Voices in Health and Wellness

Beyond the Clinic: Teaching Kids to Love Veggies and Heal Their Guts with Nathan Bratko

• Dr Andrew Greenland • Season 1 • Episode 27

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What happens when clinical nutrition expertise meets hands-on pediatric healthcare and community education? Nathan Bracco, a certified nutrition specialist and licensed dietitian nutritionist, reveals the fascinating intersection of these worlds and the profound impact it has on children's health.

Nathan's multifaceted approach spans individual clinical care, classroom education, and community advocacy. At Bay Pediatric Center, he works with high-risk pediatric patients dealing with weight management issues, food allergies, digestive problems, and diabetes. Meanwhile, his grant-funded work through the University of Maryland takes him into elementary school classrooms, where he transforms nutrition education into an exciting sensory adventure. "We make it fun and exciting," Nathan explains, describing how children taste-test fresh produce and learn to articulate their food preferences in a supportive peer environment.

The post-COVID landscape has revealed troubling trends in pediatric nutrition. Nathan observes increasing mental health issues manifesting in eating behaviors, from sensory aversions in younger children to body image concerns in teenagers. At the root of many issues? Gut health. "The standard diet for children in America is highly processed foods. They're not getting the nutrients they need to thrive and function at a high level," he notes. This nutritional deficit affects not just physical health but cognitive and emotional wellbeing too.

Despite classroom success in getting children excited about healthy foods, Nathan identifies significant challenges in bridging the school-home gap. Even when children develop enthusiasm for fresh produce, families may face barriers from lack of cooking knowledge to limited access to fresh ingredients. Socioeconomic factors create stark differences in nutritional access and receptiveness to guidance across communities. Meanwhile, navigating the complex insurance landscape requires substantial administrative resources—a bottleneck Nathan would immediately remove if given a magic wand.

Ready to learn how nutrition education can transform children's relationship with food? Listen now to discover practical strategies for making healthy eating fun and accessible for the next generation.

Guest Bio: Nathan Bratko 

Nathan “Nate” Bratko, MS, CNS, LDN is a Board‑Certified Nutrition Specialist and Maryland‑licensed Dietitian Nutritionist, serving Eastern Maryland as a practitioner, educator, and public health advocate. 

He holds dual roles: 

  • As a nutrition consultant at Chesapeake Health and Nutrition and Bay Pediatric Center, he provides one-on-one care for children with growth concerns, food allergies, digestive issues, and diabetes.
  • As a Project Leader and Nutrition Educator for Maryland’s SNAP‑Ed program via the University of Maryland Extension, he leads school‑based nutrition education and food access initiatives across Talbot and Dorchester counties 

Nathan’s integrated approach blends clinical care with community outreach: he teaches interactive nutrition classes in elementary schools—complete with tasting activities, MyPlate strategies, and local produce exposure—to empower kids and influence family dietary habits. He also serves on regional health councils and hunger coalitions to drive policy and sustainability efforts.
 
He is especially passionate about supporting childhood gut health as a foundation for mental and physical well‑being, and he is currently expanding his work into consulting, brand partnerships, and public health programming.
 

Contact Details

email: nate.bratko@chesapeakehn.com

Linked in: https://www.linkedin.com/in/nathan-bratko-ms-cns-ldn-3ab28b2a/


Dr Andrew Greenland:

So welcome back to Voices in Health and Wellness, where we explore how practitioners, clinic leaders and healthcare entrepreneurs are navigating the ever-evolving world of care delivery and what it really takes to both thrive clinically and operationally. Today's guest is someone who brings a uniquely integrated perspective to that conversation Nathan Bracco. Nathan is a certified nutrition specialist and licensed dietitian nutritionist with a master's in clinical nutrition. He plays a key role at both Chesapeake Health and Nutrition and the Bay Pediatric Center in Eastern Maryland, blending advanced nutritional care with hands-on experience in pediatric health settings. Nathan, thank you very much for your time this afternoon and welcome to the show.

Nathan Bratko:

Oh, you're welcome. Thank you for having me.

Dr Andrew Greenland:

You're very welcome, so maybe we can start at the top. Could you maybe tell us a little bit about your, the different roles that you have in the two places that you work, and how those worlds kind of intersect?

Nathan Bratko:

Right, yeah, we often wear many hats in our field.

Nathan Bratko:

So I think in one area yes, it is very clinical, individual one-on-one practice where I partner with a local doctor's office, pediatrician's office and I am referred clients, usually the clients that are or the patients that are at like, the highest risk of like, either, you know, needing to gain weight or lose weight, obesity or starvation.

Nathan Bratko:

But then I'm also seeing a lot of food allergies or digestive issues, even like type 1 and type 2 diabetes patients. And then on the other side of my role is in public health, nutrition education. So I am funded through a grant with the University of Maryland to work closely with schools, elementary schools in a school-based setting, to educate children on nutrition and teach nutrition education classes in an elementary school setting. And then there's the advocacy too. So I sit on a number of health councils and hunger coalitions. I went to a meeting this morning to listen, to hear what the most pressing issues are in food access and sustainability throughout my area. So it's quite interesting. I guess no two days are ever alike, that's for sure, and it definitely evolves over time as well.

Dr Andrew Greenland:

I'm sure, and I was going to ask you as the next thing what does your typical day or typical week look like in practice, excepting the fact that no two days and no two weeks are the same, but in terms of how you kind of integrate all of those things into your week, how does it kind of pan out?

Nathan Bratko:

Yeah, the I would say my schedule is is very concrete. You and that's an I think it's an important piece of any clinician practitioner is to have, like days that where you're in an office and days that maybe you're in the field. You know, days and hours that you're seeing patients, and then days and hours dedicated to like notes and administrative tasks as well too. So I do set up my week is like maybe Monday, tuesday or Wednesday I'm working in a school teaching, you know, nutrition classes and meeting with children, and then maybe towards the end of the week I'll be in practice, you know, at the doctor's office seeing patients. So and I usually have that booked out several months in advance um, that way it's, you know it's there and, um, I can count on having that organized got it.

Dr Andrew Greenland:

What major shifts are you seeing in pediatric or functional nutrition at the moment?

Nathan Bratko:

and particularly, you know giving us your us perspective I, I would say a lot of um, we're seeing a lot of like, I would say mental health, um, at least in this area and this is a lot of like coming from, like that post-covid um, we're still seeing a little bit of the remnants of that. Um, at an early age, uh, we often see, like picky eating, you know, children that have aversions to sensory, you know, sensory aversions to certain foods. That's usually around four or five, maybe six, stemming all the way up to like age nine. As soon as I get into more of like, the teenagers, um, I do see a lot of more, um, more of that desire to like, more of the desire to, you know, focus on their body image. So, um, I may see, uh, children or adolescents wanting to exercise more or wanting to um, look and feel a certain way. So you may see some body image issues in that field.

Dr Andrew Greenland:

That's really interesting, and I mean obviously with a functional perspective. Do you have any sense of what the kind of the key root causes of some of these things are in your experience?

Nathan Bratko:

So we look at gut health a lot of gut health and I really think that's going to be an emerge, you know that's going to be consistent all around too is because you know how we're, you know the digestion issues and their gut health play a role in all functions throughout the body, especially in, like, mental health. So, yeah, so I think just getting the vitamins and if we look at like the standard, like in America, you know like what the standard diet for children is is highly processed foods. So they're getting, you know, they're not really getting the nutrients they need in order to thrive and in order to to function at like a, at a high level. And, um, it all starts with, like how they're absorbing those foods too, and so I really think gut health is is important, an important topic amazing.

Dr Andrew Greenland:

Um, what about how receptive are? I mean, you mentioned you do some outreach work, you're working in school, you're educating. How is this sort of nutrition side of things received by children, particularly the ones where you see they're not having a great diet? How do they receive the kind of education they get in this area?

Nathan Bratko:

Oh, they love it. Yeah, so we make it fun and exciting and I can't probably emphasize that enough as, like a nutritionist is to, you know, make it fun and exciting for our audience. And so to paint a picture of what it looks like is, you know, we go into a classroom full of like kindergartners around five, six years old, a classroom full of like kindergartners around five, six years old, and we bring either, you know, fresh fruits and vegetables and we talk a little bit about shapes, colors, sizes, smells, you know, really expose them to that sensory you know, you know, getting them to identify certain fruits or vegetables through their senses, we make certain connections on you know how it's grown.

Nathan Bratko:

Census, we make certain connections on you know how it's grown, where it comes from, and then we have a taste test, you know. So kids get to taste and try these, you know these foods, and then they get to vote on you know how they, if they enjoy it or if they dislike it, and then there's like a little reflection so that they can use certain words, you know, use adjectives and learn, you know, connections to, you know, to literacy, so they can go ahead and identify and articulate, like what they tasted and tried In a setting. In a controlled setting like that in a classroom, our outcomes are very favorable. You know kids really enjoy tasting and trying new foods with their peers. They're more likely to try something that may have scared them prior.

Nathan Bratko:

You know there's certain aspects of that that are hard to duplicate at home. So if they go home, you know, with the hope of oh hey, mom and dad, I tasted melon today at school. You know, can I, can we purchase melon, you know, and have it at the dinner table? Well, their grocery store, their local market, may not have some of those items. So we make a point to work throughout the community to select local produce items that they can readily find at the market.

Dr Andrew Greenland:

I mean, you hope being the kids will be sort of a secret agents of change in trying to improve the family's diet by sort of taking taking your learnings out of the classroom at home and trying to influence what what happens? Or do you think there's a block there? And despite all this wonderful education, it's, at the end of the day, what the parents put on the table which is what the kids are going to be eating.

Nathan Bratko:

So yeah, it is for the connections to home and, you know, having children feeling empowered to ask their parents oh, I like you know tasting salad.

Nathan Bratko:

You know like having salads, or I like having you know fresh zucchini or something, and can we get that? You know parents may be like well, I don't know how to cook it, so there's a little bit of the. You know how do I prepare it? You know that that kind of like disconnect or there's the fear that when parents may not purchase a certain item because they feel like they're going to wait, you know like if the whole family doesn't like it or if they don't like it, you know they feel like they wasted their money on something that's just going to be, you know, thrown away. So we still there's still a lot more work to do working with parents and showing that parental connection and having that parental connection to empower and not only children to ask for healthier foods. But then work with parents as well to, you know, teach them and build their confidence or their self-efficacy to prepare it for the family and for themselves.

Dr Andrew Greenland:

I understand and are you noticing more families, parents, looking for sort of more integrative or nutrition first approaches? Are you getting that sort of a sense that the stuff is what the public are looking for, or are you constantly having to kind of educate people from the ground up?

Nathan Bratko:

It's different on different levels. I will say we find you know depending on our audience. You know going from, you know working with low literacy, low income individuals to say, middle and upper class, you do see that change in our audience. You know with one change in our audience. You know with one area you know you get a lot of. You know families that are just happy. You know when you're promoting, you know healthier foods and physical activity and you know I do have many families that I also still work with that may look towards you know like vegetarian diets or meat alternatives and looking more for like natural and holistic methods to you know treatment of like diseases like such such as food allergies. So I do see a wide range and I see it more it's more it's different between audiences and socioeconomic classes.

Dr Andrew Greenland:

So the places you work at are these state state clinics that you're working in? I'm trying to understand the setting, because obviously everything's a bit different in the UK. I'm just trying to understand what kind of model you're in.

Nathan Bratko:

Yeah, so the Bay Pediatrics is a private, is a private healthcare center. I do accept all health insurance, you know health insurance, and I also accept, you know, federal subsidized health insurance, which would be our Medicaid. And I work in a public school setting which is state run, so it is a little bit of private. And then you know, then obviously I would say majority of the work I do is like public it. And then you know, then obviously I would say majority of the work I do is like public got it.

Dr Andrew Greenland:

So I was going to ask you about insurance, because I've spoken to a number of sort of clinics and health businesses in the us and the insurance reimbursement thing is one of the major bug bears. I just wonder where that impacts on your work. Um, whether it's whether it's one of your bug bears or it's something you've managed to navigate with ease yeah, so I have I can't.

Nathan Bratko:

I have a team of a team of people that really help and provide me with wonderful support to navigate the insurance world.

Nathan Bratko:

Okay, um, because there is a lot of challenges from, you know, getting credentialed with insurance companies, um, you know, the contracts, um, and then the billing and payment.

Nathan Bratko:

So it's, um, it's no small feat and it really does take like a team of individuals to try and help navigate that in the states, um, you know, and there are care models and a lot of, uh, it's a lot of um and a lot of, it's a lot of, you know, note taking and phone calls. So we have what we call a prior authorization. So for nutrition counseling, you have to show, like you know, call up the insurance company to get prior authorization for them for you to treat a patient, and once that gets approved, well then you can treat the patient. And once that gets approved, well then you can treat the patient for a certain amount of visits based on a certain rate. So, no, it's quite the process to do to do it. But I also accept self-pay too, and for the individuals who do not want to go through their insurance, Okay, interesting In terms of the various things that you do in the various roles that you have.

Dr Andrew Greenland:

what's kind of working well for you? What have you spotted as one of your kind of winning strategies, or things that you do with your patients, or things that you do in running the business side of things or the education side? What's kind of working well for you?

Nathan Bratko:

Yeah, I would say that you, you know using education as like outreach, so letting those pieces carry on and influence, you know, neighbors and them. So that's kind of like where I get a lot of patients to come, you know, specifically to come see me. So it's yeah, highly highly emphasis on education.

Dr Andrew Greenland:

Okay, interesting. And what parts of the patient experience do you wish you had more time to optimize, because obviously everybody's under time pressure. You've only got so many hours in a day, you only see so many people and you only got a certain amount of time with a particular patient. What does this sort of thing?

Nathan Bratko:

Yeah, I'm sorry. So I believe your question was like you know what? Could I spend more time doing?

Dr Andrew Greenland:

Well, what would you like to optimize in terms of the time that you have, in terms of the patient experience? So, if you had more time, or you could better optimize the time that you had, what would the kind of thing be? Or you could better optimize the time that you had what would the kind of thing be?

Nathan Bratko:

I think it would be the you know the prior to the, the patient coming in and having the testing done, having the questionnaires filled out, reviewing that you know, and I think just you know, when you only have like, say, maybe three visits with the patient, you know an hour for your consultation. You know when you only have like, say, maybe three visits, um, with the patient, you know an hour for your consultation, you know, for the initial consultation and then maybe two follow-ups. You know it's important, I think, to have like all of that initial you know, get the, the data and the testing and, um, the questionnaires that they all have to fill out ahead of time. So really, you know we're making sure that process is more efficient and optimized. So that way, when they do see me, it allows us to like better focus on, you know, their goals and their treatment.

Dr Andrew Greenland:

I understand and are there any? I was going to say, how do you currently handle the administrative load, I'm guessing, with the different roles that you have and some of the things you've just alluded to around testing and forms? How do you handle all that admin? It's something I'm very interested in in different clinic businesses how they kind of manage obviously the patients that they see, but also kind of the admin and the stuff in the background as well.

Nathan Bratko:

Yeah and it's. I'm always looking for ways to keep up on clinical notes and everything. Recently I've been looking into different platforms portals that clients can go on and fill everything out, and our EHR, our electronic health records platform, does a great job at communicating with other offices. So if they had testing done at like, say, a hospital, somewhere, those results would be. You know, I'm able to like view those results, so, like the different softwares that are able to talk to each other, that does save me a lot of time, you know. So I don't have to like call an office and have records transferred over or anything. And my team again, I can't say how much I appreciate the team of like nurses and admin workers and even my practice manager, how much work they do and how much support they offer me. So my time is like is well managed.

Dr Andrew Greenland:

So I mean, and speaking of team, because you've referenced them a few times how do you balance team communication when you're working in different clinical environments, because you have the two places that you work and then you do your outreach and your education? How do you kind of keep everybody on track with what's going on?

Nathan Bratko:

Calendars yeah, well, well, notes, like everybody is really good with notes, taking very well detailed notes, and our system is very set up. You know, we we do send out like weekly emails. You know recap emails, and we set time aside at the beginning of the week to discuss, you know, critical patients or important issues that are coming up. Um, you know it goes back to my ehr, the ehr that we decided to use, which is e-clinical. Um is um is wonderful at keeping very well detailed notes.

Dr Andrew Greenland:

So so it's all about the tech and then what's something you wish that your patients better understood about your role? Obviously, you're working with patients in lots of different settings. What's the one thing you wish they better understood about what you do?

Nathan Bratko:

oh, um, you know how it really. Uh, you know how much care we really care Every person that comes in. We're really taking the time. So when we offer the recommendations and we go and develop a treatment plan, it's really well thought out and thought through and it's really designed you know personally for every person you know. So you know it's really well planned out.

Dr Andrew Greenland:

So yeah, got it. And on that note, are there any sort of moments when expectations between the patients and your team and you misalign, and what kind of things are those things and how do you handle them?

Nathan Bratko:

You know, I guess, to go back to like communication how important it is to communicate with your team so everybody really understands. You know what the expectation is and you know from everything from like booking to scheduling, to the insurance side. You know, I would say like those expectations. You know. You know this is what the you know having a system in place, I think that's the important thing is you know. Know this is what the you know.

Dr Andrew Greenland:

Having a system in place, I think that's the important thing is you know having a really thought thought out system well thought out system in terms of where you would like to be in six, twelve months time with the different practices you work in. What's your kind of plan for the future? More of the same, or do you have any particular plans for growth, development, expansion?

Nathan Bratko:

yeah, I'm currently actually expanding um. I work with another private company. Um I'm working into like more social, uh, social media. Um I can't, um, if you know, go into too much detail, um, because we do have like a non-disclosure with the company, but we do have some exciting things coming. You know coming out working with like some supplement brands, some fitness companies, and doing more into like that consulting. You know getting branching out into more like consulting for businesses and in corporations.

Dr Andrew Greenland:

So I mean, does your expansion in the clinics you work in are we talking also about being able to see more patients somehow getting more people in, or is it more about sort of diversifying into the things that you've just mentioned?

Nathan Bratko:

I would say it'd be like to diverse. You know so, um, and keeping you know the the one-on-one patients and clients. Those are like the most critical. You know the ones that are, um, I guess, the most critical in in need, um, so, uh, I do expand. You know there's um again going to the non-disclosure but into working with other clinics too, but you know, and having clinics like partner together. So but yeah, I would say about I see about like 12 patients right now a week. But yeah, I would say about I see about like 12 patients right now a week. But the 12 patients that I do see again, they're the ones that are probably the most I wouldn't say they have the conditions that dictate that we need to see these, make them a priority.

Dr Andrew Greenland:

So yeah, I mean, and the reason I ask is because it sounds like you're in a field where there must be massive demand for what you do and I'm just wondering, I don't know how, whether you have a waiting list or whether you have a sort of whether you're saturated, and I just wondered where the kind of demand for this is, and is it ever going to be met? Because I know there's probably few and far between in terms of people that do what you do. I'm just trying to get a sense of you know, how do we service all of these people with these huge needs that you've kind of alluded to?

Nathan Bratko:

yeah, and we, we do develop resources. You know that's something I'm um, you know, with the university work. You know we we look at building our resources. Um, you know into. You know other, you know into programs. You know into. You know other, you know into programs. You know group programs or public health programs. So that is one way that we can look at.

Nathan Bratko:

You know servicing a greater need. You know providing mentorship to other nutritionists that are up and coming in the field. You know so. You know the schools that we work with also have other nutritionists that are up and coming in the field. So the schools that we work with also have other nutritionists that we work with that I do meet with on a periodic basis to discuss their needs. So, yeah, what I found is, as things build, you have to increase capacity to to do more. So, um, as we're building up that, you know building up the, the need, or we're identifying new needs that come and uh, there's the natural process to like, okay, well, let's look at the capacity and, um, where can we, you know, develop new resources or or tap into um to other systems or other um you know other methods so thank you.

Dr Andrew Greenland:

Um, if there was, um, I was gonna say there was one bottleneck in your what you do and you had a magic wand to fix it, what would you? What would you wave your magic wand at? What would you want to get fixed in terms of bottlenecks or things that limit what you do?

Nathan Bratko:

oh my god um, that insurance, anyone's that ever had to like work with insurance. You know, make it easier for everybody. I would say that one because it's really you know it could limit, you know, could really limit people from getting, you know, the help that they need or the, the knowledge that they need or the care that they need. So, yeah, I would say the wave a magic wand, and, you know, make it easier, an easier process.

Dr Andrew Greenland:

I think everybody I've spoken to in the us has said exactly the same. And then, finally, if you were to sort of start again tomorrow from scratch, what would you do differently in terms of the various things that you've been involved with? What would you do if you could do, if you had to start from scratch tomorrow?

Nathan Bratko:

Oh, um, I, you know I think I would, um, you know, probably get like my doctorate. You know, keep going, but I'm still young, you know I'm young, I could probably still do it. So continuing education, so um helps expand your reach and expand Um. I can go back to the capacity. You know, like you're, um it's a big resource to have and it's wonderful um. Um, it's a big resource to have and it's wonderful um when it's available.

Dr Andrew Greenland:

So when you say doctorate. As in? What kind of doctorate?

Nathan Bratko:

I like uh um like naturopathic doctor okay yeah, so um no, which is, you know, huge um need in this area too, for that and um and also just you know, being a pediatrician too or someone who specializes in that, in that kind of care. So you know, we do see that I do partner. I have partnered with some NPs and we have one in our office too, at Bay Pediatrics too.

Dr Andrew Greenland:

So you know, Nathan, thank you so much for your time this afternoon. Really interesting hearing about your work, what you do, what goes in your business, the outreach you do, and I'm very interested about the education how you're managing to get the younger generation to have an appreciation for healthier food. I think it's a really really useful and productive thing. So thank you very much for your time. Really appreciate it.

Nathan Bratko:

You're welcome and enjoy your day, thanks.