Anne-Julie Tessier, RD, PhD
Co-Founder Keenoa
We sat down with Registered Dietitian Krystel Dubé from Équipe Nutrition, one of the largest groups of dietitians in Quebec that has integrated Keenoa into their practice. We wanted to learn more about her expertise and Équipe Nutrition’s innovative approach to nutrition counselling through the use of technology.
This article is published with the permission and by the wishes of the client discussed.
Many clients have benefited from Krystel's nutrition expertise, however a particular case of one client with familial hypercholesterolemia stands out.
This client came to her office at the end of her rope. Her blood low density lipoprotein (LDL) and total cholesterol values were high for a few years now. The client had consulted with dietitians in the past to normalize these levels with little success.
As always, Krystel began her meeting with a nutritional assessment to learn more about her client's medical history and general eating habits. To her suprise, Krystel realized that this client had an overall healthy diet and lifestyle. For example, her diet was mostly plant-based, including a relatively low intake of saturated fat and high intake of fiber. This client was active, and was sitting at a healthy BMI.
This initial assessment was not enough to uncover the root of the client's high lipid levels and no specific and effective nutritional intervention was clear. Therefore, Krystel's next course of action was to use Keenoa to deep dive into her clients eating habits.
"Keenoa allowed me to quickly and efficiently search for precise data to give better direction to my nutritional approach"
Besides Keenoa, other options for dietitians to collect detailed nutritional data is often time consuming and impratical. "Filling out a conventional food diary (paper and pencil) takes too much time for the client and the dietitian." Krystel tell us. "In private practice, we don't have time to calculate everything by hand, that would take hours and hours."
Being able to analyze her client's diet in more depth was required so Krystel could work together with her client to determine which aspects of the diet could be improved on. To do this, it was clear that her client had to keep a food diary to capture her food intake in a precise and effective way. Therefore, Krystel asked her client to use the intelligent mobile food-diary, Keenoa.
After her client carefully filled out her Keenoa diary over one week, Krystel discovered patterns through the automatically generated comparison of food intakes over several days within the Keenoa dietitian interface. “It was clear we could do more.” says Krystel, despite that the initial general assessment suggested that her client's diet was adequate.
Krystel decided on a nutritional interventons which would guide her client to increase her intake of soluble fiber, soy protein while decreasing her intake of saturated fat. "This type of rigorous yet efficient nutritional intervention is at the heart of the approach at Equipe Nutrition. I completed 3 one-hour follow-ups with this client during which we incorporating the principles of the portfolio diet."
Over a month and a half, Krystel worked side-by-side with her client. Krystel followed her client's eating habits over a few days each week, and then reviewed the Keenoa food journal together at each meeting. During these revisions, they looked at the visual and detailed food diaries to identify food sources that could be modified and improved. Krystel also found food and meal alternatives according to the tastes and preferences of her client.
Krystel suggested that her client should have a blood test after 3 months of adopting her nutritional intervention. The client took this advice, and three months later received a blood test. For the first time, the client reported a normal blood lipid profile!
"My client wrote me an email telling me that her lipid profile was normal after all these years. She didn't believe it..."
It is well known that statins, drugs frequently used to treat high cholesterol, are the most powerful in lowering levels of LDL cholesterol. Through her nutritional intervention using Keenoa and integrating the portfolio diet, Krystel was able to reduce her client's cholesterol by 39%, the middle of the range of effects observed following statin treatment [1,2]. Here are two randomized controlled studies documenting the effects of a portfolio diet: [3,4].
This case study supports the benefits of a professional nutrition intervention with a dietitian. Prevention is the approach to adopt for a healthy population and begins with changes in eating habits that can be sustained over the long term. Always consult a registered dietitian for personalized nutritional guidance.
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