Q&A with RD Cate Collings of the American College of Lifestyle Medicine
Dr. Cate Collings is nothing short of a rockstar in the lifestyle medicine movement. Not only is she President-Elect of the American College of Lifestyle Medicine, Cate is also the Director of Lifestyle Medicine at El Camino Health where she is building out their groundbreaking lifestyle program. Prior to her new role, Cate served as the Medical Director of El Camino’s Cardiopulmonary Rehabilitation Center. I sat down with Cate to talk about how she’s designing El Camino’s lifestyle medicine program, her strategy for helping patients change their eating habits, and why she’s optimistic about the future of lifestyle medicine.
Kayli: Tell us about the lifestyle medicine program at El Camino.
Cate: One of my pressing goals in lifestyle medicine is to move beyond “prevention and wellness” and really weave lifestyle medicine into the care of people with established disease, sometimes severe disease, who have likely only been told about procedures and medications but not about therapeutic lifestyle changes as a treatment option. I am also focused on helping people to acquire the skills they need to actually implement these changes in their lives. Our program recognizes that people have unique needs, so we include deep dives with a registered dietitian and an exercise physiologist and a heavy emphasis on coaching to help support them. LighterPRO is how we help patients implement the dietitian’s recommendations. In my many years of cardiology practice, I found that the greatest obstacle to dietary change was patients not knowing how to answer the question of what they were going to make for dinner that very night. I can educate them on the importance of nutrition, but after they left my office, they had to go home and take that information and try to implement it at their dinner table. Before LighterPRO, there was a huge gap in my ability to help them with that. Having the meal planning, recipes, and the building of skills and confidence bridges one of the most important gaps in their new lifestyle behaviors.
Kayli: What do you think are the biggest challenges in making food as medicine available to patients?
Cate: One big challenge is the lack of reimbursement for practitioners, especially registered dietitians. It's very restrictive around specific conditions and number of visits. In reality, almost all patients could benefit from nutrition. The second big challenge is the flooding of misinformation about nutrition that comes to people. With so much conflicting information, people assume that no one really knows what’s best, so they just continue doing what they've always done. One approach that I take is rather than dispute patients’ beliefs, I say, “What do you think about trying something new for just six weeks? You can decide what you want to do after six weeks, but let's try this experiment to see how it impacts the things that matter to you.” The key to the success of this approach is having tools like LighterPRO that help patients build skills. It creates a much more scalable way to implement nutrition.
Kayli: You have so much experience working with patients on lifestyle change. In your experience, what is it that helps food as medicine really click for people?
Cate: The people who see the most success are the ones who jump in all the way. They might not make all the changes at once, but they do make at least one big change and then observe how that change impacts their health. Do I feel better? Does it change health parameters? Does it help me reduce medications? So, I think what keeps them coming back is a foundation of education, a willingness to make a change, and then seeing the results for themselves. Education alone can’t do that. They have to be willing to get in there, get messy and try something new.
Kayli: As the incoming president of the American College of Lifestyle Medicine, you have such a unique vantage point of all the progress happening in the lifestyle medicine arena. What are you most excited and hopeful about?
Cate: I'm very excited about the way lifestyle medicine is growing so rapidly and the number of traditional practitioners who are becoming enlightened to the field and seeing it as the solution to what is often a daunting and depressing outlook on the health of their patients. More and more providers are starting to see how healthcare can be done differently rather than continuing on with prescribing medications and procedures. There is also a growing awareness at the national level with large health care organizations and policy makers. I’m optimistic that lifestyle medicine will shed the image that it is just about prevention and wellness. Prevention is certainly important for the younger years, but we can also use lifestyle as a treatment modality for patients with established disease, so getting it implemented and normalized within everyday health care is what I continue to push forward. When lifestyle medicine is embedded in the traditional model, that is when we will be able to deal with the chronic disease burden, create true healthcare reform, and really change the health of the population.
Kayli: What advice would you give another healthcare provider wanting to bring food as medicine to their patients?
Cate: First, a willingness to put a lot of energy and passion into it. It’s also helpful to find a couple of partners to go on this journey with. I know that's how it has happened for many - a collaboration of two or three practitioners who are willing to build out a food as medicine program, and then it grows from there. It is always great if you have somebody at the administrative level involved who sees it as an opportunity for the system to differentiate itself. That provides a lot of leverage for the practitioner and the administrator to move initiatives forward and show that lifestyle medicine is a solution to the pain-points the system is facing.
Kayli: You are such a wealth of knowledge in lifestyle medicine! To end, if someone were to do just one thing to improve their lifestyle, where do you recommend they get started?
Cate: I would recommend they design an eating plan that brings in more and more plant-based foods. That’s where they’ll see the most benefits to their health.