A Dad and His Dietitian Daughter Talk Nutrition in the Age of Covid

“Dad, please put down the salt!” The stern admonition wasn’t just coming from my daughter. It was coming from my daughter—for about the 20th time—who is also a Registered Dietitian. Having recently turned 65 and on blood pressure medication since Donald Trump was elected President, you’d think I’d listen to such sage and expert advice. I promise it’s on my New Year’s resolution list. 

Jean and I have more in common than a last name, Type-O blood, and being fans of the winless New York Jets football team. We also both occasionally write for this website. I offer reviews of shows and events, while Jean provides nutritional guidance and healthy recipes. When Jean was in her adolescent and teen years, she was a dancer, played piano, wrote original pop songs, and in high school sang in the chorus and starred in theater productions. But she also loved food and cooking so in spite of my best efforts to channel her into being some kind of musical performer, she decided after college to pursue a career in dietetics. That child will do anything to make me stop using salt. 

After graduating from Tulane University in 2014 with a BA in sociology and a minor in dance, Jean dedicated herself to four more years of study (plus another year as a dietetic intern) to become a dietitian. Her first professional job starting in September 2019 would eventually throw her into the shallow end of the Covid-19 pandemic pool—running the nutrition program at a Brooklyn nursing home. Naturally, Jean was infected just as the city was locking down in March. Luckily, being under 30 and very healthy, she suffered just a mild case and was back at work in a week, fully PPEd and just in time to experience the tragic death of some of the residents. Jean was willing to tough it out as long as necessary. Even though I was immensely proud of the work she was doing to help the most Covid-vulnerable people, I worried about her safety and hoped she might find another position where she could still help people, but not be at such risk.

Just as this fall’s Covid-19 spike was hitting NYC, Jean landed a new job—as the lead Registered Dietitian Nutritionist at Bethany Medical Clinic, a multi-faceted female/minority owned healthcare center with five offices in Manhattan and one in Jersey City (www.bmcofny.com). At all the New York locations and also virtually, Jean consults with clients who have nutritional challenges from dieting to diabetes. 

Given the vital importance of healthy eating and cooking, especially during a pandemic (even after many of us are vaccinated) and how much attention is paid to eating and dieting both before and after the holidays, we thought it would be an ideal time for a father and daughter chat. Since Jean has been a pescatarian since her college days, we conversed over a home dinner of salad, salmon, sautéed broccoli, and shiraz. And the salt shaker was nowhere to be found. 

DAD: So as much as I want this interview to focus on your career as a dietitian and your advice on nutrition, I have to start as a concerned father. You had a check-up the other day. Did your blood test confirm you still had the antibodies for COVID-19?

DAUGHTER: Yes Dad, and I was relieved because I’d heard the antibodies may not last forever and I first tested positive for the antibodies back in April. 

DAD: How and when did you become infected and what were your symptoms? 

DAUGHTER: I had been working at a nursing home in Bushwick, Brooklyn and by March COVID-19 was on everyone’s mind because we were caring for older people who are highly susceptible. News got around that a few staff members had gotten the virus and were quarantining at home. During the last week of March, I started having chills and was feeling tired. I didn’t have a fever so I kept going into work. One day, I felt a fever coming on and my temperature reached 100, which freaked me out. I would take a Tylenol and it would go back down. I probably should have gone home, but I was the only dietitian so the nursing home needed me there unless I was really ill. The fever lasted for only a day, and then I developed a pretty harsh, bronchitis-like cough and had allergy-like symptoms. But I started working from home once I started noticing that I couldn’t really smell anything. The loss of sense of taste quickly followed, and for someone who likes to cook this was pretty hard to take. Those symptoms lasted about two weeks, but through the whole thing I didn’t miss any work time. 

DAD: Yeah, and your mother and I were very concerned, to say the least. Had you ever gotten tested at the nursing home? 

DAUGHTER: Not for the active infection, but I did get the antibody tests about three weeks after I got sick and it was positive for the antibodies.

DAD: What did your job at the nursing home entail? 

DAUGHTER: I was the sole full-time dietitian which meant that I was in charge of creating the diet of any new resident based on whatever health conditions they had, whether it was diabetes, hypertension, kidney disease, etc.

DAD: Given everything we now know about the infection rates and deaths in nursing homes around the country, how grim was the situation in yours and how many people there died?

DAUGHTER: Our facility was 240 beds and during the height of the pandemic in the spring and summer, we were down to under 200 residents. When I was there about 15-20 died who we either suspected or were confirmed to have COVID-19. We also sent older residents to the hospital with respiratory distress because we didn’t have the proper equipment to deal with that, and tragically some of them didn’t come back. Overall, we lost 50 or more people, but I think our nursing home fared a little bit better than some others in the city.  

DAD: I wish you hadn’t experienced such pain and suffering. So fast forward to October and you’re hired by the Bethany Medical Clinic, which is like a 180-degree change in responsibilities. 

DAUGHTER: For sure. At the nursing home, my job was very clinical. I was working with very sick people and I was trying to use diet to prevent their diseases from getting any worse. Frankly, in that setting there’s not much a dietitian can do and that can be frustrating. At Bethany, I’m currently the only full-time nutritionist and my job is more counseling-based. My clients now might have high blood pressure or diabetes, but they’re not in critical condition. I’m getting people’s diet history and offering recommendations and the advice that I’m giving is a lot more preventative, which is the kind of work that I really wanted to do in the field. I feel more valued in this role because I’m suggesting lifestyle changes that people can make now—even in their 40s, 50s, or 60s— and that can prevent furthering disease they may already have or getting any nutrition-related disease.

DAD: Let’s back up and talk about your career evolution. When did you first become passionate about food and nutrition? Were you reading up on all that when you were supposed to be practicing piano? [Laughs]

DAUGHTER: I think there are two parts to that answer. The first is about food. I’ve always loved food. I think growing up in New York City, I was exposed to a lot of different cultures and the cuisines of those cultures. 

DAD: Because your parents took you to restaurants a lot? 

DAUGHTER: Well, Dad, you and Mom were exposing me to foods like sushi by the time I was seven. And we ate breakfast in a diner almost every weekend. [Laughs] Then when I became a teenager, I started watching a lot of Food Network shows and began experimenting in the kitchen. I think my passion developed as I started cooking because it’s really creative. I’ve always loved doing creative things, like writing poetry or playing music or dancing.  And there are just so many possibilities with food. You can take any ingredient and use it 1,000 different ways, and I thought that was really cool. 

DAD: When did the nutrition focus begin happening? 

DAUGHTER: During my sophomore year of high school, we had a required health class that was fairly boring, but we did have a segment on nutrition. I don’t know why but that stuck with me. I remember a lesson that we had urging us to read nutrition labels on the back of packaged foods we had at home and see what the different numbers meant. I thought that was really fascinating. Then in college I got interested in the relationship between health and more plant-based eating. I started experimenting with my own diet, partly because the meat in my school cafeteria was not that appetizing. I decided to cut out meat and try a pescatarian diet. I thought the meat was pretty gross-looking and I didn’t know where it was coming from and thought, “Do I really want to be putting this in my body?” By the time I was reaching graduation, I knew it was too late for me to get an undergrad degree in Nutrition, so I committed to two years of required science classes and a two-year Master’s program [at CUNY Hunter in New York]. It was a lot more school then I’d planned on but I definitely don’t regret it now. 

DAD: At Bethany Medical Clinic, what are the health and nutrition profiles of clients you consult with on a typical day? 

DAUGHTER: Today, for example, I met with a woman who gave birth recently and is breastfeeding her baby. She has been noticing that the food she’s been eating has affected the baby’s digestion. We discussed what she can reduce in her diet and also how to eat more healthy snacks throughout the day because she’s constantly hungry. Another client takes a prescribed stimulant to manage a health condition, but these stimulants affect her appetite. She initially lost a lot of weight so I’m working with her on how to schedule her meals around when she’s going to have an appetite. I also had a follow-up with a young man in his twenties who has symptoms of IBS [Irritable Bowel Syndrome], so we were going over how his symptoms have improved since he’s eliminated dairy products from his diet. 

DAD: What about people who are seeking basic nutrition and dieting advice?

DAUGHTER: I see clients like that every day. Today I saw a few people who are just looking to eat healthier since the pandemic has changed their eating patterns. One stay-at-home mom with two kids wanted advice on improving her eating habits. And I usually see two or three people a day whose primary goal is losing weight. 

DAD: Do some of your clients treat you like a psychologist in some way? 

DAUGHTER: Actually, they do, because eating, stress, sleep habits, and physical activity are all related. I have to get the whole picture because all of those variables can affect someone’s eating habits.

DAD: How frustrating is it for you working with clients who are primarily focused on losing weight as opposed to eating healthy meals? 

DAUGHTER: It’s a good question because there’s been a very big shift in the nutrition world where we’re trying to focus more on overall health patterns and eating behaviors rather than concentrating on reading the scale. Research has shown that being obese can lead to more health problems down the line and that has focused people on needing to be a certain weight. What’s frustrating when I’m talking with clients is that physical activity tends to take a backseat to discussing unhealthy eating habits. When I’m counseling clients, I try to focus on one or two things at the start because trying to make a ton of changes at once just leaves them burnt out. I try to ask: “How can we make your eating habits a little better? How can you make your lifestyle a little healthier? As opposed to, “I need to lose this last five pounds to fit into some clothes.” During the pandemic, people are not moving. They’re staying home, they’re not walking to work, they’re not taking public transportation; they’re not moving at all. I’ve seen a lot of people with high cholesterol levels and I think being sedentary these past nine months has really affected the cholesterol levels, maybe even more so than just their diet.

DAD: Getting back to cooking, given how busy you are now, how much do you get to cook for yourself these days? 

DAUGHTER: I actually cook dinners at home for me and my boyfriend from Monday through Thursday, and once over the weekend. And I love it. I’ve really been into the New York Times cooking site. They have great recipes and when I’m preparing them I always incorporate veggies and some kind of protein, whether it’s fish or tofu, and then fill in from there. And cooking during the week allows me to have leftovers for lunches. 

DAD: Are you a big believer in breakfast being the most important meal of the day or is that overstated?

DAUGHTER: (Laughs) I used to be one of those people who was big on breakfast, but I’m not really in that camp anymore, mostly because a lot of people just aren’t into breakfast and they aren’t hungry during the beginning of the day. And there’s no need to force that unless you have diabetes, which is a whole different story. There’s no metabolic advantage to having breakfast. Personally, I have breakfast because in the morning I’m starving. 

DAD: So, the conventional wisdom about having breakfast so that you’re not hungry all day long is a fallacy?

DAUGHTER: It’s not so much about breakfast, but about eating at intervals. Let’s say you’re a breakfast person and you have breakfast at 7 AM. If you wait until 2 PM to eat again, that’s a long time between meals. Eating healthy snacks every three to four hours is a good way to keep the hunger in check and prevent overeating at the next meal.

DAD: If you do eat breakfast every day, what is your recommendation for what people should eat in the morning, especially when there are a zillion cereals out there? 

DAUGHTER: Cereal is not something that I typically recommend. Most of them are processed and filled with sugar. For me, there are a couple go-to’s, like avocado toast or scrambled eggs mixed with veggies. Oatmeal is great and if you like more of a sweet breakfast, you can do oatmeal with berries. Greek yogurt with berries and nuts is another good one that I do a couple times a week. I don’t usually recommend eating anything that’s going to be very sugary because it doesn’t satisfy you for very long. 

DAD: During the holiday season, the perennial articles in the media discuss how people overeat, whether it’s at family gatherings or parties, and then the frantic dieting and gym visits to lose the weight. Even though there could be less of that this year due to the pandemic, what’s a dietitian’s take on this syndrome? 

DAUGHTER: First off, people shouldn’t think, “Oh, I’m gonna fall off the wagon because of these holidays and gain a ton of weight.” Just think of this time as another couple of days where you may be eating more and keep in mind the same healthy habits that you would on any other day. And don’t worry that the holidays may derail any progress that you’ve made on changing your eating habits. Also, it’s important not to fast around the holidays. A lot of people think if they’re going to have a big meal on a certain day, they can skip eating the day before or after. That kind of thinking is going to make it more likely that you’re going to overeat when you do eat those meals and it just throws off your metabolism. It’s not a good idea trying to fast or skimp on food before or after a big holiday meal. As for those New Year’s resolutions, trying a detox diet after January 1^st is definitely not a good idea. They’re not healthy and thinking that you only need to drink water for two days to cleanse is a bad habit to get into. The body’s liver is its own detox system. 

DAD: How does a nutritionist like you view fad diets in books or on websites?

DAUGHTER: Those are tough to deal with when talking with clients because a lot of people think that if something’s in a book or on the internet it has to be true. If there are a thousand blog posts on a certain diet, then it has to be fact. Some of my clients have told me, “This has to be true, such and such website wrote about it.” But professional dietitians are trained to sift through all this information—or misinformation, as the case may be. If there’s one research paper on a something like a diet, that doesn’t make it accepted. There should be tons of research and journal articles for something to be accepted as fact, and a lot of these fad diets are not based on solid research. That’s why dietitians have the credentials we have. It’s a challenge to be tactful with some clients and explain how something they read and believe isn’t based on good science. I don’t want to scare them away, and their opinions matter, but they’re relying on my expertise to help them. 

DAD: Well, daughter, I’m hopefully going to be relying on your expertise to guide my nutritional habits for a long time. 

DAUGHTER: I know, Dad. Now please put away the salt! [Laughs]

Top photo: When Registered Dietitian (and Woman Around Town contributor) Jean Hanks isn’t advising her father Stephen about his eating habits, she counseling her patients at Bethany Medical Clinic in Manhattan. Photo Credit: Bethany Medical Center