This is a Q&A with Gina Palazi, a current 4th year podiatry student from Barry University School of Podiatric Medicine. Interview by Lizz Ansert.
Q1. Do you have any specialized degrees with regards to nutrition?
I started my Masters in Nutrition online at NC State, but it is on pause as I finish podiatry school. I have been an athlete my entire life, playing Division 3 basketball and participating in a professional combine overseas in Italy. I have been working in health and fitness for the past 6 years, completed my Certification in Personal Training from NASM, Group Fitness and Kickboxing certifications, and have been to a number of talks and conferences catered to nutrition, weightlifting, mobility, etc. I also read a ton of nutritional books and listen to podcasts about health, fitness, and nutrition. I’m definitely a nerd when it comes to this area, but it is because I always like to stay informed and up to date on the newest trends in the field.
Q2. Do you think it will be helpful for DPMs or DPM students to get advanced degrees or take courses in nutrition and why?
YES. Absolutely! Just think about the majority of our patients! DIABETICS! I think we could do a world of difference with just being about to provide some degree of nutritional advice instead of just telling someone to “eat healthy and exercise”. To most of our patients, they don’t even know where to begin and also may have skewed ideas on what “healthy” even is. There are so many forums and conferences and now webinars with online resources where information is readily available for both patients and doctors. We should do our part to take advantage of it. I think it is important for everyone in this profession to be well-versed in nutrition because it not only will help patients, but it will allow us as doctors to be able to maintain our own health and wellness with hectic schedules.
Q3. What advice do you have for students and residents with regards to their nutrition in a high demand schedule?
Prepare, prepare, prepare. From what I’ve seen on rotations and externships, a lot of students and residents are so busy all day and don’t give themselves time for a quick meal. Sometimes throughout the day, their schedule doesn’t allow it. On all my externships/rotations, I made sure I got up early and ate a big breakfast before the day started just in case I didn’t have time to eat throughout the day. I also made sure I brought a meal and snacks for the day. Even if I wasn’t able to sit down and eat, I was at least prepared. Some quick and healthy snacks I’d bring were protein shakes, protein bars, almonds, and other things like that. Most of the time, I would stash these goodies in my white coat or leave them in a resident room.
Prepare, prepare, prepare.
I also always keep a lot of food prepared in my fridge for when I get home as well. This is so I never revert to buying a pizza or buying food, which can add up on the body and the budget. This helps after you have a long day and may not feel like cooking because you have food readily available to heat up. I would recommend trying your best not to starve yourself throughout the day and get SOMETHING more than just a coffee or energy drink to eat. It will help keep you sharp as a student and a physician.
Nowadays, there are also healthy meal plan services out there that deliver meals for relatively decent prices. You just need to store them in your fridge, and they are ready to be eaten the next day. Look up some meal delivery places around where you live and see if this is an option if you don’t love to cook. A lot of them come with macro counts on the packaging if you’re very strict with your diet.
Q4. When your schedule has been very hectic, how have you managed your nutrition goals while keeping that schedule?
When my schedule gets hectic, I try to remain committed to my personal goals and body goals because they help me stay committed to my career goals. I try to maintain my workout regimen 5-6 times a week, with my weekly breakdown of working out specific muscle groups on different days combined with a hybrid of High Intensity Interval Training and daily steps. When I workout, I maintain my hunger so that helps me stay on point with feeding myself. Like I said previously, I always have food prepared in the fridge so I can never make excuses. For example, I usually have a protein, a starch, and a vegetable cooked up and stored in the fridge so I can easily put together a meal before I run out the door for work or when I come home.
Don’t try to overthink your meals, keep it simple. Don’t think cooking or meal prep has to be some lavish meal with all these wild ingredients. Sometimes just throwing a few chicken breasts in the air fryer with a little salt and pepper is all it takes. It looks different for everyone, but always being prepared and keeping food readily available will help keep you on a solid path with your nutrition. In our day and age, we don’t have too many excuses not to get proper food between grocery delivery services, meal plan deliveries, and everything in between. Utilize these resources if you’re too busy not to get to the grocery store yourself. I’m a weirdo and find grocery shopping very therapeutic, haha!
Q5. If someone is trying to lose weight, what are some nutrition goals they should keep in mind?
I’m a firm believer in calories in, calories out AND consistency. I know students and residents are all tight with money, but I recommend getting a nutritionist or a coach who knows what they are talking about to help with this process. It’s just nice to have someone keep you accountable as you’re trying to lose weight. They may help you get to know your body better and just learn more about nutrition in general. When I wanted to lose weight, my friend who’s a nutritionist set me up with a great meal plan outlining my macros and was always available for questions and alterations in my diet whenever I needed her. Most people will give you a discount as a student or resident. You may even be able to submit your appointment to your insurance to get reimbursed.
If you can’t go to a nutritionist or dietician, focus on being consistent in what you’re eating daily and don’t waiver from it. People don’t realize that one stray meal or one stray weekend binge really adds up. If you are committed to losing weight, you can’t just stick to it 5 days a week or 6 days a week. It is really a commitment, and the faster you want results, the more you need to adhere to a strict diet. Losing weight is really not glamorous, but it’s doable with a strict plan and a determined individual.
Q6. If someone is trying to gain healthy weight or muscle build, what are some nutrition goals they should keep in mind?
Similar to losing weight: its calories in, calories out. If you want to build, you need to eat more good stuff; don’t consume a pizza every day haha! From my experience, I’ve built my legs and my booty from doing a conscious surplus of food in my diet while also lifting weights and lifting HEAVY. Again, seek out help from a knowledgeable coach or nutritionist so you can do this correctly and not hurt yourself. I’m a big believer in making sure you have adequate protein daily to build muscle, so start with trying to hit your protein goals daily of at least 1g per 1lb of your body weight.
Q7. What do you think is a good way to approach patients about their diet? Anything the practitioner should make sure they discuss?
First off, I think the reason I am so strict with my diet and fitness is so I can feel comfortable talking to my patients about their diet. If I look healthy, a patient will be more apt to listen to my advice, and I always want to practice what I preach. I think talking with the patients and asking them questions about their current diet and exercise routine is an easy segway to bring up concerns regarding their nutrition, especially if they’re diabetic and just reported a high Hemoglobin A1C.
I think a big issue with our diabetic patient population that we definitely need to emphasize is their sugar intake and consumption of rich foods as a whole. I think the best advice to give them without a ton of nutritional experience is ease off processed foods that don’t come from the earth and focus on more whole, natural foods. Also, if they need sweets, try using a sugar-free substitute (although these are not great in excess either), or a natural form of sugar like fruit.
Q8. What motivates you to keep a good nutrition regimen and how do you feel that affects your physical and mental performance?
I want to be the best possible student, resident, and physician I can be. I think to be able to perform at a high level, my machine needs to always be running smoothly. As corny as that sounds, when I stick to my meal plan and workout plan, I feel like I can run around the hospital all day. I make the analogy, as most fitness professionals do, that food should be looked at as fuel. If you’re not providing your body with fuel, how do you expect it to last and at peak condition at that?
I think a big part of nutrition that we tend to also put at the very bottom of our priority list is SLEEP. I know it is tough sometimes for students with exams and residents with long cases, but SLEEP is one of the most important ways to keep your body running at high capacity for long periods of time. Put down the phone/turn off Netflix at the end of the night and prioritize sleep. Your body will thank you.
SLEEP is one of the most important ways to keep your body running
Knock on wood, because of my adherence to my lifestyle, I rarely get sick. With the combination of hitting my macro and micro (supplements and vitamins) goals daily, along with sweating it out on the regular, I keep myself healthy and functioning without ever having to miss days. That in itself is a testament to living this way.
I am a big advocate of mental health and before I embarked in therapy, I utilized working out as a means of therapy. The way working out and eating correctly makes you feel from a mental standpoint is so hard to explain, but it is euphoric. It also helps that with it comes the physical benefits, which make you feel that much better internally and externally. I think after a bad day or rough exam, there’s nothing like grinding through a workout at the gym to feel centered and ready to take on the next task at hand.
Q9. For someone who is trying to start taking better care of themselves (diet, exercise, mental health, etc), what advice would you give them?
Baby steps. Everyone has been in the beginning stages. Don’t try to do too much too quickly. I may act like I know a lot, but it comes from YEARS of trial and error. I am still learning. Trust me, I have tried all the fads and done all the weird exercises. The one thing I can say is to just take the leap and get started. You’re going to fail sometimes, and I would be lying to say I don’t enjoy some cheat meals and a glass of wine (or two) here and there. Even when these moments happen, always be strong enough to bring yourself back to the plan.
Don’t be afraid to ask for help! Just like anything in life, you might need to ask for help and that’s okay! You all should be well-versed at that because I’m sure you haven’t gotten through med school without asking for a little help here and there. There are a ton of outlets to get help out there, just make sure they seem legitimate. I know it is COVID, and that may concern a great number of you. However, even going to a gym nearby and asking for their class schedule or if they have personal trainers might be a start to point you in the right direction. There are a lot of online trainers as well that can help you with nutrition and fitness in the comfort of your own home. I am also available to give advice and suggestions to steer you in the right direction! The podiatric field is a tight knit family, and I always want to see my colleagues crush it in all aspects of their life!
Interview by Lizz Ansert.