You may have read the blog entry that Joanne recently wrote in which she discusses the dangers of believing everything written about nutrition on the internet without considering the source.  One of the reliable sources of nutrition information online is the blog that Joan Salge Blake, MS, RD, LDN writes for boston.com.  In a recent post entitled “Do Sugar Substitutes Cause Cancer?” she discusses the widely-held belief that artificial sweeteners cause cancer, the historical roots of this belief, and the lack of any credible research whatsoever to support this belief.

Apologies to my former English professors who would frown at my decision to use “belief” three times in a single sentence, but I did so to emphasize my point: one of the main reasons that online nutrition information is often faulty is because the messages being conveyed are really just beliefs, theories, ideals, or hypotheses disguised as facts or well-supported conclusions.

Last month, I attended the Cardiometabolic Health Congress.  For four days, I sat in what might as well have been a series of statistics classes.  The presenters understood that the credibility of information rests on the quality and quantity of research supporting it.  Reliable information, like Joan Salge Blake writes about and Joanne and I use in our counseling, is founded on an evidence-based research approach.  The ethics of our profession demand it.

The authors of most website content, however, are bound to no such standards and are free to write whatever they please.  The result is that hypotheses are often misrepresented as conclusions despite the void of supporting data.  Remember this the next time you read about nutrition online.  Ask yourself who the author is, what his or her credentials are (if any), and be suspicious of claims that are not backed by reputable research.  If you get confused or have questions, ask one of us.  That’s what we are here for, and we are happy to help!

The internet is a wonderful tool.  I often wonder how in the world we were able to survive without it 20 odd years ago.  It provides a wealth of knowledge at our fingertips, and we can find the answer to almost any question with the stroke of a key.  Unfortunately, while the web has a lot of solid information about various topics, it also has a vast amount of bogus information.  This is markedly evident when looking for answers to nutrition questions.  I can’t tell you how many clients (as well as many of my friends and family), tell me about the latest diet or miracle food that they found out about online. Inevitably, there is very little truth to these food myths.

Here are some examples of the misinformation one can find online:

• Carbohydrates make you fat/gain weight.
• Bananas are not as nutritious as other fruits.
• Foods that are high in dietary cholesterol cause high blood cholesterol.
• Foods that contain fat will make you fat.

Given our thirst for immediate information, many of us turn to the web to help us figure out what is true and false.  The problem is that these diet myths are almost always written by individuals who are not nutrition professionals.  What is truly scary is that nutrition information is not policed on the internet.  Anyone can write almost anything and call it truth, and then millions of people can read it and be misinformed.

The moral of the story?  Don’t believe everything you read online about nutrition!  Unless the person writing it is a registered dietitian and has peer-reviewed, valid research to back it up, it is very likely that this nutrition information is false.  If you have questions about what foods will make you healthier, talk to your friendly registered dietitian, as he or she has been trained in nutrition and is qualified to answer your questions.  Be a savvy internet-user, and don’t believe the hype!

Earlier this week, I recorded a Podcast on cholesterol.  Stan Starsky, author of the snack cookbook “Peace, Love, and Snacks,” conducted the interview.  My apologies for the less than stellar sound quality; next time I will be sure to use a different phone.

If you have any questions about this topic, feel free to post them here or on our Facebook page.

In the FAQ section, I touch on why the “just tell me what to eat” approach to counseling is often unproductive.  In fact, many of my clients are people who previously tried this technique with other dietitians and came away dissatisfied.  Oftentimes the patient blames the practitioner when really neither one of them, but rather the approach, is at fault.

Yesterday, a new patient and I fell into the “just tell me what to eat” trap together.  After she told me about her issues and goals, we discussed different options for moving forward.  I suggested a collaborative approach, but she felt she could benefit from starting from scratch and having me create a meal plan for her.  In other words, she wanted the “just tell me what to eat” approach.  We discussed the pros and cons of this method and eventually went ahead with it.

As soon as she looked at the menu I created for her, I could see the disappointment and frustration on her face.  “Do you have kids? she asked me.  She continued on that the meal plan I created would not work for a mother of young children like herself.  The irony is that I created her plan using meals and snacks that I know from experience have worked for other busy parents, but the point is not whether or not they work for other people but rather that they did not work for her

I take the blame for this.  While I agreed to the “just tell me what to eat” approach because I wanted to respect the client’s wishes and because I wanted to give her the benefit of the doubt that she might be the rare exception of a patient who responds well to it, in hindsight perhaps I should have tried to be more persuasive about taking a different approach.

The problem with the “just tell me what to eat” technique is that everybody is indeed different and what works for one person is not automatically going to work for another.  After all, we are dealing with real people, not homework case studies in some nutrition textbook.  Real people have likes and dislikes, time constraints, children and spouses with their own food preferences, etc.

The client is the expert in his or her own life, not the practitioner.  Therefore, a much more effective approach is for both the client and the practitioner to bring their expertise to the table and figure out together how to create change.  I would welcome the opportunity to sit down with this woman again and this time collaborate on a plan that will not only help her towards her nutritional goals, but also work in her life instead of just on paper.

One of my patients recently told me the story of when she began yelling at her pregnant friend, “You are killing your baby!”  What had the friend done that was deemed so horrible that it warranted such a harsh reaction?  She had ordered a smoothie in the mall food court.

Dr. Steven Bratman coined the term “orthorexia” to mean an unhealthy obsession with healthy eating.  While orthorexia is not an official medical diagnosis, a movement exists among practitioners that perhaps it should be.  Being a dietitian and not a doctor, I have no business diagnosing anybody with anything, let alone with a condition that does not officially exist.  Having said that, I do occasionally get concerned that a patient’s well-intentioned pursuit of healthy eating has crossed the line from constructive to destructive.

In such cases, the patient usually recognizes, on some level at least, that something is amiss.  Consider the woman in the preceding example.  She used terms like “fear” and “obsession” to describe her relationship with food and admitted that her attitude towards food was negatively affecting her friendships.  Because she was so forthcoming about her concerns, we were able to have an honest talk about the matter and discuss what she wants to do about it.

Unfortunately, not all “orthorexic” patients realize they might have a problem.  I find that these patients tend to have an expectation that I share their black-and-white views regarding nutrition, and when they discover that I do not they are stunned.

The way I look at it, humans often risk their health for the pursuit of pleasure.  Smoking is a blatant example, but plenty of more subtle examples exist.  Consider somebody who drives to the movies, thereby risking a debilitating or even fatal car accident for the sake of enjoying a film.  Consider those who love the bustle of urban life so much that they forgo the better air quality and lower crime rates of the countryside in order to live in the city.  Countless other examples abound.

Why, then, is it so hard to understand that the vast majority of us choose to sometimes eat less healthy foods for cultural, social, or financial reasons, or simply because we like the taste?  If I took the stance that these factors should have no bearing on food choices, then I would be out of touch with the vast majority of my patients and therefore an ineffective dietitian.

When the pursuit of healthy eating becomes so all-consuming that the pleasurable aspects of eating are shunned as second-class citizens, other areas of the patient’s life can suffer.  Whether orthorexia is ever adopted as an official diagnosis or not does not change the fact that this phenomenon exists.

The good news is that help exists too.  If you are reading this blog and saying to yourself, “I can relate to this,” consider speaking with your doctor about it and asking to see a dietitian who can help you to find a better balance in your relationship with food.

Intuitive eating, the practice of eating when you are hungry, stopping when you are satiated, and honoring your body’s innate wisdom, seems like such a simple concept, but it can be very difficult for many of us to practice.  When we were little, we knew when we were hungry. As babies and toddlers, when we would feel physical hunger, we would ask for food.  Likewise, when we had had enough food, we would push it away.

But somewhere along the way, many of us began to tune out our bodies’ hunger and fullness signals. Maybe your parents insisted that you “clean your plate” at dinner, pushing you past your feelings of fullness or perhaps you learned to ignore your hunger cues and skipped a meal because it wasn’t “time to eat” yet.  Or maybe you’ve been bombarded by the media’s messages about dieting and how eating less and especially not eating even if you are hungry are the keys to weight loss. Over time, as we continue to ignore our bodies’ signals, we begin to not recognize them anymore.

The majority of my patients look at me with complete disbelief that they would ever be able to regain their hunger and fullness cues again and trust their bodies to tell them when and how much to eat.  But, with practice, many of my patients soon realize that they recognize what it feels like to be hungry before a meal and how much food it takes them to feel physically satisfied.  It takes time and patience, but eventually you can begin to trust your body to tell you what it needs.

Intuitive eating does not happen overnight, and it takes a lot of time to “unlearn” certain habits and behaviors, such as skipping meals or cleaning one’s plate regardless of hunger or fullness. But when you learn to trust your body’s innate wisdom and be kind to yourself, you will be amazed at the progress you make.

This blog entry is inspired by one of my patients who recently told me she is afraid to eat canola oil because she heard it is genetically modified. Because many rumors are circulating these days regarding canola oil that are not quite true, I want to take a moment to share some facts.

Canola oil was developed from mustard rape, or rapeseed. The developers used a natural process of plant breeding that entails selecting certain plants that display a desired characteristic, breeding them to produce more plants with that trait, and repeating this over many generations in order to increase the percentage of plants with the desired characteristic.

It would be like a rabbit breeder who desires rabbits with really long ears and to that end selects only the bunnies with the longest ears from each generation for reproduction. As the generations go by, the resulting rabbits would tend to have very long ears. Are these bunnies genetically modified? No. Their ancestors were simply selected for reproduction because they naturally contained the genetic predisposition to have the desired trait: huge ears. Because this trait has been passed down over the generations, the offspring also have big ears.

In the case of canola oil, the desired trait was low erucic acid. Rapeseed naturally has an abundance of erucic acid, which in large amounts can be toxic to humans. The canola developers wanted lower erucic acid so they selected the plants with the lowest amount of erucic acid for breeding. After many iterations, the result was the canola plant, which has very low levels of erucic acid.

The development of canola oil preceded the rise of genetic modification techniques by decades. Since that time, some canola plants have been genetically modified for such purposes as making them more resistant to pests. While I was unable to find any credible research showing genetically modified canola oil to be dangerous, I understand that some people are not comfortable using it. For those who wish to avoid genetically modified canola oil, consider buying organic canola oil. By law, organic products have not been genetically modified.