Holistic Health and AI: A Conversation with Dietitian Abby Chan

[00:00:00] Brian AI: /Are you not sure how to feel about the way AI is suddenly everywhere? AI for Helpers and Changemakers is a show for people who want to do good work and help other people. Whether you’re already using AI tools and loving it, or you are pretty sure that ChatGPT is the first sign of our downfall, we want you to listen in and learn with us.

[00:00:26] Your host on this journey is Sharon Tewksbury Bloom. For 20 years, she’s worked with helpers and changemakers. She believes that we’re about to see the biggest changes in our work lives since the Internet went mainstream. We’re in this together. Join us as Sharon interviews people in different helping professions, navigate what these new technologies are doing to and for their work./

[00:00:48] Sharon Tewksbury-Bloom: /I’m your host Sharon Tewksbury Bloom. My guest for today is Abby Chan. Abby is a dietician and she is a co owner with her partner Brian of a company called Evolve here in Flagstaff, Arizona. With Brian being a physical therapist and Abby being a dietician and a chef, Evolve is perfectly suited to take a holistic approach to health.

[00:01:11] And they offer a range of services to help people either addressing health issues or who are athletes trying to build strength or just anyone who’s trying to get or stay healthy. 

[00:01:23] we don’t go as fully in depth in Abby’s views on health promotion and being against diet culture, but she has some amazing resources. She’s written a lot about health on her website, as well as sharing tips and strategies on their Instagram. I have linked to those resources as well as everything else that we mentioned in the show notes.

[00:01:44] I hope you enjoy my conversation with Abby. /

[00:01:48] 

[00:01:48] Sharon Tewksbury-Bloom: one of the thoughts that inspired this whole project for me was this idea that we’re running out of time to figure out what it means to be human. And I think that we often discount what that core humanity is that we bring to this particular problem. And it’s something I admire in you is that you’re trying to get to the core of Our human relationship with food, our relationship with community and culture and each other and how all of that, you know, if someone comes into your office and says, I want to lose weight, you’re not going to take that at that question and give them a plan. You’re going to dig into Them as a human in the world and how they’re making sense of themselves and interacting with others and bring your story into it and the whole thing.

[00:02:36] And so I think that’s where you’re adding so much value with your humanity to it that. The AI cannot do, but I think it’s important that we, as people trying to do good in the world, reflect on how we’re doing that, how we’re bringing our humanness to it, because if we’re just doing what The computer can do, then we’re really not doing our best work.

[00:03:05] We’re not bringing our most value. We should just leave that to chat GPT, but we have to see like, how are we bringing those unique human qualities to it?

[00:03:15] Abby Chan: Yeah. And I think that’s the most profound aspect of any work that anyone does, whether that be in business, in leadership, in medical care, in being a caregiver or a parent, it’s so much of. Instead of what are we doing? It’s how are we actually taking a moment to pause and be and reflect not only within ourselves, but be able to reflect and communicate effectively with others and truly listen, because that’s again, what all these things can’t do.

[00:03:49] They can’t listen to us. They can’t listen to us, but they can’t necessarily really take that information in and again, boil it all down into. Oh, okay. I can see that this is really hard for you right now, and let’s talk about this so this maybe feels a little less hard for you.

[00:04:08] Sharon Tewksbury-Bloom: /Okay. I want to make sure we also talk about smart devices, consumer tech that’s coming into the space. Cause I know I mentioned that I had heard about a product that I think was unveiled at the, big convention in Las Vegas where they had a tray that could measure the calorie content in the food on it.

[00:04:30] And it could also measure after someone had eaten some of that food to see the difference. So certainly that raised alarm bells in my brain. But I’m curious what you’ve been seeing out there in terms of actual products and wearables and things that are in your space and Where your head is at on those items.

[00:04:55] Abby Chan: Yeah, there’s a lot of tech out there. There’s a lot of options. We could spend so much money and so much time diving into all of these things. And, It first comes down to looking at, and even when it comes to health in general, and looking at, let’s say labs, for example, right, they are a snapshot in time.

[00:05:14] So we don’t want to base someone’s health on just one lab job. We want to look at, what are the trends, what’s the difference? And I think that’s a beautiful thing about tech is that it can give us trends and it can give us aspects of, are we maybe going in the right direction? But they could also be anywhere from, 25 to 90 percent inaccurate, depending on the device, depending on how old it is, depending on the sensors in it, depending on what data it’s been compiling.

[00:05:42] I’ve actually been doing my own personal. Research on myself where I’ve actually worn 2 devices for the past month. 1 of them being a faceless 1 that it doesn’t have any numerical data on it. And you have to use an app with it. It’s more focused on recovery based things and giving a little bit more data there and compared to an Apple watch and.

[00:06:06] One thing that I love about the one that doesn’t have a face is that it doesn’t buzz at me and tell me that I need to move or shame me into, you need to get up now or have you closed your rings? And there’s a lot of ways you can disable those things, but it’s actually really challenging. I have to walk clients through often, how do we disable these notifications?

[00:06:24] How do we decrease that amount for you to close your quote unquote rings and all of that? And so I think they can be really problematic because for a lot of people, if you’re more. Let’s say on the anxiety spectrum, maybe even more in the obsessive realm of things, numbers are something that once we see them and hear them, they can live rent free in our heads for a very long time.

[00:06:48] So that could be your body weight. That could be caloric amounts of food. That could be how many calories you’re going to burn during a certain exercise. Like all of these numbers really don’t tell us a lot about how do we actually feel in our bodies. if one of these devices tells me you’re totally recovered today and you’re doing great, but I’m like, I am so sore and I am not moving today.

[00:07:10] It’s we need to look at listening into our bodies and maybe using this as some other information as well. But I think there’s, yeah, so many fitness devices out there depending on where you wear them and how you use them the accuracy will be variable and also the Time and length. So that’s also an interesting aspect where buying into something and being in the whole system of It costs money.

[00:07:34] It costs money and it costs time And so that’s one of the things where we have this data and we think it’s so valuable and we base our lives around it But then if it goes away, what do we do? Oh, we have to listen to our bodies. Oh my gosh That’s so hard. So I think there’s some things there. And even from the plate aspect the example that you gave, from a one on one individual level, from a consumer level, I don’t think it’s very helpful and great.

[00:08:03] I think that could end up again saying, here’s the calories amount that you started with. Here’s where you, what you should be eating. Oh, you ate too much. And then inherently something’s going to feel. Bad, guilty, shameful, but from my clinical perspective, as someone who works with eating disorders a lot, I don’t like to use a lot of serving sizes.

[00:08:22] I don’t like to give out a lot of meal plans or exchanges or a lot of really strict things because we’re, I’m telling people that we. don’t want to count as much and we don’t want to rely on these numbers as much. So that could actually be a really interesting tool from a provider standpoint for the provider to have the data to where someone doesn’t have to measure and weigh things, but maybe the provider can get the data on the back end and see, oh, how are we actually doing?

[00:08:45] So I think. It’s all going to depend on, how are we using this? Are we using this from a place of one metric and not the only metric? Are we using it from a place that is actually to improve our health? And also, are we still able to listen into our bodies and continuously ask the question of why am I using this?

[00:09:05] And why do I feel like I have to continuously use these things and not trust my body?

[00:09:12] Sharon Tewksbury-Bloom: Yeah, and I think about ways in which the technology could be used to more adeptly fit into the ways we want to interact with our food and our friends and all of that so for instance, when you were talking about it could be useful to the provider without requiring, maybe someone who, is dealing with an eating disorder they need to somehow report this data back to their provider, but if they’re the ones having to tally everything, that might be just feeding into unhelpful, cycle.

[00:09:47] I was thinking about how my husband makes fun of me because I am one of those millennials that takes pictures of my food a lot. Like I love a pretty plate. And so I thought, Oh, if I was working with a dietician, it would be helpful if I could take a picture, which to everyone around me would look like just my normal behavior of I’m just that kind of person who always loves to take a picture of their food.

[00:10:11] But then maybe it’s, I can tag it and it automatically goes to an app for the provider who can just check on it when they need to. And it allows me to more easily integrate in those social settings. cause one thing I’ve appreciated when you’re talking about. People trying to make a change to their food is that so many people when they make a change like going on a diet, it disconnects them from culture and from community because they’re like, Oh, no, I can’t eat that thing you made for me, or I can’t come out to dinner with my friends because there’s nothing there that fits in my diet.

[00:10:49] Or, I. Or I have to write down everything, and it’s like this very public, awkward thing of Oh, I gotta check my app before I eat that thing. So I think ways to allow people to still maybe get the support they need from the qualified provider, but also be more seamlessly in their day to day without being taken out of those important moments could be great.

[00:11:15] Abby Chan: Yeah, I think it’s great. And I am very much in the place where I don’t love tracking things. And I don’t love, I don’t love tracking workouts. I don’t love tracking food. I will every now and again, if depending on my training load and depending what I’m doing, and this will also be something I use sometimes with my clients is where I will track maybe one day, and I will go in knowing that I will track it.

[00:11:40] As appropriately as possible because oftentimes when we are tracking things, we will typically, be quote unquote good. And so I will try to track it as as possible. And that gets to be again, one thing that says, Hey, okay, cool. You’re doing like, you’re at least eating enough. I think that’s where aspects that can be really helpful for, but we need to remember that.

[00:12:02] A, we are not machines. Our body does not metabolize every single calorie and nutrient that we take in. And it can be a helpful baseline as long as it’s not something that again, consumes our life. So for some people I’m like, cool, maybe let’s just, I can, based on what you told me, I can go through and I will run that through sometimes so that they don’t have to.

[00:12:21] And then that can help me base some recommendations of we’re in a pretty good spot. Or Ooh, we’re in a big deficit here. And I can typically with just my clinical hat, I can make pretty good guesstimates of what we’re missing. But I think it can be a really great thing to do. Maybe it’s depending on your relationship with food, depending on your relationship with dieting.

[00:12:41] And if you know that you get really obsessive, that’s probably not for you. But for some people, especially for a lot of my athletes that I work with, I do need to know that they are eating enough and I do need to know what nutrients they may be missing. But we need to come from that from a very neutral standpoint.

[00:12:58] And also knowing that is not everything and these numbers can be skewed and that our bodies are not going to need the same thing every day, which is where a lot of the calorie amounts come from. people get stuck with this certain number in their head of, I can’t go over this. And it’s That’s not true. Some days our bodies need more. Some days our bodies need less. It totally depends. And that’s where we can use some of the data to make sure there is enough, but then also continuously listening to our physiological, mental, and emotional cues of, hey, what do I need right now?/

[00:13:29] Sharon Tewksbury-Bloom: Awesome. Anything else that you wanted to share in terms of what you’ve seen in your field with how AI is being used or has been proposed to be used that we didn’t touch on yet?

[00:13:47] Abby Chan: Yeah, so there’s a lot of aspects right now around personalized nutrition, which is really thought of as more genetic based testing. And I think it’s really cool. We can look at how our genetics will impact our nutrient absorption, how it could put us at a higher risk for certain. Chronic health diseases, cardiac disease or diabetes or, dementiathere’s so many different genetic factors, but we are still learning about how those genes interact with each other.

[00:14:19] So we right now have data where it’s okay, we know these 2 things are correlated, but I like to think of. hormones and our genes as a symphony, right? So it’s not just, Oh, that one’s off. it’s going to have a cascade effect for the rest of our body. So we are not yet at the place where we can totally use our genetics to base.

[00:14:40] All of our nutrition information and we can use them as one tool as well as labs and other tests and how you feel and your relationship to food and all these different aspects to really pull in what would be appropriate for one individual. But there’s a lot of things right now where it’s get your genetic test done to see if you have celiac disease.

[00:14:57] It’s just because you have certain genes that may correlate, that doesn’t mean that you have an issue with gluten. Or just because you have certain genes that are coding for what else could it be? Oh, certain genes that are coding for some nutrient deficiencies doesn’t inherently mean you have those, but there are some that we know of, hey, if you have this genetic factor, we’re just going to supplement with that because we might as well, because it’s a very low cost intervention.

[00:15:23] Sharon Tewksbury-Bloom: Yeah, and it does seem like there’s a lot of potential in the future for personalization And greater accessibility, like accessibility to expertise. But I think We’re going to be in a messy middle for quite a while where there’s a lot of noise. There’s a lot of experimentation going on.

[00:15:45] There’s a lot of not fully tested products out there on the market. Everyone’s in a tech race right now. So I think there’s a lot being unveiled and being announced that is being hurried to market. And it’s a particularly fraught time for things that could have a big impact. And hopefully it doesn’t take too long until some of that shuffles out and we start to see where the real opportunities are and not just the noise.

[00:16:13] Abby Chan: Yes, definitely. And I think that’s so much what we can use lived experience and we can use research and we can use data and compile all of that to see how does this actually impact us. But with those stories and lived experience, there’s so much where it’s it worked for me and it’s Okay, that’s great. I am not you. And so even when we look back at the big popularization of the paleo diet and one of the individuals who was really responsible for bringing it forth, later he got his genetics test done and I don’t know what test it was but it showed that he was actually. Based on this test, we could also look at what are other tests saying, but based on this test was better at Processing and digesting fats and proteins and did really well on it.

[00:16:58] okay, great for this one individual you did really well in this diet But now it is so popularized and people believe this as gospel as this is the only one true way that you can be healthy And that you can perform and it’s like We again need to always, when we’re looking at nutrition recommendations, health recommendations, exercise, all of that, we need to, yes, take some of these stories and say, okay, how can we utilize this, but also zoom out in a much bigger way and see what’s actually going on in a big picture.

[00:17:27] What’s their access to food? What’s their financial privilege? What’s their time and availability? And we need to look at all these different factors of how can this apply to me?

[00:17:38] Sharon Tewksbury-Bloom: Awesome. Okay. I think this is going to be super helpful and valuable. 

[00:17:44] Abby Chan: This is tangential, but if you heard of the guy who’s trying to live forever,

[00:17:49] Sharon Tewksbury-Bloom: No.I’ve heard of people who are interested in living for as long as possible, but,

[00:17:57] Abby Chan: he is you don’t have to include this, but God, what is his name? He’s trying to basically reverse his biological clock and hack his own DNA. And he, like his supplement regimen is, but granted, okay, so he’s like tech dude, retired early. 

[00:18:13] Sharon Tewksbury-Bloom: This the four, four hour work week guy or no?

[00:18:17] Abby Chan: No, it’s not

[00:18:18] Sharon Tewksbury-Bloom: I was like, cause I know he’s into a lot of bio hacking stuff, but

[00:18:24] Abby Chan: now. I want to look him up for you because it is fascinating He is

[00:18:31] Sharon Tewksbury-Bloom: His name is Brian Johnson. He’s a multimillionaire millionaire dude. I think he, his supplement regimen is insane. I don’t remember how many capsules he takes. It’s 70 or something, and he works out and eats this really weird, obviously weird diet apparently has no relationship with food and is fine with it.

[00:18:49] Abby Chan: But real problematic. Yeah. But thinking of the dangers of dieting and eating disorders first and foremost, we need to look at eating disorders and again, look at the data and who’s screened and who is actually being cared for in these spaces. So first and foremost, we always think of these as a thin white female disease.

[00:19:14] That is not true because we have not been screening people who exist in black bodies, fat bodies, disabled bodies for the longest time. So now we have a diagnosis that is called atypical anorexia, where you don’t meet the BMI criteria, but you meet all the other criteria. And that is a vast amount of individuals.

[00:19:32] And so many times, it makes sense from a biological standpoint that if you’re trying to reduce calories to a very minimal amount to lose weight, your body is actually going to do the opposite because our bodies are made to survive. And so you can exist in a higher weight body and still have anorexia and still have.

[00:19:54] a variety of eating disorders. And eating disorders are the second deadliest mental health disease in the country, coming up right behind opioid use disorders. And dieting puts you at a 18 times higher risk of developing an eating disorder compared to someone who’s never dieted before. It is the highest correlative risk factor in Anything else as opposed to genetics or some or say, it’s someone a coach who really encourages it or encourages restriction.

[00:20:25] It’s like, dieting is going to be the number 1 core leader between it. And so what that ends up happening when we think about weight, even being a marker of health, quote, unquote what will end up happening is when we actually boil down. All of the data and all the research, we can actually parse it out to showing that it’s actually the weight cycling that has the negative health effects of quote unquote obesity.

[00:20:50] So weight cycling as in yo dieting will put you at a higher risk of cardiovascular disease, type 2 diabetes, and early mortality. And what we end up doing is we then end up. Blaming the individual who couldn’t quote unquote, lose the weight who couldn’t change their bodies. Because again, our bodies are made to survive.

[00:21:08] So congratulations. Your body’s just really great at being human. And we can look at all of that in the broader spectrum. And for people who do exist in higher weight bodies, they actually have. outside of the metabolic syndrome that we talked about earlier. Outside of that, they have lower mortality rates as they age.

[00:21:28] They are going to be more protected from a health standpoint because they have a little bit more adipose tissue. They may have more muscle mass and bone density on their bodies. And that’s actually a very health protective thing.

[00:21:39] Sharon Tewksbury-Bloom: I was talking to a friend about how much I wish I knew more about this when I was a college athlete playing rugby in college, because that is probably the worst time in my life where I went on a very restrictive diet and I know my coach was mad at me and I wish that she had gotten through to all of us about why that was the exact opposite thing we should have been doing as we were trying to grow muscle mass and be.

[00:22:05] Strong athletes. So I was talking to a friend about this and she mentioned that she has a teenage daughter who’s an athlete and how she had fallen into the peer pressure to get into the dieting as well, and immediately in that season of her sport, she had ended up developing some stress fractures, and luckily, her mom got through to her about how this dieting had probably played a role in her not being able todo the strength building without putting too much,Putting those stress fasciitis in, so she’s gotten her lesson hopefully early in life, but yeah, those risks that come are severe, especially for,just the way we live our lives and the way our bodies actually need that fuel and that comfort and all the things that food brings us.

[00:23:00] Abby Chan: yeah, and that ends up going into there’s a big diagnostic syndrome called relative energy deficiency in sport, and it’s, we used to think of the female athlete triad, which is low bone density, no menstrual cycle. Often correlated with an eating disorder, but now it’s a much bigger diagnostic tool and criteria, which doesn’t only include females, which is huge.

[00:23:25] And I think now, because that has really just been more prevalent in conversation in the past 3 to 5 years, coaches right now are. still trying to keep up with that, right? So I think coaches have everyone’s best interest in mind. I don’t know if there’s any coach or sport med doctor out there who’s trying to harm their athletes, but because there’s so much of this rhetoric around lighter is faster.

[00:23:51] Body based aesthetic sports, and especially when it comes to female identifying individuals and those who are competing in those spaces. Again, we don’t have adequate research on female athletes, but there’s a big disservice there without realizing that there’s going to be a big gap through puberty.

[00:24:09] We need to have more body fat. On us, we need to, in order for our hormones to function and work, there’s also going to be a change in how we’re relating to our bodies during that time, not only because of body change, but also coordination. And so I think it’s really important for coaches who are coaches of teenagers to really just encourage them to continue to eat, to nourish their bodies, to find rest and know that there may be a slight decline in performance around puberty, but if we can stay healthy through that time period.

[00:24:38] There is going to be a long shot of a career in athletics and sport, and we need to look at, it’s not just about what are the effects right now, but what are the long term effects and where do you want to be when you’re 60, 70, 80? I think that’s a more important thing.

[00:24:54] Sharon Tewksbury-Bloom: I’m going to now pivot into talking about some of the new tech that’s coming out and some of the both real ready right now AI and new tech as well as what we anticipate may come in the future but these algorithms, many of them are powered by AI or are being amplified by AI and so existing issues of bias and existing issues of how the algorithms are reinforcing systems of oppression are things that we can anticipate could be just ramped up to 11 with the power of AI.

[00:25:31] that’s the one universal theme we see so far in this first year of AI going mainstream is that things that were already possible via the existing technology are just so much faster, broader, happening. at such a scale once they have AI behind them. So that’s something I want all of us to be thinking about and be really intentional about is okay, if it was an existing problem that we knew about in current society or in current technology, then we need to be paying close attention to how that’s being ramped up now that AI is behind it.

[00:26:12] Abby Chan: Totally. Yeah. humans created AI and AI learns from us and we are flawed individuals and a lot of the research in general, we think of evidence based practice in my world which is where it’s literature and scientific research. And while all of that is great and I am a firm believer of that, we also need to understand the massive research gap from a perspective of.

[00:26:38] Actual evidence on females and whether it be in the health space, or, financial economic stability, all of those different aspects, as well as anyone who is BIPOC, like black, brown person of color as well. So there’s big research gaps there, and that’s what a lot of is going to be based on. And then, even when we start to think about wearables and a lot of the data that they’re pulling into the equation.

[00:27:07] Two wearables if you have black or brown skin are going to be less effective and less. let me back up wearables. If you have black or brown skin are going to be less accurate and pull less effective data because of the different. I don’t even know how to say that. I guess it’s like the wavelengths of them.

[00:27:30] Sharon Tewksbury-Bloom: Yeah, the existing,

[00:27:32] Abby Chan: that and go again.

[00:27:33] Sharon Tewksbury-Bloom: what I’ve heard and seen through, my own research is that there’s been lots of examples of when people tried to do facial recognition or anything where putting your face on camera was what enabled you to use the technology. Those had been developed with white skin as the default.

[00:27:54] And when they were trying to use them, particularly with people with particularly dark complexions then they often didn’t pick up features or they, they were no longer accurate because they hadn’t been programmed with that in mind. And I think that, especially as you start using, I’ve seen a lot of use cases put out there about using AI that’s in a phone app, for example, for, telehealth and things where it will actually make certain assessments, like I’m reading the book Girl Decoded right now, and she’s the inventor of emotion AI and how to read facial expressions.

[00:28:37] And they were using that for diagnosing Parkinson’s and doing early diagnostics on Parkinson’s because apparently your ability to make a genuine smile is affected. By Parkinson’s and it’s actually something that a camera could pick up on earlier than other diagnostic tools. But if to the point we started with, if the tools were built with white faces only, or if that was the dominant way they were programmed, then that could make a huge gap in terms of who could benefit from a technology like that.

[00:29:17] Abby Chan: Yeah, totally. And I think there’s so much in that as well of just medical bias. from facial recognition from skin tone, when you look at dermatology, we don’t have for the longest time, black and brown bodies weren’t even included in how to diagnose skin conditions. When we look at lab values, there’s sometimes different reference values without looking underneath and asking the question of why are there different reference ranges?

[00:29:44] And it’s. When we boil it all the way back, it’s due to, trauma intergenerational trauma, and how that impacts our body and our nervous systems and our physiology.

[00:29:54] Sharon Tewksbury-Bloom: And I know one of those diagnostic tools that has been, debunked, if you will, is BMI. Is that correct? And can you give, cause I feel like that’s one that I still hear a lot of people be like, you just need to pay attention to your BMI and could you maybe give us some background on that as an example of one that has a problematic history and is.

[00:30:22] Also still prevalent throughout the medical establishment.

[00:30:28] Abby Chan: Totally. So the BMI equation was originally created in the 1800s by a Dutch astronomer, physicist. He had a bunch of different titles at that time. And it was to look at his specific population and to try to draw some conclusions or see if there are any correlations between height and weight.

[00:30:48] And if that mattered, he specifically said that it shouldn’t be used for an individual health marker. ran it, the researcher Ansel Keys picked it up in the 20th century and popularized it and renamed it the BMI, the body mass index, because before it was the Quetelet equation. And so it’s basically to look at what is the average and then start to define how those deviations away from the average impacted your health.

[00:31:16] He also stated that it was not a great measure. For health or a great measure for adiposity meaning body fat percentage, things like that, muscle mass, any thing in that realm. But he still can, he still continued to use it in a research study, which then really. Bracket launched it into the use of what it is today.

[00:31:40] It was then picked up by the insurance companies again to quickly assess someone’s health status so that they could quickly give them a price for what their health insurance plan would be. And then the issue with it is, because again, this original equation was used on white males. It has now been amplified to be used for.

[00:32:01] All bodies, female, black, brown, indigenous, all bodies that were never, ever a part of this original equation. And so I think that’s what ends up happening is that again, we come up with this equation, or maybe we come up with this standard in research and not ask, why is that the standard? And who made it this standard?

[00:32:19] It was then in last year of 2023 in June, the American Medical Association they stated that BMI. Okay. Is not significantly correlated with health and that it leaves a large population out and starts and reinforces weight stigma and anti fat bias, and it should not be used as a sole criterion for any diagnosis.

[00:32:43] Sharon Tewksbury-Bloom: Yeah, and I’ve personally had many experiences in the medical system where BMI was used to tell me that I was overweight or at times obese. I have been an athlete since I was small child. And I had a higher amount of muscle mass at a lot of times. And we know that’s one way in which the BMI quickly gets skewed.

[00:33:05] Of course, I’m also a woman, have different body type than the male type that was used to create the indicator. So lots of reasons why this probably wasn’t a great way to assess my overall health. But it was used as often the sole criteria to assess my overall health and it wasn’t, it was honestly,I accepted that as fact and it was put into my own identity as because my BMI is X, I had saved the height weight charts in my own notebooks and had accepted that this was a problem with me.

[00:33:41] for years and years. And then it wasn’t until I was in my 30s and became a bone marrow donor and went through extensive medical testing in order to prove that I was healthy enough to donate bone marrow. I had, EKGs. I had blood tests. I had all these different tests done and when a doctor said to me, you are in perfect health and you are absolutely the best candidate to donate bone marrow to this man to save his life.

[00:34:15] I was like, are you kidding me? that’s the first time a doctor has told me I’m in perfect health just the way I am. And it was such a mind blowing experience for me that I mean it literally changed my life. I was there to change someone else’s life, and yet my interaction with the medical system in this totally different way ended up changing my whole sense of self and my whole way that I approach my body and everything since then.

[00:34:41] It’s one, it’s one finite example of what we’re talking about, of data, the way data gets skewed, the way biases in the medical system, but it’s also, has all these real human stories that come out of it as well in the way that affects people’s lives.

[00:34:58] Abby Chan: Yeah, and I think thanks for sharing that. And I think it is so prevalent that so many people base their health on that, because that’s what these people in positions of power of. medical providers, doctors, research institutions are saying is the standard. And anti fat bias and weight stigma within the medical and societal world is real huge problems, especially when it comes to our lived experiences.

[00:35:25] And We often think of yes, the ways that it deeply harms people who don’t fit into the societal thin white norm, but it also deeply harms people who maybe do and especially from a health standpoint. So there’s metabolic syndrome, which everyone talks about, the quote, unquote risks of being in a higher BMI category or being quote, unquote obese.

[00:35:49] I don’t ever use the word obese in real way. So big air quotes there. But, what ends up happening is that metabolic syndrome is, insulin resistance elevated cholesterol levels, all these different aspects, and it’s a collection of diagnostic criteria. And what happens is that people who are actually in a normal weight category die at much higher rates with metabolic syndrome than those who exist in a higher weight category.

[00:36:14] And those because 1, they’re often not screened. because their doctors say they’re like, Oh, great. You’re in a normal BMI category. Cool. Oh, it’s just a little bit of high blood pressure. It’s just a little bit of high cholesterol. We don’t really need to worry about it because you’re not fitting this picture of what we think is quote unquote dangerous when in reality, those are the individuals who are dying at much higher rates and have much higher risks.

[00:36:36] Sharon Tewksbury-Bloom: That is really important to bring up. Thank you for doing that. So I want to. Take this now into the new opportunities and the new risks and challenges with evolving technology, including AI. First, since we’re on it, do you have any ideas? Has anything come to your mind in terms of addressing what we were just talking about of The medical bias, the anti fat bias the lack of real data for BIPOC people in, in these studies, anything related to that where AI or new tech could help the situation.

[00:37:17] Abby Chan: I think in some ways AI can be an aspect. ways let’s even back up and think about ways that we’re currently seeing. AI in health and nutrition is through meal plans, right? So you can pop on chat GBT and be like, here’s what I have in my fridge. Make me a meal plan. And it’s great at that. It’s awesome at that.

[00:37:39] I think it can save people money. It can save people from throwing food away, which is one of the. Hugest costs of in our food system in general. So I think that’s a really great use of it. A lot of times people then go on for specific nutrition information. And that’s where I think the wheels start to fall off.

[00:37:56] I did a article or was interviewed for an article on this breathalyzer app called I think it’s called blue me and, it’s an expensive. device that you have to buy, and then you have to pay for a membership, and then it gives you quote unquote individualized nutrition recommendations, when in reality it’s just a fancier version of a low calorie, low carbohydrate diet that you could easily find for free on Instagram, and that brings in a lot of issues as well.

[00:38:28] Sharon Tewksbury-Bloom: Yeah. One thing that I think is universal that I’m noticing is if you know how to wield it, chat GPT and other tools like it can. greatly increase accessibility to expertise.if you can say in your prompt, ChatGBT, please act like a registered dietitian. here’s the context, here’s what I’m dealing with, and I’m looking for a meal plan that hits these notes.

[00:38:57] Then it can do an amazing job. of pulling from all the knowledge that’s already available on the internet. And you can ask it things like, please cite your sources and provide those references at the bottom of the meal plan. So that you can do your checks and balances of being able to go in and say, okay, why is it telling me to increase my protein?

[00:39:19] Or why is it telling me to avoid this particular I don’t even know the right word. like, why is it telling me to avoid grapefruit, for example? maybe it’s because you’re on statins. And so it is actually doing it for a great reason. But you don’t, you’re not the expert, so you don’t know why it’s doing that.

[00:39:34] If it’s just being weird and you’re like, it’s buggy. It’s telling me not to grapefruit. Why would I not do that? Or if it’s because it’s actually really great at pulling this information. So I think. What I would love to do is help people understand how to use the tools well, how to be able to check for the validity.

[00:39:54] And this kind of goes to our existing problem of not knowing what sources to trust, not being able to get reliable, trustworthy information. And so it’s an existing problem that’s probably going to be amplified by. access to even more information by way of ChatGPTNAI.

[00:40:14] Abby Chan: Yeah, and I think a lot of times, because the questions that people are asking, because we’re still in this space where For no matter what medical condition or whatever is ailing you, the answer is always weight loss where that’s Not an answer, not a helpful answer, and really not going to lead to actual health.

[00:40:34] But those are the questions that people are going to be asking CHAT GPT, right? How do I go into a calorie deficit? What a calorie restriction look like? And it even pulls up, calculate your BMR, calculate So your basal metabolic rate, calculate your total daily and energy expenditure. Again, those baseline calculations are also based on white males.

[00:40:54] So we need to remember that. And then it also tells us, to go into a caloric deficit of X amount of calories. And those calorie drops can be pretty significant depending on where someone’s at. And from my world, What these can’t do or aren’t doing at this moment is also screening for eating disorders, right?

[00:41:16] They’re not screening for what is your relationship to food and that’s where a I don’t think we’ll ever be able to take the place Of an actual human interaction to look at all the nuances throughout your entire Lived experience of what was your relationship to food? what was your food security?

[00:41:30] What was your caregivers relationship to food? what did your coach tell you one day when you were 17 that? led you down this certain path. And so I think the AI isn’t able to do that. And I think that is what makes my clinical work as a dietician so specific and so important, because we can pull in all of those different aspects and really start to look at.

[00:41:52] How is this currently impacting your relationship to food, body and movement here and now instead of just saying, Oh, here’s how many calories you should decrease in your day. Here’s a appropriate amount of weight loss per week. And then a lot of just the basic, I call it really tired, boring nutrition 90s where it’s like, eat nutrient dense foods, watch your portion sizes, move, stay hydrated.

[00:42:16] We all know what we should be doing. So we don’t need more facts. We need to understand why are we doing those things and how can we start to bridge the gap and maybe change some of our behaviors so we can learn more about ourselves so that we can then carry on future behaviors and make change there.

[00:42:33] But I think it has to be individualized to an extent. I think that AI and chat GBT and even like Google AI things, all of that fascinating. If you’re like, Hey, what drug interactions are there with this medication? what do I need to learn about? What do I need to know? But it’s always going back to, if we’re thinking really big at, how do I fix my relationship with food?

[00:42:54] Why do I keep eating? Why do I feel like I keep binging? we’re not at a point to where. AI is going to be able to answer that for us.

[00:43:02] Sharon Tewksbury-Bloom: Awesome. ─thank you so much for being willing to talk with me about your amazing expertise, but also our just questioning of how new tech is going to be entering these spaces and affecting your work and all of our lives. So I’m so grateful. Thank you.

[00:43:24] Abby Chan: Yeah, you’re welcome. Thank you for having me.

[00:43:26] Sharon Tewksbury-Bloom: And how can people find out more about what you do and if they.do you work with people only in Flagstaff or can people work with you if they don’t live in Flagstaff?

[00:43:37] Abby Chan: Yes, I do work virtually. You can find me at, I’m the co-owner of Evolve Flagstaff, so you can find me@evolvelg.com. And you can also find me across all socials at Abby, the rd. It looks like Abby, the nerd when you spell it out, so I kinda love that. But it’s Abby, the rd Instagram, TikTok and Threads X, formerly known as Twitter, whatever.

[00:44:02] I have various amounts of activity on all those spaces, but most active on Instagram.

[00:44:05] Sharon Tewksbury-Bloom: You also have a few very old YouTube videos that I still go back and watch, which are from the main Evolve channel, where you give us the mobility flows. So I do those mobility flows on a regular basis and I just search for you and find them. 

[00:44:22] Abby Chan: Love it. Yes. Oh, and I just started teaching yoga at Evolve, so you can come and mobility flow with me live if you want to.

[00:44:29] Sharon Tewksbury-Bloom: nice, awesome.

[00:44:30] Brian AI: Thank you for joining us on this episode of AI for Helpers and Changemakers. For the show notes and more information about working with Sharon, visit bloomfacilitation. com. If you have a suggestion for who we should interview, email us at hello at bloomfacilitation. com. And finally, please share this episode with someone you think would find it interesting.

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