Unfortunately these days there’s quite some emphasis on weight being the main predictor of optimal health. Too often do I see in clinic clients who are upset or disgusted with their weight and this unfortunately reflects on the way they view themselves as a whole. During study at University, we were taught to use Body […]
Unfortunately these days there’s quite some emphasis on weight being the main predictor of optimal health. Too often do I see in clinic clients who are upset or disgusted with their weight and this unfortunately reflects on the way they view themselves as a whole.
During study at University, we were taught to use Body Mass Index (BMI) as a predictor of healthy weight. It looks at your weight compared to your height, taking into account your age. It then places you along a spectrum from an unhealthy weight to an obese category. There are flaws to using BMI, such as not differentiating between body fat, muscle mass and bone density.
However, the biggest flaw I have seen over the time I’ve been practising as a Dietitian, is the way it can make someone feel. We were taught at University to calculate BMI and explain to the patient what it means to them. I even remember having to sit a practical exam with a mock patient and do this! How easy do you think it is to tell someone they fit into the obese category? When I’m sure they are well aware of the fact they are carrying more than the “healthy” weight.
Don’t get me wrong, I still use BMI in practice. It is indicated in the care of my acutely unwell patients who may have experienced weight loss and a poor appetite to eat adequately. In this instance, BMI is helpful to set weight goals for the patient. But it isn’t helpful for every case, and my clinical judgement is important to protect the emotional well-being of clients.
You see, there’s more to being healthy than that number on the scales.
I feel the number one predictor of optimal health is self-worth. How does one expect to be healthy if they don’t perceive themselves as worthy?
When someone values and cares for themselves, other aspects of health fall into place. There’s positive body image, fitness, social health, recognition of appetite and positive acceptance of food and eating. This is referred to as a “Non-Diet Approach” and the direction many Accredited Practising Dietitians are heading in order to make successful changes among their clients.
Because yo-yo diets are yet another topic I see too often in clinic. Low carb, no carb, high protein, paleo, “I quit sugar”, shake diets, super foods and meeting all your fruit and vegetable requirements in one big “magical” pill. Unfortunately many of these are promoted and distributed by those lacking a qualification in nutrition and therefore can be quite dangerous. But mostly, evidence highlights that weight loss in the long term is not sustainable and more often than not we see weight regain down the track.
Once again, some of the diets listed above I currently do use in practice where indicated and the “Non-Diet Approach” is certainly not for everyone. But it does aim to enhance self-compassion and teach people positive food practices where perhaps the weight and other predictors of health will come later on.
Just for a little insight, the “Non-Diet approach” focuses on mindful eating. It explores food cues and triggers for eating. It helps people to become more conscious with their body’s hunger cues and eating behaviours. It’s about exploring these and making small steps to enhance self-compassion to make the best change possible.
Personally, I am guided by the Australian Dietary Guidelines and participating in physical activity most days, to ensure I keep as healthy and happy as I can be. This is something I practice for me and also for my family. Modelling of positive behaviours- starting with self-compassion- gives my family the best opportunity to also being the healthiest they can be. If there’s one memory I have from my childhood, it was that my parents never once commented on my weight or eating practices. There was never ever negative talk and for this I will be forever grateful. This is now what I want to pass onto my own children.
This Australian Dietary Guidelines are not something I dive into with all my clients, particularly with those I may be utilising the “Non- Diet Approach” with. Because these may be seen as “rules” and that can negatively fuel the situation. However, I do see the Australian Dietary guidelines as safe food practices to follow for life. They are achievable and realistic, and allow us to enjoy ALL foods. They guide us to include a wide variety of foods from vegetables and fruits to grains, meats and dairy products. For more information, check out the following website https://www.eatforhealth.gov.au/guidelines
There are guidelines for infants, toddlers, children, adults, pregnant and breastfeeding women. These are only a guide and factors such as activity level, age and other circumstances may increase or decrease your requirements.
This is where Accredited Practising Dietitians can further assist with your goals.
Remember, be sceptical of all the confusing nutritional and health advice out there. Learn to love yourself and the rest of the healthy practices will follow.
Apologies for not blogging of late. Thinking of reasons why I have been slack has given me a topic to blog about! -Nutrition among older adults/the elderly (I’ll use these words interchangeably).
Since completing my Masters degree I have been busy working back in my home town at a Residential Aged Care facility as a Personal Care Assistant (PCA). I have been fortunate enough to hold this employment for three years now- which has assisted me financially as well as provided me with an enormous amount of experience working with the elderly.
Whilst on clinical dietetic placement, 80% of my patient load consisted of older people (65+ years). This was quite common across the board for all students, in fact this is quite a common demographic within all hospitals. Therefore I was exposed to many clinical conditions such as malnutrition, pressure ulcers, diabetes, obesity, CVD, CVA, liver, cancer, renal- all of which required important nutritional management.
Similar to my placement I have also been exposed to these conditions in my work as a PCA. Although I haven’t been directly involved in their nutritional treatment, I believe my PCA work has been a tremendous help in consolidating my clinical dietetic skills. For example, I care for many elderly residents with varying levels of dementia. This has helped me communicate with elderly frustration, emotion and aggression, and to diffuse potentially volatile situations.
I have also been exposed to meal times and the need to assist in feeding residents as well as texture modify foods and drinks.
I can now see both sides of what is actually involved in ensuring the nutritional management for older people is carried out. It’s not just as simple as the dietitian putting the perfect nutritional plan into place. For example, It is difficult to feed residents with dementia! And I truly appreciate the catering staff, clinical staff and carers (my colleagues) for the effort and strategies they employ to ensure residents receive adequate nutrition.
I have however heard from staff in my workplace talk of the Dietitian doing this and doing that- not always agreeing with her management. This is difficult for me when this is also my area of expertise.
I believe that we as Dietitians have a role to play in eradicating this way of thinking. And I believe it’s as simple as the following:
2) Being friendly and making ourselves known
3) Making it easy for the clinical staff to help us
4) Educating the clinical staff just as we educate residents/patients.
It’s all about putting in effort to help those caring for the residents to ensure that we receive the help (optimal nutritional care for the older person) in return.
Nutritious food consumption is so important for the elderly. But it’s important to consider quality of life and different cultures. I have cared for many residents/patients who eat minimally and are disinterested in food. So making the experience enjoyable, with a relaxing environment and provision of favourite foods, can really improve quality of life.
I thoroughly enjoy working with the elderly. It is very rewarding and I cherish their wisdom. I’m grateful I have been given the opportunity to be involved with the elderly in different contexts- as a carer and as a dietitian.
I now embark on a new journey, having successfully secured employment as a dietitian. Whilst I will continue my aged care work, I am very excited to start my career as a dietitian.
Looking forward to sharing more stories with you all soon !
What has more calories- a banana or a packet of tiny teddies?
Hold that thought and we will return to the answer later.
Body image is “the perception a person has of their physical self and the thoughts and feelings that result from that perception”.
Everyone has experienced some form of negative body image in their lives- maybe not now, maybe only during high school years or maybe the negative thoughts are always luring in the back of your mind. And negativity can be as simple as (males and females) – “I wish my belly was flatter”, “I wish my thighs would slim down”, “I don’t like my eye colour”, “I wish I was bulkier”.
So then what can result of this? Regimented exercising and disordered eating patterns. And I don’t mean extreme psychological disorders (although this is the major concern in which we try to prevent from negative body image), I mean the need to exercise every day or else you feel guilty and the need to restrict foods or feelings of guilt when you indulge in certain foods.
I’m going to share a personal story of when I was in my late teens. I did exactly this, I truly hated my body and wanted to be skinny. I became so obsessed with it that I would run morning and night. I would skip breakfast, eat an apple at recess and an apple at lunch and then my main meal at Dinner. Looking back now I can see how detrimental this was to my health and also the fact that it would have slowed my metabolism right down (ineffective for weight loss). I also lacked energy and struggled to work optimally in class. I was an intelligent young girl back then, and I knew it was wrong back then also, so why did I do it? Body image issues. Not being happy with the way I looked. And did it make me happier? Absolutely not, because every day was like a chore to get up and exercise, essentially starve myself and struggle through the day with little energy. And what I’d most like to point out is- I would have never have been happy or satisfied with myself, because even though I lost some weight, I wanted a flatter stomach and slimmer thighs- nothing was ever good enough when I was in this state of mind.
It is actually shameful to share this story, but I have one motive only in sharing this story- I want to help change the negative perceptions individuals have on their bodies out there. And I want to educate on the safe practices to lose weight or maintain a healthy body weight. I want to help people to learn to love themselves. Because maybe if everyone introduces a little bit of positive body image perceptions into their lives, then we would have a happier and healthier society.
So the tips I advise to help with a positive self image:
1) Eat nutritious foods and ensure a balance of all the food groups. This includes plenty of fruits and vegetables, wholegrain breads and cereals, low fat dairy products and lean meats, fish, lentils, beans and/or legumes. Enjoy foods such as chocolate, pastries, cake and alcohol in moderation. Don’t feel bad when you have these, instead consume in small amounts an savour the taste of these by eating slowly.
2) Exercise regularly. For some this may mean gym and gym classes, for others it may be walking each day or playing sports. It is now recommended 30-60mins/day of moderate intensity exercise or 15-30mins/day of high intensity exercise (preferably every day of the week).
Don’t make physical activity a chore. If you don’t feel like gym or going for a walk, then consider asking a friend for social support or some incidental activity that day like walking to the shops for groceries, taking the stairs or parking a distance from work and walking.
3) If you’re a parent, don’t mention “dieting” around your children and be positive about your image (it will rub off onto theirs) and their own image.
4) Surround yourself with positive people. You are in control of who you associate with so why put yourself in negative circumstances that put you down and make you feel unhappy about yourself? Decide who is really important in your life and who makes you feel good about yourself.
5) Talk to someone. Don’t let the negative thoughts build up any longer. There are many professionals in which you can seek help from or confide in a close friend or family member- someone who will not judge.
So now I return to the question posed earlier -what has more calories? A banana or a packet of tiny teddies?
A banana actually has more calories. Of which I was surprised when a friend proudly told me a few years back as she ate her packet of tiny teddies. It wasn’t so much that I was surprised about the calorie difference, more that she was choosing the tiny teddies over the banana BECAUSE of the calorie difference. Now I probably don’t need to educate you all on the fact that a banana is a far more healthy and fibrous option with a lower GI content so would satisfy you for longer and provide sustained energy, when compared to the tiny teddies! But this is exactly the negative state of mind I’m referring to when highlighting negative body image. It’s not about calories and weight. It’s about being healthy and happy.
Adopting healthy lifestyle practices will in turn make you happy. Trust me, it’s life and it’s addictive!
Growing up in the country and how it has helped me become who I am today.
My name is Tessa and I am one week from becoming a Dietitian (one measly exam to cross off the list!) and how am I at this point in my life? Let me share a little bit about my journey…
Growing up in a small country town, everyone knows everyone. And yes this can be comforting but it can also be annoying. However, looking back, I wouldn’t change this upbringing because it has truly helped to shape the person I am today.
I started my education at St.Patricks primary school, began my high school years at McAuley College and completed my secondary schooling at St.Arnaud Secondary College. I have many memorable moments during these years- a mix of academic and sporting. I danced for 13 years (of which I absolutely loved), played netball, basketball, tennis, swimming club and squash (of which I was persuaded by my father as the club was one short for the competition- wasn’t my favourite sport!) I also competed in long distance athletics and cross country throughout high school and there weren’t many days in which I would miss a run up the bush (mostly with Dad- who I have still never let beat me!) Jack (my little brother) on the other hand, has always crossed that line before me. But who’s competing?!
Academia was also an integral part of my schooling and something of which I worked extremely hard to excel in. I had my heart set on becoming a Dietitian from Year 10 when I completed a weeks work experience with different Allied health professionals. So my focus was set for my VCE years. I thought Year 12 was the toughest year ever! (Little did I know the severity of a masters degree!). I worked my butt off and achieved an ENTER score that didn’t allow me entry into Nutrition and Dietetics undergrad at Monash, but I poured my heart and soul into it, so I knew it was the absolute best I could do. Did this stop me from pursuing my dream Dietetic career pathway? Well clearly not, because I’m nearly there today!
So when I couldn’t get into the undergraduate course, I applied for a Health Science degree at Deakin Uni to attempt the “back door” entry into Dietetics. I was accepted and deferred my 12 months because a) I needed to work towards receiving youth allowance to support myself financially whilst studying and b) I was still only 17 following graduation and sooooo not maturely and emotionally ready to venture into next education chapter in life!
I moved to Ballarat and worked in two (hard slog, slave labour) hospitality jobs. I could not have achieved this without the support of my Great Aunt Dawn and two dear friends Kyra and Bibbs. Growing up I would always get home sick. I couldn’t even sleep over at a friends house without crying to go home. So to be living away permanently was the first big challenge in my life. Towards the end of 2009 I moved back home to earn some bigger bucks for Uni at the Turkey Farm!
So 2010 came around quite quickly, and I moved to Geelong to start my undergrad degree. I cried the night before, the morning of, in the car on the trip down and as I said good bye to mum and dad (as though I was never going to see them again!). I lived on Res for 2 years and I had an absolute ball and would strongly recommend all country kids to try and experience this. No you don’t have to go out 3 nights a week and party. But you will meet the most amazing people and make friends for life. Once again I worked my butt off to receive the high marks I needed to gain entry into the masters degree- my ultimate goal. And then this happened-December of 2012 came around, when I received a “confirm or decline” the masters of dietetics degree offer from Deakin University. Waves of emotions struck as I finally realised that all my hard work had paid off.
So 2013 began and so did my trechorous journey to become a Dietitian. The most emotionally, physically and intellectually roll coaster I’ve now experienced in my life to date! It has taught me so much about myself I didn’t even know. Like my ability to smash out crazy literature reviews, to learning all the dietary related disease and illnesses to how the body can actually function off six hours sleep, 9 hour working days + 2hrs of training (don’t tell mum I continued this through Clinical!) + 3hr study/night with all the domestic duties in between! And no I don’t have kids yet, so I can be selfish! I can’t begin to imagine how some in my course have achieved this with families and others to consider in their lives. I take my hat off to them.
One of the biggest learning experiences whilst on clinical is to really appreciate and cherish what you’ve got. The strength and courage of some who are so debilitated and unwell? Well it really amazed me and really puts life into perspective.
So I guess this brings me to now acknowledging those who have helped me in my journey to being a Dietitian (particularly this last 18 months).
My friends, from home and the ones I’ve made along my university journey. Each and every one of you all bring out the best in me, and surrounding myself with your fun, positivity and company truly makes me happy.
My brothers, older and younger, and my sister in law, who although have been a far, have always believed in me and supported my strive for success. I love them very much.
My partner, who I’ve shared my life with since high school. We’ve been through ups and downs, breaks and long distance- even started living together (before you moved back to the country for work!). I cannot begin to tell you how appreciative I am of all your support. Although we share similar values and morals, we have opposite temperaments and for this I am grateful because you really calm my storm (many many many storms in the past 12 weeks!!!). You always seem to relax me and make me smile and make me laugh. No matter what time, no matter what temper tantrum, rant and rave these past twelve weeks, you’ve continued to encourage and never let me forget that I can and that I will get there- and look, I’m a week away. So from the bottom of my heart, thank you.
And finally, to my parents. I know I’ve caused them both much heart ache and stress, particularly these last 12 weeks, being the most challenging. But when I achieved something great during the placement day or I got back a great mark or I made my patient really happy, mum and dad are the first I wanted to tell. Because the real reason why I’ve been successful and come this far already in life- is the two of them. The morals they’ve instilled me, the ongoing support and always believing in me- I will be forever grateful.
So I suppose this blogging business is very new to me, and this has raved on a bit! I hope my future blogs to bring you stories and information about food and nutrition. I truly believe all have the right to access nutritious foods and be educated on how to ensure a healthy lifestyle. But for now, I really wanted you to understand my journey to reaching this point in my life so far. And I also wanted to use it as an opportunity to acknowledge those who helped me achieve this.
So growing up in the country? Yes annoying at times, but it forced me to move away to pursue my tertiary studies. It forced me to be independent and work for financial support. It forced me to get out of my comfort zone and meet so many new people. It forced me to realise there is a whole wide world of opportunities and ultimately YOU are the force behind the drive to success. Do I want to move back to the country? Well that I’m still yet to decide. One step at a time. Let’s tick of this final exam next week and then we’ll see where the jobs will take me!
Stay tuned as I continue my journey into the wonderful world of food, nutrition and health for life.