Smart Solutions for Diabetes Care: Combining Nutrition, Dietitians, and Technology

This podcast series aims to highlight the science, psychology, and strategies behind the practice of dietetics. Moderator, Lisa Jones, MA, RDN, LDN, FAND, interviews prominent dietitians and health professionals to help our community think differently about food and nutrition.

In this podcast episode, Lisa Jones, MA, RDN, LDN, FAND, interviews Rachel Stahl Salzman, MS, RDN, CDN, CDCES, about new technology in the management of people with diabetes, including technology misconceptions, ways technology can help improve clinical outcomes and a person's quality of life, and the essential role of a registered dietitian in technology integration. 

Additional Resources:

•    Weill Cornell Medicine. Accessed April 11, 2023. https://weillcornell.org/rachel-stahl-ms-rd-cdn 
•    Diabetes Dietetic Practice Group. Accessed April 11, 2023. https://www.dce.org/home
•    American Diabetes Association. Accessed April 11, 2023. https://diabetes.org/
•    Association of Diabetes Care and Education Specialists. Accessed April 11, 2023. https://www.diabeteseducator.org/
•    Danatech. Diabetes Educator. Accessed April 11, 2023. https://www.diabeteseducator.org/danatech/home
•    Diabetes Technology Guide. American Diabetes Association. Accessed April 11, 2023. https://diabetes.org/healthy-living/medication-treatments/diabetes-technology-guide 
•    ElSayed NA, Aleppo G, Aroda VR, et el.; on behalf of the American Diabetes Association. 7. Diabetes technology: standards of care in diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S111-S127. doi:10.2337/dc23-S007
•    National Certification Board for Diabetes Care and Education. Accessed April 11, 2023. www.cbdce.org
•    Stahl Salzman R. Fueling your “app-etite”: an introduction to nutrition and diabetes apps. ADCES. 2023;11(2):28-32. doi:10.1177/2633559X231151938

Rachel Stahl Salzman, MS, RDN, CDN, CDCES, is a Registered Dietitian & Diabetes Care and Education Specialist in the Division of Endocrinology, Diabetes, and Metabolism at Weill Cornell Medicine (New York, NY).

Lisa Jones, MA, RDN, LDN, FAND, is a registered dietitian nutritionist, speaker, and author (Philadelphia, PA).

TRANSCRIPTION:

Host:

Hello, and welcome to Nutrition411: The Podcast, a special podcast series led by registered dietician and nutritionist, Lisa Jones. The views of the speakers are their own and do not reflect the views of their respective institutions or Consultant360.

Lisa Jones:

Hello, and welcome to Nutrition411: The Podcast where we communicate the information you need to know now about the science, psychology, and strategies behind the practice of dietetics. Today's podcast is about diabetes and technology, and I want to welcome our guest, Rachel Stahl Salzman. Welcome, Rachel.

Rachel Stahl Salzman:

Thanks so much for having me. I'm so excited to talk about this topic today.

Lisa Jones:

Yes, well, I am excited to hear about it. But first, I wanted to tell the audience a little bit about you, Rachel. Rachel is a registered dietician and Diabetes Care and Education Specialist in the Division of Endocrinology, Diabetes, and Metabolism at Weill Cornell Medicine in New York City. Rachel is passionate about empowering individuals to make sustainable lifestyle changes and leverage diabetes technology and digital health to improve their health and quality of life. Welcome, Rachel.

Rachel Stahl Salzman:

Thank you.

Lisa Jones:

For our audience, please start by telling us a little bit about what is diabetes technology for those that may not know or be familiar with it.

Rachel Stahl Salzman:

Sure. Diabetes technology is broad in scope, so I'm so glad you asked this question. It's considered the term that's used to describe the hardware, devices, and software that people with diabetes use to manage it. It includes everything from glucose monitoring where we use blood glucose monitoring systems and continuous glucose monitoring systems known as CGMs, which people might be hearing about. It includes various insulin delivery devices such as smart connected pens, insulin patches, automated insulin delivery systems, and also digital health. Running the spectrum of various consumer wearables and diabetes apps, ultimately to help support the patient to live well with diabetes.

Lisa Jones:

Wow, that's a lot, especially if you're not familiar with it. Because I know a lot of us, this is new and upcoming technology and it's always changing and it's hard for dieticians if you're not in this field to keep up with it. So with that being said, my other question is how can this technology be used to support individuals who have diabetes when they're trying to manage their nutrition management and more broadly to meet their overall health goals?

Rachel Stahl Salzman:

Diabetes technology can offer an array of benefits and it's really such an exciting field. And as you said, it can absolutely be hard to keep up with this ever-evolving field. But it's an exciting, one because it's making it easier to live with diabetes and manage all the complexities that come along with it.

To start, it's been shown to help improve clinical outcomes, such as improving A1C and also really cardiometabolic care. More than just glucose lowering and glucose supportive, it's having effects on a variety of other health conditions for that person. It can also help reduce the risk of micro and macrovascular complications and ultimately help make it easier to improve their day-to-day living. It provides flexibility, it can help improve quality of life. And what has been really exciting for me is seeing how it really empowers the person living with diabetes to take more of that important role to manage their condition, giving them the tools to do so.

Lisa Jones:

Yes, I love what you said about the empowerment component because that is one thing that sounds very empowering, especially if you're a patient and you may not be used to technology and then you're kind of saying, well, here's what it can help with. And that's enough to get most people on board from what it sounds like. But then the other side of it, which brings me to my next question is there are probably many misconceptions that come up about using technology, especially when we're talking about managing diabetes. And my question is, since there are so many, could you start by just telling me about what is the one that you see the most?

Rachel Stahl Salzman:

Well, one that is fresh in my head from this past week in my clinical care was the misconception that using technology is going to be too complicated. For some people, there's definitely... and thinking about my patient this past week, a fear of change. We want to remind patients that the goal of this technology is used to help decrease the burden for them and ultimately help improve our collaboration by having all this data and all this technology to support them. So, it's really important for the dietician as part of that care team to help patients overcome it. And I love doing that by bringing them into the office. It's kind of like a show and tell–showing them all the different options out there.

My goal is to help give them the knowledge and tools so that they could ultimately make the decision and know that we're here to support them in whatever it might be. And this example of this patient was like an eye-opener and a game-changer when she decided to try a CGM, we just placed a sample on her. She tried it for 10 days and she came back to me and said, "I can't believe I waited this long." Those were her words. It's just so powerful for us to be able to provide patients with these things that are going to help them.

Lisa Jones:

Yes, and it sounds like you have a very powerful testimonial right there and what you are doing is decreasing the burden. So, as soon as you hear, "I'm going to help you, I'm going to decrease your burden." Or I'm sure you say it in a better Rachel way, then they're probably like, "Yes, I'm on board" and they want to try it. And I like what you said about show and tell because a lot of people learn better by seeing somebody else do it first. So that's excellent.

Rachel Stahl Salzman:

Yeah. I also think it's so important to meet the patient where they are. Technology, there are simpler types of systems to more advanced, and certainly we want to give patients what we feel is the highest level. But we need to remember to meet the patient where they are and what's going to be most helpful for them at this point in time in their diabetes journey.

Lisa Jones:

Yes, so true. Excellent point. Now, if you had to mention another misconception, I know there are probably many, but which is another one that you would say?

Rachel Stahl Salzman:

Yes, great question. I think another common misconception for some patients could be this idea that once they start the technology, it's kind of like a plug-and-play, right? The minute they start it, they're going to be cruising, their numbers will be perfectly in range and they just kind of sit back. We need to remind patients that it's not fully a plug-and-play system. Maybe ask me in 10 to 15 years from now with all the advances we'll see, they certainly will get patients closer to that. But we need to remind patients that they are still in control at the most, and these systems help move them towards what I consider cruise control. When we think about driving, we think about how cars can go on cruise control, but we still need to be there to monitor if some variables change and be able to quickly address anything going on.

So, it's important to teach our patients about the benefits of these technologies. What are the components that are going to be automated and what is part of what they still need to control? And a perfect example that I just had with a patient recently who was starting an insulin pump from using multiple daily injections of insulin, I needed to remind her that the insulin could do various things. The pump is going to help them to provide a basal rate and help keep their numbers tight overnight and between meals, it's going to help with these automated systems to correct high glucose values. But she still needs to be in control of putting in for meals, the carbs and control some of that mealtime insulin dosing decisions. While the pump provides a lot of support, she's still in the driver's seat.

Lisa Jones:

I love these analogies that you're doing because it brings it to life and it makes it seem like something that you can accomplish easier. So it's more user-friendly for the person that's listening to it.

Rachel Stahl Salzman:

Thank you.

Lisa Jones:

So, I appreciate you sharing those and I'm sure your patients do as well. So, you were talking a little bit more about the technologies, but what would you say would be the latest technological advancements in diabetes management? And more specifically, could you talk about current ones now and then what would be like a futuristic forecast for you?

Rachel Stahl Salzman:

Oh, wow. Such a great question. We could probably spend so much time talking about it, so I'll do my best to cover what I can. So as I've mentioned, this is such an exciting time to be in diabetes technology and it's so great for all the listeners out there to continue to learn and keep your ears open for all the latest advancements. I feel like every month there's a new FDA approval, something new in the news in diabetes care. So, it's always evolving, which again, as a dietician in this realm, it's really a great field. I think what we're seeing now and what we have seen are new features and functionalities from companies that already know and used. For example, we've seen tremendous advancements in continuous glucose monitors. In the past year alone, we see these systems getting smaller, more accurate, more comfortable, and for the first time approved in pregnancy. So that is what's really exciting in the CGM world.

If we were to also think about the insulin side, we have seen tremendous advancements in what we call automated insulin delivery systems. These are systems that combine continuous glucose monitoring data with insulin pump technology and algorithms that can automatically adjust insulin dosing in response to glucose levels. And this has been a tremendous support for patients. Again, giving them so much more of that hands-off approach. Again, still in the driver's seat, but tremendous support with this automation and they're just continuing to get smarter and better. I also want to add that for patients that are using insulin, we're seeing tremendous advancements in the use of other types of delivery systems. We're seeing patch pumps where patients could not use injections like they're doing with pens. They can actually just click. An example I'm thinking of is C-Cure.

They can have a little patch connected to their body for two to three days and they just click it to support their mealtime insulin dosing. So with a simple click, they could provide their mealtime insulin dosing, keeping it very discreet and easy to use. We also now see inhaled insulin, and that's known as Afrezza. So a world again, without insulin injections. We're seeing such growth in that field. And with the pens, we're seeing more connected insulin pens. I have patients using InPen, which we really love in that it helps to integrate data. Not only are they getting their insulin dose, but it's tracking their doses. It's providing reminders through a Bluetooth-connected app on their phone. It's helping them with the calculations of doing their mealtime insulin injections. We know it's a lot of math for patients. They need to calculate their insulin-to-carb ratio to determine how many grams of carbs they're eating, what is their glucose levels before the meal, and how much insulin they need to reduce it. By having a system with a connected app that's doing the math for them, that is tremendous and a big help.

I also want to highlight diabetes apps and digital health. We've seen tremendous growth in these technologies to help support our patients living with diabetes. These, for example, apps are combining data not only from diabetes devices and smart scales but also using Artificial Intelligence and machine learning to provide advanced insights for patients. So it's a really amazing opportunity and tool to get involved with. And I encourage any of the listeners out there who are thinking about apps, might want to recommend apps to their patients, but are not sure where to start to try the app out themselves. It's such a great way to learn about it and find out more. And I'll also put a plug for an article about apps that I just published in ADCES in Practice where you can go to learn more about diabetes apps.

Lisa Jones:

Oh, that's huge. And it's like mic-drop, Rachel, because all that stuff you were saying, you just proved why it's a specialty and why you have a certification in what you do because trying to remember all that stuff and it's just vast. Which brings me to my next question: how can registered dieticians, how can we keep up with all this and provide the possible care for our clients? What is your recommendation for that?

Rachel Stahl Salzman:

Yes, I have a couple of ideas. And Lisa, you'll share all the different resources in the notes from this podcast. I would say there are a lot of tools and resources out there, that's the good thing. But it could be hard to know where to go when there is a wide variety of sources, and you're looking for really evidence-based sources. So, we're here with the dietician group today, and so, if you're a member of the Academy of Nutrition and Dietetics, I strongly encourage you to become a member of the Diabetes Dietetic Practice Group. So as you might be familiar, there are many dietetic practice groups known as DPG in our academy, and there's a diabetes-specific one. And I'm the diabetes technology chair of this DPG where I work along with a committee to provide exciting educational content for all of our members, including hot-off-the-press news.

We provide webinars and we have a regular column in our peer-reviewed publication called Newsflash. So I know we're approaching annual membership dues, which are right around the corner, so it's a great time to assess your interests and consider this DPG. And Lisa will share the link to the DPG where you can learn more and see if it's a good fit for you. I also want to encourage dieticians to look at leading diabetes organizations, including the Association of Diabetes Care and Education Specialists, known as ADCES as well as the American Diabetes Association, ADA, which offer many resources to help keep you up-to-date, including consensus statements, patient education handouts and conferences. And I have to share, Lisa, one of my favorite conferences I just went to last year was at Diabetes Technology Focused Conference through ADCES.

So, ADCES puts on an amazing annual conference every year, and for the past two years, they've had a specific diabetes technology one. So I definitely encourage any of the listeners out there to look for that. And not only was it, again, so focused on technology, but they actually had a hands-on training where participants could actually try out some of these devices, feel what it's like to wear ACGM, connect it with your phone, and review it. And I feel like that has made me so much more confident in talking to patients about it. They ask me, "Is it painful? Does it hurt? How do you connect it?" And having that firsthand experience has definitely made me feel so much more skilled in supporting them.

Lisa Jones:

Oh, that is amazing. And you answered the question I was going to ask you next, but it's pretty much like how long has that conference been in effect? But two years and that's going to be something that continues to go on year after year because it's probably going to... that might even be bigger than the original one, I don't know.

Rachel Stahl Salzman:

Yes. And it will, it's growing. I also want to mention ADCES another important resource that I know with conferences... it depends on people's schedules and dates and costs and everything, but ADCES offers a free resource for healthcare professionals called Danatech, and that's available at danatech.org. And this is a site exclusively on diabetes technology where you can compare devices, and find out the latest and greatest in technology, there are free webinar certificate programs. There may be some costs associated with some of these, but in general, it's a great resource to go to. And I encourage all of you to check that out.

I also want to make a plug for dieticians who are looking to get more involved in diabetes care to consider going for the Certified Diabetes Care and Education Specialist credential. This is something that has helped me tremendously in my role, and I can't speak more highly of it. So, to learn more, you can go to the National Certification Board for Diabetes Care and Education, and Lisa will share the website in the notes. And you could look up eligibility, and you could look up details. And again, I really advocate for that credential.

Lisa Jones:

Yeah, thank you for sharing that. It sounds like a really great resource. So with all that being said now, how do you take yourself as a dietician and other dieticians that are listening and work with other healthcare professionals such as endocrinologists and diabetes educators, to then take this technology and work together for a more comprehensive diabetes management approach?

Rachel Stahl Salzman:

It's a great question. The important takeaway that I've seen in my practice and where we see success for our patients is that team-based approach and really putting the person living with diabetes at the center of it. We know that with the complexities of diabetes, having a support team is so important. So on that first visit where a patient who may be newly diagnosed or may have been living with diabetes for many years and looking to establish new care, we really set that expectation from the beginning. Working with an endocrinologist, a dietician, Certified Diabetes Care and Education Specialist. We wish we could have behavioral health support and psychologists on board. There's the team we wish they could be growing, but having the dietician is a key factor. Just the example of thinking about continuous glucose monitors, we were lucky if we had patients checking their glucose once or twice a day.

But now with CGMs, we're able to see glucose values 24 hours a day, seven days a week, and seeing nutrition as dieticians, how food is affecting their glucose levels, we are a key to help unlock that data. We can help patients to understand it. We can help patients to interpret how their glucose levels might be fluctuating with certain meals. We can help them understand if they might need some support with carb counting, maybe taking into effect some protein and fat in their insulin dosing, and then making the decision about maybe they do need to intensify their medication regimen. And that's where I'll work with the endocrinologist to see what kind of changes we can make. So, it's really amazing that we can provide this team-based approach and help kind of unlock the medication management with some of the more lifestyle components together.

Lisa Jones:

And it's fantastic, and I appreciate you sharing all the information that you've shared with us. And I think that as things continue to come out, it's going to just create more cohesion and just be able to work better together. So I think just listening to what you were saying, it's just fantastic that this is happening.

Rachel Stahl Salzman:

Thank you.

Lisa Jones:

All these advances.

Rachel Stahl Salzman:

So many. Oh, speaking of, you asked about the future, right?

Lisa Jones:

Yes.

Rachel Stahl Salzman:

We've already seen so many advances in these technologies. And one thing I want to mention is just in the past, probably like six weeks or so, we've seen that Medicare and CMS has expanded coverage for CGM. So this is only going to continue to grow as more patients get access to these technologies. So previously, CGMs with Medicare and Medicaid were only previously available to patients who are on at least three insulin injections a day. But this is now changed, which is opening the door to millions of patients to have access and coverage for these technologies. It's now available to people who might be on just one injection daily, for example, maybe a basal insulin, or also for patients who have had severe hypoglycemic episodes, who may not even be on insulin, but other medications that might contribute to it.

So, it's really opening the door. So we're going to see continued growth. And another thing I see, and I really heard this a lot at that technology conference I was at, was a growing effort for interoperability. And what this means is that more of these devices and systems are going to communicate and talk to each other. And with that unlocks more data and more integration to provide more insights, not only for the patient but helping inform that healthcare team, helping us to really see what's going on. And patients, it'll give them more choice. Maybe they want this insulin pump with this CGM, with this app and giving them that choice. I see that growing a lot in the field too.

Lisa Jones:

Yes. I love that. That opened the doors and gave me more choice.

Rachel Stahl Salzman:

Right.

Lisa Jones:

Two things that people want to hear more of.

Rachel Stahl Salzman:

Yes. Bring the cost down. I think that's been a big barrier for sure, is the cost of some of these technologies. But I do see, and I think in our future we'll continue to see these companies really making efforts to bring the cost down and give access to more people for it.

Lisa Jones:

Yes. And you're breaking down the barriers too for your patients.

Rachel Stahl Salzman:

Thank you.

Lisa Jones:

I would love to hear one story showcasing your work. I know you've already said an example earlier, but is there another one that particularly sticks out for you?

Rachel Stahl Salzman:

Okay, yes. I'm sure I'll think of some examples here. I would say I think with CGMs and just how it's helped them expand their ability to understand how their food and factors affect their glucose levels. I think of patients, for example, who were told they can't eat fruit. They said, "Oh, it's going to raise my blood sugar, I have diabetes." And I feel like as the dietician, I always like to think of what we can add more of, how we can show them that they can eat foods that they thought for years that they couldn't eat. And by wearing these technologies, putting this CGM on the patient, we talk about meal planning and they're able to realize, oh wow, I could eat this orange, I could eat this banana.

And we talk about in what portions and what may be combinations of food choices, what time of day, and maybe their activity levels to help them. My goal is to make their favorite foods fit, and find ways to help them support them, and with technology to show them that it can, giving them the confidence that they can do so in an easy way. They don't have to suffer in those ways. So I feel like in a way, I unlock a lot of that for those patients.

Lisa Jones:

Yes. You're creating magic there.

Rachel Stahl Salzman:

And I also think about, for some patients with diabetes, how it can be hard for the family. I think of a patient I have who is blind, and her daughter was leaving work multiple times a day to give the patient her insulin injections. So thinking about not only for the patient, but how family members and loved ones are supporting patients and how that's really hard work. And we were able to talk to the patient and her daughter about trying one of these insulin patches, where the daughter could fill the insulin into this patch once every two to three days, place it on the patient and the daughter can go to work and live her life. And the patient again, who's blind, is able to do the clicks, I was mentioning that earlier with however many clicks for her meals. And so, that's easing the burden for not only her, but for her family. And so, that was really an amazing way of how technology can help support them.

Lisa Jones:

Yes, definitely. And I'm sure the daughter was happy that she didn't have to keep telling work, "I have to leave to go home and help my mom."

Rachel Stahl Salzman:

Exactly.

Lisa Jones:

I'm sure there's another burden relieved. If you could just say one bottom-line takeaway for the audience. I know we talked about so much today, but if you could just give them one bottom-line takeaway, what should they do or be aware of?

Rachel Stahl Salzman:

I think with all this technology, I think two things, you've asked for one, I'm going to give you two.

Lisa Jones:

Okay.

Rachel Stahl Salzman:

I'll keep it short and sweet.

Lisa Jones:

Overachiever, go ahead.

Rachel Stahl Salzman:

Stay and be that sponge. I mean, that is what is really exciting. So stay open-minded, experiment, and learn about it as much as you can. And the big piece takeaway with all of these technologies, we need to remember that we need to address that psychosocial component. Diabetes distress and diabetes burnout are real. And a high percentage of patients and more are having it. So we need to work with the patient and remember that at the forefront of everything we do, and really be curious. Learn from the patient, find out what their pain points are before we're ready to bring on the technology, and meet them where they are. Maybe it's just having a meeting of talking, seeing how they're doing, not looking at data for one day, and really taking that approach of addressing their psychosocial needs. So I do want to make a big plug about the importance of that.

Lisa Jones:

Yes, definitely. Couldn't agree with you more, meet them where they are. And I think that's something that works in any discipline that you're in, not just specifically in diabetes or any specialty, I should say. So thank you.

Rachel Stahl Salzman:

Thank you.

Lisa Jones:

Thank you for everything that you shared. You are our wealth of information on this subject, and-

Rachel Stahl Salzman:

Thank you so much.

Lisa Jones:

Yeah. I want to end with a fun lightning-round of questions that aren't necessarily related to diabetes, but more importantly, so the audience can find out about you, Rachel. So my first question is, outside of this particular technology, if you had a day off, what would be your favorite technology, your favorite app that you would go on and why?

Rachel Stahl Salzman:

So I am a fan of Garmin. My husband and I love cycling and exploring different parts on our travels and getting out of New York City to explore or be in Central Park, which is so nice. So I like using the app Garmin, which tracks a lot of statistics about our rides and look at the different insights that it can provide.

Lisa Jones:

Oh, nice. So that's the old... I don't know if you remember the old one that you used to carry around. It was pretty big. It was bigger than maybe the size of your hand or something. You'd carry it in your car. So it's basically something technology from them that's just advanced.

Rachel Stahl Salzman:

Yeah. So you have the smartphone app and it's Bluetooth connected. All of these apps now are that connection, Bluetooth connected to a smaller device, not that big one that we can put on our bikes and look at all of the data.

Lisa Jones:

Oh, that's super cool.

Rachel Stahl Salzman:

Yeah.

Lisa Jones:

Oh, cool. So do they have something similar like that for runners too? Is it just cycling?

Rachel Stahl Salzman:

Yes.

Lisa Jones:

Okay.

Rachel Stahl Salzman:

Yeah, I think so.

Lisa Jones:

Oh, okay. I'll have to check that out. I mean, I don't know how to cycle though.

Rachel Stahl Salzman:

And it's connected to Strava. I use Strava as well to monitor those too.

Lisa Jones:

Thanks for sharing that. For those that are listening who do those activities. And I'm sure they may have something for walking for anybody that doesn't run. Ding, ding, ding in that category. All right, so what about something non-food that you like to do? So you mentioned cycling. Anything else would be something fun that you'd like to do?

Rachel Stahl Salzman:

I love... Well, you said not food, coffee. I'm a big fan of coffee. And so, I love trying different coffees. I feel like I go to my favorite coffee shop in the city and it's like a kid in a candy store with all the different types to try from around the world. So you could find me doing coffee tastings with friends-

Lisa Jones:

Coffee tasting.

Rachel Stahl Salzman:

... anytime.

Lisa Jones:

Riding your bike with your husband, doing coffee tastings. Okay, so now we know a little bit about where to find you.

Rachel Stahl Salzman:

Although he doesn't drink coffee, so it's only me drinking all of it.

Lisa Jones:

Yes. You're like, I'll try that for you.

Rachel Stahl Salzman:

Obviously, as caffeinated as possible.

Lisa Jones:

And then my last question is you know I have to ask one about food. What is your favorite food to eat in the springtime? Do you change up, or if you don't have the change in seasons, what is your favorite food to eat?

Rachel Stahl Salzman:

Yes. So being in New York, we all for the seasons. And yes, as we're approaching spring, for me, I think about pesto. I think of that as being spring. And so, kind of moving away from my warm pasta dishes with tomato sauce and kind of the heavier side to lighter pesto. And I can't say, I think I would love to have a garden and grow fresh basil, but maybe I'll encourage myself to get a basil plant this year and make sure it stays alive. But love kind of using fresh ingredients for fresh pestos.

Lisa Jones:

Nice. Now you're making me want to make some pesto pasta later. So thank you for that. So thank you, Rachel. I thank you for being on our show today and for sharing your insights with us. And we will share all the resources and links that we discussed in today's podcast. And to our audience, thank you for listening and please tune in again and share your comments and feedback on our site. Have a great day, and enjoy a healthier lifestyle with The 411 in mind.

Host:

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