Keeping the “Heart” in Heart Health: Cardiovascular Risk and Ultra-Processed Foods, Pt. 4

Key Highlights

• “Crowding in” healthy foods rather than “cutting out” less healthy ones may be a more positive and sustainable approach to eating.
• Reframing the conversation around ultra-processed foods (UPFs) may include acknowledging that the problem is not the foods themselves but the food environment that makes them the convenient default.
• Effective heart health counseling requires empathy and conversations that honor the complexity of individuals’ lives, focusing on support and empowerment rather than judgement and restriction.

In part four of this four-part series, Lisa Jones, MA, RDN, LDN, FAND, and Grace A. Derocha, MBA, RD, CDCES, registered dietitian and a certified diabetes care and education specialist, discuss moving beyond restrictive nutritional advice toward a more holistic approach that incorporates sustainable dietary patterns while emphasizing the importance of adding nutritious foods rather than eliminating others.

Transcript:

Lisa Jones, MA, RDN, LDN, FAND: And we are back to our final segment of this episode with Grace. We are so happy to have her back again. We are going to be talking about keeping the heart in heart health. And ultimately, heart health isn't just about nutrients, right? It's about connection, mindset, and meaning. So let's close out by talking about how to keep the heart in heart health.

Grace A. Derocha, MBA, RD, CDCES: I love this.

Jones: Welcome back, Grace.

Derocha: Thank you so much for having me, Lisa. 

Jones: Yes. All right. Well, as we all know, every February there is something called, besides February, it's also called Heart Month. And there's often a lot of messaging focused on restriction. So how can we keep the heart in heart health by balancing evidence with empathy? And I know last episode we talked a little bit about empathy, but in particular, heart health.

Derocha: Yeah. So the science is clear. Heart health improves most with sustainable dietary patterns, not short-term restrictions. We do know that large bodies of evidence around the Mediterranean diet or DASH diet and plant forward or plant heavy eating can really show some heart healthy benefits without requiring elimination of the entire food groups, which I love that. We love to keep every food group involved if that's what people are enjoying. So by keeping, I love this, keeping the heart in heart health. Again, emphasizing what can we add in? What can we “crowd in” instead of cut out? Normalizing some flexibility. I always talk about when it comes to food, food is more than just fuel. It is more than just heart health. It is a variety of things. It is culture, traditions, celebrations, love. Have you ever been to a party where you didn't have food to celebrate? I don’t think I ever have been.

Jones: No.

Derocha: But because that would be weird. So in this process of putting heart and heart health, also thinking about ... I have this thing where I always tell people, think about the three Ps. And the three Ps when it comes to eating includes portion, of course. So we can make any food fit into what we're eating, whether it be ultra processed foods, but thinking about how much and how often versus our fruits and veggies. So portion, trying to be present so we can enjoy the process of eating it, feel satisfied in that process instead of mindlessly eating. And then my favorite one is, the third one is pleasure or party. Enjoying what we're eating, whether that be tied to our culture or traditions or a celebration, but being able to enjoy and have pleasure in the food that we eat. So keeping the heart and heart health, to me, means all of those things all at the same time.

Jones: Oh, I love the three Ps. And it makes my heart happy every time you say “crowd in.” So I'm wondering, I would love to hear back if you decide to have a “crowd in” party and you just invite people over and then they “crowd in” all this healthy food and that'd be kind of like a fun thing.

Derocha: Yeah. Well, and research the show, the more food that you... So when I was thinking about your seven-year-olds, if you offer more variety of things than crowd those in, they're going to have something. Do you know what I mean? And with that, hopefully over time, they're going to start to learn to really like it.

Jones: Yeah, I do. I do some interesting games with her trying to get her to eat veggies. Sometimes she plays it another time. She's like, "I'm not interested in that today," but I don't push it. Eventually she’ll wake up one day and be like, "I like vegetables.” I don't know when that would be in the meantime.

Derocha: It does happen. I have a 13 and 11 and it does happen. It really does. We used to play the rainbow game where everyone would have to get one color of the rainbow every day.

Jones: Yeah.

Derocha: It took a turn at times with candy.

Jones: That’s okay. Every once and a while, right?

Derocha: Yeah, exactly.

Jones: How about reframes? Because we like to hear reframes, but what's one reframe that you, Grace, would love to see and how we as dieticians talk about ultra-processed foods and heart health?

Derocha:  It's a good question. I had to think about this. So one real reframe that I would like to see and hear is I'd love to see shift from ultra processed foods are the problem to our food environment makes ultra processed foods the default because that's very layered. I really thought about this for a long time.

Jones: Wow. That’s really powerful.

Derocha: Yeah because…

Jones: Makes it the default. Okay. I like that.

Derocha: With the way that we live our lives with, we're busy with life and work and kids and family and all of the things that kind of crowd our mind and our decision making every day. And what would it look like and take to be able to exhale? I don't know the answer. If you figure it out, least please tell me because I tried to figure it out. But that's what I think how ultra-processed foods, and again, this is thinking about it in theory, we needed them and the market allowed them to become something because the market looked at how busy we are in our culture and in our environment and we needed a solution. And so as businesses grew, they thought of what can that solution be? How can we help the people? And now here we are trying to figure out how can we cut back on some of that and come back to spending time in the kitchen and cooking our own food. So I don't know. Let me know if you figure it out.

Jones: That's something I'll be thinking about for a while too, as well as our listeners, I'm sure. But I'm also thinking, you said default. I would even say easy default. And now there's more and more like, say for example, you go to Costco or you go to BJ's or something like that. If you played a game and said, how many UPFs can I count in here? You would be a winner, right?

Derocha: Yeah. Oh yeah. And it is nice to know, remember going back to the stoplight, there are a lot of greens and light greens as well, UPFs versus a lot of reds. So trying to then make choices that allow us to pick more on the green end versus the red end.

Jones: Yes. Yeah. And that's really helpful too. You're playing two games. You're looking to see how many can count in those big box stores. And then you're also playing the red light, yellow, green light game. How many are green? That could be fun. That could be a good teaching moment.

Derocha: Yeah. I've actually definitely done that with my kids. When they want blueberries and they're not in season, frozen blueberries here we come and that's on the green end.

Jones: Oh yeah. I'm a big fan of the frozen green berries. Blueberries. I said greenberries because I was thinking of green light. That should be something that could be new. Bring out the green berries. Somebody should develop that or cross. Yeah.

Derocha: I'm sure they will.

Jones: How about for dieticians listening today? What's one small mindset shift that they can make to bring more compassion and confidence into their heart health counseling?

Derocha: I know. This was a good one too. I was like, oh, she's giving me... I had deep thoughts. So one thing that I tried to kind of come up with was for dieticians to think about as they are thinking about mindset shift, every supportive choice matters, even if it doesn't look perfect. Yes.

Jones: Yes. Throw perfection out the window.

Derocha: And it's hard. I think we all have that in us. Whatever that even means. I don't even know what that means now, perfect. But we have this imagery, especially when you throw social media into the mix of what perfect looks like, a perfect meal, a perfect body, a perfect family, whatever it might be. But again, every supportive choice as a dietician matters when you're working with your patients and clients, even if it doesn't look perfect. I think it's always leading them towards the right path for them. And it's not going to be the same for every single person.

Jones: Yes. It's going to be different. And it goes back to progress over perfection.

Derocha: Yeah.

Jones: That's what we're doing. I love that message, Grace. Thank you. So here's an easy one for you. What final message would you like to leave our listeners with as they support patients this heart month?

Derocha: Okay. So thought about this for a second too. So I was like, this is a deep one. These are good. But heart health is about more than just arteries and cholesterol. It really is also, because you're putting the heart in it, it's about support and trust and sustainability for a lifestyle. The evidence tells us that people do better when they feel respected, understood, and empowered, not judged. And as clinicians and registered dieticians, we don't need louder messages or stricter rules or restrictions. We need conversations that can honor the complexity of real lives. I think it took me... I wrote this five times, but I think that's important because again, everyone's life and everything, everything that everyone is dealing with is different in their day-to-day. So if we really try to lead with empathy, some of that cultural humility and then evidence-based flexibility, we protect not just cardiovascular health, but the relationship that people will have with food and their bodies as they're building more heart.

Jones: Aw, you put a lot of heart into what you wrote and I love it. Thank you. Thank you for sharing that with us. And Grace, thank you so much for sharing your insights, energy, and heart with us today. And thanks to our listeners for joining this episode of Nutrition411: The Podcast. Be sure to subscribe for more conversations that bring together the science, psychology, and strategies behind effective nutrition practice. Until next time, take care of your heart and each other. Thank you again, Grace.

Derocha: Thank you so much, Lisa.