"Healthy" eating

It's almost the end of the semester! I can't believe how fast it has gone by. I thought I would write my last blog about my "looking" project since the topic of my project ties in nicely with my blogs.
Rahaf and I decided to teach a seminar on "healthy" eating to the class to see what third and fourth year nutrition students believe "healhty" eating to be. The purpose was to explore their attitudes and values around the word "healthy" and stimulate a discussion on the many factors one must take into consider when trying to come up with a definition. I think the seminar was very successful and we did receive a lot of positive feedback.
We also looked at EatRight Ontario's definition of "healthy" eating. EatRight suggests "healthy" eating means following Canada's Food Guide and consuming "extra" foods in small quantities. We discussed how that differed from the class' definition of "healthy" eating, which encompassed the words "variety", "moderation", "balance", and "enjoyment."
Now, as I read through the Canadian Journal of Public Health supplement, which discusses the many factors involved in eating "healthy", I realize there is even MORE to consider. Mary Bush reminds us that what people eat is influenced by the physical environment, the capacity to make healthy eating choices, time, skills to prepare food, personal buying power, one's financial situation, and one's social environment. Kim Raine, in her article "Determinant of Healthy Eating in Canada" talks about the perceptions of healthy eating, which are defined as "the public's...meaning, understandings, views, attitudes, and beliefs about healthy eating, eating for health, and healthy foods." The public's perception on healthy eating includes the consumption of vegetables, fruits, and meat; limitations of sugar, fat, and salt; and variety and moderation. I wish I had read this article before we presented, as I think this definition is a beautiful marriage of parts of EatRight Ontario's definition with pieces of the definition developed in class. It talks about key messages from Canada's Food Guide and mixes them with the belief that every food is okay; that every food has a place in one's diet. However, Kim Raine goes on to say that this definition is lacking some very important key elemetns. Some of them include the consumption of grain and milk products, the importance of freshness (which was mentioned in class), consuming unprocessed and homemade foods, and the concept of balance (which was also mentioned in class). Kim mentions the importance of one's culture in defining "healthy eating" and one's individual psychological state (including self-esteem, body image, mood, and chronic dieting). Kim then goes on to discuss the role of environmental factors in the definition, illustrating how complex the simple term "healthy" eating can be.
There is just so much to think about, so much to take into consideration when we use the words "healthy" eating. I think the message that I will take away from this exercise is that "healthy" eating cannot be defined. Eating "healthy" is an abstract concept that is not easily translated into words. I just read the article "Measuring the Dash" and I think when you step back and look at the big picture, our life is so short and there is only so much we can control. Yes, eating some foods may help us, and some may harm us, but when we look at the purpose of life, where does "healthy" eating really fit in? I think we just have to be mindful and pay attention to life, and think about what we are eating and why. I think it's very important to create a connection between our bodies and food. For me, that is "healthy" eating.

A healthy obsession

I like to search through other blogs to see what my peers are writing about. Blogs are so much fun! And there are so many out there. Today I found an interesting one: http://www.eatmedelicious.com/2007/06/welcome-to-my-food-obsession-blog.html. The lady that writes this blog is a self-proclaimed food obsessor! She lives in Vancouver and has a degree in psychology and is now studying food technology. She is also an amazing food photographer! The shots of the food she makes are incredible. They make me want to go into food photography. Wow, I get hungry just looking at them! The above shot is of her earl white chocolate muffins.
Her blog is amazing. This is what I want food obsession to be like for all of us! She loves food, loves cooking food, loves tasting food, loves taking pictures of food, and obviously loves writing about food. She is not afraid to share this obession with the world, and I think that makes for a healthy obsession. Is there such a thing? A healthy obsession? I do think so. The word "obsession" musters up feelings of "wrong" or "bad' in most people's minds, but clearly the meaning of obsession is blurry. I mean, all throughout my blog, I write about society's obsession with food and how terrible it is, and now I am writing about one Canadian's obsession that I think is healthy. What is the difference? Why is her obsession okay?
That's a tough question to answer. Maybe it's the fact that she calls her love of food an "obsession". She confesses that she loves food so much and is comfortable with that label.
What is her secret? How come she has such a "healthy", fun, loving relationship with food? Where did it come from? How can I encourage my patients to be like her?

Gross?

Okay, I had to write about this article in the Globe and Mail:
http://www.theglobeandmail.com/servlet/story/RTGAM.20090304.wlfat04/BNStory/lifeMain/home
The article is about a web-site called "This is Why You're Fat: Where Dreams Become Heart Attacks." On this site, people post picutres of foods they have made or consumed in restaurants. The foods are all uncommon creations that are high in fat and calories. The picture I have used in this blog is from the webiste. Since it's launch on February 9th, the website has had 7.5 million viewers and 2,000 photo submissions!
Honestly, when I first went to the site, I thought I was going to vomit. You should take a look. www.thisiswhyyourefat.com. There is even a picture of a 30,000 calorie sandwich filled with ground beef, bacon, corn dogs, pastrami, roast beef, bratwurst, and turkey topped with fried mushrooms, onions, cheese and butter. Maybe this is revolting to me because I'm a vegetarian. I think that plays a role. Yet, the article in the Globe and Mail says viewers love looking at the site. They claim it's both disgusting and enticing...and it's hard to look away. What fixes society's gaze on such fatty foods? Is it because it's so unreal? But it's not...people do consume these foods. The article suggests that people are fascinated by the fact that the foods actually could be lethal. If eaten all the time, these foods definitely could kill you. It's like a guilty pleasure, and people are living vicariously through the pictures. It's like the food is dangerous; consuming it is a risk. And by just looking at the pictures, you are able to enjoy the food without consuming the calories...
What a contrast to my last post of othorexia and the obessions with eating healthy. Yet I still think these two posts are very much related. They both deal with an obsession. These are the foods that orthorexics would label as "bad."
I just don't know what to say. I think in this case, pictures speak louder than words. We have gone too far. Perhaps this is a way of backlashing against all these "healthy" claims we are forced to see and deal with everyday. It's like we are not "supposed" to eat fat, so we want it even more. Yet, we want it in excess and in ways that are just over the top! I also don't like how the title of the site puts the blame on the individual. "This is why YOU'RE fat." It's very hurtful. It's not our fault as individuals that we've developed this obsession with food items. It's our society, and much, much more....

Orthorexia: Healthy eating gone bad?

Now that I am half way through the semester and a little more relaxed, I feel like writing. This is my fourth blog in two days! Wow. After this one I should break for a bit and focus on my other projects. I just love writing though. It's very therapeutic. I'm not even writing to anyone, but I really enjoy the time I spend on my blog. I want to thank you, Janet, for encouraging us to get involved in the community and write about it.
Janet, I watched the video you suggested I view for my looking project on society's obsession with "healthy" eating. According to Leslie Goldman, a writer for ivillage, some people are becoming so extremely obsessed with eating in a "healthy" way that a new term, orthorexia, has been developed to diagnose these individuals. I had never even heard of this word before, but perhaps it is one I should know.
Othorexic individuals are obsessed with the quality of their foods, not the quantity like bulimics or anorexics. Othorexics desire dietary purity, and in those with the disease, a slip up creates psychological distress. Some orthorexics will isolate themselves from the world for fear that they may consume or even encounter impure foods. They often categorize foods into two categories: good and bad. Eating good foods allows the individual to feel good or virtuous. There is a sort of moralistic quality to food. I find this extremely unhealthy. What a paradox!
It's no wonder people are developing this condition. I mean, we are bombarded with "healthy" eating information all the time. It's just thrown at us, and it changes constantly. I mean, if I wasn't in nutrition, I might become scared of eating certain foods and cut them out of my diet as well. The media does a great job of scaring people, and this has got to change. Orthorexic individuals can actually experience under-nutrition and become nutrition deficient because they are too fearful to eat food from certain food groups. It's like we're trying to help, but we're making it worse. How can I, as a future dietitian, stop this process? Where has the enjoyment of eating gone? Where is the balance?? This is a topic that Rahaf and I will be exploring in more detail for our Looking Project! So, stay tuned for an update from our presentation in a blog to come...

Piecing the puzzle together

I work as a research assistant for Dr. Gingras and this position has presented me with a very unique opportunity. In conducting qualitative interviews with dietitians in Ontario, I have been able to learn a tremendous amount of information about the field of dietetics. There is one interviewee in particular that I was able to build a great relationship with. I felt like this woman was me. She mentioned that she was always the quiet, shy one in school that was considered kind of a "geek." She then described how she went through periods of her undergraduate career where she felt she didn't belong and was unsure of dietetics. It wasn't until her internship that everything began to fall into place. It was then that she had many "ah-ha" moments and was able to complete the puzzle with the various pieces she was given during her undergrad. I am hoping this will happen to me too as I feel all this information has been given to me but I haven't been able to use it. It's just floating all around me, and I have no channel for it.
There was another story she told me that really caught my attention. She mentioned that in her internship, her favorite rotation was the one in oncology. The reason was because she was able to encourage the patients to eat. Instead of trying to convince patients to cut out certain foods, she was able to give the patients in the oncology unit ANYTHING they wanted. Anything at all. Whatever would please them and make them happy. I think this would be my favorite too. But how ironic it is that patients have to be on their death bed before they can enjoy food? Ugh, it makes me angry!
I know some patients cannot eat whatever they want due to their condition. I get that. But somehow the restrictions have to be made into something positive. Somehow, the dietitian has to present the foods they can eat in a fun way. I look forward to talking to her again on the 4th. We will be doing part two of the interview process then, and I will be able to discuss her practice in more detail. I love having this opportunity to talk to dietitians...it has been such a great learning experience.

Where I belong?

I think it's quiet fitting that after I posted my last blog I found this article on the Globe and Mail website:
http://www.theglobeandmail.com/servlet/story/RTGAM.20090226.wldiet26/BNStory/specialScienceandHealth/home
The article describes how it is not the specific diet that helps people lose weight, it's how motivated one is. So perhaps instead of telling the patients at the hospital exactly how to lose weight ("don't use whole milk, switch to skim; don't eat cookies, try fruit instead") we should learn how to motivate them.
As well, telling society that ALL diets work as opposed to the message that NO diets work is quite confusing. Our society is just so obsessed! Quite frankly, I'm becoming tired of it. Everyone is so scared. I'm tired of people asking me if certain foods are "okay." I think this is the area of dietetics I want to focus on. I want to help people realize that life is just so short and we have to enjoy the time we have here. Obsessing about calories and fat is not a way to live! I want to bring back the joy of eating. Eating should be a time of happiness; a time to be with friends and family. Eating should not be something that evokes feelings of anxiety or guilt. Even if one is trying to lose weight for health reasons or because they need a transplant, eating should be made fun!
The article describes how it was not the diet, but the counseling sessions that influenced people to lose weight. Again, this relates to my last post in that I feel I have not been prepared to properly counsel someone. The articles says that people who attended counseling sessions lost more weight than those who did not. I think this is due to the human interaction aspect, feeling that one is not alone on their journey.
The article then suggests that perhaps community-based efforts would help with weight loss rather than individual efforts. In one little town in France, efforts were made to encourage children to eat "better" and exercise more by offering cooking workshops and opening new sports facilities. It appeared to have worked!
The community may be the key! Perhaps this is where my focus should be. In prevention, at the community level. Maybe this is where I belong as I'm so passionate about encouraging the public to lead a "healthy" life. I found this video on youtube and just had to share. If there's one dietitian that is trying to motivate kids to change, she's the one!

The Power of Food

I can't believe it's already been over a month since I last posted in my blog! I feel terrible, but then again, I feel like it was out of my control. Life got extremely busy in February as I wrote midterms, reports, and prepared for my internship interviews. And this brings me to my next topic....the internship process.
I have felt anxiety about doing internship interviews since I was in year one. Our professors "gently" would remind us that we should be volunteering and working jobs that relate to dietetics in order to give us experiences that would help us get an internship. I remember thinking, "Excuse me? When do I have time to volunteer? Maybe if you gave us less readings and assignments I could actually spare a couple of hours a week to get some experience outside of school, but right now, there's no way!" Then in second year, I realized that all of the readings didn't need to be read, and perhaps going out into the field would be a better use of my time. So I started volunteering at Toronto General Hospital in the liver and lung transplant unit. At first it was really exciting! I mean, we actually got to talk to "real" people that needed assistance. I got to read through patient charts and discuss with the dietitian which course of action should be taken. I really loved it! I also got involved with the health promotion team at Ryerson, audited patient food trays at Toronto General on top of doing the clinical work, and started working as a research assistant. Things were looking good.
Then, at the beginning of fourth year, I stopped working for the health promotion team and quit auditing food trays. I also started to get bored doing clinical work at the hospital. I would dread having to go in every Tuesday morning to do the same thing again and again. The patients started to frustrate me because they wouldn't lose weight before they received a transplant. They seemed to value eating over life. It has been proven that those with a BMI over 27 who receive a lung transplant have higher rates of remission, infection, rejection and mortality. Why did these patients not understand this? How powerful food must be if it can have a higher priority than life itself. I understand the forces at play, and I understand that a cookie often looks more appealing than broccoli. And of course, "healthy" eating is just part of the equation, as exercise plays an important role as well. But these patients can hardly breathe. Their lungs are not working properly. Exercise is out of the question for most of them, and food become the sole focus.
I just felt so helpless. I mean, these patients know what they have to do to lose weight. They know that their weight could kill them in the operating room. I am all for eating "bad" foods on occasion as I think that is part of living a "healthy" life. But if my life was on the line, I think I would do everything I could to lose the weight. Maybe this is where I'm a fault since I have never undergone this process so I really don't understand it. And again, this is perhaps why an overweight dietitian counseling those needing to lose weight might be a better option. They would understand the thought processes of these individuals in need. I really hope I don't sound cruel or mean. I do want to help, that is why I'm in this profession. I just don't think I have the right mind set or tools to be the best counsellor. I think I need more training in this area. I don't think we get enough of the psychological education needed to work with patients that desperately need our guidance. Maybe I'm wrong in separating eating from life. Maybe you can't pull the two apart. Maybe eating IS life.
Anyways...back to the internship interviews. I am not sure how they went. I felt like everyone around the table was judging me from the moment I walked it; assessing my outfit, my hair, my face, my body. Did I look like a dietitian? Did I act like a dietitian? Could I fit the mould? I guess we'll find out in two weeks. In the meantime, I sit anxiously, unsure if being a dietitian is even what I want...or even what I should be. I'm feeling very confused.

Beautifully tragic

If there's one song and corresponding video to sum up how I feel about becoming a dietitian, it's the one below.


Like the small ghost in the cab, I feel as if I'm invisible. There really is not much I can do. So I stay in closed doors, viewing the world from the safety of my job. I watch helplessly as tragedy strikes one client after another.

And at the same time, when I help people, I feel I may be making their problems worse. Like the ghost peering into the cafe, I will peer into the privacy of my client's lives trying to do "what's best". Like the ghost, I will be watching what people consume, thereby making the process of eating less enjoyable. My clients will sit down to a cherry pie, and like the ghost, my presence will be there, making them feel guilty about consuming a "bad" food.

Is this what I want? Is being a dietitian really hurting, not helping? It's quite romantic, the whole idea of helping people, curing them from illness. But in reality, are we contributing to the disease? This devastating disease that prevails in society, the extreme fear of food.

And the road ahead is lined with broken dreams
So walk, walk on by
And I fail to give you everything you need

The world is a paradox

That fact that we live in a paradoxical society is not new.  Much of the medical research released to the public is contradictory.  A lot of the advice offered to people is in stark contrast to what they read the previous year, month, week, and even day.  Because of this, it's no surprise to me that food advertisements often glorify and promote sugary, salt-filled options while society at large is told to "eat heathy", "increase fruit and vegetable consumption" and "watch sodium intake."  
 I find myself angered when I read articles that allude to this paradox such as the one found on the Science Daily website (http://www.sciencedaily.com/releases/2009/01/0901192104440.htm).  People do have the ability to express agency, and "bad" foods are okay sometimes.  Of course, the creators of these "bad" foods have ample amounts of money to advertise where farmers do not, but I believe the public is aware of this fact.  How much of an effect does advertising really have on society? Perhaps I am completely naive, but aren't people able to form their own ideas, thoughts, and opinions on whether to buy products or not? And what's wrong with buying the occasional bag of chips or box of candy? Okay, perhaps magazines should be asked to cut back on the number of advertisements for "unhealthy" foods.  But would that help?  Would that change the way we eat? Here's the other paradox: we live in an overweight nation.  Almost all advertisements feature uber thin models. It is clear that the abundance of underweight models in advertising does not encourage the attainment of an underweight status in most individuals.  So do food advertisements really work to encourage the consumption of "unhealthy" foods? Which has more influence, advertisements or the messages and articles we read about consuming a "healthy" diet? What is the real relationship between advertising and behaviour? I'm so curious to know. How much of an effect does advertising have on the way we live? Would seeing ads with "healthy" food options increase the consumption of "healthy" foods? Would advertising the consumption of fruits, vegetables, and low-fat dairy and grains increase the quality of Canadians' diets? This is something I would really love to learn more about.

The truth is, I really don't know

My mother has always been a huge fan of the dietitian Leslie Beck.  Ever since I started studying nutrition, she has exclaimed in an overly proud voice, "I know you're going to be just like Leslie Beck! I can't wait to watch you on TV some day! Would you like me to email her? I checked her web-site and got her email address! I can email her and ask her how she got started.  Would you like me to do that Leigh-Ann? Leigh-Ann, do you want me to email Leslie Beck?"

Honestly, I don't know much about Leslie Beck, so I decided to look into her work.  I found an article she wrote for the Globe and Mail last week that caught my eye (http://www.theglobeandmail.com/servlet/story/RTGAM.20090121.wlbeck21/BNStory/specialScienceand Health/home).  In her introductory paragraph she explains that she work in private practice and has a lot of clients asking about weight loss pills.  In seems in our program we don't learn much about herbal remedies, supplements, or any type of pill available on the market.  What would I say to someone that asked me about weight loss and diet pills? As a fourth year student, I feel I should be able to formulate some sort of response.  Yet what do I know about this topic? Absolutely nothing.

So I read Leslie's article.  She goes through each supplement or pill and explains how much of the research done thus far is inconclusive.  She explains that the best way to lose weight is the old-fashioned way: diet and exercise.  Although evidence points away from the benefits of taking a pill, I am in awe that have never even heard of most of the pills Leslie has listed.  I wonder, then, is this an area I should know more about? We discussed in class the benefits and downfalls of having a quick-fix.  Are clients even willing to take the slow route to success, or would they be more willing to pop a pill?

I feel like there is so much I don't yet know.  Perhaps it will become more clear once I start practicing as a dietitian.  Maybe I should email Leslie Beck.  How did she come to know what she knows? How can I better prepare myself for the world of dietetics? What type of questions should I expect to receive? If the answer to the complex problem of weight loss is just exercise and dieting, should I even bother to learn about alternatives? The truth is, I really don't know.

Who would trust a fat dietitian?

While searching for articles and topics to discuss in my blog, I came across another nutrition student's very intriguing blog entitled, "Confessions of a Fat Dietitian" (www.thefatdietitian.com).  The purpose of her blog is to track her weight loss journey by listing foods she has consumed and counting her calories.

My question is, why does this nutrition student feel the need to lose weight? Is she doing so for health benefits, or to better fit into our "nutrition community".  It is well documented that most nutrition students are Caucasian, middle class, and slim, because slim, in our society, equals healthy.  Overweight individuals are seen as lazy, weak, and in terrible physical shape.  In our cruel world being overweight is seen as having eating issues that need to be worked out.  Who, then, would trust a fat dietitian? 

In reality, I believe a fat dietitian would make an excellent dietitian.  In fact, I would argue that an overweight dietitian would make for a much better nutritionist than her skinnier colleagues. Of course weight shouldn't matter when assessing one's job skills, yet in our profession, there seems to be no escape from this.  We study food.  We analyze BMIs, weights, calories, and nutrients.  Our job is to be exerts in the field of health.  There is an underlying role we must play in being a dietitian, and that unwritten job requirement is to be skinny.  Yet, what are we, as future dietitians, doing to make sure we fit the job description?  How many of us engage in unhealthy eating behaviours in order to be what society deems "healthy"? Are all of us naturally skinny individuals? I believe that there are dietitians out there that practice harmful eating habits in order to fit the mould.  I would even argue that there are dietitians out there that suffer from anorexia and/or bulimia.

So who wants a fat dietitian? If a dietitian consumes nutritious foods and lives a "healthy" lifestyle consisting of regular physical exercise, social interaction, and has great mental well-being, who cares if she is overweight? As long as she is not hurting herself, I would much rather talk to a healthy fat dietitian than a skinny dietitian that binges and purges.  I would much rather talk to a dietitian that appreciates food, embraces food, and loves food than a dietitian that worries about her weight.  This is where the fat dietitian I discussed above is at fault.  Why is she obsessing about her calories? Why is she not obsessing about living a healthy lifestyle?  

 

Fat, fat, you don't want that!

Fat.  Why is everyone so afraid of you? Why do people cringe when they hear your name? What have you done to deserve this unfavorable treatment? You're cut out of menus, you're eliminated from recipes, you're even banned from some diets.  But why? Are you really to blame? 

The reality is that you are not an enemy.  In fact, you are vital for survival.  You help prevent against heart disease, lower blood pressure, and protect us from the cold. Plus you taste amazing! 

The problem is gluttony, or the overindulgence in your magnificent taste. Too much of you is indeed a bad thing.  You are capable of raising our cholesterol levels to dangerous heights.   So we left you, dear fat, eliminated you from our lives.   Society saw you as dangerous and hazardous.  Everyone avoided you.  I recall a time when I was chatting with an elderly lady about my nutrition studies at the bus stop when she instantly broke into song, "Fat, fat, you don't want that!" Society was told to replace you with sugar, salt, and chemicals.  It made our food taste awful.  We did miss you fat.  But we were on the rebound, desperate for some replacement.  

It's just now that change has begun to appear.  Jennifer McLagan's cookbook, Fat, is just one example of how we are now accepting you back in our lives.  It will take time, poor fat, for you to truly be accepted once again.  Even when looking at the cover of McLagan's book, I feel queasy.  Yet when I taste your smoothness and pureness, I think I am in love once again.  Sasha Chapman, in her article "Praise the Lard" writes, "Lard, along with other traditional fats, isn't as nearly bad as we thought."  Fat, we are discovering the truth and we desperately need you.  Fat, fat, we want you back!