Latest / Nutrition Connection by Dr. Kristen Hicks-Roof / 43: Dr. Nina Crowley PhD, RDN, LD - HEALTH TECH / WEIGHT MANAGEMENT

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43: Dr. Nina Crowley PhD, RDN, LD - HEALTH TECH / WEIGHT MANAGEMENT · Nutrition Connection by Dr. Kristen Hicks-Roof

• Kristen Hicks-roof: Welcome back to the Nutrition Connection Podcast, the show where science meets storytelling. I'm your host, Dr. Kristin Xroof, dietitian, researcher, and lifelong advocate of the role of nutrition, health, and wellness. Each episode, I get the pleasure of sitting down with nutrition experts and dietitians all across the food and healthier landscape, leaders whose work touches nearly every aspect of our lives. So whether you're a student, a seasoned professional, or someone simply curious about food, nutrition, and health, this podcast is just for you. The views, thoughts, and comments on this podcast do not reflect those of my employer nor the employers of my guests. So let's go ahead and get connected. Today I'm excited to bring on a PhD along with me. have Dr. Nina Crowley. She's the Director of Clinical Thought Leadership and Partnerships at CECA. Welcome to the show, Nina. Nina Crowley, PhD, RDN: I'm excited to be here. Kristen Hicks-roof: So recently, you and I both got awarded the TD-10 Award. So congratulations. And how cool was it to get you on the show soon after? So we can talk about that as one of your many accolades. But I also want to really talk about your journey and what you do at Seca. Nina Crowley, PhD, RDN: Yeah, I'm excited to be part of that elite little club now. So congrats to you. Kristen Hicks-roof: I know, right? So what inspired you Nina and made you want to become a nutrition professional in the first place? Nina Crowley, PhD, RDN: Okay, well, I will try to keep this as close to time as possible. I feel very strongly that you and I could talk all day, but I won't do that to you today. I actually think I'm one of those weird people that when they were in college knew they wanted to be in nutrition and stayed in nutrition. So my, you know, weird take is that I started at Cornell in my undergrad in nutrition and I ended up working doing my work study in the office of the person who Organize the schedules and all of that Bev. If anyone knows her from Cornell, she's amazing ⁓ She was a she was a big part of why I think I stuck with it I was in the office helping arrange the gosh back 20 plus years ago magnets on the board of like which Classes were at which time so that when people were trying to figure out their schedules They were they were there able to figure that out. I did all sorts of random stuff in the nutrition department, but I was really tight in that in that group. And I think that really helped solidify that I loved nutrition. I wanted to be a dietitian after I kind of learned that that was where I could go. I knew always that I wanted to be in health. And I had done one of these really fun aptitude tests in high school that told me sort of things I'd be good at. And now if I look back on it, it's like completely a roadmap had I followed that. ⁓ But I knew that I wanted to do psychology. I didn't know where that fit in. And so for me, the psychology piece was a little bit of an add-on. After I got my degree, I worked in a WIC program on Long Island where I'm from. And then I moved south so I could afford a home. And so I landed in Charleston, South Carolina at the medical university as a inpatient, the job that no one wants, all the stuff that everybody is done with. So I was like, pulmonary in the Institute of Psychiatry and general medicine. And I found that thing I loved the most was walking over to the Institute of Psychiatry with my fiber one samples and talking to people that were there week after week about fiber in their life. And everybody hated that part. And I'm like, but that's fun. You get to see them time and again. And so that was a little bit of a predictor of what I loved. And when the when the outpatient bariatric job came open. said, I know that I want to be an outpatient. I ended up loving it. Right away, I got put on a research study and started writing ⁓ numbers on papers and doing the mailing and doing all of the really low level work for this study. But I knew those hundred patients and it was a study on weight regain after surgical weight loss. I knew those patients in that topic so well and that prompted me to go back to school to be a health psychologist. And so that's where I landed. I thought I would do academics. I thought I might do research. I ended up loving my bariatric program and wanting to be in charge and fix some stuff. So I did that for six years and then came over to work for SICA about four years ago. And that's the role that I'm doing right now. Kristen Hicks-roof: I love how you talked about the roadmap that it would have, you know, those aptitude tests in high school. I really wish there was actually more attention that got paid to those because I do feel like it shows where you have strengths and where your passions lie. And I think sometimes I know when I was an academic, people would either be a nutrition or not a nutrition and their passions were either in it or not. And you're like, this is probably not the field for you if you, you know, aren't you don't like taking care of people. Like it just didn't make sense, right? That was like one time during my doc program, I worked in an animal research lab, right? So we're feeding mice and rats and you got to pet them and hold them. And we had this gung ho undergraduate research assistant. She's so excited to like get in the lab. She goes to her first day in the animal lab. She's like, I don't want to touch the animals. And I was like, okay, so like clearly we have a disc at that tier, right? The idea and the execution don't always make sense. ⁓ So I do think it's cool to see like as you've gone throughout your career journey, it sounds like you've really always been in the psychology and nutrition intersection of weight management. Would you agree with that? Nina Crowley, PhD, RDN: Yeah. Yeah, yeah. And you know, it was funny because it was a psychology program. I was still working as a dietician and I sort of found my way writing about weight bias and that was sort of the intersection of all of it. so like practicing and seeing it in my bariatric patients that I was working with daily and then thinking about, know, and weight bias a little, you know, 10, 15 years ago, wasn't as well known. And sadly it's well known now, but it still exists at high levels. But it was really that place where I got really excited about sort of the compassionate care of people with the chronic disease of obesity and, how do we, how do we use both nutrition and psychology? I also say I used to focus a lot more on nutrition until I learned a lot more about the behavioral side and that, you know, I went into the nutrition part for bariatrics thinking, ⁓ I'd learn all the stuff. the right way to eat, the post-op diet, and I would just like, you know, spout that off to my patients, they would follow it and I would be happy. And it was really quick to know that that, thankfully that wasn't how it was, because how boring, right? And the people are just so different and they all have a different, you know, need and approach. And it was on me to change my approach to better help them meet their goals rather than me telling them what to do to meet some goal I had for them. So that was kind of a real ⁓ way that I see that playing out. Kristen Hicks-roof: almost feel like every dietitian has to unfortunately learn this on the job. I mean, I do think there should be way more psychology courses in a nutrition degree because behavior is all rooted in psychology and what drives you, right? Like I remember I used to teach all the behavior change theories and if people are in pre-contemplation mode, it doesn't matter how much great information you provide them. They're never going to change because they just don't care to change. They're not ready. So I think that is such a powerful part. And I remember I used to teach a class. It was actually a theory class. And then I would have them, you know, the grad students, they'd have to do a counseling session. And here they do just like spit out what eat five fruits and vegetables, whatever the advice was very generic. And it's like, that does sound great in theory. And of course I would love to eat five fruits and vegetables every day, but like it's... almost 11 and I haven't even really eaten breakfast because I've been in meetings since six o'clock. So, you know, and so I think the practice of getting people to actually want desire and how to help with their weight or whatever health condition, those are sometimes very disconnected. Nina Crowley, PhD, RDN: Yeah. But the beauty of it actually is that, you know, if it were that, I mean, it might be simple, right? But it's not, it's not easy to do, but if it, even if it were, and if you go on social media, that's what it sounds like. Just do this, right? Follow me, look like me, all of that. But like, that's, that's just not, that's not. real, that's not the nuance of life. like, it wouldn't be fun or rewarding as a job if all you did was tell people to follow a thing or do the thing, right? And so I do wish there were, there was more help for, you know, our support of what we do and all of that. But it does make it a rewarding job that you have to kind of take each individual and work with them on their goals. And it's not what you go in the room thinking, is what they need to do. If you're doing that, you're doing it wrong. You've got to go in and listen and hear where they're at and then not make that mistake that I always say. I went in a room very early on thinking, all right, here's the post-op diet. Here's what I'm going to tell this person to do. And I didn't even take a stop for air long enough to hear the patient was a dietitian. So her struggling with her weight really didn't have anything to do with the lack of education. And here I am. embarrassingly telling her what to do and what to eat. And she's like, yeah, cool. know that my biology is against me. like, can you help me with that? And it's like, Ooh, I really always remember that story of like, don't go in there thinking, you know, anything until you ask those right questions from a curiosity stance. Kristen Hicks-roof: Yeah, so let's talk about your journey and you mentioned it a little bit. You had several different clinical roles. How did you ultimately, maybe not get out of the clinical, but getting into the director of, you know, clinical thought leadership and partnerships? Like, how did you bridge that gap? And then what do you do in your day to day at Seeker? Nina Crowley, PhD, RDN: ⁓ Great. Actually, you know, it's funny, I didn't have that many jobs. I'm dating someone now who's had so many different jobs. And I laugh that when we started, I'm like, and here's the two jobs that I've ever had. And now it's your turn. And I'm still learning about him. So I ⁓ got into that role in bariatric surgery at NUSC in Charleston. I was there for 10 years as the dietitian while I was doing my PhD and practicing all the behavioral stuff with my patients and, you know, learning how the chronic disease of obesity worked and I absolutely loved that role. But I did have a lot of things I wanted to do programmatically. So the director position, I worked on making happen and I call myself the director. I was actually only the coordinator, but I was the director and I got paid as the coordinator. So if we want to talk about advocacy for better salaries, there's a miss. I took the role because it was what I wanted to do and I really needed to. but I did the director level stuff. So now that it's in the past, I was the director. And so I loved that. I was able to really shape the direction of the program. And then a lot of the probably burnout kind of came from the insurance and the coverage for it. We talk so much now about coverage for GLP-1 and medications, but coverage for surgery is where we all learned how to do that. And it was hard and complicated and biased. And they really put all sorts of you know, limits on care to get someone access to extremely effective, you know, therapy for them. So that was a little bit of a burnout. And then there was a lot of, then there was COVID and then there was having to do the administrative assistant role and schedule appointments because that had to happen. ⁓ so I just, ended up feeling like I was oscillating from sort of the, the real daily grind. And then also doing the strategic big picture stuff, which is where I felt like my creativity. wasn't able to come out as much. So this role with Sika kind of came about, ⁓ you know, I had known about Sika doing body composition in the field. I had some connections within the company and they started to see what I was doing on social media and that I was present at a lot of these obesity meetings. And so I started, we started talking and kind of working on a role that suited me. And it started more in education for people who have a body comp device. And it's evolved a little bit more into, ⁓ which I think is a fantastic title and very, you know, right on director of clinical thought leadership and partnerships. And that's what I really get to do now. A lot of education for people in the field, ⁓ not maybe who don't yet have our body comp device, but talking about it from a lens of like inviting other clinical folks who use body comp to share their experience and sort of use. our trusted healthcare providers to tell that story. And so I do webinars monthly. ⁓ I have a podcast in the Know With Nina, which evolved from really from wanting to put conversations with people who I knew were speaking at conferences and who were doing really good work. I wanted to just film conversations with them about that. So we had social media content. We did that a couple of times and I'm like, this is a podcast, right? So, and I'm a huge podcast listener. And so I was like, this, I've always dreamed of having a podcast. Could this be? And so, so that evolved and now I have like 73 episodes, which is, mean, I'm very impressed with how much you're pumping out and doing it's really cool. But yeah, it's like, I think it's a thing I've arrived as doing this. And so I, and I love it. It's really like my way to be able to talk to people that are either. Kristen Hicks-roof: awesome. Nina Crowley, PhD, RDN: that I already know that are really interesting and I want to share their story or people who I don't yet know that I get to sort of ask questions and figure out. And I think that's what's really, what's really cool. So I do a good bit of that in the role. I also represent SICA at some of the corporate council, you know, that we have, if you're an industry partner with a professional association, like the obesity medicine association, the ASMBS, the obesity society, the OAC. So I get to sort of you know, be on at the table, hearing what they're working on and, you know, talking about what we're working on. And that's been a really nice part of staying in that community, ⁓ which I thought I was going to lose when I, you know, when I left, ⁓ when I left the clinical side, I thought, ⁓ these are all my people that I've, you know, built relationships with over 20 years. ⁓ Am I moving to the dark side of industry and not going be able to do that? But now I joke, now I get to go to the conferences, but like, I can buy them a drink and I can like sit with them and pick their brain on a topic. And it's just been a very different shift and not what I would have predicted or expected if I thought about it ahead of time, but it's evolved really nicely. And there's a lot of autonomy within the group. know, they see what I do and they trust that, you know, I've got a strategic direction to be able to do that. So it's been a nice fit for me. Kristen Hicks-roof: I do think it is, you a lot of people, if they're leaving academia or they're leaving clinical, like you take that familiarity and you're like, will I still be able to talk the lingo or will I still be able to do research or will I still be able to understand what they do in the practice versus like outside, right? Like quote unquote in the industry. So I think there's a lot of fear. remember I, when I left academia, I was like, what's going to happen on my research? Like, am I still going to get to write? You know, like there's So many things that I've just had to channel in different ways of things that maybe I'm missing. ⁓ doing the podcast, to me, I'm kind of the same way as you. I think there's so many incredible stories and opportunities for dieticians and nutrition experts. I'm an eternal optimist, so I think that probably is a good thing and a bad thing. But there's so many different career paths. And that's what really drove me to the podcast is like. Can we give people confidence that they can do so much more than just one thing, right? And I put that in quotation marks because it's like, ⁓ I'm just a clinical dietitian or I'm just a food service. And it's like, no, you're not just that. You are so much more. You offer so much more and you can pivot around in your career, just like, you know, leaving, you know, the actual clinical work and being in thought leadership and partnerships. Like it's a change, but you... Nina Crowley, PhD, RDN: and Kristen Hicks-roof: Also, you need people in all these different level roles and we need nutrition experts across all these roles as well. Nina Crowley, PhD, RDN: Yeah, and I mean, I'm a huge dietician lover. think that like, you know, we're the greatest. And so if you're listening, you are, we are the greatest and we are so versatile. have such an incredible skillset that I think we should be at all of these other levels that maybe aren't dieticiany type of roles, but that, you know, we've learned enough as a clinician that we can then go on to do that. And then that's bringing awareness to others of, this is a whole group of professionals that, I mean, we could joke about the types of dietitians, right? And the skill set that we could generalize many of us have, but in all seriousness, that's a very valuable person on your team who's generally very conscientious and hardworking and really cares about the patient, really cares about the outcome, like wings and landing gear, I always say. And so I see a lot of that in my, you know, I would say, 90%, 80 % maybe of my friends, closest friends are probably fellow registered dietitians ⁓ because there's such a great group. So yeah, I think dietitians can do anything. And there's a lot of places these days in particular that we should be. We should be there doing that stuff. Kristen Hicks-roof: Yeah, no, I completely agree. how does, you know, going from clinical practice and into what you do now, how do you see scientific evidence, especially in thought leadership, which is sometimes, right, like you're just ideating, you're trying to be the voice. How does scientific data and evidence fuel what you do in your day to day? Nina Crowley, PhD, RDN: That's actually, that's a really good question. So I think I'm still wings and landing gear. I'm still strategic and down here doing the work and the, you know, the daily grind. However, if that's the optimistic way to say all the things for all the things, right. With body composition, you know, this has been, it's a very highly scientific area. When I came into it, I had no idea how much like, physics I might need to understand ⁓ bioimpedance. I didn't take physics. That was like the one thing I didn't take in college. ⁓ But I've learned a lot on the job about sort of like the technology of bioimpedance and how that works to assess someone's body composition and using validated methods like MRI for muscle mass. And so being able to take that, like, here's how you assess someone's body composition. Here's this technology that we can have in our clinical space. But our clinicians, maybe they're like me, they're 20 plus years out of their undergrad program and they learned about underwater weighing or some of these different technology. I remember learning, here's all the things you could do to assess body composition. And then you kind of land in a clinic and you either do what they do or have or what they don't have. And we don't have a lot of skills to then advocate for like, hey, this is what we should be doing. For how many years did I work in a bariatric program saying, it's not just about weight, we've got other things. I'm here talking about all the psychological things and all the behavioral habit things that we want people to work on. Still saying it's not just about weight, but then, hey, they come into clinic, hop up on the scale or whatever bad language we use to talk about what weights first. I think that for our clinicians, being able to show them bioimpedance has evolved a lot in 20 years since you learned about it. ⁓ There's a lot of new innovation in this area. There's a lot of entrepreneurial ventures in this area. And so being able to sort of help our clinicians decipher what the scientific evidence is for validating a technology with a gold standard for imaging or reference. is really fun and so, and trying to figure out creative ways to do that. And again, you know, showing the voices of their peers, showing, you know, taking it from the real scientific for some people to the real basic. That's where I always struggle sort of like, how do we put this into a 20 or 30 second sound bite? I'm the worst with that. I'm like, well, there's so much nuance. We've got to go into this and this and this. And they're like, that's 10 minutes. No one's going to keep listening. So. you know, being able to sort of bridge that scientific stuff with marketing and, you know, education and being able to sort of get that to the people who need to know that has been really where I've been able to join those things. And I think hopefully have impact in bringing that to our communities, you know, whereas I think four years ago, we were in a different time, right? I got out of the surgical program right around the time where, you know, ⁓ the GLP-1 medications were coming on board as being more popular and understood. So that I think also leveled up the conversation around body composition, because people started to think about it and talk about it. And there still is a lot ⁓ of misunderstanding, a lot of fear mongering too around like muscle, you're going to lose all your muscle. And so You know, for me, I look at that as an opportunity to say, do people even really know how to assess muscle? Because they're saying this and they're saying this is gold standard and there's a lot. So I think there's plenty of work to do in ⁓ untangling ⁓ misunderstandings around the technology and around the science. Kristen Hicks-roof: What I think there's so much you talked about how science is continuously changing and the tools have improved. And I think they're only going to continue to improve in health tech in general, right? Like I had Melissa Yeager talking about my fitness pal and how even like dietary record keeping is changing with AI and photography. And you'll continue to see body composition change of how we're measuring it, how accurate it is, and how can we bring those in clinic? Because I think for so, so long, We've, yeah, just put people on scales and you're like, ⁓ you're still 150. And it's like, but are you actually having composition changes that are favorable? So you are doing positive things. You just may not see it in a general number. So I do think that there, we have to have dieticians and nutrition experts help to transition with the times, with technology, with science, to be able to be thought leaders, but also show how nutrition can be measured in different ways, whether that's from. the psychology to the body composition. So what's been your favorite so far though? What have you really enjoyed about your career that you're most proud of? Nina Crowley, PhD, RDN: Ooh, that's a good one. ⁓ Well, I did always say I one day wanted to be a professional conference attendee and I have achieved that. I get to go to some of the greatest conferences and I get to, you know, hang out with some people who are doing really cool stuff from both the speaking and the, you know, education side and also the industry side. That's been a really, that piece has been really fun to see how industry is able to support the work of dietitians in not a weird and sketchy way that I would have thought years ago. Like, ⁓ are they being paid by, you know, big whatever we call big everything these days, right? Not that I thought that exactly, but I definitely didn't get that the way industry works with our education and how that works. didn't realize how... evidence-based that is. And so it's been really fun for me to sort of sit at that place and be able to both go to conferences the way I've always done and education and listen and then be invited as a speaker now, maybe not in bariatric surgery and behavior change as much, but in body composition and really in how to counsel and discuss that with patients too, because that's a piece that I am really really adamant about that we're not just taking data and shoving it at people the way we do with a lot of things. That we're not just saying, instead of your weight, here's your body fat percentage, right? Here's a number, go home and freak out about it or think about it. There's proper ways to do this. There's using all the data points in a holistic way. There's being able to counsel about what... ⁓ what can change and what, should we be looking at? And it's different for everybody and really just taking that sort of behavioral lens to the counseling piece around body composition. So I'd say a version of that would be my most favorite. ⁓ prior to this, you know, I do have a big piece of my heart that's for advocacy and policy. And so I've done a lot of work with my, you know, dietitian and obesity care groups in. getting people to advocate for better obesity care, comprehensive care, access and reimbursement. So some of the policy work and even wins that we've had in the past few years have been really exciting. And I still am a board member for the obesity action coalition. So the patient side of this is also extremely important. And I think we all need to check back into why we're doing what we're doing and it's for the patient and we've got to. continue to use their voice and have them be part of the conversation, especially in this place. So there's not one thing, it's all the things. it's really been a nice evolution of saying yes to this or that and not exactly knowing where that was gonna lead. And sometimes thinking you say yes to too many things and certainly saying yes to too many things. But knowing that every person I met, Kristen Hicks-roof: I want to. Nina Crowley, PhD, RDN: at that meeting or I got to sit and have a dinner with this person or stay up really late with this person and all of those conversations serendipitously come back around to a different connection, a different conversation that have added in some way. Kristen Hicks-roof: I mean, I think that is so right that like somehow, serendipitously, what a great word that you use there because you're right, somehow it always comes back and it's like, ⁓ I do know someone at X field or I do know someone who's doing this. Let me connect you with them, right? Like, so I do think that is the power of networking cannot be underrated. But I want to circle back a little bit because I think you touched on something that I haven't really talked about on this podcast, which is advocacy and policy. How did you break into that? What tips or advice would you have for someone who's like, yeah, I want to advocate, but like, I don't know how to do it or where do I do it or who do I connect with? Nina Crowley, PhD, RDN: I love that. ⁓ Yes, and I think that there is so much we can do from the very little baby steps. So I would say a very little thing you could do in advocacy is consider language and how people are talking about patients and people and the disease states that we're working in. And so in my world, the obesity care space, ⁓ there is still a lot of inappropriate language around, you person first language seems so obvious, right? We wouldn't call a patient with cancer a cancerous patient, yet we call, you know, and even people who are, I would call colleagues are often the obese patient, you know, and they're saying those words as if they're labels rather than the whole functioning person who has a condition, right? So that's a very simple thing you can do. And if you're aggressive or assertive like me, you can call people out on that when you hear them doing it inappropriately. Online is a good place to call people out on bad images, right? Headless people that, you know, if you're a dietitian in media and you're doing interviews and you don't offer a good photo, they'll pick something maybe off of, you know, wherever they get these photos and they're headless people eating typical foods that we would say are bad for someone, right? And like those are things where you can say, here's a photo of a person who has excess body weight or a higher body size or is living with obesity, doing something that all people do, moving their body, eating food, but that doesn't have to be stereotypically unhealthy food. So those are things you could do that are like, you send along that image and then that article is being represented in a different way. I think that's advocacy. ⁓ I think in the more traditional sense of advocacy, I always laugh because I'm a very Like I don't like to get into politics type of stuff. I never did. But I got involved in my state dietetic association. And so that was something that was part of that role was learning, you know, what are we advocating for? And I'm like, ⁓ I could talk about how awesome dieticians are all day. Well, that's all we're doing to start having a relationship with a legislator or, you know, someone ⁓ in government is this is what dieticians do. ⁓ why don't you have someone on your team who actually has a credential, right? Like, hey, maybe if we did a little more advocacy years ago, we wouldn't have some of these wild and appropriate people representing nutrition at the highest levels of our society, right? I mean, maybe advocacy could have helped us be at that table and having those conversations when it's not a crisis. So, hey, you we do these state dietetic policy ⁓ events every year. And we always joke like, we're just going again. There's nothing, you know, no legislation to talk about, but here we are going to say, here were the dietitians. Here's what we do. That's important work because they always have a question of like, ⁓ well, what meal plan should I be following for bloody blood? Right. And like, we're not judging that. saying, okay, good. I'm glad you asked that. Here's what, you know, here's who you have in your area. I think you should see a dietitian. ⁓ and then if they have a positive interaction, they're more likely to then say, this clinician really helped me. ⁓ Maybe that's who we should have on the panel, on the board, at the table and all of that. So I think those little things are very much related to advocacy. And I think the dietitians through the Academy of Nutrition and Dietetics have really done a good job making some of those opportunities easy to access. then there's higher level things that you can do. And there's always, you If you're in the obesity care space, the obesity action coalition does a lot of really good work in access and whether you're a patient, there's so many more patient clinicians now, right? So back in surgery, was like, we always tried to have a patient voice on a panel and to have someone who was a post-surgical patient was a little bit harder to find. These days, many of our colleagues are also patients of taking a biology changing agent to help with their long-term weight health. And so as a patient yourself, think about what could be helpful for you and get into that space as well and sharing your story that way can be another way to do it. Kristen Hicks-roof: I like how you talked about you don't necessarily have to go into these very controversial topics, right? Like you don't need to go and support a bill or something like that. It's really just you can also just express what are dietitians? How do they help the patients? How do they help the community? How they help billing and reimbursement? Like there are a lot of other not smaller because they're equally important, but they are lower level in terms of not as much demand to be able to, you know, really position dietitians at the forefront. Nina Crowley, PhD, RDN: Well, don't need the whole, like I remember too sitting in an office and like on Capitol Hill thinking this is what I have to say. I have to repeat the statistic about the obesity stats in our state and I have to get that right. And it's like, you know more than they do. Finishing your internship, probably even starting your internship, just walking in the door, you know more than they do. just like falling into that and being able to say, know, this is what we do, we should be at the table. I think that it's a very, it's like most things that where you think it is and where it actually is, you can never predict, right? So just raise your hand, say yes, go to the event, have that conversation, and then just see where that goes is really what I would say. Kristen Hicks-roof: So what kind of, do you have maybe two or three tips of advice for someone who's interested in a role like yours, like director of clinical thought leadership and really thinking a higher level director role? Nina Crowley, PhD, RDN: Yeah, I would say, you know, the biggest thing is when you're thinking about what's next, I think a lot of times we're looking for jobs that exist, right? Like I'm, you know, I'm impressed with all the really cool jobs you're constantly posting. Like even just looking at that list, it's like, we can be in all these really cool spaces, right? But I think sometimes we box ourselves into thinking, That's the job. Like what do I do now to get that job? And I think a lot of our experience has been doing your thing and then finding a relationship that might lead to a job that's not on paper or that you get to actually kind of write yourself. And so I think just maybe from a mindset position, not limiting yourself to thinking that like these are the things that you have to do to get that exact job. I mean, just moving in that direction. And I would say, even though I feel like at one point I'm like, all right, I'm 40 now. Am I here? Have I arrived in my career? I still feel like I say yes to everything that is kind of interesting or a little bit curious to me because they've all led to something. So I'm like, I don't know, I guess I probably one day need to say no to something, but. I feel like saying yes to things before you're looking for a job, before you're like, oh, that's an area I want to get into. Just go to the thing, be around the people and diversify what those things are that you're doing. Because I'm sure you have this experience, every talk you give, you're talking to two, 300 people. There's a few people in that audience who reach out and are like, oh my gosh, what you said resonated. I want to see you at this. And like to me, those type of things are the groundwork that you do so that the random spontaneous serendipitous opportunities that pop up, you're just getting more activity in that space. like maybe approach it like you would dating, like it's activity, go on the date, do the thing. And then like, eventually you are gonna find your way to the next right thing, but saying no and maybe having too protective of boundaries. ⁓ you won't be in the space to have those conversations as much. So I would say that's probably a big piece of that. Go to the meeting, have the conversations, hang out with different people than the ones that you already know really well. I think that's enough. Kristen Hicks-roof: Yeah, I mean, I think saying yes, I have a fault. If anyone listening has a training where I can learn how to say no, please tell me, DM me because I would love to learn how to say no better. But I think saying yes has opened so many doors that I never thought was possible. Like I remember I was giving a webinar about mental health and nutrition and then all of sudden, Hawaii Department of WIC was like, we love your talk. Can we fly you out to Hawaii to do a workshop? And I was like, what? Like, no way, you're actually gonna pay me to go to Hawaii. was like, this is awesome. But really it's because you're right, people are listening and if it relates or connects with them or they're like, hey, I know this person has an opportunity. And you know, my niche jobs list, I very often don't post anything that actually has dietician in the title. And that's very purposeful because I want dieticians to think, wow, I have such versatility and skills. Nina Crowley, PhD, RDN: Yes. Kristen Hicks-roof: that I don't necessarily need a role that says dietician. And so that's why a lot of people struggle finding those roles because they're searching in whatever job search platform dietician and those roles may not be exactly what you're looking for. If you had a crystal ball, this is my favorite, what do you think is coming next in nutrition? Nina Crowley, PhD, RDN: Yeah. Hmm. Is it a hopeful crystal ball or is it a realistic crystal ball? Hmm. ⁓ it's coming next to nutrition. Well. Kristen Hicks-roof: whatever crystal ball you want Nina Crowley, PhD, RDN: I think that it has to be next that we're seeing real evidence-based stuff get to the forefront. That's the hopeful crystal ball, right? Like I can't imagine continuing on in a very unhopeful state. So ⁓ I'm an optimist too. think that, you know, we've got to keep pressing what we do because And again, my background is very much in obesity care, but I think that can extend to other areas of nutrition. the quick fix, the try this crazy thing here, like it's a boomerang, right? You've been in it long enough to know that like that stuff comes and goes and comes and goes. like, you I know from the patients I've worked with in obesity care that they appreciate the partnership they have when they have a good dietitian, they appreciate being able to have someone who is there for the ride, right? So like, I think we're along for the ride. I think that we've got to stick out this time right now that feels like people are just picking weird stuff to focus on. They're quick fix thinking. I think that the beautiful place we're in with even, you Despite the weird media attention around GLP ones that I think is sometimes getting it incredibly wrong We're talking about obesity in the media Daily like five years ago I never would have had way too many things to post on LinkedIn to even manage right and now I'm like There's six things that like happen today that are interesting and I have thoughts about all of them. So I think that we've Remember where we've come from and that we're here for the long haul and being able to be the evidence-based practice that we are founded in and alongside the behaviorally based partners that we are with our patients. We're not the people just telling people what to do and then being like, oh, weird, that didn't work. See you next week. And that'll be $500. Like that's not what we do. And so I love that about our profession. It can feel disheartening. when other people are getting paid more to do much less appropriate care. But I think we're here for the long haul and I think we can do a little bit more with advocating for that role. So stick it out is the. Kristen Hicks-roof: One, think the fact that people are more into now than ever about health, wellness, food, agriculture, whatever it is, medications, that let's continue to have dieticians be at the table, be in the decision-making process, coverage of Medicare, Medicaid, private insurance, right? All of our services, both prevention and management. And so I think there is so much opportunity. And that is the goal, right? That's the goal. If the trends are going that way, show that we are this long time partner and that we are gonna help with the continuum of care. It's not gonna be a one and done, it's across the continuum. And that goes from infancy all the way to elderly. That is not just a one time point in your life. So Nina, thank you so much for being on the show. And if you liked the show, make sure you like, subscribe, leave a review. But most importantly, check out the next episode because every episode I bring out a different dietitian and nutrition expert to tell their story and give you advice.