About Us

Registered Dietitian in San Diego

If you have 15, 50 or 100 pounds to lose, diabetes, high blood pressure or heart disease, Diane Machcinski can help you.

Winner of the California Dietetic Association Dolores Nyhus Outstanding Achievement 2010, the highest award given to a California Dietitian for outstanding contributions to the field, Diane has 20 years of private practice experience and has helped over 1700 clients look and feel better.

She possesses a Master's Degree in Nutrition Education and keeps abreast of the latest, cutting-edge, nutrition information. Her work experience includes Chief Clinical Dietitian at Scripps Memorial Hospital, Clinical Dietitian for Scripps Executive Health, Clinical Dietitian in Toledo Ohio, Program Manager San Diego County Community Health Services, and Instructor of Nutrition and Nutrition & Fitness at Palomar & Mesa Community Colleges.

A+ Nutrition is just a call away.

Diane wants you to look and feel your best by making small changes in what you eat and improving the quality of your life.

Additional Awards

• California Dietetic Association Practice Award for Distinguished Service”, Oakland, CA, Spring, 2004

• California Dietetic Association Practice Award for Excellence in Private Practice, Business and Communications, Palm Springs, CA, Spring, 2000

• "Top Ten Foods", NBC News Network Internet News, March, 2000


• "RDs Make a Difference", CDA Bulletin, November/December 1999

• "Smart Eating for the Whole Family", Real Woman Magazine, September/October 1999

Resgistered Nutritionist in San Diego

Lorena S. Pacheco, MPH, RDN, CPH

Lorena is a Registered Dietitian Nutritionist (RDN) with a Master’s in Public Health in Epidemiology, Certified in Public Health and currently pursuing a Doctorate in Epidemiology degree from the Joint Program in Public Health at University of California, San Diego (UCSD), and San Diego State University (SDSU).

She has been part of the A+ Nutrition team since Fall of 2009 and is experienced as an Outpatient Dietitian and as a Clinical Dietitian in the acute care setting. Her experience working with people from Tijuana to San Diego across a variety of disease populations makes her extremely valuable. Research involvement includes trips to the San Quintín valley in Baja California, working with both UCSD and SDSU investigators and Mexican researchers from the Universidad Autónoma de Baja California (UABC) in Tijuana. Lorena has a multicultural background and is bilingual (Spanish and English).

Lorena has a passion for health, nutrition and wellness and provides individualized care for every patient.
Janice Shigehara

Janice Shigehara

Janice is a Certified Diabetes Educator and Registered Dietitian Nutritionist with over 20 years of experience, including 15 years at Scripps Clinic consulting with more than 1,000 individuals with prediabetes, diabetes, and gestational diabetes.

Her teaching and media experience include heart-healthy food demonstrations and talks for CBS and ABC local affiliate stations as well at the AAUW Poway/Rancho Bernardo branch and numerous healthy cooking classes at Scripps Clinic.

Janice is also a SoCal resource expert in cardiovascular disease for the Academy of Nutrition and Dietetics, and Program Director for the Dietetic Service Supervisor Certificate Program at San Diego Mesa College, overseeing students placed in long-term care facilities

Janice enjoys the challenge of working with people of different ages, ethnicities, socioeconomic, and educational levels, to make positive lifestyle changes that will work for them in the long-term.


I never realized the calories in some of the beverages I was drinking! More water for me. Thanks Diane.


With Diane, my blood pressure hasn’t been this low in 6 years.


I loved the supermarket tour! I am much more aware of the sodium content and fat content in the foods I was buying!


I could never lose weight until I came to see Diane. I am a marathon runner and with Diane’s help, I’ve lost 5 of the 10 lbs. I wanted to lose in a relatively short period of time.



Thank you for changing my life ... by teaching me about proper carbohydrate intake, you soon returned me to the energy level I had twenty years earlier and helped me lower my glucose levels.

Written for Janice


We were pleasantly surprised by the creative ideas that she presented and discussed with us. A very valuable session!

Written for Janice


She was always most supportive and professional during my weight loss program. Thanks to her support and encouragement, I have not only lost weight, but my cholesterol level is at an excellent level. Because of her professionalism, I am recommending her very highly to my other friends.

Written for Janice