Future dietitians and weight bias

I came across this disturbing article the other day about weight bias among future dietitians. A new study in the Journal of the American Dietetic Association showed only two percent of future dietitians have positive or neutral attitudes towards obese individuals with the rest moderately biased.

Dietetic students were asked questions about both a normal weight male and female as well as an obese male and female with the same health characteristics other than weight. The results indicated that the majority of the 182 students who participated viewed obese patients' self control, attractiveness, eating habits, compliance to treatment, self-esteem, and insecurity negatively.

Although this may show that dietitians are not immune to weight bias, this can impact treatment negatively. What patient wants insensitivity by a professional? How can a patient learn to trust her/his dietitian and get though the treatment plan?

This makes me wonder what dietitians think of eating disorder patients as first impressions. Do they think we are all stubborn, non-compliant? Do they feel some of us are too thin or too fat to be there? Whatever stereotype a dietitian or any other professional may hold affects both the patient relationship and treatment in the long run. No one needs stigma held over them. Perhaps, stigma reduction classes, similar to medical students compassion training classes, should be implemented into in the class curriculum, as well as positive role models and mentors who do not reflect weight bias.

Note--this is only a small study with a mostly Caucasian group, so there might be differences in ethnicity attitudes. This also can obviously not be a clear generalization, as with any profession, there are always the good apples and the bad.

Asian food labels, Calories, and their significance?

Last week, I headed to the Asian supermarket. I go once about every 3-4 months, all depending on when I run out of this: Yes, kimchi! It's probably one of my favorite foods. I'm not the typical Korean, eating it for every meal, just dinner, along with my other veggies, rice/noodles, and protein.

While I was there, I picked up other items, like noodles, sweet wild rice, crackers, sauces, frozen potstickers, bean paste products, and even some whole sardines! (for the dogs not me) Who knew sardines came in other sizes than just those ones you see canned? :grin:

The majority of items there have labels both in Asian and English languages. However, I was thinking about this very thing. I used to love to try all the different Asian ramen noodles there. They are much tastier than the standard supermarket kind. I used to buy 5 or 6 different types--everything from kimchi flavor to sesame to even green tea! That was until I read the actual food label. As I've mentioned before, my ED descent led me to a life of being fat-phobic. So I was naturally appalled at how many fat grams this 4-5 oz package of noodles had. Well, that was the end of that, and I never touched those specific noodles again, rather opting for something like soba noodles which were less calorific.

Then, I was thinking, what if all my food items were only with Asian food labels, like this one below.
I say this, because I cannot read Asian characters. Would this make a difference, or would it backfire and just cause me more anxiety not knowing how much a certain food item was? I mean, what if I were stuck on some island like all those people in Lost and had to forage for myself? (The Lost people did find normal, packaged foods which they lived off of for awhile) Would I be thinking about calories then?

This led me to think about the actual history of the "Calorie." (kcal) How did it become to play such a significant role in how we eat, diet, and exercise?

According to this brief article in the Journal of Nutrition, it really wasn't until 1887 when chemist Wilbur Atwater published a paper about the "Calorie" relating to food energy that the concept even arose. Atwater used the calorimeter as away to measure the energy in food. In this case, the Calorie is the amount of heat produced when a food is burned to dry powder or ash.

It wasn't until about two decades later that the idea behind calories with dieting hit mainstream. Prior to this, we could say "modern" dieting began with the likes of William Banting in England, forerunner of the Atkins plan, Sylvester Graham, inventor of the Graham cracker who believed in strict vegetarianism, and Horace Fletcher, aka the "Great Masticator" who felt everyone must chew their food something like 32 times before swallowing. None of these men said people should eat X amount of calories.

That is until Dr. Lulu Hunt Peters published her book, Diet and Health, the key to the Calories in 1918. This is considered the first modern diet book where counting calories became the key to weight reduction. The book gives a formula to find ideal body weight, sort of a forerunner to the BMI configuration. She also includes advice on how many calories one should eat based on their ideal body weight with an analysis of macronutrient information. Dr. Hunt, surprisingly, did not promote diet aids nor saccharine.

However, she was apparently not shy to tell readers that dieting was hard work, a life-long commitment, where vigilance was required--that dieting was based on self-discipline. Some have credited her with starting the idea that being overweight is a moral sign of weakness. Despite this, the book proved to be successful, selling somwhere between 800,000 and 2 million copies.

After this book, there came others who emphasized food combinations and when to eat certain foods. Some even mentioned "magic pairs" of foods to eat. During this time (1920s and beyond), there were also many substances touted as the miracle cure for obesity (hmm, that one hasn't changed a bit, has it?), as well as an array of diet plans.

So ladies and gentlemen, that's a brief overview of how the Calorie came about in the role of dieting. It's quite amazing when you think about how much "clout" we give to a simple word, a simple measurement of heat in science, isn't it?

Other Sources:
The history of diets
The history of dieting
When did dieting begin?
Lulu Hunt Peters and the birth of the modern diet book

*Note--I'm still working up to eating those Korean ramen noodles with much more than my usual alloted fat grams.

Healthy eating obsession

The Today show had a short segment on the obsession with healthy eating this morning with Leslie Goldman, author and blogger of the Weighting Game and Madelyn Fernstrom, director of the University of Pittsburgh Medical Weight Management Center. For the most part, I thought they got their point across about the hazards of obsessed healthy eating and how it can lead to vitamin/mineral deficiences, loss of weight, loss of muscle mass as well as eating disorders and/or orthorexia.

What I found interesting were the comments from the show. Some people understood what was being said, while others felt their lifestyles were being attacked. It just goes to show how many people are misinformed about the whole topic. The operative word in all this is "obsessed." I wish people would understand that most people know there is nothing wrong with wanting to be vegetarian, vegan, macrobiotic, or raw foodist (okay, the last two kind of make me raise my eyebrows but to each his/her own) as long as they are educating themselves and it is for the right reasons, not being masked by fear, an eating disorder or otherwise. That would mean correct nutrients and caloric intakes were being met as well as a heathful dose of psyche, ie "balanced," not black/white thinking.

One commenter mentioned that we should "highlight the positive aspects of these 'unhealthy' foods"--that maybe that would help people see a bigger picture.

What do you think? Is there a way to stop all the paranoia of obsessed healthy eating? Or is this a moot point with the nation worried about the obesity epidemic?

Dieting is now going virtual

In this new study, University of Houston researchers are recruiting an international pool of 500 participants in a healthy eating and physical activity challenge. The catch is that it is taking place in the virtual reality game Second Life.

The premise, err competition is that participants (avatars) will receive lindens (the currency of Second Life) for behaviors like trying new fruits and vegetables, physical activities such as walking on a treadmill, riding a bike, etc. Participants receive "challenge" points for each healthy behavior. Then whichever country team has the most challenge points wins the International Health Challenge.

Apparently, there is also going to be a space in Second Life for interactive games and learning opportunities for those who sign up for this health challenge.

The hope of this study is that it will allow participants to practice and learn new behaviors in this virtual reality setting and in real life.

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Hmm, it's an interesting proposition. I have never actually been in Second Life, though it's often discussed in one of my podcasts. I think you have to be careful with virtual reality environments, not only with the suspicion of pedophiles, but in the time consumption there. I know quite a few grown adults who are very into the computer games where everyone makes their own avatars and such. One of them even tried getting me into it. I thought it was interesting for awhile but soon realized just how much time I was spending there--time that could be spent elsewhere. That, and my satellite wasn't fast enough to keep up with what was going on.

I guess my concern would be "internet addiction." That and whether a program like the study above really helps in real life. Though internet addiction is still subject for debate, I do think people can spend unhealthy amounts of time on the internet. Then when you couple it with competition, it can really rev people up. I'm still uncertain about how these challenge points work. I mean couldn't you just keep grabbing different fruits and vegetables for the mere addition of points? Or step on the treadmill continuously to rack up points? I guess maybe I'm not seeing how this can translate into real life other than possibly the accountability factor.

Don't get me wrong, I do think there are some computer-based interventions and programs out there that do help people with various disorders, I am just not sure about virtual reality. Bu then again, may be the idea of the "social" component could be helpful? Who knows, maybe this will provide an interesting outcome.