Public Health Nutrition from Foodies in the Field
Public Health Nutrition from Foodies in the Field
Looking Forward, Looking Back through Public Health Nutrition, with Professor Danielle Gallegos
Danielle Gallegos is a Professor in Nutrition and Dietetics at the Queensland University of Technology. With over 30 years of experience, Danielle continues to contribute significantly to public health nutrition work - particularly in the areas of food security, food literacy and early childhood care. Danielle is the Director of the Woolworths Centre for Childhood Nutrition Research, an Advanced Accredited Practicing Dietitian (AdvAPD) and a Fellow of the Dietitians Australia (FDA).
In this episode we talk about what the future of public health nutrition potentially holds but also where it’s come from, and Danielle’s journey within this evolution.
For further information, check out Danielle's researcher profile at the Queensland University of Technology; and Danielle’s Linked In and Twitter pages.
The key paper related to this episode
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CREDITS
Host: Sophie Wright-Pedersen
With thanks to Professor Danielle Gallegos for her time and thoughts
The Foodies in the Field podcast would like to acknowledge the traditional owners of the land on which this podcast was made and where Danielle was speaking from, the Turrbal and Yuggera people, as well as where you may be listening from today. We pay respects to elders both past and present and acknowledge that Aboriginal and Torres Strait Islander people were the first foodies of this nation.
Sophie: [00:00:00] Hi. Welcome to Public Health Nutrition from Foodies in the Field, a podcast showcasing stories from passionate foodies about who they are and what they do. I'm Sophie Wright-Pedersen, your podcast host. On today's show, we have Professor Danielle Gallegos from the Queensland University of Technology. Who, for over the past two years, I've had the absolute privilege of having her, not just as a PhD supervisor, but also as a mentor.
Danielle has an inspirational bio to say the least, and over the last 30 plus years, she has made a hugely significant contribution to the public health nutrition field. But from knowing her personally and working alongside her, some of the most inspiring parts that I find about Danielle is her approach to work and life generally.
She's curious, creative, empathetic, insightful, extremely driven, and seems to be inspired by the potential future of the world around us (and by food itself). She's worked on many different projects with many different people and cultures, not just in Australia, but internationally as well. And brings, as she would say, a transdisciplinary perspective to the way that we work with food, which blends science, sociology, philosophy, and creativity to produce something that everyone can find their place in.
Her passion lies in food security, food literacy, and early infant feeding. And as she talks about on this podcast, she makes sure to amplify the expertise of the people and communities that she works with in this space. In this episode, Danielle shed's some light on what the future of the public health nutrition discipline potentially holds for everyone, but also reflects on where it's come from and her journey within this evolution.
Where do you see the future of the public health nutrition field going, or I guess, where would you like to see it go? Where do you think it needs to go?
Danielle: I think the future's report is interesting in that it outlines some really key capabilities that we are going to need moving forward. And when we present that work, we present it in a dystopian viewpoint and in a utopian viewpoint. Mainly because there could be two scenarios that could play out, which means that public health nutrition could look really different depending on the two scenarios. So if you think about a dystopian future, you're thinking about, there's no climate change mitigation. We've got, you know, like conflict going on we've basically, everything's kind of fallen over. We've got no health services. The way we kind of constructed it was a bit like ebola meets Covid and climate change has kind of happened. We've got no food systems, we've got no health systems, like complete dystopia.
Sophie: Which is interesting because as you're saying that, I'm kind of thinking that's not actually that dystopian...
Danielle: It's not that no, and that's why it's a little bit scary for people because you go, "that could actually happen". Like it could literally happen. So we had that scenario and then we, we thought about a utopian scenario, which is we've mitigated climate change, we've got intergenerational communities, we've got rooftop gardens, we've got food that's grown kind of in, you know, within the community. Free access for everybody, that utopian version of the world. And so think about those two worlds, public health nutrition looks different, but still uses the same core capabilities.
Sophie: I guess like maybe going back a bit like how did you get to the point of knowing what the future of public health nutrition or dietetics generally should look like?
Danielle: So it was an initiative of the Council of Deans of Nutrition and Dietetics Australia and New Zealand, which is a bit of a mouthful I know. The Council of Deans started because all the discipline leads, if you like, or all the people that were leading dietetic programs, we were kind of a bit grumpy with how, the accreditation processes were going for university programs and we felt like we needed a bit more of a voice. It was also not a lot of, there was nutrition research going on, but there was not a lot of strong advocacy around nutrition and dietetic research. So essentially all of the leads of nutrition and dietetic programs in Australia and New Zealand at the time, got together and went; we're going to set up a Council of Dietetic Deans basically. We have been able to employ a strategic projects manager, which is Rachel Boak, who has a PhD. Her work has been around us responding to various policy initiatives that come out. We're actually working much more closely with Dietitians Australia, but also the Nutrition Society of Australia, to actually think about what dietetics and nutrition looks like. So it's basically another forum in which we can actually advocate for the profession. But also for the discipline: so [00:05:00] nutrition science and dietetics.
Sophie: Awesome. And so from that, this is how you got to the Future's paper?
Danielle: Yeah, so the BDA, so the British Dietetic Association have done one. They were fairly inward looking. They weren't... they just talked to other dietitians. And we talked to a lot of dietitians for this, but we wanted to actually make it outward looking to kind of go, well, let's think what other people outside of the profession think, which is a bit challenging really, because sometimes people outside the profession go, " Oh well, what I have to say has got no relevance to you". And we want to go, well, actually what you have to say has got a lot of relevance to us, just let us talk to you. So getting some of those outsiders to talk was a bit challenging.
Sophie: And who were those outsiders? Like who were you targeting to talk to?
Danielle: People in economics, futurists, people that were, we didn't get all those people obviously, to talk to, but anybody who might have been kind of people we think were peripheral to nutrition and dietetics, but we think were actually core.
We also made sure we talked to not only professionals of long standing, you know, I'm not going to say older professionals, professionals of long standing. As well as people new to the profession. And in a whole range of different discipline areas. So not just people that worked in hospitals, but public health people and people that work in the community. So big broad range.
Sophie: I did see that you had students.
Danielle: Yep, and students as well. We did a bit of focus groups and some interviews.
Sophie: And so, from those findings and you've got this utopian/ dystopian kind of world, where do you see the future going?
Danielle: There are a couple of things that came out really strongly and some of those things we are already doing and we're doing really well. So things like, for example, we are the science translators. Right, so it doesn't matter what area of dietetics you're working in or nutrition you're working in, we have the skills to be able to translate the science, not only into messages that can be heard, but practical things that people can do. And as the science gets more complicated and complex, we need to be able to do that in a much better way. And in a way that's accessible to everybody, not just to the few people that can read and understand scientific concepts.
Sophie: So do you have any examples of like how people could maybe do that?
Danielle: Gamification: turning things into games. We one of the things that came through is for example, that you know, we need people that are media presences...
Sophie: And there's some pretty big ones out there already. But you think that there, like there needs to be more?
Danielle: Absolutely.
Sophie: And any like spaces, like any kind of niche spaces?
Danielle: Well, I don't, the thing with futuristic work is you don't know what the niche spaces are.
Sophie: No. That's fair too.
Danielle: Because they're not there yet. But the core skill remains the same. So one of the really fun ideas about doing that communication piece in a utopian environment was like being the movers and shakers behind community events that involve food. So not necessarily about the nutrition side of it, but about the commonsality side of it. But then you could be communicating the nutrition science embedded in that. You could come up with all sorts of really, really interesting creative ways to get those messages across.
Sophie: And you came up with six roles, why these six roles? And, I guess a bit more context as to what you expect them to do?
Danielle: I mean, it was a thematic analysis. So we basically said, well, this is what people said, and I've got to show you the mind map it's humongous right. We did this big mind map to kind of go, okay. And so we kind of clustered similar things together. And so one of the big things, for example, people said, we know food. We need to continue to know food. Food is our, the material, and we are one of the few professions that actually has an external materiality to it. And so if we don't know the materiality of food and what it can do and how it does it and where it grows, and how we can transform it then a part of what we do is lost. The food aficionado came from that. Like, we need to be the people that know food. Know how it works, know how it tastes, know how it grows, can you know, move and manipulate it. And in the future it would be not only, it's about future foods: insects about, you know, fake food...
Sophie: And the meat that gets grown in labs. And I guess it goes back to that thing of what you said before with communicating, we need to know food so that we can communicate with chefs like big food production, big food production companies, farmers, we come to the tables that we should be at, we can communicate on a level at the same as all those other people in the room.
Danielle: That's right. And if you think about, you know, just that [00:10:00] one scenario about being a food aficionado. So I like to think of our profession, and when I talk about our profession, I'm not just talking about dietetics. I'm talking about nutrition scientists, nutritionists, dietitians, people that do food with that science lens over the top. But there's a lot of us, right? We're not just dietitians. We are a very broad range of professionals working in this space. But if you think about, that food situation as we move into the future. You've got agricultural food systems, you've got manufacturing systems, you've got AI, because AI will be there as well, you've got, social systems.
So I think of our profession, I've talked about this before as being the parkourists. So if you think about if you've ever watched Parkour, and if you don't know what parkour is, it's, you know, those people that kind of use the, a built environment to kind of, you know, leap between buildings and they, you know, tumble and climb building walls and are fascinating to watch. But if you think about that; one they've got to practice a lot, two they don't always make their landings, but they keep going. But they've got to have confidence and courage to actually do it. But what they're doing is they're seeing the spaces between the buildings in a different way. They don't see them as a gap. They actually see it as a space to leap, or as a, they don't see it as a wall, they see it as a platform to leverage.
Sophie: That's a really interesting way of looking at it.
Danielle: So if you think about the different systems we've got at the moment, they're all siloed. We need, us as a profession, to actually jump the gap. So not see them as a gap, but actually seeing them as an opportunity to stitch them together in new and different ways and to think about, well, what does that look like?
But in order to do that, I need to understand the language of those different systems. I don't need to know everything about those systems, because that's what you want systems navigators down below. These are not mutual exclusive roles, right? So systems navigators, down the bottom, I'm gonna need to go, I need to be able to talk your language.
I don't need to know everything about what you do. I need to be able to be humble, to understand that what you are talking about is as important as what I'm talking about. Because as you know, we are all weird because we think food should be, and nutrition should be the priority and nobody else you talk goes it's a priority. We go, what about food? And they go "hmm?" But in this new kind of world, if you think about us as the parkourists, about I'm gonna jump this gap, I'm going to find that wall to leverage off and I'm going to then engage the people that I need to and have those conversations.
Sophie: And we talk so often about being interdisciplinary and multidisciplinary, but in actual fact, we need to be transdisciplinary.
Danielle: To be transdisciplinary, it's about creating something new. So I go, oh, this is what I know. And the agricultural person or whoever else will go, this is what I know. We both need to kind of put aside our professional peculiarities if you like and go, oh, that's really interesting. Oh, that's really interesting. What if we smoosh these two things together? What would we get? Oh, and all those and's rather than the but's, right? So rather than going, but that won't work. You go and how would that work?
Yeah, so multidisciplinary, we just kind of keep working in our silos and we join together. Interdisciplinary, we kind of do the, a bit of a connection, but we still retain our individual things. Transdisciplinary is we. We smoosh them to get something new. No, it's a new, it's a new thing. Any of these things, right? Yeah. Um, you know, they're not mutually exclusive, these roles, some of them you actually go, well, I'm gonna have to do that. If thinking about being a diet optimiser, I would need to know how in some cases, being equity champion.
Sophie: I was looking through like the capabilities that got pulled out of this, the manic analysis and there's 16 of them. And I was reading through them and I think like, oh yeah, these all make sense to me. And then there's some that are quite like, I don't know what the word is, but like when I read them, I was like, Ooh. Disrupting expertise and courageous and confident and like the quote you used for courageous and confident is: "we are risk averse, and navel gazing. We need to be bold and non-judgmental." And then disrupting expertise was: "collaborating with those with lived experience will strengthen what we do."
And I thought, I really like that. Like I really like both of those things. But I feel like, you know, for people who are early in their careers potentially, or even students now, that's quite confronting to be like, I'm going to disrupt expertise, or I'm gonna be like courageous. And without kind of also feeling like you are stepping over a line that might not have the best implications. Like is there some way of going about doing those types of things do you think, without it feeling too imposing?
Danielle: Really good question. I mean, I think well, I'll come back to the word humility. Right? So I mean, the disrupting expertise. Is, you know, how [00:15:00] many times during your degree did you hear you're going to be the experts in nutrition? You are the experts. You are, you are the people. We're elite. If those of us with a university degree are the elite , you know, we're a minority and we get told, well, you'll be the expert. You'll be the person that will be the expert in this. And and that's true. We have the learned experience, the book experience, the stuff that we can actually discern from science and actually then might be able to make sense of.
But I don't know how a First Nations man survives in their community with chronic kidney disease. I have not got that experience. I've not experienced racism. I've not experienced some, the level of disadvantage that many of the people that I currently work with do. And so, I'm not an expert in their lives. All I can do is go, can you teach me? Can you teach me what this is like and how can I help you? Rather than me going, this is what you need, and I can tell you exactly what to do. It's a, a shift in mindset to go, this is not about what I can teach you. It's about what I can learn from you. And then we can work together to figure out how to make it better. If you take that approach, I don't think there is a step-over mark because it's about that I'm here to learn rather than I'm here to teach.
Sophie: And I guess even like when you're saying that, and I totally agree, like I've, you know, worked in spaces where I feel, I hope that I've done that, but I feel like I've definitely taken that approach and it works really well, but also like, not just with people who we're giving diet advice to, but also like you're saying with, you know, just say people from agriculture or from other, you know, stakeholders, you know, community stakeholders, working with, you know, community centers or social workers or whoever. Like everyone's got their own sense of expertise and, and we, we do know stuff, but we don't know everything.
Danielle: And you'll never know everything.
Sophie: No, you can't..
Danielle: There's no way you'll know everything, right? And so if I'm going to actually continue to be a lifelong learner, then I'm gonna have to go, I don't know, everything. And, and as you get a bit older, you start to realise that the more you know, the less you actually know. Like, you know, I feel like I know nothing now. But I want to go back to the courage thing though. Because the courage thing's really interesting because you know, because we often say, especially to younger professionals, you need to have a passion and you need to step up and you need to, you know, lead from the front and that's really hard and overwhelming. Very overwhelming.
And we go, oh, you need to step outside of your, you know, your box and, you know, do something different. Everybody's box is different. For some people, courage is, I don't know, parachuting out of a plane that's courage, right? Other people it's just getting up and out of bed in the morning and opening the front door. So courage takes all different forms. And it really depends on where you are in your career and what your personality is to figure out, well, what does courage mean for me?
Sophie: What do you see as the biggest challenges for the future of public health nutrition?
Danielle: Well, in the immediate future, I think one of our biggest challenges, is getting recognition that we need a public health nutrition workforce. Many states over time, in the last 10 years or so, that those workforces have been decimated.
I don't think though that we can, we can't keep going. Government. Government. Government. What are you gonna do about it? Because, you know, in reality, they haven't done anything to date. We need to keep advocating for that. But, you know, I think there are other opportunities where we can build a workforce. But I think building that workforce. Uh, in particular, I think there's, a lot of our public health nutritionists are dietetically trained. Um, I think there's potentially a, a bit of, I was gonna say stigma, but I'm not sure stigma's the right word, but people that aren't dietetically trained, I don't think we've got as positive a view on their training to be in that space.
And I think we're just one workforce and we need to embrace all people with different training. I, I mean, I was thinking about when you asked me to do this podcast, one of the other things I was thinking about and reflecting on was the whole science thing. So we're scientists basically. But being a public health nutritionist is, goes beyond the science way, beyond the science.
There are lots of other discipline areas that you draw on in doing that. I think science adds value to what we do. I think it gives us a lens that really informs our critical approach to the work that we do. But equally, I think the social sciences have a role to play. And I also think being creative has another role to play as well.[00:20:00]
So my dilemma becomes then when we're trying to put all of that into one degree. What misses out? And invariably what misses out is the public health side of things or the creative side of things. So I think that's going to be, moving forward is going to be something we're going to have to grapple with. What is, do we say our dietitian training is, and again, I don't want people to misconstrue this because I think our dietetic training at the moment is awesome because it provides us with our generalists who can then go into public health or through, and I don't want to talk about the domains because that crosses it, but you know, can work in different contexts.
Sophie: Definitely. I think it also allows us to communicate with. We work in public health nutrition, we work quite closely with the medical sciences like you do, end up working quite closely by having that dietetic science, health science training. You can communicate, I think, a lot better or, or maybe more easily than maybe someone who's been trained in health promotion, for example, that doesn't have a medical science under.
Danielle: Absolutely.
Sophie: Like I've, I've just noticed that in my practice absolutely. Of comparing myself to health promotion officer versus me as a public health dietitian and when you read scientific language in order to inform your practice, you actually understand what's going on. So I definitely, although I would classify myself as a public health community dietitian, I still very much rely on that, I guess, clinical expertise to do what I do.
Danielle: And the last thing you would want would be somebody who doesn't have a science background arguing for population level fortification of foods for something . And not understand that if we do that, we're going to actually kill people, you know? We definitely don't want that. The challenge is going to be in is how do we round out that education in other ways? And that could be micro credentialing. It could be professional development, post-degree. It could be a whole range of things, but how do we round that out? So that people have a real sense of some of those other languages that I think we're going to need. Because if we don't have an understanding, have a, I'm gonna say we don't have to be an expert, but you need a bit of an understanding of those languages.
Food systems is a really good example. We probably touch on food systems, both in nutrition, undergraduate degree and in our dietetic undergraduate degree. Dabble in, you know, the food supply chain. Dabble in all of those, elements of the food system. And there may be some uni's out there are doing it, which would be awesome, but you know, when do we send students out on a farm? But when do you go interview a farmer to understand what it's like being a farmer? Not enough time to do that.
Sophie: No, it's not. And like I've had this thought, you know, I've talked to lots of people and we had these discussions all the time. How could we get everything that we need to know into one degree? Because, I felt like I didn't have enough public health nutrition or community nutrition. I think I had one subject and then was just flung out into the world and just kind of felt like I winged it to be honest, and had some great mentors.
Danielle: So we talked about this earlier this week because we were talking about how far public health nutrition has come. So when I trained 30 odd years ago, we had no public health nutrition. And no very minimal community nutrition. My community nutrition was giving a heart health talk at, Prince Charles Hospital. It just so happened that my research project was actually, weighing preschool children, and looking at, the different, or the way that children might identify as being overweight or underweight, calculated. So I, I compared and contrasted three different methods, using real data from real kids. But if I hadn't done that, I wouldn't have had any exposure whatsoever.
And so all of my public health nutrition was learn on the job. So, I don't know if I wanna admit this or not. Do I admit this ? Um, I didn't understand what process impact, or outcome evaluation was until 1999.
Sophie: I didn't understand it properly. I also shouldn't admit this, cause my first job, I was like a sole practitioner essentially. I didn't really understand it either. And now I'm just like, oh yeah, that's really easy. But I, I have to go back to that, like when I've had students, for example, in community nutrition that've come and done placement with me and even now, and I have to always remember. I had no idea what I was doing. And when I've got students, I'm like, they probably also have no idea because it, it is a completely different language.
I mean, I guess that leads into like how did, like how did public health nutrition evolve in your eyes?
Danielle: I mean, I think we had some really awesome, leaders in that space. So if you think about, you know, all the people down at FSANZ for example, who work, who are really working at that very population, a healthy end of public health nutrition.
People like, Heather Yeatman, people like Roger Hughes, for example. Andrea Begley would be another one. Now, they all moved into academia eventually, but they're all also working at that kind of coalface of public health type of work. People always sort of dabbled in it as well. I mean, here in Queensland, I [00:25:00] have to say one of the first community nutrition was Barbara Radcliffe. So Barbara probably had one of the first community nutrition roles where it became a community nutrition role and not a let's do dietetics on the side role. Which is what a lot of them used to be, was like, we want you to come and do community nutrition.
No, actually, what you want me to do is diabetes education. In a community, but it's dietetic rather than nutrition or public health nutrition or preventative. So I think we had some, really, some people that really pushed the envelope fairly early. I do think that we have people working probably at a project level. Like so doing projects and programs and developing programs. But I think our thinking about what public health nutrition is, or should be has matured drastically in the last wee while. I mean, even I fell into it. And it was really from project work that I fell into it. You know, someone that said, are you a public health nutrition? I've gotta go what's that? I don't know. I don't really know what that is.
Sophie: So what were you doing? Like how did it. How did that come about?
Danielle: So I, when I graduated from dietetics, here at QUT I got one of the new graduate, what we now call new graduate roles. So at the Royal Brisbane Hospital, and I was a clinical dietician and the food service dietician, so I was one of the first. We had a food service dietician, but I kind of, half my role was doing food service.
So I remember working with Chester when he first had his first program. That was the forerunner for Food Works, analyzing the entire Royal Brisbane menu. Right. So that was my first little job. And then, but after that, eventually my partner got a job over in Perth, so I ended up in Perth. Worked in hospitals, did bits and bobs, but then finishing up a short term contract at Osborn Park Hospital. And there was a project that was working in kind of a gap between the two corridors, like literally this office and the gap between two corridors , called the clustering project... And you go I see what's the clustering project?
So the clustering project was a project that was designed to place people from the same cultural background in the same aged care facility, so that they were less culturally isolated. And so the two people that were running that program at the time, said, we're both going on leave, can you answer the phones for a couple weeks?
And I went Sure. Got nothing else to do. Got no job to go to. Sure I'll do that. I said, would you like me to pop out to the nursing homes and just ask them what they're doing about food? And they went, great idea, off you go. So I went out to visit all these nursing homes to ask them, about what they did for their, you know, people that were of a different cultural background about food?
And that report was titled: About as Ethnic As We Get is Tin Spaghetti on Toast.
Sophie: That's such a great title, but also paints a really bad picture of what, it was aiming to do, I guess.
Danielle: Exactly. So from that I got funding for two volumes of a World of Food through the Commonwealth government. And so that lasted me for a wee bit. But from that I met some wonderful people and one of those wonderful people was, or persons, was Grant Stone. So Grant was the librarian at Murdoch Uni who introduced me to Allen Mansfield, and that got me doing my PhD.
So my PhD was titled Mapping Ethno Food Scapes in Australia, the popular title would be Stir Fry Ravioli with Chips. So Cultural Studies, sociology got introduced to people like Michelle Fuko, Anthony Giddens, you know, kind of like opened my eyes to a whole different language and world that I had never, ever come across so still doing, I was doing age care consultancy then when I was doing my PhD, I was dabbling in a bit of this and a bit of that. Did, Good Food for New Arrivals came up about then as well. So working with refugee families, and this is probably not public health nutrition, it's probably more community nutrition. But working in that kind of a more of a public healthy kind of way, if you like.
And so it gradually, I just built skills and built knowledge and information about working in that space until I kind of went, oh, actually, that's kind of what I do. So it was more of a, metamorphosis rather than, you know, kind of like a gradual change and a gradual building of skills rather than kind of like, oh, I'm a dietician one day and now I'm going to be a public health dietician or a nutritionist the next day. Not like that it just gradually evolved.
Sophie: And you've stuck along that journey of going down, you know, community and public health, nutrition. Just quickly there, how do you delineate between public health, nutrition and community nutrition?
Danielle: For me, public health nutrition operates at a really broad population level. So public health nutrition would be fortification of food. Or it would be those real macro policy [00:30:00] level that, I mean, the dietary guidelines, for example, you could argue, are you know, that's public health nutrition. Community nutrition for me is much more place-based. So it's much more around place-based building partnerships with community, in order to have population based outcomes. The distinction's quite nuanced, but it's really, community nutrition for me is like, do I understand my community in order to develop change within that community. That has not, it's not going to just impact one person but will impact the entire community. So from that point of view, a population. Whereas, public health nutrition is that more that big ticket stuff.
Sophie: I just think it's interesting because I kind of just switch between the two depending on Yeah...
Danielle: Yeah, But it's a bit like, what I don't think is switchable is community dietitian and community nutrition.
Sophie: Okay. Why?
Danielle: Because I think there are two functions and two roles. I mean, you can be a community dietitian nutritionist, and have both of those roles in there. But a community dietitian for me is doing medical nutrition therapy, disease management with communities, but with typically with groups or with individuals.
So if you are asked, for example, if you are take on a nutritionist role, and they go, oh, you're a dietician. Woohoo. Great. You can do our diabetes stuff. For me, the response should always be, I'm sorry, I'm not doing that because you need a dietitian in that role. You're employing me to do community nutrition work, which is at a much broader level. And it's preventative rather than that either secondary prevention or tertiary management.
Sophie: And I was literally just about to ask you that question because even I've seen that transition of being in the community nutrition space, and that medical nutrition therapy role of a dietitian really encroaching on that community nutrition role.
And I guess for anyone that's in those positions and is getting that kind of push, is there any kind of advice you have? About like how to manage, not letting that encroach? Because it will come from management and typically to make money because it's bulk billable, through Medicare and all those types of things.
Danielle: Yeah. I mean, it's a really awkward position to be in. But if you, if you're employed, be it in a nutrition position. If they had employed someone without a dietetic qualification to do that, they wouldn't be able to value add to the position in that way. And I'm not saying that they're not needed, those positions cause they're absolutely needed. But they're needed in and of themselves. So as soon as you start to go, sure I can do that clinic. You're actually watering down a business case that you actually need those roles. You're also then detracting from your ability to expand what happens in a community nutrition role.
So if you are employed to do community nutrition, but you spend half your time doing dietetics, in a community, you know, in a dietetic and again, in some remote areas they're, they're actually, they are joint position. And you only do do both of those things. And rightfully so. You know, you go, no, I'm the community dietician nutritionist, I do community nutrition work here, and I do these community dietitian roles. And they're seamless and they have to be because there's limited resources in those spaces.
But having said that, even in those spaces, it should be a case for going, we've got a business case here for a dietitian because that dietitian will be doing our renal clinic and our diabetes clinic and our, and peads and we're doing our food service in our hospital and our aged care facility. And then actually we've got this community nutrition role, which is actually maybe going out to outlying communities. And/or building up prevention and actually trying to get population wide programs going in. So if I'm doing all the dietetic work on one side, I've got no time to do the other stuff, because again, it's the nature of the work as well.
Because if I've got, it's a bit like when you're an academic between teaching and research, teaching gets priority. Because I've got to front up to the lecture. Got to mark the assessment and I've got to do that within these deadlines. The research stuff is kind of do that in your own time. There's no kind of real deadlines for that unless it's a grand application when there is a deadline or, but if you want to submit a journal article, it's up to you when you submit the journal article. You know, it's like up to you when you kind of collect the data. So it's a bit like that. So when you're seeing patients or you've got patient's to see in your face, you've got other people that know they're there, you know you've got to see them. Whereas the community nutrition work is about building partnerships over time, which, you know, how do I measure that KPI?
Sophie: Yeah. Oh, that's one of the conversations I've had with so many people in this space is what am I actually reporting on? Because sometimes, like I have nothing to report on. It's like I saw 10 people today in a clinic versus, I've had a few meetings and here are the minutes, if you ever wanna read [00:35:00] them, which you probably don't. But do you have any, like, is have you seen any examples of like, how to report against public or health or community KPIs, if we could call them that?
Danielle: I think you need to be creative about doing that. I mean, the thing with public health nutrition, community nutrition is that the KPIs a long time coming. I think one of the reasons why we lost a lot of the workforce was because public health nutrition, community nutrition work is the long haul, right?
You can't go, as you know. You can't go, oh, we did X and we've reduced Y over here. There's so many things in between X and Y, but you just can't go. Bingo, we hit the jackpot. Because it's this big jigsaw puzzle. But the thing is like, for example, you know, I was talking a long, long time ago now to somebody who is going to agricultural shows, popping along to an agricultural show, handing out a few pamphlets, doing a bit of a taste test at the front.
Right? Okay. So what's the, what's the goal of going to the agricultural show? Are, you know, are you in trying to increase fruit and vegetable consumption? How are you gonna demonstrate that? You're not, you've got no way of going to an agricultural show and then saying, oh, and by the way, by me handing out five pamphlets, I've actually increased, you know, fruit and vegetable consumption by X percent.
But go to the agricultural show and next door to the Farmer's Federation. I'll just go and have a chat to the Farmer's Federation next door. Oh, farmers I think a bit of a problem with, you know, like, oh, so shall I have a come along and have a chat to, you know, talk to you about what we might be able to do within the farming community to do bla.
Yeah, that'd be great. You've actually then gone as part of my KPIs about going to this. It's not that I handed out 150 pamphlets, it's actually that I had a conversation with 10 different organizations, which I followed up with five different meetings, which actually resulted in us actually working with them to develop something else.
So it is about thinking about what you are doing and why you are doing it. And not necessarily going, well, it's because I'm trying to get behavior change happening, but more I'm building partnerships.
Sophie: Yeah. And I think that's such an important thing. It took me a while to realize how important that was when I started my career of like, you just feel like you're wasting time. But it's not until like, I don't know, 6- 12 months later that all of a sudden someone picks up the phone and calls you and you're like, oh, that conversation I had like six months ago actually has now had a massive impact. Like we got food bank into Alice Springs because I'd had a conversation with someone and then I got this phone call six months later and now they're there. Like, and that, I never planned that, but if I hadn't gone and networked and created connections, that probably never would've happened.
Danielle: That's right. And it's the serendipitous conversations too, like, you know, even in, you know, the coffee queue or whatever it might be. But, and you can't underestimate those. And you can't underestimate research is a bit the same. Well, the type of research that I do is a bit the same. So, you know, you might go and talk to 10, 10 different organizations, or 10 individuals, you know, individual people in organizations and think, well, that came to nothing. But those 10 organizations now know you and know what you do. So then next time you have a chat to them, they go, oh yeah, okay, well, you know, we'll, we'll think about.
May not come to anything, but then the next time you're pulling together a grant, you go, can I have a chat? You know? And they go, yes, yes. They're definitely on board. We think that partnerships happen immediately. But they, and they need nurturing. It's like a friendship. Friendships happen, but they need constant nurturing in order to flourish and to blossom. Partnerships are the same.
Sophie: One of the indigenous researchers at CSIRO who is doing their PhD, his motto is relationships before partnerships. And that to me is just like the perfect way of describing exactly what you just said. But I was going to ask like kind of before we went down there, like you continued along the community or public health, nutrition path. Like why did you continue down that path and not go back to clinical dietetics?
Danielle: So when I did, my PhD was at Murdoch University. Murdoch doesn't have a dietetic program. I was doing work in the Center for Social and Community Research. Was doing work with the indigenous unit there on, Noongar interpretive histories.
I was doing work with education, up in northern Western Australia. Not on the ground, but helping them write grants and do all sorts ofthings in that perspective. I did projects on fly in and fly out families and parenting, on managing work in motherhood, on perinatal mental health, on, you know, very, very diverse kind of projects that I was working on.
That was kind of almost immediately post PhD. I've stayed a member of Dietitian's Association all throughout, but I was on the cusp of going, do I stay or do I go like, what do I do here? Like, I'm not really working in, you know, and every time you mention nutrition people go, huh? And you go, oh my God, we are so not relevant.
There's so many people, you know, like, we are so not based in [00:40:00] a sociology department, at a university that doesn't have nutrition. Back in the, this would've been in the early 2000's. Oh my God that's 20 years ago. It's been a while.
Sophie: So you, but you, but you didn't leave dietetic's?
Danielle: No, I didn't leave dietetics because dietetic's, the dieticians are my family. That's my identity. So I kind of like all good families. It's a little bit dysfunctional, you know? But that's what makes a really awesome family because you kind of accept the, hopefully accept the weird, along with the straight lace, along with all of the, you know, the crazy, that's what you want in a family.
That's what makes it interesting and what makes it flexible. And I'm a joiner. So when I joined the Dietitan's Association back in 1988, when I was still a student, it was kind of like these people get me. Like we talk food and we talk nutrition, and we talk health, and you know, they get me. So I kind of stayed connected. Because food is fundamentally what I get. Like food is it for me, like it's, it's about eating it, it's about cooking it, it's about how other people do that. It's about experiencing it, it's, it's all about the food for me, not necessarily about the health. It's all about the food. So I stay connected. And then the job at QUT came up.
Sophie: This job?
Danielle: Well, it was a senior lecturer job. I was in contract positions where I was, I had been for 15 years on yearly rollover comp. Rolled over. So, I hadn't had, you know, one project work for one. But nothing permanent. Well, I got the job, so, and then, so we moved over in 2008, and so I moved into academia.
But even then, it was a little bit tricky for me because I had been in, I was embedded in the sociology space and that was the type of work that I was doing. So, you know, I had a conversation just recently with a nutrition sociologist who said we wrote this paper about, you know, accounts, taste back in, you know, whatever it was, and now you're doing this stuff. How does that work? And I went, well, I just, you know, you're a chameleon. You just, you know where you are, you make the most of what the opportunities you've got where you are and you do stuff well.
Sophie: How is that going from like, coming from that really sociological basis of what you're working in and then coming back into you know, a nutrition and dietetics cohort of, you know, academic staff who would've been still probably in that very much medical scientific mindset. Like, what was that like?
Danielle: Challenging.
Sophie: Yeah?
Danielle: Yeah, yeah. Because you start, your brain starts to think in a different way. The whole positivist approach I found quite, quite challenging. There's no black and white for me. There's never been any black and white for me. It's always been different shades. You can't say shades of gray anymore. . . No. But yeah, it was, it was quite challenging for a while. But you know, we were talking about the naval gazing before and the...
Sophie: What do you mean by naval gazing?
Danielle: We're in inward looking.
Sophie: Okay.
Danielle: We're not outward looking. It's always about us, the profession. Or about what, how come, why aren't you employing us? Why, why aren't you employing dietitians? What about us? Rather than outward looking about saying who can we partner with? What's going, you know, how can we improve, how can we improve the nutrition knowledge of nurses, doctors, which is absolutely happening, but we're not outward looking.
We're just this, even that divide between dietitians and nutritionists: we are one profession. Let's not make this about us and them. We are one profession. Do different things. But we are one profession. So that's the naval gazing. There's another part of that that was about, risk averse. So there's this perception of dietitians as the diet police and as being very pedantic.
And the world's not like that. And nutrition's not like that. And it's an evolving inexact science. It cannot be that exact. The risk averse. We are risk averse. We're a predominantly female profession. Who have been inculcated with being good women. This is where I think the pleasing stuff comes in. I think we do like to be pleasant and be pleasing and not necessarily think outside the square, just in case it might go somewhere that we're not entirely comfortable with. Which is why courage is on the list, which is why confidence is on the list.
Sophie: And we need those things to also be like systems navigators and to jump in between systems and, and liaise with people because we don't know everything and we can't know everything.
Danielle: Well, no, and it's also because, things are chaotic. change is happening. It's and change is a constant. I think that sometimes dietetic profession attracts people who like things to be black and white. Right. You either [00:45:00] you follow this diet and you'll get better. You do this and this will happen, but it's not like that.
Sophie: Yeah, totally. And I think it's that difference between the theory and the reality of nutrition.
Danielle: Well, the other thing is, is that nutrition science is a young evolving science. Right. Things are going to change. And that's why we need the communication side of things because, and people will go, oh, the bloody dietitians they've back flipped again.
You know, first of all with eat less fat. Now now's eat more fat. Now's eat less protein. Now it's eat more protein. You know? And you go, well actually that's not us saying, not all of us saying that. Constants have been, eat more fruit and vegetables, eat more grains. They've been the constants. Oh, well, some of us are telling you not eat grains anymore.
That's not us. Eggs would be a good example. Don't eat too many eggs. You know it'll pull your cholesterol up. Milk might be the other example, right? Don't eat this. Don't eat that. You know, because it'll do this. Well, actually, we've found out that it doesn't do that, and it's got to be more nuanced than we thought.
Sophie: You were talking at the start about not relying on government to build the public health nutrition workforce. And, and we had this conversation a little bit the other day about people having to kind of make their own jobs, or doing it in different ways. Like how do we go about doing that? Like where do we look to if we're not looking to government?
Danielle: It's really hard when you are new because you need to build. Skills, right? I think the generation that are graduating now are really, really good at doing that. I think the biggest message is, is you don't know what's possible yet because some of those jobs haven't been invented. So you need to just think about those capabilities and where you can get those capabilities from, rather than going, I'm gonna do a particular job necessarily, because I think if you go, oh, I want to be a this. Okay, you can be a that, but it could be very, very different. In five years time that job's not, doesn't exist anymore. It's something else. So we talk about being a chameleon, and I think that's definitely, you know, you know, kind of, oh, okay. I can use my skills in these particular environments. I think looking at the civil society organizations, so non-government organizations in particular.
Sophie: Okay. What would be an example of a civil society?
Danielle: Any non-government organization.
Sophie: Okay. Like the Salvo's or like those types of...
Danielle: Yep, all of those. Any of those are going to be building, working with, using those, you know, all those capabilities and skills. Not being afraid to just try stuff that you go, I dunno if I'm qualified for that. Just go for it. Like if I hadn't answered the phones for the clustering project. And then gone look, that's gonna be a bit boring. Shall I go out and do that? You know, that wouldn't have ever transpired. So you just don't know what you don't know. So if you, if an opportunity comes up, you go, oh, I could do that.
What skills am I learning in doing that? And where could that take me and where can I use my nutrition brain in that particular scenario? Because you can always use your nutrition brain somewhere.
Sophie: Cause everyone's eating.
Danielle: Everyone's eating and everybody... food is involved in so many different aspects. You can actually go. Wow. And if they're not, they should be. And so you can go, we need to do this. So I think for anybody coming off, it's just about, let's think about doing different jobs or different things that help you build a jigsaw puzzle of skills. And where you can actually add your value add, which is nutrition and food too.
If you then about thinking about going into business for yourself, go, well, where can I use that? Where's the, where's the gap? Or where can I work? I mean, I reckon there's a real role for people doing knowledge translation. I think there's a real role for people doing Community partnership brokering.
If you're a community organization and you want to write a grant for something. I think the school food area is gonna explode. Okay. So if I wanna work with schools, would I look, what would I do? What would I need to do? How would I go about that? What partnerships do I need to build? You know, I think that the opportunities are endless.
Sophie: So I guess the message is just look,
Danielle: Do it. Like, you know
Sophie: give it a go.
Danielle: But, but think about what we talked about then. Communication, partnership building, courage, thinking outside of the square. You know, think about that long, that list of capabilities. You know, being entrepreneurial. Right, navigating systems.
Sophie: Definitely and looking at food through, maybe not always a dietetic lens, but still bringing that to the table.
Danielle: You can actually weave food in to absolutely everything you absolutely can. And if you think about then food sovereignty approaches, again, you're not the expert. I'm the, you're the facilitator. How do you facilitate a food, a local food system- sovereignty approach? Food policy councils. Can we set up food policy councils?
It's a bit more of a precarious existence because you're generating your own income. Victoria are a bit better off. But I reckon every single city council could have a public health nutritionist on staff who would be absolutely smashed for work. Smashed.
Sophie: A hundred percent. And the thing is, you could, [00:50:00] you could go and get a job at the local council that's like, you know, advertised, whatever, and then you just build it into a public health nutrition position.
Danielle: That's right
Sophie: And I guess that's what you're saying is just embed it , and I think, I think that's actually a really good point and we'll probably find that we'll get more jobs. By just infiltrating all these systems with like us and then like, guess what? I actually have this maybe like agenda that,
Danielle: So think about parkour, think about leaping those systems. Thinking about pushing off from the wall. To somersaulting, landing. Oh look, I've moved from there to there. You know, still standing. Had a few falls along the way. A few scraps, some bumps, but I'm still standing. I've joined the systems together. And I'm now weaving my way through those spaces between the systems. Slowly but surely. Sewing them together.
Sophie: What has been the best or some of the best moments of your career when you look back?
Danielle: Vietnam was phenomenal. I learned a lot about my own cultural safety and no cultural awareness and you know, it's really different being the only person that doesn't speak the language to being, you know, in that situation.
And I learned a lot about systems and about sitting back and not getting in my own way, and letting things play out the way they needed to play out and like not, you know, the people have to take the journey. You can't circumvent the journey. It's almost like you need to go through all those steps before you can reach there.
So that. I think the current gig I've got, as the director for the Woolworth's Center for Child Nutrition Research, that was a big, like, that was a real, that was a real risk for me moving out of my comfort zone. You know, I was in a very good comfort zone. And I kind of went, wow, well, I'll put it out there.
I'm going to do stuff that I want to do. It was a bit of an arranged marriage with a couple of other partners, and it was funded by Woolworth's. I wasn't overly comfortable with that. So I had to kind of figure that, work that through. It's still really challenging because we are doing a lot of work in a relatively short period of time. But it's happening and I think we're having a good, we're having an impact, and we're doing some research that's really worthwhile. It's always in those moments where you are most, it takes the most courage to do where you learn the most.
Sophie: Oh, I can imagine. And then my very final question is, what has been your favourite food moment?
Danielle: It's very privileged of me. My favorite food moment would have to be a restaurant that we went to for my 30th wedding anniversary. In the Lake District in England. In a restaurant called L'Enclume where all the food is grown within a hundred mile radius of the restaurant, I can't remember how many courses it was. We've actually got the menu printed on our wall framed. But the best course of that meal was the salad course because they brought out the salad ingredients and they made theater out of making the salad. So test tube for the dressing, and it was, but the vegetables were the heroes of the, of the meal and of that particular course.
Anyway, it was, it was magical. But having said that, so that's one best food memory. The other recent best food memory is Simon and I are sitting on the cliffs in Orkney eating tangerines because we are on, we're in this awesome place eating this very simple food. Like they just a couple of tangerines.
Vietnam, there's a hundred memorable
Sophie: It's a difficult question.
Danielle: Oh, it is a very difficult especially when you're a food person.
Sophie: Thank you so much.
Danielle: That's alright!
Sophie: So thanks for listening. There'll be links to Danielle's research profile in the show notes. Where you can also get in contact with her and read further into all of her amazing work in this space, as well as the future's paper that we referenced a few times, particularly towards the start.
And remember, we're on Instagram or Twitter if you'd like to get in touch or ask any questions. I've also included the Foodie's email in the show notes if you'd like to connect that way. And if you do get the chance, please leave a review. To help spread the word all about public health nutrition.
