FDA Regulation Updates for Dietitians
This podcast series aims to highlight the science, psychology, and strategies behind the practice of dietetics. Moderator, Lisa Jones, MA, RDN, LDN, FAND, interviews prominent dietitians and health professionals to help our community think differently about food and nutrition.
In this podcast episode, Lisa Jones, RDN, LDN, FAND, interviews Diana Monaco, RDN, CDN, FAND, about the FDA's recent regulation updates, including regulation surrounding plant-based milk alternatives, salt substitutes, nutrition facts on food labels, FDA resources for dietitians, ways dietitians can partner with the FDA, and more.
Additional Resources:
The New Nutrition Facts Label. U.S. Food and Drug Administration. Published April 13, 2022. Accessed May 24, 2023. https://www.fda.gov/food/nutrition-education-resources-materials/new-nutrition-facts-label
Food Code 2022. U.S. Food and Drug Administration. Published March 27, 2022. Accessed May 24, 2023. https://www.fda.gov/food/fda-food-code/food-code-2022
FDA Issues Draft Guidance on Dietary Guidance Statements on Food Labels. Food and Drug Administration. Published March 23, 2023. Accessed May 24, 2023. https://www.fda.gov/food/cfsan-constituent-updates/fda-issues-draft-guidance-dietary-guidance-statements-food-labels
Sodium Reduction. U.S. Food and Drug Administration. Published March 23, 2023. Accessed May 24, 2023. https://www.fda.gov/food/food-additives-petitions/sodium-reduction
FDA Takes Additional Steps to Improve Nutrition, Reduce Disease with Expanded Use of Salt Substitutes to Help Lower Sodium Intake. U.S. Food and Drug Adiminstration. Published March 23, 2023. Accessed May 24, 2023. https://www.fda.gov/news-events/press-announcements/fda-takes-additional-steps-improve-nutrition-reduce-disease-expanded-use-salt-substitutes-help-lower
FDA to Redefine “Healthy” Claim for Food Labeling. U.S. Food and Drug Administration. Published December 27, 2017. Accessed May 24, 2023. https://www.fda.gov/food/cfsan-constituent-updates/fda-redefine-healthy-claim-food-labeling
FDA Reopens Comment Period for the Draft Guidance on Labeling of Plant-Based Milk Alternatives. U.S. Food and Drug Administration. Published April 28, 2023. Accessed May 24, 2023. https://www.fda.gov/food/cfsan-constituent-updates/fda-reopens-comment-period-draft-guidance-labeling-plant-based-milk-alternatives
FDA Issues Request for Information on Food Labeling in Online Grocery Shopping. U.S. Food and Drug Administration. Published April 21, 2023. Accessed May 24, 2023. https://www.fda.gov/food/cfsan-constituent-updates/fda-issues-request-information-food-labeling-online-grocery-shopping
Diana Monaco, RDN, CDN, FAND, is a health and communications specialist with the Food and Drug Administration covering the human and animal food beat in the Office of Regulatory Affairs.
Lisa Jones, MA, RDN, LDN, FAND, is a registered dietitian nutritionist, speaker, and author (Philadelphia, PA).
TRANSCRIPTION:
Speaker 1:
Hello and welcome to Nutrition411: The Podcast, a special podcast series led by registered dietician and nutritionist, Lisa Jones. The views of the speakers are their own and do not reflect the views of their respective institutions or Consultant360.
Lisa Jones:
Hello, and welcome to Nutrition411: The Podcast where we communicate the information you need to know now about the science, psychology, and strategies behind the practice of dietetics. Today's podcast is all about the FDA. We have Diana Monaco with us here today. She is a dietician, but also a 30-year employee with the Food and Drug Administration. She works as a health communication specialist and she covers the human and animal foods media. So, a wealth of information here with us today. I just want to say quickly, hi Diana. Thank you so much for coming.
Diana Monaco:
Hi, how are you? Thank you for having me.
Lisa Jones:
Great. I do want to give your depth of knowledge more credit here, and I do want to talk a little bit about your degree first.
Diana Monaco:
Okay.
Lisa Jones:
Diana has a degree in public relations and journalism, and a degree in nutrition and dietetics, both from Buffalo State College, now Buffalo State University. She also has 26 years as an adjunct instructor in the nutrition department at Buffalo State University, a preceptor to over 40 dietetic nursing and public health students. So, I just want to give you a round of applause.
Diana Monaco:
Thank you. Thank you.
Lisa Jones:
That is a huge accomplishment and a great deal of experience. And again, so excited just to hear what you have to bring because I believe that the FDA, there are so many different things that come out, it is so hard for dieticians and nutrition professionals to keep up with this information. So, just having you here to break it down and give us the latest and greatest is just amazing. So let's start, shall we? Are you ready?
Diana Monaco:
Sounds good. Yep, I am.
Lisa Jones:
Okay. I have a couple of questions for you. And the first one is, how can dieticians partner with the FDA as a resource to help support their patients or clients in their nutrition management and overall health goals?
Diana Monaco:
That's a great question. We consider dieticians key stakeholders as a conduit between FDA and the consumers and the patients that they're working with. So, we have resources on the importance of good nutrition, for example, for a variety of audiences. So, if you are working with children or the youth or parents or seniors or women, we have all different kinds of information kind of targeted right to them, and it helps the health educator. We have a lot of information on the nutrition facts label, which is an important tool. It has a scientific base to it. And the label is one of the ways, the tools that dieticians use to work with their patients and clients so they make better food choices. So the FDA has come up with all different kinds of ways to kind of present that, right?
And so we have an interactive nutrition facts label online. So let us say if you were told that you have high cholesterol, you could go online, you could look up cholesterol, it will show you where it is on the label, it will show you what foods have cholesterol in them and the health consequences. And so they could do this on their own time consumers, and it goes in addition to what the dietician is doing. So, both of them are working toward the same goal. We have health educators' toolkits that have all different kinds of downloadable materials that the health educator can use. We have videos. We do a lot of videos. We have actually our own video studio at the agency, and it's called Behind the Scenes, and it explains how to read the food label. It seems like a simple thing when you're looking at it, but it really has a lot of information there.
So, it translates it all. And we also translate it into other languages as well, so Spanish being one of them. We also, because the information is constantly changing, we actually had a couple of changes last January to the food label, and we have continuing medical education programs. And they're for free, and physicians could take them, healthcare professionals could take them, and then they could get CMEs for that. We have a resource library that, again, you could download all different kinds of information, not only on the food label but on dietary supplements, on food safety. We have all different kinds of stuff talking about food safety, on food safety. Dieticians really are the key to teaching that. We saw, especially during the pandemic, how important it was to wash your hands and to be aware of what you were doing.
And we have information, for example, for pregnant women. And we have a booklet. It's called Food Safety for Pregnant Women, and it goes over not only explaining why food safety is critical for the pregnant woman and her unborn child but also what kind of low-risk and high-risk foods she should be eating, how to handle the food safely, and that kind of things. So, I could probably talk for another, whatever, 20 minutes, but we really do have so many resources, and we're really trying to expand how... Because not everybody looks at printed materials. Some people like videos better, some people like social media, and some people like something interactive. And so it's a nice way to figure out what will work with the patients.
Lisa Jones:
Yes. Diana, I'm listening, I'm writing all these things down as you were talking.
Diana Monaco:
Okay.
Lisa Jones:
It is a vast amount of information. And I think the easiest thing to do is probably for a dietician, somebody listening to this podcast is to bookmark this site.
Diana Monaco:
Right.
Lisa Jones:
Because just the CME stuff, a lot of people don't know. I bet you there are so many things that people didn't know that you had there available. So, just having that there, and then the fact that sounds like it's constantly updated, which sounds like a job in itself, to make sure all these updates are happening.
Diana Monaco:
Right.
Lisa Jones:
And I'm very impressed with your studio. I think that's really cool.
Diana Monaco:
Yes. Yeah. I know it's kind of neat, right? We do all kinds of things in there and it's important to reach people in different ways. It really is. So, video is the new thing, not new, new but it's one of the things that people really like. They like that better than reading pages and pages of material. They like to just have it kind of done in a visual way.
Lisa Jones:
Especially if you're a visual learner, and then that helps too. Maybe if you read it, digest the information that way, and then go back and also watch the video, I think it's kind of just helps to reinforce that particular information. And then you have something for everyone, which is great.
Diana Monaco:
Right. And the dieticians remember that everything is government based and so there is no copywriting or anything. They could put things in their PowerPoints or they could make handouts, and there's no worries about any of that. They could use it all as they wish with their clients.
Lisa Jones:
Oh, that's even better, right?
Diana Monaco:
Yep. Yeah. Yeah, because that's always a concern as well, right?
Lisa Jones:
Yes, especially with... Nobody wants to be sued for something.
Diana Monaco:
Right.
Lisa Jones:
That's a whole nother podcast, right?
Diana Monaco:
Yep.
Lisa Jones:
All right. Well great. I appreciate you sharing everything that you have to offer. So I do have a question about... Because a big thing that we're hearing about lately is the specific details. Could you share the specific details about the proposed changes in the dietary guidance statements?
Diana Monaco:
Okay. Yeah. So, let me go back a little bit about this. So, it is a draft guidance. And when we say draft guidance, that means that it's not a regulation yet. It's in draft form. And so in March of this year, that came out, March 24th. And what it's doing is it's providing food manufacturers with recommendations on how and when to use these statements, and I'll talk a little bit more about what exactly they are, on the label of their food products, we're trying to promote good nutrition, more consistency in labeling, and assist consumers in actually making more informed choices. And so all of this is part of FDA's overall goal to help reduce the burden of chronic disease and advance health equity through improved nutrition. And that particular statement is an important statement because that's the goal of all of things with nutrition.
So when we think about the eating patterns in the US, they don't align with the dietary recommendations, right? Most people in the US, they're not eating enough fruits, enough vegetables, dairy, and whole grains. They have too much saturated fat, sodium added sugars. And so poor nutrition plays a role in this whole chronic and preventable disease when we're looking at heart disease, diabetes, obesity. So, these dietary guidance statements, again, are just going to be one more tool, if they go through to be a regulation, to help people understand more about their food. And so let me give you some examples. They could be either a graphic or a written statement. And so let's say you had whole wheat bread. And so on there, the company could make your grains whole grain. And so it's just a statement, and then it's kind of a reminder to that consumer like, oh, whole grains, I'm making a good choice.
Let's say they pick up a bag of shrimp, it could say seafood, including shrimp is part of a nutritious dietary pattern. Again, that kind of reminder like, oh, this is something good that I'm picking up. It's a positive. Bag of broccoli or something, vary your veggies or focus... Make half your plate fruits and vegetables, all of those statements. And there's a whole list of them that actually industry, the food industry could actually put on their packages. And so this is just kind of a nice way to promote, again, that consistency in labeling, give people some idea of what it is, when they are going to choose a food, what that is. Now, if dieticians were interested, again, I said this was proposed in March, they could write comments online or in the mail. They could send it as well. And they could do that by June 26th of this year. And they could say, "Yeah, I do really support this. I think it's great. I think it would work with my consumers or my patients. And so they could be part of the activity that goes on in the FDA."
And we love not only when the industry writes, but we want consumers and health professionals to write us and comment on these things as well.
Lisa Jones:
Yes. And that's excellent because one of my follow-up questions to what you were just saying is, as a dietician, thinking about ways that they can then use the information to better advise their clients on healthy eating habits, and that you already have a built-in amazing call to action, which you were saying is kind of putting these messages on the food. And then you're just telling your clients, okay, go ahead and look for X or go ahead and look for this.
Diana Monaco:
Right.
Lisa Jones:
And it'll tell them. And then that's something easy that somebody then can go do.
Diana Monaco:
Right.
Lisa Jones:
Dietician has it easier because they can give them something concrete to do. But then the patient or a client, even easier, because a lot of times they feel lost with all this information.
Diana Monaco:
It is. There's so much about food that has changed over the last 30 years, and all of a sudden we're being bombarded. And the consumer today is like, "Oh, is this food good? Because last year it was, and this year we heard it's not." And so right, these continuity of messages are going to be a better way. So people know like, oh yes, I know this is a good part to have in my diet. It's something good that I could add.
Lisa Jones:
I love it. So we have to make comments by June 26th.
Diana Monaco:
Right. Right.
Lisa Jones:
So everyone listening, make comments by June 26th, please do.
Diana Monaco:
And that you're supported. And actually, on the site, on our fda.gov site, you could actually see graphics and you'll see how they actually put them on the packages. And so you'll see crackers and I think spinach and bag spinach and all of that kind of stuff. And you could actually read through and see how it all is going to work, and it's kind of interesting. And they could also put the MyPlate symbol on there as well. And so that's also kind of, again, that message. I don't know if you remember, we used to have the food guide pyramid used to be on packages.
Lisa Jones:
Yes.
Diana Monaco:
And so this is that same kind of idea, that you can put that as well.
Lisa Jones:
Yes. And I'm kind of chuckling because I remember when I was seeing clients, they would turn around and be like, "That little man that's running up the steps, he's not that realistic because he is too skinny." And I was just like, "Okay, well, we'll let them know."
Diana Monaco:
Yeah, that campaign was a little bit short-lived. Yeah.
Lisa Jones:
Yes. Yes. So I'm sure you remember going through that with the comments that you must have received.
Diana Monaco:
Oh, yeah. That's...
Lisa Jones:
That was a good one. So could you talk a little bit about the key considerations behind the FDA's decision to amend the exclusion of salt substitutes in food labeling?
Diana Monaco:
Of course. Yeah. This was something... I don't know if your listeners had listened to it, but the White House had a national strategy on hunger, nutrition, and health, and they had a whole day series of that. It was really, really interesting. And they haven't done something like that in about 50 years, so it was really wonderful. So, as part of that in March as well, the FDA decided to amend the exclusion of salt substitutes. But again, remember this is a draft guidance, and this one goes until August 8th when you can write comments for this one. And so currently right now, when we look at salt substitutes, they're not permitted to be listed in place of salt in about 250 foods. We have what we call standards of identification for many foods. And so for food and beverage brands, they want to allow a little bit more flexibility and ingredients so we can actually meet the goal of lowering altogether sodium altogether.
So let me go back a little bit with that too. In October of '21, the FDA approached the food industry and said, "Could you reduce your sodium in the next two and a half years by 12%?" So the average amount that people are taking in is about 3,400 milligrams, so bringing it down to 12% will bring it to about 3000 milligrams, and that'll be in June of next year if that works out. That still is not the recommendation. Because as dieticians, we know the recommendation is 2300 milligrams a day for people 14 and over. But this is just one more way that now we're going to start looking at foods, if they choose, foods like cheese, frozen peas, ketchup can tuna, that they could start to use these salt substitutes, and now the overall intake of sodium goes down. So you see it's kind of like a multi-part plan, multi-pronged plan to reduce that sodium. Just lowering the number wasn't doing it.
You just keep saying, oh, I want it... I don't know when you started what the sodium recommendation was, but I remember it being 3,500 when I first practiced as a dietician and it just kept getting lower...
Lisa Jones:
Yes.
Diana Monaco:
... almost every year and stuff. And so salt substitutes, that's just going to be one more way. Now, we have to make sure, when we look at the... They've included 140 out of those 250 foods that actually can allow salt substitutes. So they're things like canned products like apple sauce, corn, green beans, mushrooms, things like oysters, peas, pacific salmon, tomatoes, tuna eggnog, those kinds of things can all use the salt substitutes. There are 140 of them, and we do have to watch them. So the dietician's kind of job or education will be helping those that cannot have salt substitutes. So when we look at a salt substitute, instead of regular salt, which has sodium chloride, they instead put potassium chloride. So they're taking at that sodium part.
And for some people, people that have, not everybody, but some people that have kidney disease, heart disease, high blood pressure, liver disease, diabetes, that extra potassium would not be good for them, so they're going to have to learn how to look at the label and read it and make sure that they're not doing any harm to their care plan. So that's going to be key for the consumer and the dietician to work together on that.
Lisa Jones:
That's where I'm thinking would be... You mentioned earlier that video, a video resource would be an excellent idea there, especially for somebody that... If you have a consumer that's not going to be reading a long document...
Diana Monaco:
Right. Right.
Lisa Jones:
... kind of send them to... "Here's the website to review this video. Let's go view it together and what kind of questions do you have."
Diana Monaco:
Yep. And this will be great. So it's not in regulation yet. So I'm sure all of those educational materials, they always follow. So if indeed this does go through and it's all done by... well, August 8th is the deadline for the comments... let's say it's done by next year, and then they'll be probably all those educational materials that will follow to educate consumers, make sure that they know, make sure that they realize what they're reading on the label and all of that. So it's all interesting how it works it. And everybody gets to comment and it's not just FDA coming up with these regulations. We have advisory committees and that type of thing. So there are all different kinds of people on these advisory committees. It's physicians, it could be dieticians, it could be industry, it could be academia, whoever is on there. So everybody puts their input as they're doing these draft guidances.
Lisa Jones:
Yeah. And that's what I was just thinking about. I can't imagine collating all that information with all these comments and then formulating...
Diana Monaco:
And you have to work with industry too. They've known about much of that this is ongoing, and they have to have some time to reformulate if they want to, and reformulate and packages and all of that. So nothing is done overnight. And a lot of people say, "Oh, things take a little bit longer in the government," but lots of players involved, lots of things involved that go on with this, and so it has to be done. And so that's why it takes a little bit of time, so it's done right.
Lisa Jones:
Yes. But you also kind of explained the process,
Diana Monaco:
Yeah.
Lisa Jones:
Because if you're not in it, working directly with it, you don't realize what's happening behind the scenes.
Diana Monaco:
Right.
Lisa Jones:
And there's so much going on behind the scenes, as you have been explaining, that it makes sense why this is taking... And it should take this long, because we don't really just decide to do something and then all of a sudden here's the regulation when it didn't go through, what it needed to go through in order to get to where you're at.
Diana Monaco:
That's right.
Lisa Jones:
Because I do kind of think trying to get clients or patients to follow this 2300 recommendation... I remember one time when I was doing home care, the home care nurse asked me to go talk to the patient, and it was a 93-year-old woman and I had to go give her a low-salt diet. So I walked into her house. And she was 93, so most of the stuff she did was canned foods because she wasn't able to cook as well as she used to. And she basically told me like, "I'm 93, I'm not going to go on a low salt diet." And I couldn't argue with her.
Diana Monaco:
Right?
Lisa Jones:
I don't have the...
Diana Monaco:
Affordability as well.
Lisa Jones:
Yeah.
Diana Monaco:
That comes into play as well. And canned foods might be a lower cost and fit in the budget better, and even storage. A lot of people don't have a full refrigerator or something. Yeah, so that's why working with industry as well, their products not only in the retail level but also in the food service level, that's all important because the hospitals and that type of thing that are buying for large quantities, for example, that need for their patients low salt, there's not a lot of choices for them to do. So this kind of... It brings up the topic, brings up the conversation, and so the industry has to play into this as well.
Lisa Jones:
Yes. It all goes back to meeting the patient where they're at. And there are many patients that... And I'm sure like many listeners, especially if you're dietician counseling patients, the 2300 is hard. So I like the fact that they're trying to make changes to adjust that, so it's not as low with the salt substitutes.
Diana Monaco:
Right. Right.
Lisa Jones:
So thank you for explaining all that.
Diana Monaco:
You're welcome.
Lisa Jones:
And as a dietician, what topics should we be aware of in the next year? Is there any that you can highlight that is upcoming for our audience?
Diana Monaco:
Yeah. We have several draft guidances, and more things that are on their way, and dieticians might want to comment on them. We have plant-based, alternative milk. And so that has become a hot topic, and you can imagine that. So when we look at these plant-based alternative milks, they are milk alternatives. Sorry about that. There are all different views of this, right? The consumer now has all of these choices, and they're looking at, oh, I could buy almond, I could buy oat milk, I could buy this, I could buy that. And the agencies take on this is, okay, well it's okay, we're going to let you call it milk, even though these are not dairy products, and we realize that consumers do understand almond milk is made out of almonds or something like that. But what we did find out with the focus groups is that they did not understand that the nutrient difference was very different between regular milk and let's say, for example, an almond milk.
And so we are asking for a descriptor to be on the packages that actually compare the plant-based milk to regular milk so people start to understand, "Oh, the protein is different," or "Oh, the vitamin D is different." Whatever it is that might be different, it would then be highlighted. And so that was actually closed, the comment period, but they reopened it. And sometimes that happens when things are a little bit more controversial. And so they reopened it again, and now people could comment till July 31st. And so just watching that, even in the news and watching different publications and stuff like that, seeing what the farmer says, a dairy farmer says compared to maybe what somebody in the almond industry is saying, it's all kind of interesting that everybody has their side of the story. So that's one piece of guidance.
There is also guidance about the word healthy. Should we put healthy, the word healthy on foods? Should we have a label that has a little symbol or something that we put on our foods? How many things can we put on a label? Right? All of that. So that's also part of the discussion now. What exactly is healthy? There's been lots of articles and stuff like that about, oh, look at FDA is not calling such and such food healthy, because it doesn't meet the descriptors in the draft guidance. So again, another place where we have to work through that to see how that's going to fit into the food industry. We had what is called the food code. I don't know if everybody knows what the food code is, but the food code is all of the recommendations to prevent foodborne illness that the states and the local authorities use to mitigate all foodborne illnesses at the retail level.
So that's in restaurants and grocery stores, that kind of thing. And the food code gets updated every once in a while, and this is its 30th year actually in existence, and everybody uses the food code. Now if they have something that is even more restrictive than the food code, they could certainly use that, but most everybody uses the food code. And we had some changes to that too. The FDA reduced the barrier to food donations. So food donations were always kind of an iffy topic. And so they're clarifying for the first time that food donations from a retail food establishment are acceptable as long as proper food safety practices are followed. And so we know that one-third of all the food in the US goes uneaten. And as dieticians, we kind of cringe at that number to realize that there are so many people that need food.
And so this is nice. This barrier was lifted. It was put into the food code so everybody could look at how that has to be handled, and maybe we could start distributing that food instead of throwing it out. For a little bit more, I consider it a little bit more fun regulation, I guess if you want to call it that, dining outdoors with dogs...
Lisa Jones:
Yes.
Diana Monaco:
... the FDA has finally said okay, as long as the state also agrees. But that's always been something, let's say in California or something, that they've allowed dogs. And so now it's going to be legal if indeed the states agree with that. So kind of a more fun kind of law. And the one that I've been following myself, I just find it really, really interesting, is all of these kinds of online groceries and meal kits and everything. What are people actually getting? Do they realize it? Is it at temperature? Does it have food allergen information on it? Does it have ingredient information on it? What is the consumer actually getting? What is that platform? So back in, I think it was October of '21, the FDA met with, they call it e-commerce. And these are, again, these online groceries and meal kit people, and even Uber Eats and all of that kind of thing, and met with them and said, "How are we going to handle this? How are we looking at all this? How are we informing the consumer? Are we being safe? What are we doing in this arena?"
So that's also another place, as of July 24th, people can make comments about that as well. And so that one, I'm having fun just watching how it's all kind of progressing and all of that. And I've never seen so much... At one time, it used to be maybe one or two places you could get meat from, and now it seems like every farm or whatever is sending out maybe meat products, or chicken or different cheeses or that kind of thing. So even in that arena as well. So that's going to be very interesting.
Lisa Jones:
Yes. I was just thinking, I can't even keep up with the names. In the beginning, it was like, Hello Fresh, and there were a couple of competitive...
Diana Monaco:
Right.
Lisa Jones:
And now if you asked me to write a list of all of them, I would miss probably most of them because there's like a new one popping up every day.
Diana Monaco:
Yeah. And now the Hollywood stars are getting involved and all of that. We have to understand if we're shipping something to Alaska, we're shipping something to Vermont, we're shipping something to Miami, Florida, how is it all getting to all these places? What is the temperature?
Lisa Jones:
Yes.
Diana Monaco:
We start off with adults usually, and many of these meal kits are for the whole family, but are there allergens listed? Can somebody realize what's on there? Do they know where to get that information? And so yeah, it's going to be really interesting to see what happens.
Lisa Jones:
And then dining with dogs.
Diana Monaco:
Yeah. I'm thinking...
Lisa Jones:
Dining with dogs, you may have... I'd be curious to find out if you report anybody writing about cats next. I don't know.
Diana Monaco:
Yeah, cats next. You never know, right?
Part of the industry looks at... Many of these things don't even have to be... They're shelf stable, but yet they're in containers that look like milk cartons. They're in a cold area. Most of them really don't have to be, because they're, again, like I said, shelf-stable and all of that. So they're treated like milk, but is that confusing the consumer? And so that'll be interesting to see. And that's what the dietician should comment, how do they think that fits it. It actually has a place. We're not disparaging the product itself. We just want to make sure that... We've heard some stories about people putting this in baby bottles. Do they understand that it's not the same as whole, dairy milk, bovine milk? They're understanding that almond milk is not bovine milk...
Lisa Jones:
Yes.
Diana Monaco:
... in the nutrition difference. Yeah.
Lisa Jones:
And then also too, the protein, because all those levels vary. So what are they actually getting? So I think that's one I'll be watching myself. So again...
Diana Monaco:
Some of these have so much sugar in them. Are people realizing that? Yes, it might be very tasty, but it's almost like you're drinking a can of soda or something, right? They are tasty, but that's why they're tasty, because of all the added sugar.
Lisa Jones:
Yes. That's a really good point.
Diana Monaco:
Yeah.
Lisa Jones:
Diana, could you share one story or example, showcasing your work over the last couple of decades?
Diana Monaco:
I have to say, I've had such a fun career. I really have. I've gotten to do so many things, but probably the one area that I loved probably the most was food safety. And so I had to figure out a way, as an educator, to come across to all different kinds of groups. So was it the four-year-old playing outside, the mom changing diapers, the school food service personnel, feeding hundreds of teenagers, the food bank person? And so for many, many years I worked with, and I'm sure a lot of people have seen this over the years, at the time, it was new, but the gel-based lotion that simulates germs on your hands or whatever. And so we used a campaign, it was called the Fight Back Campaign, BAC for bacteria. And so this germ was a green germ, and he kind of represented all the core practices of food safety, clean, separate, cook, and chill.
And so it was visual, and it was fun and we'd go out to all different kinds of groups and do all different kinds of outreach. I used to have a tabletop display. People would put their hands underneath and see the germs. They weren't really germs, it was just the lotion being lit up. But it was kind of a nice message about washing your hands and singing the happy birthday song and all of those things that we now know all about. I used to have as well, a germ tent, and it was actually a tent that families could go through and they could see the germs on themselves. So they'd all get stickers when they came out if they were clean, if their hands were clean, and all that. So I really liked food safety. I really liked teaching it. I think it's so important. During COVID, we saw it was so important, the pandemic. And that was one of the probably...
I did state fairs. I did all different kinds of groups, so it was one of my better memories of all the different things we can do, just even at a public health level. I did a food allergy conference at a time when people were very confused about allergens in the school place, and how to handle more and more children having food allergies. And we did a conference and it took one year to put together, and it was with pediatricians, allergists, and all different kinds of pulmonary people, and we had speakers from all over. And we had about 800 people come to this conference, and we had food vendors. It was a time when the word gluten was brand new. Nobody really knew what that meant, gluten, gluten-free. And I worked with moms. I worked with this one mom that had three kids with food allergies, and she had waited for an appointment with a particular physician in New York City for a very, very long time, and her poor little baby was just covered in a hive-type of situation every time that she would feed him.
And it turns out that the baby was playing with the dog food. And so whatever was in the dog food was affecting the baby, and that's what was the problem. And so just working with these moms and what they went through and the things that they had to do... and even planning for a vacation... it just educated me. I never realized. I just thought, oh, everybody just goes to wherever at the time. It's different now, but oh, you just go to Disney or go whatever, but it wasn't like that for them. And so the education that they gave me was invaluable, just as a human being and as a dietician, just to see what people go through in their homes when they have children with food allergies. Just amazing. So I would say those are the two top I've had. Tons, tons more, but those were the two that really affected me in a great way.
Lisa Jones:
Yeah. And they're both really memorable too. Thank you for sharing, especially the fightback. And I still see that every once in a while.
Diana Monaco:
Yeah. It's a partnership with all agencies. So it's not an FDA program. It's from the National Partnership for Food Safety. And so it's actually an organization that does all that. It's a one-person run group, but it's a wonderful, wonderful group that does that.
Lisa Jones:
Yes. Yes. So I believe we had... It was Shelly Feast, I believe.
Diana Monaco:
Yeah. Yeah, Shelly. Oh my god, she's fabulous.
Lisa Jones:
And then we had a podcast episode a couple of, maybe it was last year sometime, about that...
Diana Monaco:
Okay.
Lisa Jones:
... on food safety.
Diana Monaco:
Yeah. Yeah.
Lisa Jones:
So how about, could you say one bottom line takeaway for the audience? And I know we talked about so many things, Diana, so this is going be a little difficult to narrow down, but if you could just tell dieticians one thing. And I know what I would say, but I'd like to hear what you have to say.
Diana Monaco:
Okay. I think when you look at information, interestingly enough, our commissioner now is Dr Califf, and he's a cardiologist and he talks a lot about misinformation that's on his platform. And at first, when he first threw all that out, I was kind of listening to him, and stuff like that. And then the more I got into that, I thought he was right. And he says it's one of the number one reasons for different kinds of disease states and this kind of thing, and it's true. If you don't have the right information, you're not going to do the right thing. And so these sites, these scientifically based sites such as the FDA, we're not the only one, but such as the FDA, are really a place that people could find the information to be trustworthy, and they could feel confident in what they're reading or on what they're looking at.
And so again, we go back to that pregnant mom and she's wondering how much of that seafood and what kind of seafood am I supposed to have when I'm pregnant? She could go right there, find the information, it's correct, it's up to date, it's scientific. And so I think as dieticians, healthcare providers, that type of thing, we should always steer our people that we're working with towards sites that are actually science-based. I know the internet is just a vast array of all different kinds of information, and it's overwhelming, it really is. But maybe if people were funneled to those sites that really are going to give them the right information and good information, things would be a lot better. So I would really say that that's the bottom line. Where are people getting what they're talking about or what they're listening to?
Lisa Jones:
Yes. And you said... I was just going to say bookmark this website and for similar reasons, because there's no way I could have summarized everything you said into one bottom-line takeaway. I would've not passed that test. So thank you for sharing that.
Diana Monaco:
Anytime. Anytime.
Lisa Jones:
And all the information... you have got to check the website out to keep up to date with this information, such great information.
Diana Monaco:
Thank you.
Lisa Jones:
So now, I want to ask you a couple of fun questions before we wrap up.
Diana Monaco:
Sure. Of course.
Lisa Jones:
I'm going to give you a choice because we have a couple of things coming up. And we are recording this episode right before Mother's Day and Memorial Day.
Diana Monaco:
Okay.
Lisa Jones:
So I want to ask you about your choices. You can either talk about Mother's Day or Memorial Day with this question, but what is the most unique gift given or received?
Diana Monaco:
On Memorial Day or on Mother's Day?
Lisa Jones:
Yeah, that's probably a Mother's Day one. Yes.
Diana Monaco:
I'm not a mother, but I'm a godmother, and I still get gifts, which is really nice actually. So I got the gift this year of... My niece is pregnant. And so that to me is a gift from... We haven't had a baby in the family in a long time, in about 30 years, and so we are just super excited, and I'm constantly sending her all different kinds of information. And she's sucking it all up. She loves it all. And each week or every two weeks, we get a picture of what the baby is looking like, if it's a sonogram or matching it to a fruit or a vegetable. Right now it looks like an ear of corn. It's the size of an ear of corn. So that's been a gift for me. Yeah.
Lisa Jones:
Congratulations.
Diana Monaco:
Thank you. I know. We're so excited.
Lisa Jones:
Yeah. Then you're going to be buying lots of gifts there.
Diana Monaco:
I already have a bag already started. Yep. Yep.
Lisa Jones:
With all the cute little... Such a fun age.
Diana Monaco:
It is.
Lisa Jones:
How about your favorite food or drink? And this could have been on a Mother's Day celebration or a Memorial Day celebration, whatever, your pick.
Diana Monaco:
My favorite food, and it's kind of a weird food, but once I introduce it to people, they come back and they go, "Yeah, I like that too." I love to just walk around. I'll go to a farmer's market or something and just walk around and eat sweet peas out of the pod.
Lisa Jones:
Oh, nice.
Diana Monaco:
It's my favorite food ever. And so you could catch me... And there's only a brief time. It's only about two or three weeks, well, in my area anyways, where I live, that you can get sweet peas in a pod. And so it's a fun time. I wait for it. I can't wait till it comes. And then my second favorite fruit is chestnuts. And so I love my chestnuts boiled. And I introduce people to that too, and they go, "Wow, I can't believe that. It's really good." So yeah.
Lisa Jones:
Yeah, especially...
Diana Monaco:
I grew up in a very ethnic house, and so we have lots and lots of foods that we ate. And I tell people all the time when I was... I worked at a grocery store when I was 16. That was my first job, and I remember a can of beets coming by. I was checking it out. And I said to the lady, I go, "Oh beets come in a can." Because my mother really canned everything and everything was bought fresh, and so we hardly ever really went to a grocery store. We had milk delivered, chicken delivered, and eggs delivered. And so my idea of a grocery store was really... I don't have any real memories of it when I was young because she just made everything. And so it was a nice way to grow up.
Lisa Jones:
Very nice. Chestnuts. You got me thinking about chestnuts at the holidays now.
Diana Monaco:
Yeah. Yeah. Oh my God. Chestnuts are the best, the best.
Lisa Jones:
Last question, how about fun activity or tradition? You can talk about either one, on either Mother's Day or Memorial Day weekend.
Diana Monaco:
Oh, let's see, Mother's Day, Memorial Day weekend, a fun tradition? I don't really know if we have one. Usually on Memorial Day weekend, we go to a place called Presque Isle, which is not that far from us, and we just go bike riding. So I always connect Memorial Day with bike riding.
Lisa Jones:
Oh, nice.
Diana Monaco:
And so that would be my memory. Really, every Memorial Day, I get my bike out, get it all ready, and we usually go on our first bike ride around... It's a place in Pennsylvania. So that's usually what we do, but...
Lisa Jones:
Well, that counts as both a fun activity and a tradition. A very nice...
Diana Monaco:
That's it.
Lisa Jones:
... way to wrap up. So Diana, thank you for being on the show and sharing your insights with us today.
Diana Monaco:
Anytime.
Lisa Jones:
We greatly appreciate it. And I'll make sure that we put all of the resources and links that we discussed today.
Diana Monaco:
Excellent.
Lisa Jones:
And to our audience, thanks for listening, and please tune in again and share your comments and feedback on our site. Have a great day, and enjoy a healthier lifestyle with the 411 in mind.
Speaker 1:
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