Feature Interview
Dolores Wolongevicz , Simmons Associate Professor of Practice & Director of the Health Professions Education Program

This interview, conducted by by Nat Thomson, Simmons MSW Candidate, runs abridged in the October 2024 issue of the Simmon's MPH Monthly. Dolores Wolongevicz, PhD is the Simmons Associate Professor of Practice & the Director of the Health Professions Education Program. We thank Dr. Wolongevicz for her time!

Dr. Wologevicz, thanks so much for talking with us. I learned that you earned your BS and MS from Simmons, so I was wondering if could you share with us a bit about how the school has changed over the years, in your estimation?

I earned my BS and MS as well as completed my post-baccalaureate dietetic internship at Simmons. My PhD was at BU School of Medicine. As highlighted on Simmons’ Mission & History page, we continue to be “Rooted in Tradition, Thriving on Change.” Over time I have seen Simmons strengthen its commitment to inclusivity, community and a learning environment that truly allows students to become thought-leaders and agents for change. 

What drew you to nutrition initially, in your studies?

I have always enjoyed cooking and baking and originally considered opening a catering business. But, as fate would have it, in high school my best friend had booked a campus tour of Simmons. She was interested in the Physical Therapy program and had asked me to go with her. And, well, the rest is history[laughs]! I toured the food science lab in the old Park Science building and my eyes were opened to all the possibilities that the field of nutrition and dietetics had to offer. As a registered dietitian I could continue on the food service path, or I could work in clinical, community, research, communications, education, business or government settings. The opportunities to work at an individual and population level to help make a difference in people’s lives were endless, well, only limited by my imagination! I have also always believed in the transformative power of food to nourish, heal and prevent many chronic diseases facing Americans including obesity, heart disease, hypertension, stroke, type 2 diabetes and certain cancers. So, a career in nutrition and dietetics seemed like a logical and fitting journey for me.

Could you talk a bit about how the science and the culture of and around nutrition, diet and exercise has changed over your time in the field? What are the significant shifts or changes?

I'll focus on nutrition and diet here as that is the scope of my practice. I think it’s important to highlight that the word dietetics can be traced back as early as the writings of Homer, Plato, Hippocrates and Galen. In ancient Greece it was well recognized that food played an essential role in maintaining health and treating disease. In my opinion, this foundation has not changed. However, it wasn’t until the 19th and 20th centuries that we had an explosion in nutritional science with the majority of vitamins, and their link to diseases and deficiencies, being discovered. In the 19th century we also saw dietary studies that led to the discovery of human metabolism with subsequent recommended intakes for total calories, protein, carbohydrate and fat as well as calcium, iron, thiamin, riboflavin and vitamins A, C and D. Nutrition science is still a newer science though, and it continues to evolve with advancement in our identification and understanding of other bioactive food components such as phytochemicals found in fruits, vegetables, cereal grains and plant-based beverages such as tea and wine. We still have a lot left to learn. For example, there are many phytochemicals that have yet to be discovered. The extent to which pesticides, herbicides, food additives, preservatives, emulsifiers, colorants/dyes and food packaging like Bisphenol A, Per- and polyfluoroalkyl substances, Phthalates, microplastic contribute to disease and harmful health consequences remain largely unknown. Funding, industry influence, study design challenges are a few key barriers in my opinion that play critical roles in preventing these areas from being fully studied. 

What is your POV on how the FDA tends to operate in terms of regulations, labels and generally working to regulate appropriately what one might call “big food”?

Well, let me say first that I am not a food law or policy expert nor a food technologist. My perspective is based on my limited knowledge of the overall functioning of the FDA. In general, I believe there is always room for improvement. The FDA is charged, in part, with maintaining the safety of our food supply including regulating infant formula, bottled water, food additives, dietary supplements and foods. Except for some meat, poultry & egg products which are regulated by USDA. They are also responsible for evaluating and monitoring the safety of ingredients added directly to food and substances that come into contact with food. This includes substances added to packaging materials, cookware or food storage containers. In my view there has always been an inherent bias in the system of how FDA approves a product. For instance, the FDA does not test or conduct research on a product. The decision to approve a product is determined by review of the scientific data provided by the manufacturer of the product. In addition, I think the FDA must reconsider its final ruling on GRAS notification. These substances like spices, flavoring and some preservatives are generally recognized as safe, hence GRAS, and are not required to be reviewed by FDA. Currently, it is a voluntary process by which any individual or manufacturer can, if they want, inform the FDA of its self-determination that a substance is GRAS, meaning, I would argue, that we may have many hidden, harmful substances in our food. My view, therefore, is that FDA should be strengthening its oversight and enhance its critical review of GRAS ingredients. 

In terms of the food label, there are improvements that can be made here as well. Nutrition education for the consumer must be clear, concise and actionable. And, in fact, the FDA is listening to expert and consumer feedback and they’re expected to make an announcement shortly about upcoming changes to the food label, specifically front of package labeling to help consumers more easily identify healthier foods. There is speculation that these labels will flag products containing high levels of sodium, saturated fat or added sugars. This front of package information will complement the Nutrition Facts Label on the back. There is also an initiative underway to update the "healthy" claim on the food label to reflect the current state of nutrition science and federal dietary guidelines.

I used to work in marketing and worked with a lot of consumer packaged goods brands- cookies, crackers, drinks, cheeses - is there anything you think MPH students should be aware of regarding these types of products, in that they are often affordable and easy to find, but maybe don’t pack much of a nutritional punch? Or put another way, how do you conceptualize the marketing of food in the context of seeking proper nutrition? 

This is where using the Nutrition Facts label is going to be key! A general guide is to choose foods higher in dietary fiber, vitamins, and minerals, and lower in saturated fat, sodium, and added sugars. It’s like being a food detective – comparing calories and nutrients in different foods to find the ones that are best for you. This is where checking serving sizes comes in handy because the nutrition information on the food label is based on the serving size listed for the food.  Be sure to also look at the % Daily Value. A value of 5% or less is considered low while a value of 20% or more is considered high. So, choose foods that have more of the nutrients you want to get more of like dietary fiber, vitamin D, calcium, iron and potassium, and less of the nutrients you want to eat less of like saturated fat, sodium and added sugars. Also, focus on choosing foods that are on the perimeter of the grocery store. Here you’ll find fresh fruits and vegetables, fish, seafood, poultry and lean meats. Then check the interior aisles to find healthy canned goods, like beans, vegetables with no salt added and fruits with no sugar added as well as whole grains, such as brown rice, bulgur, quinoa and barley. Next up would be frozen foods like frozen fruit with no added sugar, vegetables without added sauces, and individually wrapped poultry, fish and seafood.  

Readers might be familiar with different types of “fad” diets, ketogenic, Whole 30, what have you. What are your thoughts on these and what wisdom might you impart upon MPH students? I did Whole 30 for a month and I found it to be pretty smart but challenging and quite far afield from how we are socialized around food and shopping for food as Americans. To me it really illustrated how commercialized our grocery options are.

There is no one size fits all eating pattern that is right for everyone. The one that is right for you is one that you can stick with long term, is affordable and includes foods that are personalized to your tastes, preferences and culture. The key is to build a healthy eating routine that works for you! A great starting point is to choose a variety of healthy nutrient-packed foods as the foundation; foods like whole fruits, vegetables, whole grains, protein and oils. Aim for half of your plate to be veggies and fruit;  choose whole-wheat bread, corn or whole wheat tortillas, or plain popcorn. Choose healthy oils like olive oil or canola oil. Try unsalted, unflavored nuts and seeds for protein. Consider meatless meals like vegetarian chili or lentil soup and cook at home as often as possible as this puts you more in control of what and how much you’re eating. 

I would argue that someone like myself comes from a pretty privileged place as far as groceries and nutrition. I have access to big beautiful produce sections and farmers markets and also have the money to spend on them along with the access to nutritionists through my healthcare, along with access to nutrition education information. There are many like me, or us, but there are also millions of people in the states who don’t have this type of access/privilege. How do you think MPH students should consider this arguable inequity? Are there key things to consider and solve across the micro, mezzo macro levels?

This is a great question. I do think that there are multi-level, interconnected factors that are impacting nutrition and food systems, particularly among historically marginalized and low-income groups. A systematic review by Sawyer et al. immediately comes to mind. They developed an evidence-based systems map that clearly illustrates the dynamics of how, dare I say, a "toxic" food environment promotes the 4 A’s of consuming unhealthy foods (availability, accessibility, acceptability, affordability) which ultimately leads to over-consumption of ultra-processed, high calorie, high fat, high sodium, nutrient-poor foods. The system underlying the food environment was largely interpreted through an economic lens of supply and demand with five sub-systems; geographical accessibility, household finances, household resources, individual influences and social/cultural influences, directly influencing poor dietary intake. Albeit challenging given the individual, social, cultural, structural and economic practices surrounding food, this work highlights the need for a system paradigm shift where the focus is on health and well-being. And, while change is important at all levels, micro, mezzo and macro, the authors present a compelling case that change must occur at the macro system level to offer any hope of a sustainable impact on dietary quality. For instance, a new grocery store in a low-income neighborhood may not lead to a change in consumer purchasing behaviors; perhaps it is unsafe to walk to its location, or the food prices for healthier foods are higher than less healthy choices, or healthier food options are limited or are not the ones that are part of that community’s culture. Therefore, it is critical to implement strategies that impede the continuous cycle of crafting a food environment system which perpetuates the production and supply of unhealthy foods, particularly among low-income, historically marginalized groups.

One macro level policy that I would encourage MPH students who are interested in nutrition-related work to dive deeper into is the Dietary Guidelines for Americans. These guidelines are the foundation of federal, state, and local nutrition programs and initiatives for health promotion and chronic disease prevention. However, I would argue we have not made great strides in ensuring these guidelines are equitable and culturally sensitive. The evidence-base comes mainly from Western and European studies. Also, there is still controversy around how much of this policy is influenced by industry. 

Are there one or two pieces of research you have been involved in that are of special significance to yourself and/or the MPH program/students here at Simmons?

My research linking dietary patterns and diet quality to obesity in women has been cited in systematic reviews by the Nutrition Evidence Systematic Review team at the USDA. The NESR completed a series of systematic reviews to examine the relationship between dietary patterns and outcomes of public health concern. The systematic reviews conducted by NESR are used to inform dietary guidelines and federal nutrition programs.

I have also contributed to the chapter "Nutritional Epidemiology: An Introduction" in the textbook, Nutrition and Public Health which discusses the impact of nutrition on non-communicable chronic diseases that are of public health concern such as obesity, cardiovascular disease and certain cancers.

What are the top 3 or so nutrition oriented public health challenges that MPH students should consider or get involved in?

In my view, I would say nutrition security, food security and climate change, as well as US nutrition policy which I mentioned earlier. 

Nutrition security and food security are related, but they do have key differences. Food security, as originally defined by the Life Sciences Research Office, exists when there is, as they say, access by all people at all times to enough food for an active, healthy life. Food security includes at a minimum, one, the ready availability of nutritionally adequate and safe foods, and, two, an assured ability to acquire acceptable foods in socially acceptable ways. So, without resorting to emergency food supplies, scavenging, stealing or other coping strategies. Nutrition security, on the other hand, exists in combination with food security and other social determinants of health, including healthcare access, housing and other basic human needs such as clean water and a clean environment. There are clear links between food and nutrition insecurity and poor health outcomes among historically underserved individuals. According to NIH, black and latino individuals are more than twice as likely to experience food insecurity compared to white individuals. And, those who are experiencing food insecurity tend to have less healthy eating patterns, as in, fewer fruits, vegetables and whole grains, and more sugar, fat, and salt. Poor nutrition, in turn, is associated with diet-related chronic diseases, with 85% of healthcare spending in the US attributed to diabetes, cardiovascular disease and such, per the USDA. Also the USDA has found that poor nutrition causes more than 600,000 deaths in the US annually. All of this connects to areas to impact change and disrupt, if you will, the structural racism embedded in the complex adverse, unhealthy, food environment system detailed by Sawyer et al that I mentioned. 

Where might climate change fit into this? 

Climate change threatens agriculture. Changes in temperature, precipitation, water supply, extreme weather put our food supply at risk causing reduced food availability and access to food, as well as impaired food quality. And, according to the United Nations, our current food systems, from what we eat to how we produce our food, are a large part of the problem, contributing about one third of greenhouse gas emissions. 

We thank Dolores so much for her time speaking with us!