Becoming a Dietitian: Nutrition Q&A + More with Christina Constantinou
Updated: Nov 15, 2022
Three Things We Dive Into In This Episode:
Failure, pivoting, and the winding road to becoming a Registered Dieitian
The difference between nutritionists, dietitians, and therapists.
Why we DON'T focus on the pursuit of intentional weight loss at our practice
📘Resources
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Pursuit of Intentional Weight Loss - A study by Caitie
📌Episode Highlights
[01:38] Kindness for Yourself
Take a quiet moment to be kind to yourself and spread that kindness with each other.
Being kind to yourself can give you the energy to do things and build good relationships.
[12:03] Who is Christina?
Christina Constantinou is a registered dietitian with experience working in different roles. She is a clinical dietitian and fills an outpatient role at Full Soul Nutrition.
Her Greek origins are a significant part of her identity.
Many would describe her as a warm, cozy, and down-to-earth person. People often find themselves comfortable talking to her.
Christina’s work as a dietitian brought out the best of these characteristics within her.
[15:41] The Many Hats of a Dietitian
As a clinical dietitian, Christina works in an inpatient setting at a hospital alongside doctors and other dietitians.
She counsels patients whose treatments include diet and lifestyle changes. Usually, she would only have a short time with them.
Christina works one-on-one with her patients for an hour each at Full Soul Nutrition. She discusses several different things regarding nutrition and better health.
The counseling skills she honed as a clinical dietitian carry over in her outpatient role.
Christina first was a relatively new dietitian when the pandemic hit. She learned to be adaptable and work well under pressure.
[21:24] Step-By-Step Guide to Becoming a Dietitian
Christina’s journey to becoming a dietitian was one of her biggest challenges.
The first step is to take prerequisite nutrition and science courses in your undergraduate studies.
The next step is to apply and match with a dietetic internship and complete hours of supervised work.
To match for an internship, you have to apply to different offered programs and rank them. There's a 50% chance of matching with your preferred program.
Lastly, you must pass your board exam to become a registered dietitian.
[25:30] Overcoming Obstacles
One of Christina's terrifying moments in her journey was when she didn't match with any of her preferred programs.
Fortunately, she found out that she could apply for programs that hadn't filled their spots. She applied everywhere she could.
Christina matched with a program from home and moved her whole life from New Jersey to Missouri.
Despite the change, she completed her internship and passed the board exam on her second try.
Christina and I both found that the real learning starts once you begin your career as a dietitian.
[32:03] Christina’s Internship Experiences
Christina had to move to Missouri at 21 years old and face terrifying challenges alone. Despite that, she found it was one of her best decisions.
Christina’s struggles made her stronger. What she thought was the end of the career she dreamed of became the beginning of her journey.
She learned to be more sensitive and find value in her experiences. It's hard to do what's best for you, but Christina persevered.
Christina: “Taking each day by day and really finding value in each of these experiences and everything that was happening in my life at that time. Professionally, personally, and spiritually, all of these things made me so much stronger. It made me such a better clinician.” - Click Here To Tweet This
Christina had thought she was an incompetent dietitian because of her failings. Similarly, I also faced failure in the form of other people's judgments.
Our failures don’t define our abilities as dietitians. Instead, it built our resilience and taught us to grow stronger.
[42:46] Defining Dietitians
Dietitians vs. Nutritionists: dietitians must be licensed or registered to practice. However, nutritionists are not regulated.
Dietitians vs. Therapists: therapists often work to understand the reasons behind your behavior, thoughts, and feelings. They take action to improve mental health.
Dietitians won’t psychoanalyze you. Though there may be overlap, they focus on proper nutrition for better health.
Dietitians educate their patients about nutrition and explore their relationship with food and their bodies.
It’s okay to have a therapeutic relationship with your nutrition counselor. Working as a dietitian goes beyond teaching what’s healthy and not.
[50:31] Weight Loss and Better Health
Restriction of food is one of the most consistent predictors of weight gain. Focusing on weight loss can mean focusing on shame.
Restrictions stop you from being your whole self. It promotes negative emotions rather than a positive mindset.
Christina: “If the end goal is supposed to be positive, how are we going to get there with all of these negative emotions and negative steps? So I think shifting the light and shifting the mindset of noticing and realizing that if you're going to be at your most positive and best self, you have to do so in a positive way and in positive mindsets.” - Click Here To Tweet This
Remember that weight is not a reliable indicator of health. It’s more important to look at behaviors.
Caitie: “Weight is not a behavior, individuals and an individual's body shape or size does not tell you anything about how they live their lives and how they do or do not intend to pursue health.” - Click Here To Tweet This
Society today is fatphobic; this stigma negatively impacts your health more than weight.
Stay tuned for part two of this episode, where Christina and I answer more of your questions!
About Christina
Christina Constantinou is an Associate Dietitian at Full Soul Nutrition and a clinical dietitian. She's a registered and licensed dietitian, a certified Intuitive Eating Counselor in Training, and has a Master's degree in Health Communication and a Bachelor's degree in Nutrition Science. Her individualized approach to nutrition helps her educate and empower people's relationships with food.
Connect with Christina and learn more about her on Full Soul Nutrition’s website.
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Transcript
Christina Constantinou: Having lived through the pandemic and having worked as like a health care provider during the pandemic, it's just everything's changing right in front of your eyes and all you have to do is adapt. There's really nothing else that you can do. Being a relatively new dietitian when the pandemic hit, that was the scariest thing ever, just again, walking into a room with three doctors that have face shields and masks on. All you can see is their eyes, and you're like, “hi, I'm here to talk about nutrition.”
Caitie Corradino: Welcome to Whole, Full and Alive, a podcast exploring the art and science of falling in love with your life, with your story and with who you truly are underneath your titles, your resume, your relationship status, and your bank account. I'm Caitie Corradino, a registered dietician nutritionist, certified fitness and yoga instructor, eating disorder recovery coach, Reiki healer, and founder of Full Soul Nutrition, but underneath my titles and resume, I’m a big fan of kitchen dance breaks, early mornings, all things chocolate truffles, world traveling and serendipity.
I'm here to share no bullshit stories and actionable tools to help you feel unshakably worthy. You have everything you need within you to feel whole, full and alive right here, right now. Let's get into it.
Hey there, welcome back to another episode of Whole, Full and Alive. I am coming to you from Denver, Colorado. It's Tuesday, November 1st. I went to the Lizzo concert last night. It was amazing. My eyes are very heavy right now, as I'm speaking to you, the most worth it kind of heavy ever though. I love, love, love, love, love Lizzo. I think she is just an icon in every sense of the word. This episode is not about Lizzo and why I love her, and I could probably do an episode about Lizzo and why I love her. But I'll try to pull myself over and not talk too much, but actually am feeling called to share one thing about the concert last night before I dive into today's episode.
Something she said that just really struck me in how profound it was because it was so simple. She said while she was on stage, in the middle of one of her songs, she was like, “hey, when was the last time you said something kind to yourself? Seriously, when was the last time you actually said something truly, legitimately kind to yourself?” She was like, “my challenge for you right now is to close your eyes and say something super kind to yourself about yourself.”
“If you can't think of anything, just say,” I think she said something like, “you're beautiful, and you are strong, and you can do anything,” something like that. She was like, “now, open your eyes. That level of kindness, that level of care that you just gave to yourself, go and give that to somebody else.” So as soon as you're fully filled up with your own kindness, with your own love, now go and give that same attention, that same kindness, that same sincerity to another person, just one other person.
She was like, “because that shit, that shit expands. That's gonna magnify, like the good energy that we have in the world.” Just you saying something kind to yourself and then using that to kind of fill yourself up and then taking that and giving it to somebody else, and it sounds very much like a on the surface, something like Mr. Rogers or like Barney would say. But what it's delivered by someone like Lizzo, it’s, first of all, more people are gonna hear it because she's freaking awesome, and the way she delivers things is amazing.
Also, it just reminds you that really is something that we can all do. We really can take a quiet moment to close our eyes and just say something kind to ourselves. Being kind to yourself is not being complacent. Being kind to yourself is giving yourself the energy to be able to do the things that you actually want to do, rather than the things that just quiet your inner asshole for five minutes.
Being kind to yourself and being on your own team gives you the ability to enter relationships that are actually good for you rather than the ones that just, again, kind of quiet the inner asshole. You don't settle for breadcrumbs, because when you're on your own team, you don't need breadcrumbs for other people. You only need good, juicy, fulfilling relationships. So yeah, a message from Lizzo at her Halloween concert in Denver last night that I was lucky enough to attend, just feeling called to share that with you in today's intro.
Now, let's get into to today’s episode. It’s a special one, and let's see if I can like smoothly transition my way into an intro after that little rant about Lizzo. So today's episode is special. Today's guest is my associate dietician, Christina Constantinou. When I say associate dietitian, I mean that she is the other dietitian who sees clients at my private practice called Full Soul Nutrition.
So in other words, Christina is the first person that I've ever hired as an entrepreneur in private practice. Christina is the other person that my clients have the opportunity to work with when they come to do one-on-one work at Full Soul Nutrition. So Christina is also a registered dietician nutritionist and a certified intuitive eating counselor.
She works in Outpatient Nutrition Private Practice at night, and during the day, she works in clinical dietetics, so she works for a hospital in both their inpatient and outpatient units there too, I believe. So she's a very well rounded dietitian, lots of knowledge not only about eating disorder recovery and intuitive eating, but also a good degree of knowledge about medical nutrition therapy and working with people in various stages of hospitalization, which is very interesting.
She'll talk a little bit about that. Let's see, how can I relate this to Lizzo and kindness and all of that. Well, I think the obvious thing is that Christina is an incredibly kind person. She has a very, very warm energy, and that is the reason why I was so confident about hiring her. Yes, she has credentials and education and a genuine interest in practicing holistic nutrition in the same way that I do, which is very important that her mission and values were aligned with my practice.
But also, Christina is one of those people that sprinkles kindness around. She is definitely one of those people who you can tell is comfortable enough with herself that she is not threatened by other people, and is kind enough to herself that she has energy to be able to give to other people, that is something I think I say at the beginning of the episode. She's just a very, very cozy person.
As someone who doesn't have all that much experience hiring that many people and as someone who also went to school for nutrition science and not for hiring an HR and things like that, I really did have to kind of make up my own interviewing process and kind of work my way through the process of finding an associate who I felt comfortable bringing into my practice.
I'm so thankful that I found Christina because she does have both the tangible and intangibles that I was looking for in a teammate at Full Soul Nutrition. I'm so excited for you to meet her today.
If you are interested in becoming a registered dietitian, this is going to be a particularly important episode for you to listen to because we actually talk a little bit about the process of becoming a registered dietician, and Christina talks a little bit about some bumps in the road that she hit while she was trying to become a dietitian, and really courageously and thankfully shares about an experience she had with rejection from a school and how that kind of made her reroute, and how that also changed her life for the better in a lot of ways.
Christina and I were planning to only talk for like a little bit about her journey towards becoming a dietitian, and then we're gonna dive into nutrition Q&A based off some questions that we received on Instagram. But we ended up talking a lot about her journey to become a dietitian, like for a while, and we have a really nice conversation about failure and trusting the path and reframing this concept of everything happens for a reason, because that's not helpful, right?
But yeah, it ended up being a really good conversation with a lot of good nuggets to take away. So that is going to be the first part of the episode and then we do a little bit of the Q&A. Towards the end of this episode, we start answering some questions that we received on Instagram, but we're actually going to finish answering those questions in a part two that will be released on Wednesday this week.
This is going to be a two parter. Christina will be on two episodes, and we're also going to have two episodes released of the podcast this week, which is very exciting. One more thing before I dive into this episode with Christina, I want to let you know that next week. Next week, Thanksgiving week, we are releasing an online course. Now before you run away from this word course, I want to say that it isn't like this super dense thing with 90 minute long lectures and modules and things like that.
This is actually a really action packed, experiment-based, journal prompt-based kind of online course with just some really short but super juicy modules and audio things for you to listen to you. This course is called Whole, Full and Alive because it's meant to accompany this podcast.
If you like some of the concepts that we're talking about on this podcast, if you're interested in working on nervous system regulation, self worth, body image, intuitive eating, could nutrition, healing your relationship with exercise, all the different things we talk about on this show Whole, Full and Alive, the simple, digestible, yet palpable and juicy online course is going to be for you.
It's gonna help you create energizing routines and rituals that actually feel good that don't have anything to do with rigid and restrictive dieting. It's basically a way for you to work on your health and wellness, while still healing your body image and regulating your nervous system and things like that. So I'm really excited for that to be launched next week. Look out for it, definitely doing a sale on it for Black Friday.
With that, let's get into my interview with my amazing associate dietician, Christina Constantinou. Christina, thank you so much for being here today.
Christina: Thank you for having me.
Caitie: So this is so similar to what we do every other week on Zoom, but we're just recording it now, which is really exciting. It's been the best to have a team member. Being a solopreneur is pretty damn lonely. Sometimes I've got my little networking groups and things like that, but sometimes I just want someone in my corner who's doing the exact same thing as me.
It's been so, so, so nice to have a teammate in Christina, and I'm so excited for you all to meet her right now. So, Christina, before you tell us more about what you do as a dietitian, please tell us who you are.
Christina: I'd love to. Firstly, thank you for all the kind words. The feeling is very much mutual. I've loved having someone in my corner as well, so so happy to hear you say all those nice things. But who I am as a person, I would say the first thing that comes to mind anytime somebody asked me that question is I'm Greek. It's a huge part of my identity culturally and just like spiritually as a person.
My parents immigrated to the US when they were in their 20s, and so it really is a huge part of my life. Greek was my first language. I was like that little preschooler that didn't speak any English in the States when she first came to school, so huge part of my life. I lived in Greece for a couple years, so that really is like a huge part of me. Then apart from that, I would say I am obviously a dietitian.
That's also a huge part of my identity, but apart from that, I would like to think that I'm like a warm and bubbly person. Those are like words that have been used to describe me before.
Caitie: Own it, just own it.
Christina: But yeah, I would say those are probably like the biggest parts of me.
Caitie: Yeah, I also because I interviewed and hired Christina. I feel I can speak to who she is beyond what she does. Christina is a very just down to earth and just comfortable, cozy person. When you're hanging out with Christina, you don't feel judged, and that is a really important thing. When you're spending time with Christina, you feel like you can just be yourself, and she's not going to be fazed by it.
Working with me, slash for me is not something for everyone. I'm a lot. I am a lot. Christina is just such an anchored person that I can be like, “hey, we're changing everything. We're burning everything to the ground, scratch the whole plan,” like just about every week. She is just so go with the flow, so calm, so centered, that she can be along for the ride, and I absolutely love it.
I think we're a really good team in that sense because if we were both like me, I'd be insane. Maybe if we were both like you, Full Soul Nutrition wouldn't exist. So we really need this sort of yin and yang, and I feel like we're just such a good team in that sense.
Christina: I totally agree. Again, thank you for gassing me up and saying all of those nice things. Cozy is like my all time favorite word, so for someone to tell me that I am cozy is just like I could cry.
Caitie: I love that so much yeah, and she was just wearing really like somehow super cozy looking clothes but also very fashionable. Your sweaters are cozy but also just so much more fashionable than the way I dress. I'm sitting here in tie dye pants and a crop top on October 18.
Christina: Own it. Own it, girl.
Caitie: Owning it. So beyond who you are Christina, what do you do? What do you do in the world?
Christina: I am, as we all know by this point, a dietitian, but I like to tell people that I wear a lot of hats as a dietitian. I am a clinical dietitian by day and then I am an eating disorder, holistic dietitian counselor by night, so I do wear kind of a lot of hats in the nutrition world. All of those nice things you said about me about being an anchor, I feel like I owe it to being a dietitian and to my journey of becoming a dietician, so I'm excited to talk about that, too.
Caitie: Yeah, so what do you do as a clinical dietitian versus what you do as like an outpatient counselor focusing more on eating disorder recovery and holistic stuff?
Christina: Yeah, so as a clinical dietitian, I work in an inpatient setting. So in a hospital, on a team of seven dieticians — I work for pretty smaller hospital. We're a level one trauma center, and we get a lot of traumas. So sometimes my day is full of just traumas essentially, and patients that aren't eating, and I have to manage their tube feeds if they've come in and are put on a ventilator, and can't eat by mouth.
Some days, my day is counseling a newly diagnosed diabetic, or somebody who has hypertension and doesn't know how to treat it with diet and lifestyle changes. Sometimes it's a mixture of the two, so I see a lot of that during the day. Then in the evenings, I am in an outpatient role at Full Soul Nutrition, and so I work with clients one-on-one in a completely different setting than the hospital, right?
I would say in the hospital, I probably spend about 10 minutes tops with a patient, and then as a counselor, I spend at least 60 minutes or 55 to 60 minutes, one-on-one with my client, counseling them on whatever they need, and that could be an eating disorder. It could be just learning how to heal their relationship with food. It could be a multitude of different things.
So it's very black and white, my day and night jobs, and so it's interesting. I mean, it's great, because I have gotten the world of experiences in the past couple of years as a dietitian, but very, very different roles.
Caitie: Yeah, I mean, there is that so much that's different about working in inpatient clinical setting, and then working, obviously, in the outpatient counseling setting. Also, there are some things, I mean, I worked inpatient for a little bit. It was a brief stint, but I did do it. There are some things that you learn from inpatient clinical dietetics that you can carry over into your role as an outpatient counselor, and I'm curious, like, what are those things that you think can carry over?
Christina: Yeah, I would say a lot of my interviewing, like motivational interviewing skills and my counseling skills have really come from my inpatient settings, since that was my first job right out of school. I mean, they teach us that in school, right, like how to interview somebody and how to have like a counseling session. But I think once you're fully immersed in it, and once you step into your first role as a dietitian, you never really know exactly how to do that.
So for me, I stepped right into the hospital and right into an inpatient setting, and so I had to quickly adapt and learn how to talk to these people. So I think a lot of my counseling skills I've kind of developed in the hospital, and I've definitely carried them over with me in my outpatient role.
Caitie: Oh my gosh, there's nothing scarier than going into your first patients. I remember it clear as day like the first time I had to go into someone's room, due to just have a triple bypass. They were like, go talk to him, and I was wearing my white coat for the first time. It's still like crinkly from like being folded up, and I'm like, oh, my gosh. When you're just thrown into that, you have to become so comfortable talking to strangers about really personal things, and you have to become comfortable holding space for people in that capacity.
It's not easy. The only way you learn is by doing, for sure. But if you I think if you can do that, you can counsel someone in that setting, if you can, oh my gosh, the worst is when you walk into a room, there's like three doctors in there, oh my gosh, with patient, and they scowl at you. If you can do that, you can do anything. So I feel like that skill of just throwing yourself into a patient's room or throwing yourself into a shark tank of three doctors that are observing the patient, like what can't you do after?
Christina: I could not agree more and I will say like having lived through the pandemic and having worked as like a health care provider during the pandemic, it's just everything's changing right in front of your eyes, and all you have to do is adapt. There's really nothing else that you can do. Being a relatively new dietitian when the pandemic hit, that was the scariest thing ever.
Just, again, walking into a room with like three doctors that have like face shields and masks on, and all you can see is their eyes, and you're like, “hi, I'm here to talk about nutrition.”
Caitie: I can't even imagine being in the hospital during that time. Yeah, I mean, adaptability is probably a huge skill that you pick up, and you have to be adaptable when you're counseling someone for an hour. Anything can happen in that space, in that time. An hour's a long time to be sitting face to face with someone having a personal conversation with them. So yeah, yeah, thanks for sharing that.
So I always ask my guests, what is a challenge you've overcome in your life that has brought you to where you are today in your career, that has brought you to doing the thing that you do? You and I are going to talk about something specific today, because before we got on the Zoom call, I put out a question sticker to Instagram asking people what nutrition questions do you have.
One of the questions that came up is what is the difference between a nutritionist and a dietitian, and that inspires me to ask you about the process of becoming a dietitian, because I know that was a challenge for you. It was a winding road and a story and definitely one that brought you to where you are today, not only in your professional life, but also your personal life. You can definitely speak to that. Yeah, so take it away.
Christina: Yeah, for sure. I love sharing my story, so I can sit here and talk about it all day. So please stop me if I'm rambling. So for those of you who don't know about how one becomes a dietitian, I will touch a little bit on that. But it certainly was like the biggest challenge for me thus far in my life, going through the process of becoming a dietitian and landing where I am now in my career.
So again, the process of becoming a dietitian is a long one, and no one really talks about it enough, so I'm going to do that. Starting with, you have to have undergraduate like prerequisite nutrition courses. You cannot move forward until you have those. So for a lot of people and for me, I went into college not knowing what I wanted to do. I was undecided. I was like, I'm just gonna figure it out, right?
That's what like college is for, and I somehow landed in a nutrition course. Eventually, someone told me that like dietetics was a thing, and I just kind of fell into it. I mean, of course, I love what I do, and it all happened very like serendipitously. That's not a word.
Caitie: Absolutely a word.
Christina: But you essentially have to have all of these nutrition and science courses under your belt before graduating, and it could be from a four-year program or a two-year program, whatever it is. You have to have these courses done. After having these courses done, you then have to match to a dietetic internship, is what it's called, and I'll talk a little bit more about what that means. But you have to match to an internship and complete 1200 supervised hours.
Caitie: Unpaid.
Christina: Yes, unpaid. You're basically paying them. But 1200 supervised hours before you can sit for your board exam. So the nutrition courses are a prereq for the internship, and then the internship is a prereq for the board exam. You cannot take the board exam without having done those things.
Caitie: You also need your masters now too.
Christina: Now, you need your masters. I mean, both of us have our masters, and we were kind of grandfathered into that but moving forward if you have the decision to have your masters. So that is the chronological order of the way things have to go to become a dietitian. So your senior year or your last semester of whenever you're fulfilling these courses, oftentimes there's a course designated for the matching system and for preparing you for the dietetic internship.
I remember being like so terrified my senior year of college. All of my friends were doing business and having the time of their lives their last semester and here I am taking 18 credit hours with organic chemistry and learning how to apply for the dietetic internship. So basically, they tell you that you have to apply to these programs. The way that it works is if you're familiar with residency programs for doctors, it's essentially an algorithm.
You rank the programs that you want to go to, and they rank you. Then you get put into an algorithm, and you either match or you don't match, same thing for dietetics. So we typically are in this course where they tell you that there's a 50% match rate, and there's a 50% chance that you'll match, and there's a 50% chance that you won't match. Those are your odds. So you apply to your programs. They essentially rank you, and then you either match or you don't on Match Day.
Caitie: Ah, match day. I have [inaudible] just thinking about my match day, but anyway.
Christina: Oh, me too. So Match Day rolls around, and essentially, you open your email and you figure out if you've matched or not. I opened my email on Match Day and didn't match. I had applied to all programs on the East Coast where I had wanted to stay. I went to Rutgers undergrad, and I wanted to stay at Rutgers. I was open to other places on the East Coast, but I wanted to stay in New Jersey ultimately. So I was petrified.
Tears were had, and no one really prepared us, or at least, I felt like no one really prepared me for what happens if you don't match. So I was terrified on Match Day after opening that email and realizing like, okay, now what. So after some like crying, soul searching, whatever, I reached out to a couple professors and reached out to some people that I had known from the previous graduating class.
There's apparently or, well, there is something called scramble day, the day after a match day where all of the programs across the country that have not filled all of their spots, because remember, it's an algorithm and so you fill these spots. They send out a mass email saying we have X amount of spots in our programs, please apply. So I did just that I applied anywhere and everywhere.
I had decided that I wanted to go, I wanted to pursue this, and I wanted to be in a dietetic internship the following year. I mean, you could always take a gap year, and there's options for people, but I knew that this was what I wanted to do. So I applied everywhere in the country. I think I applied to every single school on that list, and I matched second round, essentially, to a school in St. Louis, Missouri, which prior to that day, I did not know existed.
I then picked up my life two months later, and moved to St. Louis, Missouri, completed my dietetic internship and sat for my board exam, failed the