Not Your Nana’s Nutritionist

Everybody eats, therefore everybody knows about nutrition. At least that’s what you might think by clicking through various articles and posts about health, food and what you should and shouldn’t eat.

The true nutrition expert is registered dietitian (or registered dietitian nutritionist, abbreviated RD or RDN, respectively). RDs all have a college degree – many have advanced degrees – and completed didactic coursework plus hundreds of hours in internship rotations (unpaid, for the most part!) before sitting for and passing an exam to earn the privilege of putting those precious abbreviations after their names. Not only that, but RDs must complete at least 75 hours of continuing education credit every five years to maintain their credentialing and be allowed to keep those little letters.

What credentialing does a nutritionist need? Nothing, really.

The truth is, while some states have laws on licensure for health professionals, practically anyone can call themselves a nutritionist. Only dietitians can administer medical nutrition therapy and have some of their services covered by insurance providers.

Where can you find an RD?

Traditionally, RDs are found in some kind of clinical setting – working in a hospital or outpatient clinic. They may be developing diets for newly diagnosed diabetics or celiac disease patients, or working alongside cardiologists to help at-risk patients adopt heart-healthy diets, to name a couple of roles. You may envision her as the weight loss specialist (NOT “the food police”) suggesting foods you may want to incorporate into your diet and which to save for special occasions. But hospitals and clinics aren’t the only places where RDs can be found. You may see us in:

• Schools: Have you been to a school cafeteria lately? It may surprise you. Many school foodservice directors at the helm are registered dietitians, and these folks have a tremendous job trying to feed thousands of children daily, in a limited amount of time and on a limited budget. For some students, school lunch may be the most reliable, substantial meal of their day, so the foodservice director needs to make sure the lunch she serves is not only nutritious but also appealing so that it gets eaten and not tossed in the trash.
• Community Settings: Many RDs heed to a calling to help underserved and underprivileged populations. These are the RDs running programs for WIC (the Special Supplemental Nutrition Program for Women, Infants and Children), SNAP-ed (formerly known as food stamps) and many more, helping individuals spend their food dollars wisely and learn basic cooking skills.
• Kitchens: RDs are chefs, working at major restaurants, spas, or managing their own chef/culinary business. Many have traditional culinary training in addition to their nutrition degrees, training at the Culinary Institute of America or other fine institutions.
• Research/Academia: Nutrition research is ongoing, and who better to be designing and conducting studies than the food and nutrition experts? Not only do RDs work in food science, but many have expertise in behavioral nutrition, economics, and other fields.
• Industry: Call me biased, but RDs working with industry are the unsung heroes. Talk about effecting change – these are the folks with actual seats at the actual table, helping companies reformulate products to make them more healthful and desirable to consumers (it’s not nutrition unless people buy and eat it!). These folks have the ear of senior leadership, telling them what issues they need to address today, given the current policy and labeling landscape. These are RDs taking the research conducted by their their colleagues in academia, and disseminating it to their front-line RD peers working directly with consumers.
• In the Media: More and more (and rightly so), RDs are being called upon to provide expert insights to educate consumers on a larger platform than simple one-on-one communications. We see RDs as commentators on news programs, writing articles in major newspapers, building up audiences on social media. Heck, even winning reality TV shows!

Today is National Registered Dietitian Nutritionist Day and a time not only to recognize these allied health professionals, but to also applaud them for the sometimes thankless jobs they are doing. These are people working every day to improve the health and diets of those around us so that we can live longer and better.

Feature photo and RDN logo were both used with permission by the Academy of Nutrition and Dietietics

For more information, or to locate an RD in your area, visit www.eatright.org.

Field Notes: FNCE 2014

A few weeks ago I attended the Academy of Nutrition and Dietetics Food & Nutrition Conference & Expo™ (commonly referred to as FNCE®, pronounced FINN-see). This is the annual event in which 8,000 or so registered dietitians and others working in the nutrition field congregate and learn the latest nutrition science and research, sample new products, get a peek at the latest trends, and network like crazy. For me, FNCE is like an annual reunion, where I get to see – or meet for the first time – people I communicate with throughout the year on social media and via email. It’s fun, but hoo boy – is it exhausting!!

Which is probably why it took me this long to write up my FNCE recap. I needed the rest and recovery!

There is so much to do at FNCE, but my main job there was with Welch’s, working the booth and introducing its new Farmer’s Pick by Welch’s line of 100% fruit juices. Still, when I wasn’t at the booth I spent much of the rest of my time on the exhibit floor and came away with the following insights on the latest trends:

1. We love our snacks! According to the USDA, about 96% of Americans reportedly snack at least once per day. That trend was certainly apparent at FNCE, with snack foods galore. And not only were these snack foods packed with nutrition and taste, the brands also wanted you to know what they didn’t have, like GMOs or nuts or gluten or high-fructose corn syrup.
2. Kids are king! Maybe it’s the mom in me, but I was getting some good ideas for school lunches and snacks for my grade-schooler. With so many schools instituting no-nut policies, it was interesting to see all the nut-alternative products made with beans, peas and lentils, packaged in fun ways with kid appeal. But that’s not to say…
3. We’re nuts for nuts! So many nuts were at FNCE (and no, I’m not talking about the attendees!) There were peanuts and almonds and pecans and so much more. Maybe it’s because…
4. We’re also nuts for protein! Protein may be the one nutrient of which most Americans consume the right amount, but boy do we love protein! And there are myraid ways to get protein – not just the traditional sources like meat and dairy, but also protein-fortified bars and beverages.
5. We like to mix things up! Setting aside the “yogurt gets a passport” trend (see previous blog post on that topic), we love customizing our own foods, mixing savory with sweet, crunchy with creamy. You could see that in action with yogurts (SO many yogurt options), cottage cheese – even strawberries.

Curious to hear from other RDs and the trends they picked up on at FNCE. Leave a note in the comments!

 

Disclosure: Welch’s is a client, but I was not compensated nor asked to write this post. All thoughts and opinions are my own.

TIME for one more opinion?

OK, so I finally read the TIME magazine article that people have been buzzing about lately. I know I’m a little late to the game, but hey – I’m a busy mom of young children! Reading of any kind – even getting caught up in the not-so-critical-but-certainly-buzzworthy news of the day – is a bit of a luxury. I’m a subscriber to TIME (and several other magazines…most of which end up in a “to read” pile until the next time I fly and have to turn off all electronic devices.) But this magazine – with *that cover!* – was moved to the top of the pile once it arrived in my mailbox.

Clearly this was a thinly-veiled but nevertheless clever stunt designed to spur debate, boost magazine sales and increase website traffic. I mean, the timing was just right with the magazine hitting newsstands just before Mother’s Day. Bravo, TIME marketing team.

And I’ll admit, I fell prey to TIME’s social experiment. When I first heard about the cover and saw the provocative cover photo, I was outraged. I mean, who is TIME magazine to suggest whether or not I’m “mom enough”? And that picture? With that mother? And that…that…KID? Yuck!

Then I thought to myself: hypocrite.

Breastfeeding rates among women in the U.S. are climbing but we’re still far lower than other first-world nations. And while we can celebrate the fact that 75% of babies born in the U.S. have been breastfed according to the CDC’s 2011 Breastfeeding Report Card, a scant 35% are breastfeeding exclusively at 3 months (meaning the baby is getting formula or some other kind of nourishment in addition to breast milk), and only 44% are continuing to do any kind of breastfeeding by 6 months.

Why are moms not continuing to breastfeed? It’s a complex issue, but the general consensus is that moms don’t have enough support. Whether it’s a lack of baby-friendly hospitals or baby-friendly workplaces, or a glut of meddlesome relatives or unsupportive partners, or a combination of factors – who knows? All I can tell you is that if your 3 YEAR old is coming at you as his own personal bubbler, you are WAAAAYYY ahead of the game. And I should be applauding that.

You see, the TIME magazine cover gave me a sense of where the breastfeeding bashers are coming from. They want nursing moms not to “flaunt” breastfeeding, to put the boob and baby away and nurse in a dressing room or in a hiding spot away from the general public so they can go on with their normal lives of dressing little kids up as tarts and having young men wear their underwear above their pants. Because seeing a baby pressed up to a breast makes people uncomfortable. Even if we don’t actually “see” it, we KNOW what’s going on under that hooter-hider.

My main beef about the TIME piece is that the article really didn’t address any of this. You flip through the magazine, looking for more info about that sexy young mom with her preschooler appendage, but all you find are smiling pictures of a 72-year-old man. In fact, the article was all about Dr. Sears and attachment parenting and how the whole philosophy is based on single anecdotal observations by Mrs. Sears in her childhood and by some lady who went to Venezuela a lot instead of finishing college. As a dietitian who believes in an evidence-based approach, this is appalling.

A not-so-minor-side-“beef” with this article: in one fleeting bit near the end is a gloss-over on Dr. Sears’ controversial stance on vaccinations. It’s not mentioned directly (in the passage a mother was discussing “whether to vaccinate” her 6-month-old during her child’s routine checkup), but Sears advocates an extended schedule for vaccinating, which has no real scientific basis and could actually introduce more harm than do good. Does he also advocate slowly removing band-aids, bit-by-bit, so as not to stress the child excessively? I wonder.

But I digress. Look, TIME magazine was clearly out to make people think and talk, and talk they did. But will it help boost breastfeeding rates, or will it set us back even further as the stigma of breastfeeding is perpetuated?  We shall see.

Photo credit: iStockphoto

Have you hugged your RD today?

Today’s a special day, haven’t you heard? No?

Not only is March 14 “Pi” day (the number pi is approximately 3.14), but this year it is also national Registered Dietitians Day, or RD Day for short.

OK, so maybe we haven’t gotten the attention of Hallmark or Google yet, so there are no greeting cards or fun search-engine graffiti to increase awareness of this notable day, but RDs all across the country are wishing each other a happy RD Day…and I hope others take note of today, too.

The fact is, it’d be hard to find a single person who hasn’t been affected by the work of a registered dietitian. I mean, have you ever…

• eaten a school lunch? (especially lately? You should see some of the great things schools are doing for lunch and breakfast.) An RD likely prepared that menu, sourced the ingredients and ran nutritional information to ensure the meal met certain criteria for calories and nutrients.
• read a book, article or brochure on healthy eating? It might’ve been written by an RD, who spent the time reviewing complex research and putting the information in clear language to make it easier for people to understand…and better yet, to follow.
• bought food from a grocery store? Many supermarkets have RDs on staff to help guide healthy eating programs at the corporate level, and help consumers make smart choices at the store level. And many food manufacturers have RDs doing product research, marketing and communications, among other functions.
• tried a delicious, healthy dish at a restaurant or from a cookbook? Culinary RDs know all about recipe development using healthful ingredients, and understanding that enjoying food is as much about the experience of eating as it is about the flavor.
• heard about MyPlate (or its predecessor, the food pyramid)? This icon for healthy eating is based on the Dietary Guidelines for Americans, which is updated every five years after a thorough evidence-based review of the research by leading food and nutrition researchers, many of whom are registered dietitians.

Yes, we have “diet” in our titles, but dietitians are more than that. Sure, we help people who want to “go on a diet,” but many of us think of “diet” in the more general terms – as an eating plan to help people live healthfully. You may find us in hospitals, clinics, schools or restaurants; online, on TV, in the bookstore, in the paper or in a magazine; working for a company, for a health club, at a university or in the public sector. We’re not the food police, but we do love food. And we’re here to help people live healthier, longer and better.

MyThoughts about MyPlate

Today, Agriculture Secretary Tom Vilsack, along with First Lady Michelle Obama and Surgeon General Regina Benjamin, unveiled the new icon replacing the food pyramid, which first debuted in 1992. These icons are designed to translate the complex Dietary Guidelines into a simple, “how-to” guide for following a healthier diet. The most recent pyramid, unveiled in 2005 as MyPyramid, was widely panned by health professionals as too complex and not user-friendly.

The new icon is called MyPlate, and is a simplified version of the recommendations laid out in the Dietary Guidelines. I applaud the USDA and Obama administration for choosing a straightforward design which applies more directly to the act of eating. But I am concerned that the icon has been oversimplified. That said, here are “MyThoughts” about MyPlate:

Likes –

• The name: ChooseMyPlate. “Choose” implies empowerment, and that the responsibility for eating healthfully (and making behavior changes) ultimately resides with the individual.  “My” is a carryover from MyPyramid, which were actually 12 individualized pyramids based on age, sex and activity level. The “my” is a nod toward one’s individual dietary needs:  while the elements of every person’s plate would be the same, a toddler’s plate would look different from an adult male’s plate.
• It can apply both to a single meal as well as an overall diet, and just by a quick glance you get the main message of: make half of what you eat fruits and vegetables – slightly more veggies than fruits. I also like how exact measurements have been left off the icon…that the different food groups are really more or less relative to one another.
• The “Milk” group is back to being categorized as “Dairy,” which is a little more accurate about the foods you’d find in the group, such as yogurt and cheese. Calcium-fortified soymilk is also in this group, and while technically not a dairy product it is often a dairy substitute.
• The plate design makes it easier to visualize what to put on your plate at a meal. Many RDs, myself included, use a plate technique with clients to educate about portion and food groups. HOWEVER, many people are still eating meals on the go – in the car, in a carry-out bag or in some other convenient form – such as a sandwich. Using a plate approach still requires some imagination for translating the actual food one is eating into these categories.
• While there was a lot of discussion about physical activity no longer represented on the icon, I’m OK with that. This is meant to be a representation of how people should eat – other behaviors such as physical activity and practicing food safety principles can be a separate conversation.

Dislikes –

• Dairy appears to be an afterthought, and not a main component in one’s diet. Also, its shape is different from the others, making it difficult to envision how much dairy relative to other food groups a person should eat.
• “Protein” is ambiguous to the average American. Why they chose to do away with the more descriptive “Meat and Beans” group is beyond me. Protein is a macronutrient, whereas fruits, vegetables, grains and dairy are all foods. I’m glad they didn’t rename the grains group “Carbohydrates”!
• Fats have been excluded. Will this icon send an inadvertent message that fats don’t belong in our diets? The fat-free craze of the 1980s was a diet disaster and should not be repeated. People are still learning that certain fats do deserve a place in our diets, such as oils, seeds and nuts.
• Non-plateable foods such as soups, cereals and mixed dishes will be hard to translate into the new plate model. Consumers will need to “deconstruct” their foods to see how it fits into their daily needs.
• The plate represents an ideal – as it should – but it excludes other foods people eat, including items addressed in the dietary guidelines such as foods with added sugar and alcohol. Granted, MyPyramid also didn’t address these foods in the icon, either. While such foods/drinks should be limited and need not be a part of a person’s everyday diet, we cannot simply ignore these foods and pretend they don’t exist, particularly if we’re going with an icon we hope people will apply to their everyday dinner plates.

In general, I think the new icon is a good starting point to help consumers think about what they eat in a single eating occasion and as a whole. But it should not exist in isolation. Registered dietitians still need to translate what the icon means and apply it to individuals to help them meet their healthy eating goals.

If you’re interested in starting a healthy eating plan, let’s make an appointment! I work with individuals and families on adopting healthier lifestyles, weight loss and general wellness. Check out my website at http://www.enlightennutrition.com/ or contact me for more information.

Everyone’s a critic

I was recently approached by a writer for Washingtonian.com to serve as the nutrition expert, analyzing a food diary submitted by a reader. Happily, I agreed.

I was even happier when I received the food diary the following day. Although it’s a little nerve-wracking to analyze the diet of someone I have never met and know nothing about their motivation for completing this task, their goals and so on, this diarist provided me very detailed information not only of the foods she ate, but of her mood, preferences, and other things going on in her life at the time. Plus, she provided six days’ worth of information, which is like a goldmine (typically, we ask for 1-3 days, preferably one weekday and one weekend). I spent a fair amount of time looking at what she had written about the foods she ate and preparing my analysis and write-up.

Both the diary and my write-up appeared in their entirety on the blog the day after I completed my task, along with a headline and intro. As soon as I saw the live article, I began anticipating the criticism (yes, I’m my own worst critic). The headline alone highlighted a potential landmine that I didn’t address – the diarist’s affinity for cookies and snack food. In my notes I had a few other critiques that I consciously chose not to address and hoped I wouldn’t get raked over the coals in comments.

Why didn’t I just address everything?

Well, mostly because I recognize that this diarist is human. No one, not even registered dietitians, have perfect diets. There’s always room for improvement, things we can do better, and ways we can live healthier.

Also, it’s my philosophy that it’s easier to do more of the things you’re already doing well than to stop doing things or making changes (like, in this diarist’s case, eliminate her beloved oatmeal chocolate chip cookies). Yes, many of us want to be told to do this and don’t do that, but when it comes right down to actually doing things, once you tell us to stop we want that thing so much more. I’d much rather have someone tell me, “keep doing that, you’re doing great!” than otherwise. Wouldn’t you?

Finally, there’s only so many changes a person can do at once. As a nutrition coach (I hesitate to use the Washingtonian’s term “expert”), I prioritize my recommendations and offer just a couple for people to work on at a time. Faced with too many goals, it’s easy to just throw your hands up and say “forget it!” Better to focus on small steps – the big change will come.

The downside of engaging in this Washingtonian critique is that I don’t have the opportunity to interact with this individual and see if my advice worked for her, or to fine-tune my advice based on her preferences, available time, cooking skills and other variables that inevitably come up in counseling sessions. Maybe she’ll contact me, maybe not – but at the very least I do hope I provided some food for thought not just for her, but for the readers of the blog as well. I’m looking forward to any comments.

My nutrition counseling practice, Enlighten Nutrition, provides individualized nutrition counseling for residents in Northern Virginia – including analyzing people’s diets and coming up with eating plans to help them meet their goals. I also work with businesses and organizations on their nutrition communications and health professional outreach programs.