Would grocery shopping with a nutritionist help people eat healthier?

Doctor and researcher Kristina Lewis plans to test this hypothesis


Kristina Lewis, a medical researcher with Kaiser Permanente of Georgia, snagged one of the inaugural awards from the New York Academy of Sciences’ Sackler Institute for Nutrition Science. Lewis, a practicing doctor as well as researcher, hypothesizes that information doesn’t translate from nutritionist to patient, rendering the benefits of seeing a dietician “minimal.” Instead, she has a proposition: Patients might change their eating habits if their sessions with nutritionists were conducted in grocery stores rather than clinical consulting rooms. Thanks to her $50,000 Sackler grant, she’s testing this theory in a study. In the meantime, we asked her to weigh in on supersize sodas and the economics of nutrition.

Why might shopping with a dietician be better than visiting her office? This study’s purpose is to test if nutritional advice in context is more effective. Think of it in terms of exercise: If I wanted you to become more physically fit, would you be more likely to exercise if I sent you to work out with a trainer in a gym or if I had you meet the trainer in my office to talk about going to the gym and look at pictures of equipment? The latter may not be the best method to modify behavior. I see nutrition advice in the same light. I want to go where people make food-purchasing decisions—the store—the same way you teach someone to exercise in the gym, to determine whether delivering advice at the point of food purchasing will help patients learn better and become more likely to follow that advice.

What made you specialize in obesity research? I went to medical school in New Orleans; that’s where I really started becoming interested in obesity. People struggled, and the food environment was so bad. How can someone change behavior when the whole environment around them is set up to fail?

What are environmental determinants of obesity? They vary by location. Extensive research has been done on the “built environment.” Are there parks? Is it safe? Is there access to healthy food? Another layer is the culture around eating. Finally, policy: How do we legislate what’s in our food supply?

On policy, what about sugary drinks? There are people who think sugar-sweetened beverages are the major contributor to the obesity epidemic. I’m not sure we know enough to say that, but certainly a daily large sugar-sweetened beverage is not a good thing for people trying to lose weight.

Has the recession contributed to obesity? It’s possible. Healthy food tends to be more expensive. That said, a factor contributing significantly is we eat most of our meals out.

This article originally appeared in our August 2013 issue.

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  • Renee Hoffinger

    Thanks for bringing this to light. I am an RD (registered dietitian) who has been shopping with my patients (mostly Veterans) for over 15 years and YES! it is incredibly effective. We also have a biweekly cooking class. Most adults are hands-on learners. Mastery of skills cements learning, increases motivation and likelihood of success. (we conducted a simple outcome study to confirm this). I would disagree that eating healthy is more expensive; perhaps slightly less convenient given our environment and learned habits. The healthiest foods are basic: beans, produce from the farmers’ market, whole grains. Cut out the Little Debbies, sodas, etc. and you will have plenty left for the real food. Have fun!

  • Leah McGrath

    Will be interested to see the results of this. I am a Corporate Dietitian for Ingles Supermarkets (by the way we typically spell dietitian w/ a “t” and no “c”) . I have been in Public Health and worked in a Clinical/Hospital setting and I would say it is easier to teach nutrition information where people shop for food.

  • http://foodconfidence.com Danielle Omar — Food Confidence RD

    I’m also a Registered Dietitian and have been meeting my clients in my “office” at the local Whole Foods for years. Although some clients are concerned as to privacy, it’s a very effective way to teach people about food and ingredients. You would be amazed at how many people cannot identify greens like kale, Swiss chard, and collards or who have never seen a parsnip or other common vegetables. It’s a great learning experience and invaluable in my private practice.

  • Barbara Ruhs

    I’m so convinced about this idea that I left my job across the country as a Registered Dietitian at Harvard University to pursue my dream of working as a supermarket dietitian. As a corporate dietitian for a locally-owned grocery chain, it’s exciting to reach millions of customers with nutrition education messages each week. Retail strategies can have a powerful impact on improving public health – this needs to make good business sense and collaboration with the food industry is essential. Thank you for writing about this!

  • Amanda Powell

    While I completely agree that hands on coaching in an environment where people actually purchase food is an extremely beneficial platform, I would like to bring to light the comment “rendering the benefits of seeing a dietician minimal”. I think it is unfair to say that meeting a dietitian in an office setting is not helpful, there is plenty of research proving the effectiveness of nutritional counseling on obesity. I personally can speak from experience – I am a dietetic intern graduating in 2 weeks, who has also struggled with obesity my entire life. I have never had counseling in a grocery store setting (granted this is an area that I have long considered making a part of my career), and I have managed to lose a significant amount of weight and improve my lifestyle. That being said I appreciate the research and I think it is fantastic to have more supporting information for our field! However we clearly must continue to prove ourselves and our effectiveness to others.

  • http://www.pieholeblogger.com/ Pie Hole Blogger

    I disagree that eating healthy is more expensive. I’m a dietitian and no mathematician but… if you buy food like dried lentils or beans and used that as your protein with some in season vegetables (or frozen) – not organic or free range or free everything else, and cook up some pasta or rice, you could easily make 4 meals here for < $5 total. Definitely nothing wrong with having some meat, buy a whole chicken on sale (~$4) and cut it up yourself. Cook the meat into casseroles or sauces like spaghetti to make it last longer – add veggies to all the dishes to extra fiber. Use the chicken frame to make a soup – throw it in a pot with water and boil it for 1-2hrs, easy. There are also good meat pickings on the frame and you can throw in a few vegetables too, voila, more food from something you would have thrown out. For more tips and diet/nutrition research, I write a blog at: http://www.pieholeblogger.com/

  • Susan Nicholson

    I’m an RDN in Atlanta and write a menu planning column (7-Day Menu Planner) and I’ve yet to see or hear of an RD with any supermarket in metro Atlanta. I’m sure they must be here, but where? Publix and Kroger dominate the market here and as far as I know, Publix has maybe one RDN in it’s corporate office in FL. As for Kroger’s, I’d like to know if any RDN’s are in this area and if they are here, I’d sure like to meet them.