Core Nutrition 2024: Personalized Nutrition and Balance

DeliveryRank chats with Kimberlee Vorster of Core Nutrition - a Registered Dietitian with a passion for fostering balanced eating habits and ditching the fad diets. With an Honours degree in Nutrition and Dietetics from the University of the Free State, South Africa, she is dedicated to personalized care, understanding that one approach doesn't fit all. With expertise spanning from critical care to disease prevention, Kim's goal is simple: Create adaptable and sustainable nutrition plans that lead to positive mental and physical transformations for her clients. At Core Nutrition, she believes in using wholefoods as a tool for health and longevity, aiming to prevent ailments before they occur and optimize well-being for a lifetime.

Kim, your approach to nutrition emphasizes personalized care and balance rather than fad diets. Can you elaborate on how you guide clients in finding this equilibrium and how it impacts their overall well-being?

Fad diets are popular eating plans or recommendations that usually promote rapid weight loss or health benefits – they often lack scientific evidence. They are not individualized, and therefore don’t take factors into consideration like personal goals, specific nutritional needs, existing chronic conditions, religious obligations, daily routines and food preferences. Many of these diets limit specific food groups or nutrients, which may lead to nutrient deficiencies (a form hidden malnutrition). These diets are often unsustainable as most people can’t stick to these severe restrictions long term, resulting in "weight cycling," whereby lost weight is often regained. Continuously following a new fad diet may have a negative impact on a client’s relationship with food, which can easily develop into disordered eating. Often leading to: labelling certain foods as 'good' or 'bad', setting unnecessary restrictions on nutritious foods due to it’s calorie content, avoiding family gatherings or eating out due to fear of food and developing an unhealthy obsession with calories or portion size. 

Dietitians are medical professions who focus on personalized nutrition and balance, considering the goals and needs of each client. In order to create an individualized program, it is important to consider body composition, diet history, medical background, activity levels, habits, routines, and personal goals. Analysis of previous blood test reports is important to establish which markers need to be checked long-term, as a means to screening and monitoring chronic diseases and/or deficiencies. All these factors should be considered when compiling and customizing a plan that aligns with the individual's health and personal goals and fits into their everyday. 

Education plays a crucial role in patient care and medical nutrition therapy. It is important for patients to understand dietary recommendations for managing specific medical conditions or deficiencies, understanding their eating behaviors and triggers, portion sizing, how to meal prep and menu plan, how to make informed food choices and how to read food labels. 

Follow ups are important for monitoring progress, discussing challenges and amending the plan where necessary. Everyone needs motivation, guidance and support when making a behavioral change. 

Sustainability is the key to achieving balance. Highly restrictive diets stand is stark contrast to sustainable programs. Balance is found in adaptability and flexibility. If the changes cannot fit into your current lifestyle, they are unlikely to last. Your health journey should be individualized before it can be implementable. Always prioritizing long-term health, fostering a positive relationship with food, we aim for goals that will last.

Core Nutrition places a strong emphasis on prevention and the role of food in maintaining long-term health. Could you share some key strategies or practices you recommend to individuals for optimizing their health through nutrition?

All Dietitians prioritize prevention and acknowledge the vital role of nutrition in sustaining long-term health. Our approach is centered on optimizing health through personalized nutritional strategies. 

Risk Factors for chronic disease:

• Unbalanced diets: A diet consisting of excess processed foods, sugars, sodium and unhealthy fats, and a lack of nutrients is a key contributor to the increased risk of obesity, inflammation and chronic diseases like diabetes, cholesterol and cardiovascular disease.
• Being overweight or underweight. Excess body fat and visceral fat increases the risk of inflammation and insulin resistance – risk factors for diabetes and heart disease. Being overweight may also lead to high blood pressure, cholesterol and put strain on joints and organ function. Being underweight may cause deficiencies which can weaken the immune system and increase the risk for osteoporosis, cardiovascular and fertility problems.
• Lifestyle Habits: Excessive alcohol consumption, smoking, and inactivity are major risk factors for obesity and chronic disease.
• Hereditary Factors: Genetics predisposes individuals to increase in risk of chronic diseases (genotype). Lifestyle, eating behaviors and exercise can affect how these genetic mutations are expressed (phenotype). 

Conclusion: 

Preventing chronic diseases comes down to: eating a balanced and healthy diet, regular physical activity, and limiting harmful lifestyle behaviors (such as drinking and smoking).

Key Strategies for Optimal Health:

1. Screen for chronic disease and deficiencies. Early detection is key to prevent or manage chronic disease. 

2. Maintain a healthy body weight.

3. Follow a balanced diet which includes:

• Lean protein and plant-based proteins.Complex, wholegrain carbohydrates. Choose starches containing more than 6g of fiber.
• Unsaturated fats like seeds, nuts, avocado olive oil, and omega 3 rich foods like salmon.
• A diverse range of colorful fruits and vegetables for essential nutrients and antioxidants.

4. Controlling portions to ensure a balanced intake of nutrients. Portion sizes should always be client-specific. For those who have not seen a Dietitian, you can use the MyPlate Model for establishing which proportions of food should be on your plate:

• ¼ plate protein (meat/ eggs/ plant-based protein)
• ¼ plate carbohydrates (starch)
• ½ plate vegetables or fruit
• Fats should be used sparingly 

5. Limit refined foods, takeout and treats. Make mindful decisions when having these. 

6. Reduce sodium intake to decrease the risk of high blood pressure and cardiovascular disease. Choose products with less than 120mg sodium per 100g. Flavor foods with fresh herbs instead. 

7. Stay hydrated: Limit carbonated, sugary/ caffeine containing beverages. To meet your fluid requirement, please aim for 30ml/kg per day.

8. Keep active: Engage in regular exercise to improve cardiovascular health, fitness, mental well-being, and maintain a healthy weight.

By integrating these strategies into their daily lives, individuals can significantly reduce their risk of chronic diseases, promoting long-term health and well-being.

Your expertise spans various areas, from pediatric nutrition to chronic diseases. How do you tailor your approach to cater to the specific needs of clients across such a wide spectrum of nutritional requirements?

As Dietitians, we learn how to provide medical nutritional therapy for all stages of life and Chronic diseases during our course of university studies. Although we have the knowledge it is through experience that we learn how to better personalize screening techniques and adapt the delivery of information for patients at any stage of life.

As mentioned above, it is important to allocate a holistic assessment of an individual before compiling an intervention, such as: age, body composition, activity level, habits, preferences, and personal goals. Communication with clients and other health care professionals is crucial to allow us to tailor the nutritional plan. Working with a multidisciplinary team (MDT) is essential for optimizing a patient’s medical intervention.

All medical professionals, and allied healthcare professionals, are expected to continue studies as a means of continuous professional development (CPD). In order for us to provide evidence-based recommendations we stay up to date with the latest nutritional research by frequently attending courses and webinars and doing research. 

Informed clients are more likely to make sustainable changes. Therefore, we take the time to explain their nutritional needs and recommendations that would contribute to their overall well-being and nutritional goals. We prioritize regular follow-up consultations to provide continuous support and monitoring; as circumstances, health status, and goals often change, we frequently adapt the nutritional plan.

In summary, our approach includes evidence-based practices, individualization, communication, education, and continuous support, with the goal of providing nutritional guidance to clients of various age groups with a wide spectrum of needs. 

Gut health is increasingly recognized as pivotal for overall well-being. What methodologies or steps do you typically employ to address gut-related conditions, considering their complexity and individualized nature?

Gut health is increasingly acknowledged as a key factor in overall well-being, influencing not just digestive health but also physical and mental health. 

The main function of the gut is to digest and absorb nutrients. Additionally, maintaining a healthy gut microbiome is essential for keeping the immune system strong and improving mental health, as it plays a crucial role in mood regulation and cognitive function. This connection is commonly known as the gut-brain axis. Microbiome imbalance leading to poor gut health may cause a variety of problems like gastro-intestinal disease (like IBS and ulcers), nutrient deficiencies, poor mental health, low energy levels, inflammation, and increased risk for certain cancer and chronic disease.

In addressing gut-related conditions, it is important to start by identifying the underlying cause(s) of the symptoms. This often involves collaborating with a gastroenterologist/ general practitioner (GP), as occasionally a gastroscopy and/or a coloscopy are indicated by the doctor. Assessment of the client's current diet, lifestyle, and medical history is important for understanding and identify potential contributing factors to their condition or symptom(s). We also review any previous attempts they've made to improve their symptoms. For clients with severe gut symptoms, maintaining a food and symptom diary can be particularly beneficial in pinpointing symptom triggers. When specific diagnoses are unclear, we focus on enhancing gut health and managing symptoms.

Based on this evaluation, a personalized nutritional plan is developed. For those that do NOT have specific gut-related medical conditions but want to improve overall gut health, we would recommend:

• Specific foods that promote gut health, such as probiotics (kefir, kombucha, yogurt, etc.), prebiotics (whole grains, fruits, vegetables, etc.), and fiber-rich options like beans, seeds, and whole grains.
• Stay hydrated, as hydration is beneficial for overall health and gut motility.
• Provide guidance on limiting certain foods or beverages that might exacerbate symptoms, such as alcohol, artificial sweeteners, spicy and acidic foods, and sugar.
• Establish overall healthy eating habits by having regular meals in a relaxed environment.
• Address other lifestyle factors, including quitting smoking, managing stress, staying active, and avoiding alcohol. These habits are crucial in supporting gut health and overall wellness.

It is important for individuals to monitor their symptoms in terms of frequency and intensity over a period of weeks to establish the impact that their changes have made. It is important to manage symptoms as well as strive for long-term gut health and overall wellness.

Pediatric nutrition is an essential aspect of your practice. How do you assist parents or guardians in fostering healthy eating habits in children, especially considering the challenges that may arise during different developmental stages?

It is well known that nutrition during the first 1000 days of life may influence a child’s overall health and eating later in life. Eating habits and food preferences are established at a very young age. Therefore, we help guide parents to establish healthy balanced diets through education, practical strategies, and understanding developmental stages.

Here are a few essential aspects that to focus on:

Establishing Healthy Habits Early

To optimize nutrition and prevent eating challenges, parents need to be educated how to create a balanced diet for their children, for optimal growth, development and nutritional status. Parents should also be educated on age-appropriate foods and portion sizes to meet their children’s nutritional needs. It is important to expose children to a variety of food groups, flavors, and textures when they start with complementary foods.

Promoting a Healthy Eating Behaviour

Eating behavior: Children are influenced by their parents and everyone around them. I encourage parents to avoid expressing personal food preferences, and to model healthy eating behaviors. Children are more likely to eat a variety of food if their parents do.

Relationship with food: Feeding methods and communication during meals can significantly influence a child’s relationship with food and their food acceptance. Forcing children to eat may have negative consequences such as refusing to eat, not eating according to satiety cues, or feeling anxious at mealtimes. Food should not be used as a reward or punishment; children should rather be encouraged to eat and not feel forced to eat. We guide parents on teaching moderation when it comes to treats, without banning them completely.

Environment: Our focus is to establish a relaxed environment during meals, where children feel comfortable and part of the family. Eating with the family in an environment with minimal distractions (like TV or cellphones) may encourage healthy eating. Meal routine and consistency is important to establish good eating habits. Providing regular healthy meals can control appetite, energy levels, and reduce overeating or snacking on unhealthier treats.

Assessing Growth and Nutritional Status: Regular monitoring of growth, weight gain, and nutritional assessments allows us to identify and address any concerns. We then make dietary suggestions, including potential supplementation, to address weight gain and nutritional status, promoting healthy development and growth in children.

Promoting Physical Activity: Parents play a crucial role in shaping a child’s attitude and behaviours towards physical activity. If parents have a sedentary lifestyle, children are more likely to be inactive as well, which increases the risk of childhood obesity. We motivate parents to be active with their children as it is important for their development and maintaining a healthy weight. Engaging in physical activities with children like going for walks, cycling, playing with a ball instead of watching TV or playing video games can improve a child’s activity levels and even willing to try new things, such as different foods.

The MDT Approach to Address Eating Challenges: Challenges during developmental stages, including fussy eating, gut issues like constipation, and sensory problems, are addressed collaboratively. Dietitians work closely with pediatricians, speech therapists, and occupational therapists to tackle eating problems.

If you would like to find out more about Core Nutrition, please visit https://www.corenutrition.co.za/