Anna Rios is a Registered Dietician at Marin Community Clinics in California providing medical nutrition therapy to patients of all ages. 

One of the most common barriers to going plant-based is the fear of missing out on certain foods and dishes that we love. I have worked as a registered dietitian at an outpatient clinic for over 4 years now and some clients that get referred to me are not interested in making lifestyle changes initially. These clients are a challenge to work with in the beginning, but are always the most rewarding. Let me tell you about my work with a patient named Daniel. I started seeing Daniel via Telemed towards the beginning of quarantine earlier this year. He was referred to me after getting his lab results from his doctor earlier that week.

Daniel’s lipid panel was elevated and he was frustrated because he was told to change his dietary habits. Daniel was not ready for change and he refused to talk much throughout our first visit. He said, “I do not want to be put on a bland diet and eat salads for the rest of my life. I love my baked goods, especially brownies and I will never give those up!” My approach was very “hands-off” and I simply showed him a few examples of how he could start. Since he seemed to love sweets so much, I decided to start with something else.

Longterm Health Changes Start With Addition, Not Subtraction

One very important strategy that I learned over the years is to avoid taking things out of a client’s diet and focus first on what you can add. Does this mean Daniel was not going to reduce his intake of red meats, butter, and sweets? No, he was definitely going to do that, however, when someone is hesitant to change, you do not want to start off by telling them to reduce the food that they love. After a long initial consult to learn more about Daniel’s current diet and lifestyle habits, he agreed to make a goal: Adding 3 new foods to his diet; cucumber, spinach, and carrots. No mention of sweets, no taking foods away, just an easy, attainable first goal.

I saw Daniel on video calls every two weeks and we made similar goals every time. Some goals we made included things like adding more beans, lentils, and chickpeas to his diet while others included him adding 5 more minutes to his walking routine. There were very rare occasions when Daniel was unable to complete his goal but he always showed up to our Telemed appointments because he knew that he didn’t have to be perfect to become healthier.

Replacing Unhealthy Foods With Plant-Based Recipes

After a few months of seeing Daniel, he was finally ready to discuss his love for baked goods and sweets. During one of our Zoom calls, we celebrated a 10-pound weight loss and were discussing his progress when he said, “Should I be reducing the number of sweets that I eat?” When I heard that I immediately lit up and knew this was his turning point. I asked him to start by making a small goal of reducing his sweets to 4 days a week rather than having them daily. I also discussed the topic of healthier baked good options and offered to give him my chickpea brownie recipe. When I told him the brownie’s main ingredients he gave me the most bizarre look and says, “You’re telling me people make brownies with chickpeas, almonds, and oats?!” I nodded and told him to try it before judging it. He accepted the recipe but did not look too excited to make it.

A few weeks later we see each other again on one of our video calls and I notice a big grin on his face…I just knew something good had happened! “I baked the brownies and they were so delicious and tasted nothing like chickpeas or almonds! They are a bit less sweet than I prefer but I’m sure I will get used to that part.” He proceeds to tell me that he has been having 1 every day for the past week and has not touched his processed baked goods at all. When I heard this all I wanted to do was jump with joy but also needed to stay focused and continue working with Daniel to make long-term, sustainable lifestyle changes.

After trying the chickpea brownies he was motivated to continue making changes towards a plant-based diet. He replaced regular butter with vegan butter, meats with mushrooms and beans and most importantly, he had finally stopped eating processed sweets and baked goods. After 4 months of working together, he was already down 20 pounds and feeling much more energized. Daniel was jogging instead of walking now and his time had gone up from 30 minutes a day to a full hour of exercise! He was also very proud of himself when he saw his lab results after his 4 months of hard work:

Daniel’s cholesterol had improved significantly which motivated him even more. I still see Daniel to follow-up and make sure he stays on track but I fully believe he will never go back to his prior lifestyle. Something that Daniel says frequently when asked if he misses his old eating habits is, “Not one bit. I think about everything that I have gained without really having to give up flavorful food and my brownies. It’s really just fear of change, and we simply cannot afford to put our health at risk just because we fear a slight change.”

Daniel is now happier than ever cooking in the kitchen and trying new healthy recipes. Healthy does not mean boring and that is exactly what people need to know!