Saturday, 27 February 2010

Moving Beyond Nutritionism

eek. it's been such a long time since I've blogged... sorry! :)

I wanted to talk about dietitians and nutritionism.

What is Nutritionism?

In his book, In Defense of Food: An Eater’s Manifesto, Michael Pollan dedicates a whole chapter to nutritionism, which basically states that the key to understanding food is its nutrients. That is, that food is essentially "the sum of their nutrient parts".

Pollan takes aim at the “nutritionist ideology” of focusing solely on nutritionism- on nutrients at the expense of foods’ other qualitative properties, and other factors surrounding food and food choices- environment, production methods, culture, upbringing, experiences, society, history, etc.

So, he's saying that health is promoted through food, and more specifically through their nutrients: eat this % carbohydrates and you'll have lots of energy, eat antioxidants and you'll prevent this disease, eat less calories to lose weight....

And the problem with this is that the nutrients are taken out of context of food, and food is taken out of context of the diet, and the diet is taken out of context of the person (and all the factors that contribute to health and well-being).

We've been talking about this in a class I'm taking and a classmate said that she felt inhibited in properly counseling clients because of the science foundation of her dietetic training, stating that her training limits her from really being able to understand her clients and therefore being able to help them meet their goals. She's left oftentimes simply able to say "there's no conclusive evidence for eating or not eating that".

Moving Beyond Nutritonism

A new movement, called Critical Dietetics, was created as part of Dietitians of Canada (DC) that seeks to move the profession beyond nutritionism and explore questions like:

What counts as “knowing” in dietetic practice? How do we, as nutrition professionals, come to know what we don’t know? How does the evidenced-based culture of dietetics give voice? Where does dietetic culture render silence? What is it that we have already accomplished as a profession? In what ways do we continue to evolve? What do we envision for the future of our profession?

Where I am

I use nutritionism in this blog... I have lots of posts that break down the research and state that this nutrient has been found to prevent this or that... And what's difficult for me is that I know people want this information... these are the posts that get the most traffic. A communication expert came to talk to us (in another class) and said that it is our role as nutrition experts to provide answers for our audience. This contradicts Critical Dietetics which asks us to question our knowledge and rethink how we know what we know.

One source states that to identify ourselves as experts is very presumptuous of us, meaning how can we be experts of someone else's life? Food and eating is so personal to people, how can we assume an expert role over that?

I'd love to know what you think.

I think that while many of us are guilty of 'nutritionism moments', I still think that most of us look beyond nutrients when we counsel our clients...That said, I think it's important that we not be scared to take a critical look at our profession...

I also believe in the scientific foundation of our training and that our role as dietitians is to stay current of this ever-changing science, and to always be aware that food is more than a vehicle for nutrients and that what we eat, how much we eat, and why we eat are determined by a myriad of factors that we need to be able to recognize with the help of other disciplines. Our role is also to help our clients meet their needs and goals, to support, teach and learn from our colleagues, and, ultimately to have conviction in our message and our profession.

Click here for more information on Critical Dietetics


Jackie C said...

I feel we 'think' this issue to death. It's so clear that it is so much more than the simple physical chemistry of the human body, and how it reacts to nutrition. So many subtleties go into the big picture of why one person gains, and another loses, while both are eating the same diet, for instance; or other similarly frustrating circumstances. I have often wished that I could find the magic bullet, or the gifted professional who would be able to find 'the answer' for me, by simply looking at me, and in a few short words, could wipe away all my frustration, worry, and grief by explaining my problem, and thereby 'fixing' me. But I know that no one else has the answers for me, they are inside of me, and although others may offer advice, and even guide me in their wisdom, it is only me who can ultimately decide whether I can accept my own truth, or be open to the wisdom of others,when they are able to help, and ultimately find peace.

Gina said...

Such an interesting post. This is so true though, as I know in my years of studying dietetics it was all about the percentages of this, and the RDA for that, and when I started counseling clients I SOON realized that I just couldn't provide them this information in a way that made sense, or that was realistic to their needs. Now I try really hard to just be general, and focus on FOOD, NOT micronutrients or macronutrients. It's especially hard when I counsel about sports dietetics. "You need to get 10-20 grams of protein after a workout..." "You need to make sure you get no less that 20% fat in your diet".....that's just confusing and annoying information! I try now to make it more general and simple and easy to understand and easy to replicate. People may like to HEAR the specifics, but when it comes down to actually putting this suggestions into practice, they work better with general guidelines that will help them reach their goals.

Anonymous said...

This is such an interesting post. I think nutrition can be such a difficult field at times due to the fact that science is always discovering new things. And there are so many different studies..each can say the exact opposite.
I also think as RD's we know all these facts but sometimes relaying them to the patients is not always going to be the way to get through to them and help them with their goals. As Gina had mentioned, being general can sometimes be better. Thanks.

Nutrition Chick said...

Great post! You really open up a can of worms with this topic. There are SO many factors to nutrition and dietetics, I think it's one of the most complex fields to work in. Ever changing information, coming from all sides... sometimes it's exhausting! But I do think that as a profession we need to broaden our view of what a healthy food is, and consider that it is more than fat, carbs, protein and micronutrients, but also routes of origin and production.

Jessie said...

Since I am in the midst of my dietetics training, we are getting bombarded with scientific information about the specific nutrients that affect this specific body functioning, and we take tests on, basically, "nutritionism". I see where the emphasis on specific nutrients is essential when someone has a deficiency or if their medical condition requires it (like if they are a renal patient, etc.), but for the average healthy person will respond better to counseling about whole foods and favorite foods and a healthy lifestyle in general, one that works for them. I try to take this approach as a I'm learning, but sometimes I feel like I'm fighting against the system! Oh well, I'll keep trying :)

Melissa said...

I believe knowledge can be powerful but it can paralyze the heck out of us as well.