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In the Media Nutrition Research

What to eat to lower your risk of breast cancer:

October 26, 2019
Dietary approaches to lower breast cancer risk

Two of the scariest words, “breast cancer”. To those who have been in this position, I’m sorry. CANCER SUCKS.

There are so many contributing factors to this diagnosis! It’s super important to note that no single food or diet can prevent breast cancer. Sorry, but want to keep it real!  But research shows there are some foods you can incorporate into your diet to lower you risk. 

Breast cancer is super complex!  Some things that contribute to this diagnosis, you can’t control….I’m looking at you genetics, age, and family history. But some things you can control (or at least attempt to control), like weight, physical activity level, and smoking status.  Did you know, research shows that lifestyle choices/dietary factors are responsible for 30% of ALL cancer?!  Today we are going to walk through foods to include in your diet and foods to avoid.

So first and foremost, association is not causation. The below foods are recommended because there is an association of their consumption with a lower risk of cancer development. With that being said, research supports an increased consumption of:
Fresh fruits (especially berries)
Fresh veggies (dark veggies like kale, spinach, broccoli)
High fiber foods like whole grains, beans, legumes and pulses
Low fat diary
(and other foods high in Vitamin D)
Fish (salmon, oysters, herring, mackerel, sardines)
Soy (foods only, not supplements) – soy beans, tofu, soy milk

Outside of specific foods, there are certain dietary patterns associated with lower cancer diagnosis. Research shows the Mediterranean diet is associated with lower risk of developing breast cancer. Short story, this diet is plant based (so eat a ton of fruits and veggies), use plant based oils (yes, olive oil), have seafood twice a week, cheese and yogurt (but be mindful of portions), and enjoy nuts!

Ok, so we’ve talked about foods to incorporate, but what about foods to avoid? Remember, no one food causes cancer. But, again, there is some research and recommendations around which foods to avoid.
Alcohol (I know. Look, I’m sad too, but you need to know the science.)
Added sugar (please note, not naturally occurring sugars like those found in dairy and fruit, but added sugar. Think desserts, flavored yogurts, and more)
Trans fat
Processed meat and highly processed foods

Anything else you need to know? Yes! Other items to include/ tips that are associated with lowering your risk:
Green tea (1-4 cups a day)
4 hours per week of exercise or longer (brisk walking is just fine!)
Maintain your body weight (even a 10% weight gain increases your risk)
Breast feeding

Remember, no one knows your body better than yourself! Do those monthly checks, stay on top of your wellness visits and don’t forget to get your mammo!!

In the Media

Worksite Wellness and the RDN

September 22, 2016
Welcome to Caroline Susie RD

Worksite Wellness and The RDN-Why You Should Be Running the Show!

I wrote this piece for the SCAN DPG.  Dietitian in wellness?  Read this.  

It’s hard not to get behind a worksite wellness program. Programs promote health, and wellness in employees and increase company morale. The landscape of corporate wellness has changed greatly over the past 15 years.   In 2010, 74% of employers offering health care benefits also sponsored at least one wellness program.(1) What was once considered something that appealed to new recruits has now become a strategic priority for most companies. Offering wellness programs is not only the right thing to do for employees’ health (2) but it is the right thing to do financially. Richard Easley, senior benefits consultant at Hay Group, a global HR management consultancy firm says, “The companies that get proactive about implementing relevant wellness programs are the ones that are going to attract and retain the best talent, keep them healthy and productive and lower their overall health care costs.”

In the early onset of wellness programs, you found an exhausted HR employee planning health fairs and organizing teams for community runs. Participation based programs boost morale but as healthcare changed, companies knew they needed to make a change too. Insert outcomes based programs and a dedicated wellness leader, like a RDN. Comprehensive wellness programs include health assessments, biometric screenings, risk identification, activity challenges, health management workshops, integrated technology platforms and incentive management. Outcomes based programs not only hold employees (and in some cases spouses) accountable for their health, but employers have the data to see biometric improvements. Many outcomes based programs can show data improvements not only with biometric data, but with other claims such as ER visits, lower hospital admission rates, better management of chronic diseases, and lower pharmacy costs. Studies confirm the effectiveness of workplace interventions like promoting wellness, healthy eating, and physical activity partnered with motivational interviewing and rewards (3). Who better to lead these initiatives than a dietitian?

In addition to promoting health and boosting morale, wellness programs are in place to prevent illness. At the core of every wellness program is nutrition and physical activity (4). With nutrition being a critical element in any wellness program, it is imperative to have a RDN in place to design, develop and implement validated wellness programs.(5) At this time, there is no standard requirement/certification for wellness program managers/directors (6). We know that RDNs can provide MNT that is not only cost effective but also positively impacts physical and biometric measures (7). In addition to offering MNT, RDNs can be trained in motivational interviewing, health coaching, communication, marketing, behavior change, physical activity, and more. By focusing on health outcomes, program coordinators (RDNs) can develop and facilitate behavior change programs such as stress management, weight management, smoking cessation, and emotional wellbeing. RDNs are the total package.

Every team performs better with a coach. Health coaching is essential for a successful wellness program. Dietitians are not only qualified to coach, but also can “train the trainer”. Coaching provides sustainable evidence based healthy behavior changes through positive psychology and motivational interviewing practices. While new technologies continue to evolve such as gaming, wearable fitness trackers and health challenges; face-to-face interactions, like health coaching, are not going away. (8)

There is no time like the present to get involved with corporate wellness. 50% of companies expect to make changes to their health wellness offerings and or add wellness incentives in 2016 or 2017. (9)


  1. Kaiser Family Foundation, Employer Health Benefits: 2010 Annual Survey. The Kaiser Family Foundation, Menlo Park, CA; Health Research & Educational Trust, Chicago, Ill: 2010.
  2. John C. White, Stephen Hartley, Ronald J. Ozminkowski Association Between Corporate Wellness Program Participation and Changes in Health Risks, American College of Occupational and Environmental Medicine. 2015; 57: 1119-1126
  3. Hutchinson AD, Wilson C. Improving nutrition and physical activity in the workplace: a meta-analysis of intervention studies. Health Promot Int. 2012; 27: 238-249
  4. Centers for Disease Control and Prevention. National prevention strategy: America’s plan for better health and wellness. Centers for Disease Control and Prevention Website: Published June 16, 2011.
  5. Mincher, Jeanine L., Leson, Suzanne M. Worksite Wellness: An Ideal Career Option for Nutrition and Dietetics Practitioners, Journal of the Academy of Nutrition and Dietetics. 2014; 114: 1895-1901
  6. Mattke S, Schnyer C, VanBusum KR. The Worksite Alliance: A review of the US workplace wellness market. July 2012: 1-46. Http://
  7. Leachman-Siawson D, Fitzgerald N, Morgan K. Academy of Nutrition and Dietetics Position Paper: The role of nutrition in health promotion and chronic disease prevention. J Acad Nutr Diet. 2012;11(7):972-979
  8. Optum, Creating a healthy, high-performing workforce: 6th Annual Wellness in the Workplace Study, (April 2015). Retrieved from
  9. Wells Fargo, Employees Benefit Outlook 2016;


Corporate Dietitian Tool box:

AND and DPGs like CV Wellness

Onsite health coaches

Onsite employee health nurses

Biometric screening

Health assessments

Flu shots


Tobacco cessation program

Weight management program

Diabetes education program

Employee assistance program

Prenatal/postnatal program

Ergonomics program

Onsite fitness centers

Activity challenges

Healthy café options

Wellness committee

Data collection

Mobile apps







In the Media Nutrition

If It Fits Your Macros- Marketing 101

September 21, 2016

Macros….if you are a dietitian (or diabetes educator), this trend is called carb counting.

“If it fits your macros!” Have you heard this at the gym?  Or at the coffee shop?  This is marketing 101. Counting your macros is the grandchild of counting your carbs, which has been around for 20 years. I need to hire this marketing person….I mean she/he is simply rebranding a concept to make it cool and trendy. GENIUS!

Macros is short for macronutrients. There are 3 macronutrients: fat, protein and carbohydrates. All 3 are essential for life. You don’t want to eliminate any of them. The recommendation for macronutrients is usually 50-65% carbohydrate, 15%-30% protein and 20% fat. The recommendation is based on multiple factors like age, height, weight, gender, activity level, etc. If you want a personal breakdown, contact a registered dietitian!

The “if it fits your macros” is basically macronutrient counting/flexible dieting plan. As long as the food fits your plan, go nuts. But, not so fast! All calories are not created equally. My beloved chips and queso from my favorite tex mex place might be the same calories as my dinner of baked chicken, roasted veggies and a baked potato. Which do you think I want you to eat? Nutrition trumps calories every time. I am a huge advocate for eating REAL, whole food over junk food and or smoothies/juices. REAL, whole food has vitamins, minerals, fiber and other essential nutrients while juices and smoothies (depending on how they are made) are full of sugar and calories. Yes, a pop tart is the same macros as oatmeal…..which one would I swat out of your hand?   Should be a no brainer here, right?!

IIFYM pros: great for people who love counting things, measuring serving sizes

IIFYM cons: can technically fill up on junk food if you abuse the system

What does this dietitian think? If you like counting your macros, super! But at the end of the day, this is a trendy form of carb counting from the 90s. (Yes, I know I just dated myself there!)

In the Media Nutrition Research

What’s in Your Coffee? Guest Contributor: Andrea Hardy

August 11, 2016

Andrea is the most amazing dietitian.  She’s real.  She gets it.  Do you have a “bucks” addiction?  Check this out:  The Obesity Epidemic – What’s in your coffee, and is it contributing to obesity? A look at coffee and weight gain. Guest Contributor, Registered Dietitian Andrea Hardy 

I’ll admit it. I drink coffee. A LOT. Don’t tell my husband, but rather than trading my visa reward points for travel, I use them to get Starbucks gift cards.

While I have what one might term a ‘coffee addiction’ – I take special measures to make sure that I’m making a smart choice when I set off for my morning hit of caffeine. I order coffee, and I drink it black. So if you see me touting a Starbucks cup around town, I can guarantee it’s a grande americano, no room.

While I drink my coffee strong and black, that often isn’t the ‘popular choice’. What people call their ‘morning coffee’ is actually equivalent to a small meal, and a fistful of sugar.

While I hate to rat on my favourite place to get my coffee and work on this blog from – I have to share with you how YOUR coffee habit might be contributing to your weight. I’m just hoping to make you all informed, health conscious consumers. And not to pick on Starbucks alone – any joe-brew coffee shop pulling shots to make these fancy coffees are VERY SIMILAR in nutrition content – so listen up!

First off – and I say this time and time again – you should rarely, if ever DRINK your calories. Liquids have this tricky little effect on satiety (the feeling of fullness). While you may be consuming 300+ calories in that vanilla latte with extra whip, your body just doesn’t compute. You won’t get that same hormonal response that solids trigger, making you feel like you’ve just had something calorie-containing. Despite consuming a mini-meal in the form of a latte, you won’t feel full and might even still be hungry!

Secondly – you can’t really count a ‘venti vanilla latte, extra pump caramel with whip’ as coffee. Yes, coffee is touted to have health benefits – but add on the syrup, whipping  cream, and artificial colours and flavours? Completely negates the effect – and then some! If you are consuming coffee for health benefits, you should be having it straight up – (a bit of milk and sugar is ok).

Coffee’s Health Benefits:

  1. Coffee is Antioxidant-Rich. Coffee is a rich source of a variety of antioxidants. These powerful little molecules can help protect your cells from damage and scavenge free-radicals in the body. Of course, fruit and veg should be your ‘go-to’ for your anti-oxidant fix, but a little extra help from your daily cuppa joe is a perk! These antioxidants may be the mechanism as to why those who drink coffee regularly are protected against inflammatory diseases such as cognitive disorders, and liver disease.
  2. Coffee can make you happy. In so many words – coffee acts on your neurotransmitters to leave you feeling alert, focused, and happy. 
  3. Coffee can enhance an athletes performance. Because caffeine is a stimulant, research has shown that athletic performance can benefit from caffeine intake in moderate amounts. Caffeine tricks your body into releasing extra epinephrine – your ‘fight or flight’ hormone – thusly getting you ‘pumped up’ for whatever action lies ahead. Beneficial for athletes – but this effect is also what causes you to feel anxious, paranoid, and clammy after drinking one too many doppio espressos.

Who is coffee not so good for?

Those who are caffeine sensitive – Consuming caffeine at any level in these individuals can increase blood pressure, cause heart palpitations, and severe jitteriness. Coffee should be avoided by those people.

Those with psychiatric disorders – Because caffeine futzes around with your neurotransmitters, those with mental health issues can be especially sensitive to caffeine, and its negative effects. It’s recommended you discuss this in detail with your family doctor to determine if coffee is safe for you to drink.

So, whats the skinny on Starbucks drinks?

Back when I did a bit of work with school nutrition, there was a game called ‘Sugar Shocker’. Have you heard of it?

Here is the Starbucks version of what I used to teach kids about the amount of sugar in their favourite sugary drinks. Consider it adultified.

-Grande caramel macchiato 240 kcal and 32g sugar (13 sugar cubes)

-Grande chai latte 240 kcal and 42 g sugar (17 sugar cubes)

-whipped cream 70 kcal 2g sugar (~1 sugar cube)

-white chocolate mocha 400 kcal and 58 g sugar (plus whip!) (23 sugar cubes)

-Java chip frappuccino 340 kcal and 62 g sugar (25 sugar cubes)

Let’s just, for interests sake, look at adding a snack onto that. Your morning coffee break of a caramel macchiato, plus a birthday cake pop is setting you back 410 calories! You decide to go for the oh-so virtuous banana loaf instead? 670 calories! Thats more than a THIRD of what you likely need in a day – and I don’t see anyone skipping any meals because their counting their morning coffee as one. (Ahem – nor do I encourage that…)

Ways to Have Your Coffee (and drink it too!) 

  • limit your specialty coffees to less than once a week, and order a tall
  • order drink half sweet
  • choose skim milk
  • add milk instead of cream to your coffee
  • enjoy a lower calorie, portion controlled drink:
    • a tall, skinny vanilla latte has 100 calories
    • a tall cappuccino has just 60 calories
    • Drink coffee like Andrea: I love my americanos. Paying the small amount more for an americano compared to drip coffee allows me to enjoy the luxury of espresso without having it in a latte or cappuccino. If your not a black coffee kind of person, add a splash of milk and top with some cinnamon to help cut the bitterness.
    • If you’re really hungry, and need a Starbucks snack, they sell yogurt, bananas, and nuts. The protein boxes are a fantastic go-to meal for those in a rush too!

So. Where does my vanilla bean frappuccino with caramel drizzle and extra whip fit?

Moderation. It is dessert. A special treat, really. A once and a while, splurge-worthy occasion. On the weekend, I will occasionally treat myself with a flat white or caramel macchiato. I suggest you save your elaborate drink orders for a weekend treat, and choose low-cal, coffee based drinks during the week to get all the coffee benefits, without the sugar crash afterward!

– Andrea


  1. Winston, A. Hardwick, E. Jaberi, N. (2005). Neruopsyciatric effects of caffeine. BJ Psych. Vol 11 (6). DOI: 10.1192/APT.11.6.432
  2. Burke, L., Desbrow, B., Spriet, L. Caffeine for Sports Performance.. Retrieved from: