In this episode of The Huddle, Janice Baker, MBA, RDN, CDCES, CNSC, BC-ADM, joins Julia Socke, RDN, LDN, CDCES, for an insightful conversation on common nutrition myths and the importance of holistic diabetes care. Drawing on nearly 43 years of experience, Janice shares her evidence-based perspectives on topics like low-carb diets, artificial sweeteners, and protein. She also discusses her collaborative approach to working with other healthcare providers and highlights often-overlooked aspects of diabetes management—such as foot and dental care—that contribute to truly comprehensive patient support. Join us for an enlightening discussion that blends clinical expertise with practical strategies for whole-person diabetes care.
In this episode of The Huddle, Janice Baker, MBA, RDN, CDCES, CNSC, BC-ADM, joins Julia Socke, RDN, LDN, CDCES, for an insightful conversation on common nutrition myths and the importance of holistic diabetes care. Drawing on nearly 43 years of experience, Janice shares her evidence-based perspectives on topics like low-carb diets, artificial sweeteners, and protein. She also discusses her collaborative approach to working with other healthcare providers and highlights often-overlooked aspects of diabetes management—such as foot and dental care—that contribute to truly comprehensive patient support.
Join us for an enlightening discussion that blends clinical expertise with practical strategies for whole-person diabetes care.
Julia Socke
Hello and welcome to ADCS's podcast, The Huddle, Conversations with the Diabetes Care Team. In each episode, we speak with guests from across the diabetes care space to bring you perspectives, issues and updates that elevate your role, inform your practice and ignite your passion. I'm Julia Socke, Director of Diabetes Education and Accreditation Program. I am a registered dietitian nutritionist and a certified diabetes care and education specialist. And for many years prior to joining the ADCS team, I worked with people living with diabetes on all aspects of diabetes self-management, including healthy eating. On today's episode, we'll be learning about some common nutrition myths that may be affecting your patients and discuss how we can help them unlearn some of these false narratives. Our guest today is Janice Baker. Welcome, Janice.
Janice Baker
Thank you for having me. I appreciate it so much.
Julia
We're so happy to have you, Janice. Could you tell us a little bit about yourself and how nutrition myths have impacted the people with diabetes that you work with?
Janice
Sure thing. Well, I am also a registered dietitian nutritionist. I'm also a certified diabetes care and education specialist, a certified nutrition support clinician, and board certified in advanced diabetes management. And I've been in practice since 1983. So having said that, four decades of seeing ideas and concepts and thoughts about food and eating and diabetes management. So many things come and go. It's been quite an interesting ride and we're not done yet. So yeah, needless to say for our patients with diabetes, with all of the information, misinformation, disinformation, all of the sources of where they get their nutrition advice has exploded. It's not just from the dietitians or their healthcare providers. It's obviously from so many other sources. It does take a lot to keep up with everything and to help our patients sift through what they're exposed to and make sense of it and how it applies to them.
Julia
Yeah, absolutely. You know, with so many years of experience, I'm sure you have probably heard it all. But if you had to say, you know, what are some of the most common nutrition myths that you do hear?
Janice
If we check into each era, we can see something a little different and contradictory with the next major era. So of course, the big thing that we hear about is the idea about carbohydrates being bad. You know, that's the most common or what are good foods, bad foods, know, a very all or nothing or black and white type of thinking. And what we have seen is this really gets people into a lot of distress, honestly, and trauma about foods that they thought they may be able to work into their diet and their culture, of course, and their nutritional needs. And then they're told, no, that's bad. You can't have that, or this is gonna happen if you eat this. And I have people come to me and they're so confused.
It doesn't stop there being that I'm a nutrition support clinician and I really value that credential because I do see a lot of malnutrition in the community setting. And that includes people with diabetes for different reasons. You know, making sure first of all, along with blood sugar management is that they're getting the foods they need to support their overall health and wellbeing, not to mention mental health, which is part of the big picture.
So it's carbohydrates, you know, in the nineties, was everything should be low fat, fat free. That was pretty miserable. And now everything is fortified with protein. More protein, the better. So protein is being put on a pedestal. And while reevaluating people's protein needs, depending on their age and medical status and what else is going on, it just seems like the marketing is always so much more powerful than the truth. And we see that in a lot of ways, definitely. But we come through cycles of this and it's very profitable to confuse people. We know that.
Julia
Such great points, Janice, because one thing that I also really experienced in my clinical career was kind of what you described, this cycling of, you know, different kind of fad diets. You know, and it's changed drastically over time, as you said, you know, where at one time carbs were good and then another time carbs are really bad. So it can be very confusing for people with diabetes. I'm curious your thoughts, Janice. I know one myth that
I heard a lot was really around sugar substitutes not being safe. And I'm curious, what are your thoughts about that? And is that something that you've heard quite a bit from the people that you work with?
Janice
Yes, yes, that is one thing that comes up quite a bit. And when you say the term sugar substitutes, that includes many different choices, right? So, you know, we started out way back in time with the pink stuff, the Sweet and Low. And there was even some concerns about that. And, you know, again, in the typical normal ways that people use all the sugar substitutes, actually, they're very well studied, their safety is very well established, and there's a lot of citations showing that. Of course, there was Equal, NutriSweet, the sugar alcohols. One thing about the sugar alcohols, those were being used a lot in so-called sugar-free products for a while. When that was a big thing, the sugar-free cookies and the sugar-free candies was actually a lot of gastrointestinal side effects because they can cause the sorbitol, anything with xylitol, used in large quantities, they can cause GI side effects. That's known. Sucralose, Splenda, all of these have been really well established in normal amounts of use with an added safety factor to be perfectly safe. But I also say to my patients, listen, it's a choice. There's a lot of nice options if you don't want to use them, that's okay. There is workarounds for that as well.
Julia
Absolutely. And now, Janice, you hit on something really important just a minute ago about the impact of marketing. You know, we know that that's definitely one place that people are exposed to some misinformation. But where do you think the other areas are that these myths come from? And have you found over the course of your career that the sources of these myths have changed over time because of the internet, social media, et cetera? What are your thoughts on that?
Janice
Yeah, know, early in my career, and I was just talking to a colleague about this the other day, a lot of the books that were written, like in the 80s, we were just talking about the myths about food combining. One product was the Beverly Hills diet. The first edition was when I was in college and saying, you know, if you eat fruit and potatoes at the same time, would make vodka in your stomach. I mean, things like that. And these people were on talk shows. They were made popular because they became celebrities because of these new diet fads and then they were copied and if they were on TV it had to be true. So it wasn't just the internet but of course now with social media and all of the influencers and how good they are at making the content, they're very good at it. It's all about fear, fear sells. We're afraid of what the consequences might be or how accepted we are or what our blood sugars are going to be. So when we have this fear of whatever that may be, and it's very influential, it can make a very big difference in people's choices.
Julia
Absolutely. And, you know, it can be really difficult, at least in my experience, to have an effective approach in discussing these myths with our patients. So I would love to hear more about what your most effective approach has been in dispelling these myths. And also, has your approach changed over time?
Janice
That is such a great point. And yes, early in my career at the way we were trained and remember, I was trained in the eighties, early eighties during my dietetic internship, which was fabulous, but we were taught our patients with diabetes, and I worked in the hospital setting for 15 years, we were taught to teach the exchange system. I don't know if you've ever heard of that or remember it. Still in my closet I have some of those books just for fun for historical purposes. And to see a patient with diabetes, you had to get them how many exchanges of fruit, fat, meat, bread, things that you could have per meal. And it was just one directional, right? And this is what you do when you get out of the hospital. Totally different right now. And one of my favorite ways to look at things is that people want to be heard, not fixed.
So now it's just very different than that one of the best ways that I work with patients. And a lot of times this is referred to as motivational interviewing, which I've been trained in, but really being curious with people, are, what are your goals? What gets in the way of taking care of your diabetes? What are your favorite foods? People love when I ask about what their favorite foods are. They never thought anyone, especially a dietician, would ask them that.
Because I always say, listen, one of the most important parts of this is making sure that nutrition and food for you is enjoyable because it's not going to be sustainable if it's not. We're born to get pleasure from food. It's a very important part of our quality of life. So making sure people know that what they value and what they enjoy is respected and honored and included.
Julia
That's such a great point. A little bit earlier, you were hitting on that aspect of fearmongering that happens. But also, it's this point that you just brought up about having a sustainable eating plan and one that you enjoy is so important and having that openness to really understand what it is that's important to this person, not just what their likes, but also their cultural and religious preferences that also really play in. And some of these myths may actually prevent people from participating in maybe some of those activities that are tied to their culture and religion.
Janice
That is so critical because we know one of the determinants of health, now we're looking at social determinants of health and one big one is social isolation, being lonely. And you can even be lonely when you're with people, right? And if you feel like you're attending a party or an event or a celebration and you can't eat that birthday cake or the taco or the other cultural food, you know, you're still isolated and it's still stigmatized. Or if you do enjoy the birthday cake or the challah on Friday night for Shabbat, you're still feeling isolated and then you feel guilty and then it becomes the cycle of restriction and guilt and that never contributes to health.
Julia
Yeah, absolutely. Janice, I'm sure you maybe have experienced this over the course of your career. I certainly have. But for my patients, what I realize at times is that some of these nutrition myths are actually perpetuated by health care professionals. And this can be a really, really tricky territory. So what advice do you have for diabetes care and education specialists to navigate this particular challenge?
Janice
Yeah, yeah, I have encountered that quite a bit, even with my own healthcare providers. And fortunately, because of how long I've been in practice, and I've made friends with a lot of physicians and physician assistants and nurse practitioners, developing a good relationship with other healthcare providers really makes a difference because then they feel comfortable about talking to you, about asking you questions. But when they bring up something like my own personal physician. He's an internist, we're about the same age. And he tells me what he tells his patients. I just say, I think I have an idea what may be a better approach to this. And we've known each other a long time and work together. So he respects me for that because I call it out. And I think that's another responsibility we have as CDCESs and registered dietitians, I like this phrase, if you see something, say something. If you hear something, don't be afraid. You can gently or politely, of course, bring it up and say, you know, that's an interesting comment. And actually, the way nutrition science is showing is this approach might be better for these reasons. So you're not attacking, of course, that never works. It does the opposite. But calling it out in a way that's respectful and letting them know you're happy to be a resource for them is one approach I tend to use.
Julia
Absolutely. And I think also the point made earlier about maybe coming from a place of curiosity with our patients, that could also be an approach used with our colleagues as well. You talked a lot about myths, but what are other things you feel are important to talk about with patients?
Janice
In the world of diabetes, which encompasses a lot, we know it's not just about blood glucose levels anymore. We're looking at what we call the cardiometabolic aspects of it. And that entails a lot of things. And it keeps me very busy keeping up with the literature because of the explosion in technology, obviously, the medications that are out there that are just, makes your head spin how many there are now, the different types of insulins, oral medications, but also things that I remind my patients of, especially that are not so sexy.
You're not gonna necessarily see these promoted on social media, but the importance of sleep. First of all, I ask all my patients about their sleep patterns. And that is a very big impact factor on, as I always say, blood pressure, blood cholesterol, blood glucose levels, appetite regulation, and we're learning how sleep is the way to detox, right? We're learning about how the brain during good quality sleep and good quantity sleep actually cleans up a lot of stuff during the night. And when we're sleep deprived, how much that affects other health aspects of our life. So that's one thing I bring up. And I often refer to sleep specialists or talk about what their sleep habits are, sleep hygiene. So that's a very big deal. I used to never bring that up previously, but we know so much about that now. The other part is dental health, oral hygiene. We hear about the microbiome all the time. know, people are buying probiotics, prebiotics, all this stuff, but the microbiome starts in the mouth. And we know that periodontitis, gingivitis that leads to systemic inflammation which can lead to insulin resistance, cardiovascular disease, and of course loss of teeth, limits your food intake, your food choices. So dental health, oral hygiene is a very big part. Again, not very sexy. The stuff that works typically isn't. And then again, along with that is foot care. Again, sometimes this just gets pushed aside. I ask all of my patients, have you had your feet examined at your regular visits? A lot of times it's no, and we've been telling them for long time, always take your shoes and socks off, make sure your feet are checked for circulation, for nervous system function. It's a very big deal. Again, like a lot of things, starts very silently until it's not silent anymore and very hard to take care of.
So those are three big parts of it alongside of the food and nutrition that I usually talk about.
Julia
Great, thanks so much, Janice. So any final thoughts for our listeners?
Janice
Yes, one thing I like to say and because of where I'm at in my career, I'm so grateful, first of all, this 42, almost 43 years of practicing as a diabetes educator, registered dietitian, it just seems to have flown by and I'm still so grateful for what I get to do because it's always challenging, of course, but it's really fun and I learn all the time.
One thing I'm realizing is like there's a lot of other things that are part of health and that's finding joy in life. So not just a happy life, but a life with meaning. I know that's been also brought up as a very big part of how we take care of ourselves, having purpose and passion.
Julia
Janice, thank you so much for joining me on the Huddle today and for providing your valuable perspective and experience. We're so appreciative. Thank you for listening to this episode of the Huddle and engaging with ADCES. And remember, being an ADCES member gets you access to many resources, education, and networking opportunities. Learn about the many benefits of ADCS membership at adcs.org. The information in this podcast is for informational purposes only and may not be appropriate or applicable for your individual circumstances. This podcast does not provide medical or professional advice and is not a substitute for consultation with a healthcare professional. Please consult your healthcare professional for any medical questions.