Plant-Based Programs in Healthcare, with Lily Correa

Eating a plant-based diet is one of the best ways to reduce your risk of disease. A pattern of eating that emphasizes vibrantly colored fruits and vegetables packed with vitamins and minerals, as well as heart-healthy whole grains, fiber-filled legumes, and healthy unsaturated fats from nuts and seeds has been shown to promote a healthy lifestyle and reduce risks of heart disease, cancer, diabetes, and other serious medical conditions. Naturally, the healthcare industry is beginning to incorporate plant-based programs and meals as part of a more holistic approach to medical care. Bellevue Hospital in New York City has recently established The Plant-Based Lifestyle Medicine Program, designed to help people improve their health by switching to a plant-based diet and active lifestyle.

So, it was really fun to sit down and chat about the latest trends in plant-based programs in health care with my friend and colleague, Lily Correa, MA, MPH, RDN, DipACLM, registered dietitian nutritionist at Bellevue Hospitals Plant-Based Lifestyle Medicine Program. Lily holds a Master of Public health degree with a concentration in Nutrition from Loma Linda University. She worked as a dietitian and Bilingual Health Educator at the Preventative Medicine department at Kaiser Permanente in California, before pursuing health supportive culinary arts studies at the Natural Gourmet Institute in New York City. She is also a recent Diplomate of the American College of Lifestyle Medicine. Lily is passionate about plant-based nutrition and firmly believes that the kitchen is the greatest tool from which to promote optimal health and wellness. Check out my live recorded interview with Lily below, as well as the full transcript of our interview, in order to learn more about how she is helping people live their fullest lives, one plate at a time.

Check out the transcript of my interview with Lily below.

Plant Based Programs in Healthcare with Lily Correa

Things you will learn in this episode:

• Lilys work as a plant-based dietitian
• How plant-based diets are used in clinical settings
• Tips for going plant-based
• Recipe conversions with patients
• Meeting patient criteria for Bellevues plant-based medical program

Follow along with Lily and her recommended plant-based resources:

• Website
• Instagram

Interview: Plant Based Programs in Healthcare with Lily Correa

Check out the transcript from my live video interview with Lily Correa.

Sharon: Hi Everyone, this is Sharon. Thank you for joining us; Im really excited to have a special guest with me today, Lily Correa. Hi Lily, how are you doing?

Lily: Good, how are you?

Sharon: Im great. Its really going to be fun talking with Lily because she is a fellow plant-based dietitian, and she is the dietitian at Bellevue Hospital Plant-based Lifestyle Medicine Program in New York City. So, she has a really cool job, and this is a program that is the first of its kind. So were really excited to learn more about her work in plant-based nutrition and how powerful it is in helping people prevent and treat chronic diseases. So were hoping to get a little advice from Lily and some of her best tips, and also to learn more about what hospitals are doing to provide healthier food and healthier lifestyle programs. As we know, hospitals have had a bad reputation in the past for having unhealthy food, right? Welcome Lily, and I wanted to first kick it off by letting you tell us a little bit about yourself and how you got started in plant-based nutrition.

Lily: Great, thank you! Well, I actually grew up with a great example, my grandpa was a 7^th Adventist pastor, and for those of you who dont know the 7^th day Adventist religion is based around vegetarian nutrition as one of the tenants of the health message. So, I had an example growing up and I was interested in it through that. My family didnt grown up vegetarian, but I actually attended a university that was 7^th day Adventist for my college education, so when I got there, for the most part people were vegetarian, and the cafeteria served all vegetarian foods, so that was more of my bigger introduction to vegetarian living. What was interesting was that in that time, I was playing volleyball for the collegiate team, and during the time where the vegetarian diets for athletes and performance were looked at as inferior, but yet I was playing and seeing athletes who grew up vegetarian all their lives, and they looked pretty strong to me! I played a lot alongside some of the guys on the basketball team as well, and these guys were big, tall strong guys who made it to the final four playoffs. So, it got me questioning these things people were saying about vegetarian diets and performance, and thats one of the bigger reasons I got interested in plant-based diets as well, through athletic performance.

Sharon: Wow, thats really interesting, especially because theres so much attention around plant-based nutrition and sports now. Just as you said, when I first studied nutrition, plant-based diets were frowned upon; almost like they were risky, and now we know they have so many benefits, so thats really cool. And I also want to mention that Lily went to school at Loma Linda University, and I went to school there as well! When I went there many years ago, it was before the Blue Zones. And now we know that this university, where they were plant-based, the campus was plant-based, the little cafeteria, even the little market was plant-based, the hospital too, so they were so ahead of their time right?

Lily: All the way, and thats actually the reason I chose Loma Linda University, because they have that specialty in vegetarian diets within their nutrition program, which is different from the traditional curriculums that we see around the United States for dietetics programs.

Sharon: Right, when youre looking at studying nutrition as Lily and I have done, there arent a lot of programs where they have this plant-based emphasis, and theyve been really a leader in that field at Loma Linda for so long, so its really so cool that we got to study there. So, can you tell us a little about your work at Bellevue and how this program started, and how powerful it is in helping people?

Lily: Yeah, so I really love working for this program, I feel like I am one of the luckiest dietitians around, because as you mentioned this is the first plant-based lifestyle medicine programs in a safety net hospital. I love that Bellevue hospital is the first public hospital in the United States, established in 1736, Im actually sitting in a conference room full of pictures behind me of all of these different eras throughout Bellevues history, and I love that the first plant-based lifestyle medicine program is within this hospital. So, I also have a literature background, and that humanities speaks to me in that sense too, being able to be a part of such an innovative program. One of the reasons I love working in this program is because I get to work alongside 4 amazing physicians and a health coach, and that makes up our team of 6.

Sharon: So, if someone was interested in going to that program, what would be their first steps?

Lily: So, we have a hotline actually, that we have on the website. Really if you just go, type in plant-based lifestyle medicine program Bellevue, youll get information sheet from NYC Health and Hospitals website, and theres a number listed there thats our hotline that we set up for self-referrals. So, the way the patients come to us is through this hotline, they get on this waiting list, we actually had 688 people on the waiting list. The program is nearing its first year, we started on January 16^th of this year, and we had projected to see 50-100 patients within the first 6 months, and we actually exceeded that goal, we ended up seeing 173 patients, and we still have 688 on the waiting list, so were thrilled that there is a high demand for this type of program in New York.

Sharon: Wow, so can you tell us a little about what it would be like to be in the program? What are the kinds of things the patients are learning, how are they using the diet to help them in their lives?

Lily: Our patients come to us, the criteria to come into the program is known cardiovascular disease, type 2 diabetes, overweight, obesity, hyperlipidemia, hypertension. So, how they come into the program first is theyre going to have the initial assessment with one of our physicians. Dr. Michelle McMacken is the director of our program, and so she is one of the 4 physicians that we have. Plant-based clinic happens on one day, so Wednesday afternoons its set aside for the plant-based clinic. Patients come in, they have a 40-minute initial assessment with the doctor, and the health coach and I sit also in the clinic, in a room where the doctor actually walks the patient over to us and does this warm handoff, so its very personalized attention, you meet the patient, we schedule our initial assessments which are both for an hour, and what we try to do for the patients is, we try to also accommodate schedules, but we looking at trying to see them every 2 to 4 weeks. Research shows that in order to make lasting behavioral changes, or what I like to call upgrades, it takes many patient contact hours, looking at least 14 week type of program, research shows that to make those lasting behavioral changes that people can keep throughout their lifetime.

Sharon: So, what kinds of outcomes have these patients had when theyre successful with this program? What kind of benefits have they seen in their health?

Lily: Well its really cool, one of the great things about how this program works or how plant-based diets in general too, is how at the 3 month mark, were keeping data for 3 months, 6 months, a year, and at the 3 month mark were seeing improvements like A1Cs going down. We had a patient who is one of our more remarkable cases, well call him Mr. B. He comes in is his early 40s, he has an A1C of 8.2, high blood pressure, hyperlipidemia, and within 6 weeks that A1C, we saw it go down into the 6s, and at the 6 month mark he was at 5.6, reducing one diabetes medication and getting off of one completely, blood pressure also reduced significantly. So, these are the upgrades we can see pretty quickly, just within the first 6 weeks of following this plant-based lifestyle, were seeing improvements.

Sharon: Wow, thats amazing! And you are using 100% plant-based lifestyle, right?

Lily: Right, so our approach is going to be to help patients transition into a whole food plant-based diet. Now we get patients who come in at all sides of the spectrum. Actually, one of the advantages we have is that patients come in knowing that this is a whole food plant-based program, so the expectations are there for the most part. But were trying to help patients to get to wherever works best for them. If it means that they are significantly improving how much vegetables, how much fruits, how much legumes they have in their diet, and theyre still incorporating maybe fish, maybe chicken, whatever it is once a week or so, were seeing the improvement even within just the addition of incremental portion sizes of vegetables, legumes and fruits. But the main goal is to help people transition into a whole foods plant-based diet.

Sharon: So, you really work with people where theyre at, looking at their eating style, which I always think is always really the secret to long standing diet change; really looking where youre at and making those changes that work for you. So, youre seeing these health outcomes so quickly, and I think thats one thing some people often dont realize, is that when you make a change in your diet like a plant-based diet lifestyle switch, you can see pretty dramatic changes pretty quickly right?

Lily: Yes, not just with weight loss, but I always tell people to look at how are your clothes fitting, thats a better indicator of health versus what the scale is telling you. Were looking at labs, so lots of improvement in lipid profiles, like I mentioned the blood sugar controls, blood pressure, all of those markers of better health come pretty quickly.

Sharon: Thats amazing! Can you tell us some of your tips when you work with people, especially if they have a lot of changing to make in their diet? You talked about eating more vegetables and fruits and things like that, but what are some of the things you have found successful when it comes to helping people make changes in their diet?

Lily: One of the things is really looking at first how we approach change. One of the awesome things I learned when I was doing an internship for a company called Exos. They had one of those mottos where they were talking a lot about upgrades. So I really took that on because I looked at the word change, and change to us as human beings can be a little intimidating, it can be a little bit like were creatures of habit, I dont want to change, maybe a drastic change, or it can be just an intimidating word. But when youre looking at a word like an upgrade, like when you upgrade your phone or your computer, you dont want to go back to the older model, its always a positive connotation. So, I like to begin by framing it as lifestyle upgrades. Were really looking at showing patients how very stepwise the whole process can be, and how even one step, I always like to stay that every step eventually makes a mile. Getting one portion of vegetables to lunch, or having a fruit as a snack, versus the 100-calorie pack Ritz crackers, or whatever it is. Were looking a swaps, were looking at crowding out, thats something our boss always likes to have that term, talking about crowding out the other foods, were more looking at addition versus subtraction.

Sharon: I love that, crowding out, I use that too because I think a lot of times people think of diet change as a bunch of nos or avoids, or you cant do this, but basically what youre doing is eating all this good stuff and thats filling you up, filling your plate, so you dont have room for the things that are less healthful, and I think thats a strategy that can really help people, because I really see a lot in my work that people dread these long lists of things they cant do anymore, when it comes to their diets. Do you have any other tips that you find are really helpful as people want to start being more plant-based?

Lily: Yeah, and thats one of the things that you just mentioned, a lot of people think about for example the term diet, theyre thinking about scarcity, and doing without. So, I always ask patients to approach it in not from a place of what youre not going to be able to have or what youre going to do without, but what youre going to be adding into your life. So, for me its like a food adventure, colorful, showing lots of pictures, models, were looking at this starter guide that we came up with, theres pictures in there of colorful lentil soups, and edamame dishes with rainbow quinoa, and all of these things. I ask my patients to start with something as simple as one meal, like breakfast. And were very big into oats, overnight oats, its very surprising always how that is such as revolutionary concept for people, doing overnight oats, I love it! Maybe for us, in the dietetics world its a little more like were used to eating a certain way, or we get introduced to these concepts early on, but I always find that its a surprising concept for people when I tell them about overnight oats. I show them pictures, we talk about how to do it, and then when they start doing it, they have a command on breakfast.

Sharon: I love that oats idea too, thats one of my favorite things, when youre looking for a go-to plant-based breakfast, thats packed with nutrition, not too hard to make, and you can do it so many different ways; this time of year you could do dried berries since the berries are out of season, or persimmons, or pomegranates since theyre in season, and in the summer you could do peaches, so you can have different types of fruit topping, different kinds of nut toppings, you can do it differently and use the oats as like a canvas for your other plant offerings. Do you have any other tips that really resonate with all of your patients?

Lily: Another thing, one of the barriers that people come up against is, say they want to do this, and are really excited about taking on this lifestyle, but their family is not. Its always like ok, how do I get support, because building a team around you is a huge way of being able to obtain these lifestyle upgrades and keep them. So, one of the ways that I try to help patients navigate this is by having empowering conversations with their family. Lets say if conversations about goals dont work, then we talk about recipes, this tempeh taco recipe that I have adopted as a tenant of my practice, because when I was starting to experiment more into vegetarian lifestyle back in 2012, I looked up this recipe for tacos, because I wanted to eat more tempeh. Its also my covert way of introducing more tempeh into peoples lives because I think its great! A lot of times when people are getting into plant-based they are looking at meat substitutes, maybe theyre looking at those soy crumbles, but when were looking at whole foods, something like tempeh can be used as that ground beef or ground turkey substitute for tacos. So, I have this tempeh taco recipe I always hand out to patients, and I tell them ok, how about you have a family taco Tuesday night. Whats great about this recipe is everybody knows tacos, everybody loves tacos, and people eats tacos on Tuesdays. So, I try to bring as many familiar elements into this dinner introduction as I can, to help people really bring their families into this lifestyle, or at least show them that it can be fun, it can be colorful, and tasty. We take the connotation of healthy food doesnt taste good, this recipe packs a punch, its very tasty, and its never failed me. Every patient Ive handed this recipe to, comes back and tells me this was a hit, it worked.

Sharon: Thats so great, because I asked Lily to share her favorite recipe, and shes going to be sharing her tempeh taco recipe with us, Im going to be sharing it on the blog, and youll see the recipe, a photo of it, and she tells me she shares it with every single one of her patients. I love that whole taco Tuesday thing, because I use that as well, one of my tips is to start with something youre familiar with, exactly what you just said. People think eating a plant-based diet is going to be so different, but if you just look at already what your favorite foods are during the week, if youre doing tacos its so easy to make them plant-based, like this tempeh filling or even just black bean filling, look at those foods, if you have a spaghetti recipe you love, make it a plant-based recipe. I have a really popular recipe for a lentil Bolognese, which is basically swapping out the ground beef for lentils. So just those familiar foods, just try to make them more plant based, I love what youre sharing there. So, do you have any other tips that are really working with your clients as theyre going more plant-based that you want to share with us?

Lily: Yes the other thing that I love about doing recipe development for example, are recipe conversions, we have this class we do around recipe conversions, where we have patients bring in their favorite recipe, and we do one as a class together to convert it to plant based, especially for the holidays we did one like this. And then we have them partner up and look at how they can make this favorite recipe plant based. So, swapping out a few ingredients in something they already like goes along with the concept of that familiarity. We definitely are attached to food culturally, theres traditions that we have as families that we make around food, and we dont want to lose that. Thats one of the bigger fears that I hear around patients doing something new like this, is that theyre going to maybe lose themselves or they wont be able to participate in family traditions. So, I really try to help them look at again how theyre adding into their lives, but also when were looking specifically at recipes, swapping out a few ingredients here and there, and still making it tasty. And thats one of the things that having a culinary background for me has helped a lot. Being able to read through recipes with patients and having them say, oh, well I dont have this specific ingredient in my pantry, I cant make it right now, and I just say oh, well you can just swap it with this! and it will taste the same, use a teaspoon of this instead. And this is actually my big call for our colleagues, dietitians, to really get back in the kitchen or get in the kitchen if they arent already in the kitchen. I dont know if you agree around this, but there always seems to be an expectation for dietitians to be really knowledgeable around the kitchen, and sometimes there isnt that connection. So thats one of the reasons why I wanted to go into more culinary, I did the Natural Gourmet Institute program, because I saw that really awesome connection, and that need to fill that gap for myself in terms of my career and how I can help people make that connection with food more, and that transition into plant-based foods more, if I knew more about how to help them swap ingredients.

Sharon: Yeah, thats really true, our field of nutrition should really be more culinary focused so that we can help people learn how to bring all these traditions into the kitchen. We know people are losing their culinary skills, theyre not learning it in school. I feel very strongly that one of the most powerful things you can do for your own health is to get into the kitchen and start cooking. Even though there are a lot more healthy options in supermarket stores than there used to be, its really much easier to have control of your nutrition and your lifestyle when youre cooking your meals, you can control how much sugar, salt, fat, youre adding, you can control the ingredients, you can have more whole grains, vegetables, pulses, legumes, and beans and lentils, all the things we want you to be eating more of when youre in the kitchen cooking, so I agree with you on that one for sure.

Lily: Absolutely. I also tell my patients about when theyre having trouble letting go of a certain food for example, because we are attached to certain foods. I tell them that our attachment to food is 80% here (brain), and maybe only 20% here (tongue), because our taste buds are regenerating, were making new ones every 2-3 weeks, so what we have to do is give our body a chance to adapt to the new foods. How we do this, for example, is someone comes in and says I love having a glass of whole milk at dinner time, or breakfast, and I cant let go of it because its warm milk with a piece of bread. So, I say ok, how about we start with half a glass of whole milk, and half a glass of cashew milk. So, youre getting the same texture of milk, but youre still having the taste of the whole milk. And we do it stepwise, do that for a week, and then the next week were going to try of the cashew milk and of the whole milk, and then we can switch over to different milks, maybe almond milk, vanilla almond milk for example from Trader Joes, its so creamy. I try to match it with the texture, and well work even as basic as that so we can get people used to getting off of a product that they really seem to favor and get them used to plant-based. Once theyve gone to an almond milk, or cashew milk, or whatever it is, they have a hard time even trying to go back to whole milk because you can taste the very rich different feel. Similar to when you reduce salt or sugar for a week in your diet, then you can really taste if you try to go back to it after 7 days.

Sharon: I love that, thats a really great suggestion. Well I wanted to thank Lily for joining us today, I love all of her tips and suggestions for eating a more plant-based lifestyle. Were going to be sharing her recipe for tempeh tacos on the blog, so make sure you check out the link for the blog that goes along with this interview. Im also going to be sharing a lot of resources from Lily, some links for some of her favorite resources and her program at Bellevue, so make sure to check that out on the blog. And I just want to thank you for joining us, thank you Lily!

Lily: Thank you for having me Sharon!

Sharon: So nice having you! This has been Sharon reminding you to live and eat well.

Lily was kind enough to share a delicious plant-based recipe she gives to every single one of her patients because it is such a hit! These tempeh tacos are a delicious and nutritious lunch or dinner option for anyone looking to improve their health through a plant-based diet.

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For other interviews, check out some of my favorites:

What is Biodynamics?
Eating for IBS on a Plant-Based Diet with Kate Scarlata
Plant-Based, Low-FODMAP Diets with Kate Scarlata

Image: Quinoa Corn Bean Chowder, Sharon Palmer, MSFS, RDN

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