Interview with Maple Schompoopong, M.S.,R.D.

We had a chance to zoom interview Ms. Maple Schompoopong, the Dietitian at Loma Linda University Medical Center, Loma Linda, California. She was willing to share the knowledge about healthy diet and the impact of nutrition on people with Alzheimer’s. The summary of our interview is below.

Hana:  Can you describe the job of a dietitian?

Maple: Dietitians can work in many settings such as hospitals, schools, or on sports teams. The main responsibility of a dietitian is to try and improve the health of others through nutrition and diet education. I would also like to mention that there are differences between a dietitian and a nutritionist. A dietitian has to go through formal education and training to receive their degree and credentials, whereas a nutritionist doesn’t require formal education in most states.  In addition, only dietitians can provide medical nutrition therapy to patients in hospitals.

Hana:  What kinds of diagnoses are made by dietitians?

Maple: We don’t usually provide a nutrition diagnosis for a patient, but rather identify nutrition problems that we want to address while the patient is in the hospital.  For example, some patients may have inadequate oral intake, or some may have medical conditions which require increased nutrients. Then we provide diet and/or supplement recommendations to try and resolve the problems identified. We do diagnosis if a patient meets malnutrition criteria or not.

Hana:  What is the age range of the patients you see?

Maple: I’m a float dietitian, so I get to work in various types of care facilities, which has allowed me to see a larger age range of patients. I’ve seen patients from ages 10 to 100.

Hana:  Can you share your experiences with patients older than 50 years old? What are their typical nutrition problems?

Maple: Older adults are more likely to be at risk for malnutrition due to poor appetite, which can also lead to weight loss and muscle/fat loss.

Tara: What kinds of foods would you recommend for overall brain health? And what effects do they have on our brains?

Maple:  For brain health, we recommend eating a well-balanced diet that includes a lot of fresh fruits and vegetables, whole grains, fish, and lean meats. We also recommend foods rich in B vitamins like flaxseeds, brown rice, and the foods previously mentioned. These nutrients help maintain our brain’s overall health.

Tara: Are there any foods that support memory in general?

Maple:  Yes, foods that are blue or purple in color, such as blueberries or eggplant, can help boost memory. Blue and purple foods get their color from flavonoids called “Anthocyanin.” Anthocyanins help to improve memory by reducing inflammation and fighting off free radicals that can damage the brain.

Tara: If I have to study for a test that requires memorization, what foods would be best to have before the test?

Maple:  Eating a lot of vegetables, walnuts, and even dark chocolate can help improve your memory. Make sure that you are not skipping meals, because you need energy for your brain to function properly. Also don’t forget to drink plenty of water and get enough sleep the night before your test.

Tara:  I usually eat two meals a day and skip breakfast. Should I change my meal pattern and start eating 3 meals a day?

Maple:  I would recommend that you try to have 3 meals a day, since you are still growing and need more energy to get through the day. You can choose to have a lighter meal for breakfast, but make sure you eat something to give your body and brain enough fuel to start the day off right. It’s also important to include a variety of snacks throughout the day.

Tara:  We are working on a project researching dementia. I have read, from Google, about foods that could help prevent dementia and Alzheimer’s. The information is kind of overwhelming. Which foods would you recommend to prevent dementia and Alzheimer’s?

Maple: There is a lot of information out there. I recently read about the MIND diet, which is a combination of the two main dietary guidelines that we usually recommend; the Mediterranean Diet and the DASH Diet. These diets are recommended to help people lower blood pressure, and reduce the risks of diabetes and heart disease. Both diets recommend a lot of fresh fruits and vegetables, nuts, whole grains, and lean meats. The creation of the MIND diet, with the variety of foods recommended, is aimed at reducing the risk of cognitive decline and dementia.

Tara:  Another buzz word for a healthy diet is the Mediterranean diet you mentioned. I heard you consume a lot of fish on this diet. Can you explain this diet further and how it prevents Alzheimer’s disease?

Maple:  Yes, the Mediterranean diet was created based on the eating habits of people that live near the Mediterranean Sea and were observed to have better overall health. The Mediterranean diet emphasizes eating a high amount of fruits, nuts, legumes, and fish, like you mentioned. It also includes olive oil that has been shown to improve memory. Fatty fishes and olive oil contain healthy fats, which help to fight off inflammation to the body. For this diet, you can still eat some poultry, chicken, eggs, but it is recommended to avoid red meats, added sugar, and processed foods.  

Tara: Thanks. I read in an article that it is better to consume moderate oily fish.

Maple: Yes, it’s better to choose fatty fish like salmon, tuna, and sardines, which are rich in omega 3. Some other foods rich in omega 3 include fish oil, walnuts, chia seeds.

Tara: Since Omega 3 can help in preventing dementia, how much do people with Alzheimer’s need to eat to help with their condition?

Maple: Generally, it is recommended to consume omega 3 rich foods at least 3 times a week. Some studies have shown consuming fatty acids from omega 3 rich foods, like fish and nuts can help people with dementia, but I think more studies need to be done to determine the exact amount needed to improve their condition.

Tara:  The ketogenic diet is very popular now. Do you think foods Ketogenic can help prevent dementia?

Maple: The ketogenic diet consists of eating foods high in fat and low in carbohydrates. Initially, it was studied and shown to help patients with epilepsy. Some studies have seen improvement in cognitive function in subjects with mild Alzheimer’s symptoms, but there still needs to be more research conducted on this subject. The ketogenic diet is not for everyone, speak to your doctor or dietitian before starting this diet.

Tara: So, what foods should be avoided to reduce the risk of getting dementia?

Maple: To reduce the risk of dementia it is recommended to avoid high-fat dairy products, red meats, butter, processed foods, and added sugar, because they can lead to high cholesterol and heart disease, which are high-risk factors for dementia.

Tara: Just to follow up on the prior question, at what age should people start avoiding these types of food?

Maple: These foods mainly contain unhealthy fats. It would be best to try and limit these types of foods as early as possible. Instead of focusing on foods to avoid, try to focus on including more of the recommended foods during your teenage years.

Tara: This question is for someone, who has already been diagnosed with Alzheimer’s. Are there any foods or diets that can help slow down the progress of dementia and Alzheimer’s disease?

Maple:  I would recommend that they continue to eat the same foods recommended on the MIND diet previously mentioned. Maintaining a well-balanced, healthy diet is very important for these patients.

Tara: For Alzheimer’s patients, who have trouble eating or even chewing, how would you prescribe their diets?

Maple:  For patients who have difficulty chewing, we would refer them to a speech therapist to be evaluated. The therapist can change their diets to one of the dysphagia diets, which may be easier for the patient to chew. There are different types of dysphagia diets from pureed foods to chopped foods. If the patient is still having difficulty eating even after their diet is downgraded, they might need alternative forms of nutrition through tube-feedings or IV.

Tara: That’s all the questions we have. Thank you very much for your time.