nadia: Great advice, thank you. So we talked a little bit and during your intro about how you are specialized in Eating Disorders. My question is what can a college student do if they suspect that their friend has an eating disorder?
Sterling: I think it's good to confront the friend and to talk about it with the friend and see if the friend needs some support. We've had some circumstances actually where friends have reached out to the parents or the support system of that suspected person with an eating disorder. Eating Disorders can be really sneaky. A lot of people are in denial about that so it can often take a lot of repeated advances to kind of get somebody that help that they need. I think that friends always they can always make a change because maybe the person, whether or not they realize it, hearing it from someone they respect and also listen to all the time changes things.
Alyssa: Do you have any advice on words you might use with your friend? Like would you be casual about it, would you be direct?
Sterling: You know yeah I think honest and I think also pointing out like “you seem really tired, you seem irritable, you seem different” you know pointing out some of the things that have caught your attention… “I'm concerned about you, I've noticed that you no longer come out with us, I noticed that you no longer are at lunch with us anymore” you know. “I notice that you're always exercising, have you seen a doctor?” We don't want to be accusing of them, you just sort of want to state your observations kind of neutrally. You don't want to attack and you certainly don't necessarily want to um comment on weight and body necessarily. But I think loving kind gentle uh is is certainly the approach that I would recommend. And not necessarily using the words disordered eating or like that. I wouldn't diagnose anyone, I would just state your observations of the things that have caught your eye you know? The things that you're worried about.
Alyssa: Okay great advice. So I think you have one more question right, Nadia?
Nadia: Yeah one more question it's do you have any tips on getting the right nutrients and healthy food when you're eating on a budget whether it's from the cafeteria or buying food on your own?
Sterling: Yeah, so our approach that we use in eating disorder recovery but I also use it with my athletes is called the plate by plate approach and that is where we are recommending that you're filling the plate with all five food groups. That's protein, starch, a dairy or a dairy alternative, vegetables or fruit, and fats. And that way you're really getting all of your nutrients in. So if you think about going into the dining hall and looking for source of protein whether that's chicken or meat or if you're a vegetarian beans or tofu, and then thinking in terms of what starch: what am I going to fill my plate with whether that's rice or pasta or some kind of grain, breads, cereals, waffles you know whatever that is. And then looking for some kind of calcium source: cheese, dairy, milk, soy milk. And then some kind of vegetable or fruit and then think about what kind of fat source. And then in terms of budget if you are not in a dining hall and you're on your own you know milk is a very inexpensive source of calcium. Cheap proteins are eggs and beans and you know chicken doesn't have to be that expensive. Refried beans which by the way is a misnomer, there's not actually much fat, anyway. But things like that are are pretty cheap. Tuna is a pretty inexpensive source of protein, rice is inexpensive, and then frozen fruits and vegetables which don't get much attention are actually a wonderful nutrient rich way um for people on a budget to get in lots of good anti-inflammatory um sources of fiber. And the best thing about that is that there really is no waste. I think a lot of times people bring in fresh fruits and vegetables and then there's so much waste because they don't get to it or some gets moldy. But what's really nice about the frozen is that it it's it just really costeffective and there's there's no waste. You can add that to a smoothie, you can thaw it and use it you know right into a bowl um like in the morning. I think that also can help.
Nadia: Yeah I can go to the dining hall but I have a kitchen this year so that's been something that I've been having to figure out on my own. It's definitely hard to buy like the fresh fruits and vegetables because it's not like I'm going to eat every all of it like every single day, and then I'm having to throw it out because before I can even get to it, it's like it's moldy. So the frozen section of Trader Joe's is my friend I think.
Sterling: I think for the dorm too: like things like apples and pears and bananas they tend to last longer and you know it's like the berries that tend to go bad first that make it harder. Those might be good to buy frozen and I know it's hard in a dorm to Store Frozen um but if there is freezer access that that would be that would be good. And then just thinking of meals that you can do like little burritos or quesadillas or things that are just not super expensive that you can get multiple uses out of.
Alyssa: Yeah, definitely thank you. We had a funny we had a funny conversation a couple weeks ago. Nadia showed up on FaceTime and she had this block of frozen chicken like four chicken breasts you know with a plastic on top of it and styrofoam on the bottom or whatever's on the bottom and she's like “I'm eating this tonight.” It's like rock solid. “What do I do about… what do?” I'm like oh my goodness well “Is it sliceable? can you chop into it?” she's like you know hacking at it I was like okay that does not look safe, you're just going have to defrost the whole thing and cook the whole thing and maybe you can freeze some of the stuff that you already made. Maybe you should individually put chicken in the freezer
Sterling: Absolutely, I found my frozen chicken alternative. They're individually Frozen so I don't have to you know do the whole thing and then have to eat all the chicken you made. coms individually Frozen yeah it's like in a bag I mean it's like a weird a weird thing, but if I can just take one out and that's my lunch then you know that's really easy. Yeah, and I think you'll find some tricks along those lines like you can take it out of the freezer and put it in the refrigerator the night before and then it thaws for you which is really nice.
Nadia: Yeah it's definitely a learning process.
Alyssa: It is a learning process and you won't make that mistake again with that (laughs) Everybody goes through that. Wendy I have a question and I don't know if this is going to open up a whole can of worms, I hope it's not too challenging of a question to answer on this podcast. You seem to have a filter towards helping people who are under fueling with relative energy deficiency and people who need to eat a lot for their sport. What about people whose problem is overeating? Is that also called disordered eating and how can you help with that?
Sterling: Yeah we have lots of patients in our practice um who struggle with either bypassing their body's natural stopping place or who truly struggle with something called binge eating disorder. In my next book we are talking about how our plate by plate approach can be used to actually help patients through that. One of the biggest causes of something like overeating or binge eating disorder is actually restriction, so what we find is that people are more likely to buypass their body stopping place if for example they are using a diet mindset. Or they are may be living in a larger body and they are trying to cut back on their food because they are trying to diet, or they're trying to lose weight. And so what tends to happen is they go through their day and they're like oh I'm just going to eat a little bit at breakfast I'm going to eat a little bit at lunch and then they get to dinner and they can't find their natural stopping place and they tend to bypass it. Or alternatively as some of our patients do, and by the way binge eating disorder is the most common eating disorder out there so more people people are struggling with that than any other eating disorder, they binge which is eating a larger amount of food that most would consider to be typical in a certain period of time. The reason that happens is because they haven't had enough to eat throughout the day. They are in deficit from not having had enough um throughout the the day: perhaps missing an afternoon snack that they needed. It's common in athletes, it's common in males, and it's certainly common really common when people restrict. Now there are many causes besides just the physiological cause why people um binge. It can also be emotional, it can be to due to boredom, it can be due to stress. And so we know that there are a combination of factors that lead to why people might binge and so often when we have people that are struggling with for example a binge eating disorder or something like that, we are doing a combination work with a dietitian to look at their food to make sure that they are eating regular and consistent meals with all five food groups: breakfast lunch snack dinner snack. Not skipping meals no dieting, like really eating regularly. They're working often in combination with a therapist to manage stress, to look at alternative coping mechanisms for times when they're feeling bored, and learning to not use food to cope. And so it becomes pretty complicated and we tend to work as a team which is really interesting.
Alyssa: Thank you so much Wendy. We know you have a book coming out next month, can you tell us just before we go a little bit about what services you provide to people and where people can find you ?
Wendy Sterling: Yeah yeah thank you for asking. So I am a sports dietician and an eating disorder specialist. I help athletes with their performance, but I also help adults and teens and kids with both Sports Nutrition or with anyone struggling with eating. Whether that's disordered eating or actual Eating Disorders. My book which is coming out next month is actually for adults and it's to help them through their relationship with food and their eating disorder. I can be found on Instagram, we have a handle called plate-by-plate approach which is for those with eating disorders looking for visuals on what the plate should be with eating disorder messaging. My handle is @wendy_sterling and then my website is sterlingnutrition.com
Alyssa: Perfect thank you so much for being here with us today, Wendy. That was really like helpful like usable information for the college students and for the parents.
Wendy Sterling: I'm so glad thank you so much for having me it's so lovely to connect with you both again.