Tag Archives: wellesley dietician

What Is the Difference Between a Nutritionist and a Dietitian?

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The title of Nutritionist is unregulated. Anybody can call themselves a Nutritionist. You are a Nutritionist. Your neighbor is a Nutritionist. So is your infant. And your dog. The title is meaningless and does not indicate that the person has any training or expertise whatsoever in nutrition.

In contrast, the title of Dietitian (short for Registered Dietitian, RD) coveys that we completed a program of formal academic study in nutrition, graduated from an accredited internship program that included working in a wide range of specialties within the field (everything from food service to organ transplant), passed our boards, partake regularly in continuing education, are registered with the Commission on Dietetic Registration, and have a license to practice in the state. Dietitians are held to a code of ethics, just as doctors, nurses, and other licensed health care practitioners are, and we are recognized within the medical community as the experts in nutrition.

Despite the meme posted at the top, some Dietitians do refer to themselves as Nutritionists. Doing so is nothing more than a public relations strategy. While Nutritionist is a hollow title that means nothing, its inclusion of the word “nutrition” yields a title to which laymen can relate. Furthermore, some people mistakenly believe that Dietitians only work inpatient jobs at hospitals. These misunderstandings are so common that the Commission on Dietetic Registration now gives the option for a Dietitian to call him or herself by the alternate title, Registered Dietitian Nutritionist (RDN).

So, all Dietitians are Nutritionists, but not all Nutritionists are Dietitians. If you are looking for help with your eating, check the person’s credentials first and make sure he or she is a Dietitian.

He Said, She Said: Chocolate

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Does chocolate deserve to be seen as a guilty pleasure, and what sort of place can it have in a healthy lifestyle?

He Said

If chocolate and coffee were people, they would probably get along great. Together, they could commiserate over being unfairly portrayed as guilty pleasures when really they each have much to offer. Their reputations are not based on themselves, but rather on the company they keep.

Take chocolate for instance. A tablespoon of pure cocoa powder is low in calories (12) and virtually free of sugar (0.09 g), provides a bit of fiber (1.8 g) and even a little protein (1.06 g), and contains calcium, iron, magnesium, phosphorus, potassium, zinc, trace amounts of vitamins, and other antioxidants, too. Sure, it contains caffeine as well (12 mg), but not enough to be a concern for most people.

Despite pure chocolate’s health benefits, consuming it plain is a rough experience. In fact, some of my high school friends used to do it as a dare. To make pure chocolate more palatable and enjoyable, people typically add sugar and fat. These added ingredients, when consumed in excess, are what can be detrimental to our health, not the chocolate itself.

If you want to capitalize on chocolate’s health benefits while minimizing the sugar and fat, opt for dark chocolate, or make hot cocoa from scratch so you are in charge of the recipe. For those of you who are truly adventurous with your eating, add a spoonful of plain cocoa powder to your morning oatmeal.

Alternatively, if you are like me and no form of chocolate quite hits the spot like full-of-fat-and-sugar milk chocolate, leave the guilt part of “guilty pleasure” aside and just go for it. Balanced eating and a healthy relationship with food certainly have room for some candy.

She Said

Among my patients, there doesn’t seem to be a more polarizing food than chocolate. Many of my patients have a love/hate relationship with it. On the one hand, it’s the quintessential indulgence, one to be savored on special occasions and eaten with gusto. On the other hand, especially for those who are struggling with an eating disorder, chocolate can be a fear food, one that they feel  they cannot control themselves around, that once they start eating it, they won’t be able to stop, resulting in exponential weight gain.

While everyone can agree that chocolate does have some well-documented health benefits due to its antioxidants, a great number of my clients treat chocolate with kid gloves, oftentimes limiting it or completely omitting it from their intake. When I try to explain to these clients that chocolate, like every other food, can have a place in one’s diet, the common response is: So you’re trying to tell me that a Snickers bar and a plate of broccoli are nutritional equals?! Isn’t it better to be eating only foods that are nutritious and cut out all the other junk?!

My response to the above question is this: Food is not just fuel. Yes, our bodies use the food we eat for a number of physiological functions, but there is a lot more to the act of eating. Food is enjoyment, pleasure, connection, and memories. Sometimes food is fun, and sometimes it’s more functional. Would I suggest that someone eat only a diet of chocolate? Of course not. Similarly, I would not suggest that someone eat only a diet of the most nutrient-dense foods possible. Balance is key, and there is room for all different kinds of food in your life.

So, if you are really having a craving for chocolate, I say go ahead and have it! Just make sure to savor and enjoy every bite.

Noms: Finale, Boston

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To keep with our chocolate-themed newsletter, we thought it would be fun to review one of our favorite dessert restaurants, Finale. We had our very first date at the Finale in Coolidge Corner (which sadly is no longer), so the restaurant holds a special place in our hearts. Despite the closing of the Coolidge Corner location, we love going to the Back Bay Finale to celebrate special occasions or when we are in the mood for a fancy dessert.

One might assume that Finale only serves dessert, but one would be incorrect about this assumption! In addition to its myriad sweets, Finale has a rather impressive, although abbreviated, “Savory Menu” as well. All savory items are less than $16, which is a pretty good deal any way you slice it. Joanne has been to the Harvard Square location several times for lunch, and she very much enjoys the Greek salad topped with roasted chicken, especially appreciating the unexpected mango and candied olives. Another tasty savory meal is the truffle macaroni and cheese, which is very rich, warm and comforting on a cold winter’s day.

Obviously, desserts are the stars of the show at Finale, and ranging from $9-12, they are a good deal, given the quality of the ingredients and the beautiful presentation on the plate. On our first date, Jonah got the crème brulee, which had a perfect crispy crust on top of a creamy sweet custard and was garnished with fresh fruit. Joanne got the Manjari Mousse, which is a “bittersweet Valrhona Manjari chocolate mousse layered with chocolate buttermilk cake.” While the cake and mousse on their own are divine, make sure to ask your server for extra crème anglaise and French apricot puree, as those two sauces put this dessert over the top!

The last few times we have gone to Finale, we opted for the dessert sampler under the “Shareable Desserts” section of the menu, which allows you to try up to nine miniature-sized versions of Finale’s signature desserts. These little bites let you experience everything without bursting your wallet (or your stomach!). While the shareable desserts are a bit pricier at $17-27, they can be a more economical way to enjoy your sweets with a group of friends.

If you are hankering for a sweet way to end the evening, you should definitely make a special trip to Finale. Sweet dreams!

Balance

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A couple of people sent me the link to this article about identical twin brothers who performed a nutrition experiment on themselves.  One of them adopted a diet very low in fat while the other followed a diet extremely low in carbohydrates.

By the end, neither one of them felt well.  One brother concluded, “We should not vilify a single nutrient.  It is too easy to demonize fat or sugar, but that enables you to let yourself off the hook in other ways.  The enemy is right in front of us in the shape of processed foods.”

While I agree with the first part of what he said, his last sentence undermines his initial point.  Just as it makes no sense to scapegoat a particular nutrient that exists in the larger context of one’s eating pattern, it is similarly ridiculous to blame a particular form of food (in this case, processed food) that exists in the vast expanse that is one’s overall lifestyle.  To do so is to badly oversimplify what is a very complex picture.  Exclusion, oversimplification, and blame rarely lead to good nutrition.

The people I have seen who have been able to attain and maintain good health are the people who find balance: balance in their eating, and balance in their lifestyles.  Every food has its pros and cons and therefore no food is “the enemy.”  Even processed foods have their upsides: enjoyment, convenience, shelf life, price, etc.  Otherwise, nobody would ever eat them.

While eating processed foods all the time clearly has ramifications, so does never eating them.  Decreased enjoyment, social isolation, weight gain (yes, gain), preoccupation with food, and eating disorders can all result from this kind of restriction.  Misled by a culture of dieting and nutritional scapegoating, many well-intentioned individuals struggle with these issues.  Joanne and I regularly work with such patients at our practice, where we help them to find a healthier relationship with food and ultimately better health overall.

The time to leave exclusion and scapegoating behind is now.  Instead, understand that every food can have its place in a healthy lifestyle.  Pursue balance.  We are here to help.

Is the Risk of Foodborne Illness Worth It?

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Almost immediately after posting a Wall Street Journal article entitled “Does Rinsing Fruit Make a Difference?” on our Facebook page yesterday, I got an email from a family member talking about pre-washed salad mixes in the past tense (“What a convenience they were.”) and asking me if I will change my own eating habits because of this article.

When it comes to foodborne illness, risk always exists.  One can take every known precaution and still contract a foodborne illness, or one can grotesquely forgo all food safety guidelines yet not get sick.  The question is not one of risk’s presence, but rather one of risk’s relative magnitude.

Each one of us has to decide for ourselves how much risk we are comfortable taking.  The article talks about the health of one’s immune system as being an element of consideration, but other factors are in play, too: What does one like to eat?  What can one afford?  How much time does one have for food preparation?  What are the realistic alternatives if one forgoes a given food?  Pros and cons exist for eating and not eating a given food, and these must all be considered before reaching a conclusion. 

The answer to my family member’s question is no, I will not be changing my own eating based on this article.  Generally speaking, I do not care for vegetables.  I know, I know, a dietitian who does not like vegetables.  As it turns out, dietitians are people too and we have our own challenges with food just like everybody else.  The modes in which I enjoy vegetables are slim: carrots and peppers dipped in humus, spinach in lasagna, and broccoli and mushrooms on pizza.  In terms of true enjoyment, that’s about it.

Raw salad greens topped with fresh fruit and nuts are moderately enjoyable, but the tipping point is such that convenience is a major factor for me.  Take away pre-washed salad mixes and the likelihood that I will buy whole greens and prepare a similar mixture on my own is very slim.  Therefore, when I weigh their benefits against the risk of foodborne illness, continuing to consume pre-washed salad mixes makes sense for me.

Somebody else might reach a different conclusion for his or her own life and that is perfectly fine.  My case is nothing more than an example; I am not suggesting that others should or should not reach the same conclusion for themselves that I have reached for myself.  Everybody has different needs, priorities, goals, and constraints, which is why Joanne and I feel so strongly about providing individualized nutrition counseling that is customized for each one of our patients.

He Said, She Said: New Year’s Resolutions

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You already know that New Year’s resolutions do not typically last, but you have not yet heard our opinions as to why and what you can do about it.

He Said

A few weeks is not yet enough time for most New Year’s resolutions to have fallen apart, but if past statistics are any indication, by the end of the year only 8% of us will have been successful in achieving our resolutions.  The poor rate of conversion from resolution to reality is partly due to the goals themselves, as Joanne will discuss below, but being honest with ourselves about how ready we are for change is of utmost importance, too.

According to the Transtheoretical Model describing behavior change, individuals can fall into any one of five stages.  The preceding link gives detailed explanations of each stage, which I will concisely summarize below.

  • Precontemplation: The person does not see a problem and therefore has no intention of changing.
  • Contemplation: The person recognizes that a problem may exist but feels ambivalent about what to do.
  • Preparation: The person has decided to make changes and is formulating a plan.
  • Action: The person is implementing changes but has not yet maintained them for six months.
  • Maintenance: The person has maintained the given changes for six months or longer.  (Note: Some versions of the Transtheoretical Model also throw in an additional stage, Termination, but often this stage is considered part of the Maintenance stage.)

Classically, the idea is that a person moves from one stage to the next in the sequence in which I listed them, but in reality someone can jump from any one stage to another at any point in time.  The Model is not perfect, but it expresses an invaluable truth: Not everybody is ready to change.

This truth, by the way, is perfectly fine.  Change is a process, as the Model indicates.  When Joanne describes our counseling approach to people unfamiliar with how we work, she often tells them, “We meet our patients where they are.”  She does not mean that literally as if we make home visits; rather, she is referring to their stage of change.  Recognition of said stage is critical to successful counseling.

What do you think would happen if I counseled a patient on the changes he can make to his eating (thereby treating him as if he is in the Preparation stage) while he does not even see a problem with his diet and came to my office only because his doctor insisted he see a dietitian (which suggests he is in the Precontemplation stage)?  He would not feel heard, the session would be unproductive, in all likelihood he would not return for another session, and whatever health condition he is dealing with would remain a problem.

Conversely, if I listen to him without judgment as he shares his emotions and opinions, acknowledge the validity of his feelings and point of view, and discuss his doctor’s concerns with him, he may transition to the Contemplation stage and move closer to ultimately making and sustaining behavior changes that will improve his health.

Alternatively, perhaps after learning more about his condition and the potential consequences, he decides that he will maintain his current lifestyle anyway, at least for now.  It is his life, he can do what he wants with it, and I respect his choice without judgment.  At least he will have had an opportunity to weigh his options and make an informed decision.

Similarly, we each have to meet ourselves where we are at, too.  In other words, when we make New Year’s resolutions, we have to be honest with ourselves about how ready we are to make the given change happen.  The calendar’s flip from December to January does not automatically transition us to the Action stage.  In all likelihood, if we were truly in the Action stage, we would have implemented the change before New Year’s rather than wait for the holiday.  Willpower can only force change for so long.  Whatever was holding us back before New Year’s will remain and ultimately catch up to us after the holiday and bring an end to the resolution.

Instead of setting yourself up for failure by setting a goal that is unfit for your readiness to change, use the New Year as an opportunity to be honest with yourself about your health and how you feel about it.  In other words, meet yourself where you are instead of forcing yourself to take an action before you are truly ready for it.  Reach out for whatever information or support you need.  Consider the following examples:

  • A husband in the Precontemplation stage might give in to his wife’s urging to finally make an appointment with a dermatologist to have his strange-looking mole examined if for no other reason than to appease her.
  • Perhaps a diabetic in the Contemplation stage might decide to schedule an appointment with his doctor to discuss his ambivalence regarding monitoring his blood sugar at home.
  • An individual in the Preparation stage might meet with me to plan specific and achievable changes to his eating that will improve his cholesterol, then go home and discuss the upcoming changes with his family.
  • An osteoporosis patient in the Action stage might continue to use the package of personal training sessions she bought so she can continue learning how to lift weights safely and preserve her bone structure.

Most important, remember that New Year’s is just an arbitrary point, and one need not wait for a new calendar year to start the process of making change.  Said differently, we do not need an exterior cue to trigger internal change.  When we are truly ready, we will make the change happen no matter what date it is.  One of my favorite quotes is from Andre Agassi’s Hall of Fame induction: “ . . . every journey is epic, every journey is important, every journey begins today.”

 

She Said

Mid-January through the beginning of February is a tricky time for many of my patients.  Their motivation for keeping all of their nutrition resolutions is starting to dwindle, and many people feel like they have failed in one way or another.  What I often find is that many of my patients had set the bar too high in terms of nutrition goals.  They expect too much from themselves and have no other option than to not meet their goals.  Most of these goals are so overly ambitious that it would be very difficult for almost anyone to follow through with them.

So what’s a person to do?

When my patients ask me for help setting nutrition goals, I tell them to think S.M.A.R.T., as in goals that are Specific, Measurable, Attainable, Relevant, and Time-bound. No, I didn’t invent this clever mnemonic; it has been attributed to George T. Doran who wrote a paper called There’s a S.MA.R.T. way to write management’s goals and objectives in the November 1981 issue of Management Review.  But I really like the simplicity of this handy acronym.

Specific goals are those that are clear-cut and unambiguous.  Examples of specific goals could be “I will make a kale smoothie for breakfast…,” or “I will prepare a new salmon recipe…”  Measurable means that the goal must be quantifiable in some way so that you can clearly assess your progress.  This can be accomplished by adding to the above goals; for example, “I will make a kale smoothie for breakfast 2 times….” and “I will prepare a new salmon recipe one night….”

Attainable goals are those that are ones that realistic for you.  If, for instance, you know that making a kale smoothie for breakfast 5 mornings per week isn’t likely to happen (e.g., you often sleep late and don’t have time, you have difficulty going to the grocery store to get the ingredients, etc.), then shoot for something you absolutely know you can do.  In other words, it’s much better to start with smaller goals and then build on them than to start with goals that are too ambitious for you.

Relevant goals are ones that are worthwhile and applicable to you.  If upping your omega-3 intake isn’t that important to you, then don’t set a goal to eat more salmon.  By the same token, if you are already succeeding at one area of your nutrition (say, getting your leafy greens), then maybe it’s time to focus on something else, like increasing your nut intake.

Finally, it’s important that your goals are time-bound, that there is a particular time frame for achieving them.  You could add on to the examples given above: “I will make a kale smoothie for breakfast 2 times this week,” and “I will prepare a new salmon dish one night per week for two months.”  By giving yourself a deadline, you will be more likely to achieve your goal on or before that deadline.

If the above seems a bit much, the one piece of advice I give all of my patients is to keep it simple.  When goals are overly complicated and ambitious, it can be overwhelming.  And be kind to yourself – you are human, after all!

Pan-Glazed Chicken with Basil

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Courtesy of Cooking Light’s 5-Ingredient 15-Minute Cookbook.

Ingredients

  • 4 4-oz. skinned, boned chicken breast halves
  • 1/2 tsp salt
  • 1/4 tsp freshly-ground pepper
  • 2 tsp olive oil
  • 2 Tbsp balsamic vinegar
  • 1 Tbsp honey
  • 2 Tbsp chopped fresh basil

Directions

1.     Sprinkle both sides of chicken with salt and pepper.

2.     Heat oil in a large nonstick skillet over medium-high heat.

3.     Add chicken; cook five minutes or until lightly browned.

4.     Turn chicken; cook six minutes or until chicken is done.

5.     Stir in vinegar, honey, and basil; cook one additional minute.

Noms: The Local, Wellesley

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To celebrate Jonah’s birthday, we decided to venture out to The Local, a restaurant that just opened up in Wellesley last November.  Per usual, we went for an early dinner (5:30  pm), so when we arrived, there weren’t many patrons.  Suffice it to say, the place began to quickly fill up, and as we walked out the door at 6:30 pm there were people waiting for tables.  The Local’s menu is divided into clever sections such as “Snack Things,” including warm potato chips and dip and spicy Chex mix, “Mac and Cheese Things,” which allowed the diner to customize his or her mac and cheese, and “Bigger Things,” which was comprised of larger entrees including chicken cacciatore, short ribs, and semolina-crusted fish and chips.  Impressively, none of the appetizers is more than $14 (most were $5-8), and none of the entrees costs more than $19.

To start our meal, we had the fried pickles, which were crispy and delicious and not greasy in the least.  For our main meals, Jonah had the grilled cheese sandwich with a cup of tomato soup, while Joanne had the Atlantic salmon, which came with roasted Brussels sprouts and parsnip puree.  Although Jonah’s grilled cheese was smaller than others he has gotten at similar restaurants, he felt it was the perfect amount of food and was comfortably full by the end of the meal.  Joanne’s salmon was perfectly cooked, and the contrast in flavors among the salmon, Brussels sprouts, and puree was addictive.

While our meal was tasty and uneventful, it appeared as though the couple dining next to us were not happy with their orders.  We overheard them telling their waiter that the steak tips they had ordered were not cooked to their liking, so they sent them back.  In addition, it looked like there were other issues with that couple’s meal, including missing meal components.  Our guess is that since the restaurant is still only about a month old, it is working out the kinks.

All in all, The Local was a pleasant surprise for its delicious food at very affordable prices.  It will surely be added to our favorite restaurants rotation!

The Real You Is Sexy

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Aerie, the lingerie branch of American Eagle, is going with a “The Real You Is Sexy” campaign for their spring line.  My understanding is that the ads are not retouched in any way and show the models just as they were when the photographers took their pictures.  Aerie deserves credit for this move, but this change alone does not fix the underlying problem.  The greater problem is with us, not the fashion industry.

Reality is more complex than I am about to make it seem, but the basic premise is that we compare ourselves to models, feel pressure to look like them, feel bad about ourselves for not looking like them, and adopt certain behaviors – healthy or not – in an effort to match them.  Other advertisement campaigns that do retouch photos can dramatically alter a model’s appearance making him or her seem flawless.  When such a picture is held up as the ideal, we are comparing ourselves to someone who does not even exist.  As such, who can possibly live up to that standard?  Aerie deserves credit for at least removing this as a factor from the equation.

The larger problem though is that we compare our bodies to others in the first place, and that is not going to go away even if the fashion industry completely does away with retouching.  For example, I work with a patient who watches women leaner than herself pass by in town and feels bad about herself as a result.  No retouching there; she is comparing herself to people she sees with her own eyes.

We do not know what somebody does to look a certain way.  I do not know any of the Aerie models and I have no idea what they do to maintain their looks, but chances are neither do you.  They might look the way they do because they are genetically predisposed to have that figure and on top of it take excellent care of themselves.  On the other hand, they could also look that way due to eating disorders, overexercise, or other unhealthy behaviors.  One of my patients, a former model who is working to overcome anorexia, tells me of the pressure in the industry to gain a certain look at any costs, healthy or not.  If a model gets his or her frame through an eating disorder, are we really to look up to that image as an ideal just because there is no retouching involved?  In that sense, we still should not be using models – retouched or not – for a point of comparison.   

To further the point, we should not be comparing our bodies to anybody else either.  I discussed with my patient, the one who compared herself to other women in town, that we have no idea what those women do to maintain their looks.  Some of them are probably perfectly healthy, while others might struggle with eating disorders or other unhealthy behaviors.  Some of them are deeply unhappy and live rigid lives in isolation so they can do exactly what they need to do in order to maintain their physiques.  Some of them would laugh if they knew other people look up to them because no matter how great somebody else says they look, they still hate their bodies themselves.  I know all of this because I just described patients of mine.  These problems are much more prevalent than one might think.

It is time to stop comparing our bodies to others.  Weight, waist-to-hip ratio, and other anthropometric measurements do not define us and should not determine our self-worth.  Love and accept yourself the way you are now, not X pounds from now, and focus on leading a healthy lifestyle built on a foundation of balance.

Confusion

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A friend and I recently got into an email exchange about how rapidly nutrition advice seems to shift and how this often leaves people confused, frustrated, and feeling paralyzed about what to do.

No doubt, guidelines do evolve in response to new research, and in fact the Dietary Guidelines for Americans are updated every five years.  The shifts, while perceived as quite fickle, are much more subtle than most people realize.  However, the reason we perceive nutrition advice to be oscillating like the ever-changing wind is not due to this evolution, but rather because of misinformation.

Take yesterday as an example.  Each day, Joanne and I receive a blast of nutrition-related articles.  For each topic, we are provided with the story geared towards the general public, such as an article in the New York Times or Boston Globe, as well as the research piece or journal article on which the story is based, such as a piece in the New England Journal of Medicine.

Yesterday’s topic read, “Fats and Oils That Can Improve Your Health.”  As soon as I began to read the story, something seemed fishy.  Ghee and coconut oil topped the list of supposedly-healthy fats.  Although alternative medicine touts both of these fats as having health benefits, the research up to this point has not supported these claims.  Therefore, I was surprised to see them headlining the list.  When I got to the bottom of the article, I discovered that sure enough the story was written by a “Holistic Health Counselor,” as opposed to a credentialed and licensed expert in the field.

Next, I read the position statement released by the Academy of Nutrition and Dietetics on which the above story was supposedly based.  The content of the two publications bore little resemblance to each other.  Regarding coconut oil, the Holistic Health Counselor wrote, “This versatile oil goes well with both sweet and savory dishes and boasts many health benefits.  Made up of medium-chain fatty acids, this oil is good for those trying to lose weight because the body can easily use this healthy fat for energy.  A large portion of the fatty acids found in coconut oil are made of lauric acid, which can serve as an antimicrobial, antiviral, and antibacterial, helping to combat viruses and boost the immune system.”  On the other hand, the position statement read, “New food products containing coconut oil and other palm oils (eg, milk, spreads, yogurt) are touting health benefits of MCTs [medium-chain triglycerides, or medium-chain fatty acids].  Given that 44% of coconut oil is 12:0 and 16% is 14:0, and these fatty acids are hypercholesterolemic, consumption of coconut products is not currently recommended.”  Do you see any relationship between these two passages at all?

Omitting a link to the Holistic Health Counselor’s story was a conscious decision on my part in order to avoid further dissemination of misleading information.   If I showed you the article though, you would discover that it is concise, organized into a list with bold headings, and features colorful and attractive photos as well as a head shot of the author.  Compare that to the text-heavy, chemistry-laden, pictureless, 18-page monstrosity that is the position statement.  The former will attract more readers and gain steam and wide circulation due to forwarding to friends, postings on Facebook, etc.  The latter is lost in the dust, only to be read by the likes of me.

Generally speaking, most people never read primary source articles.  They simply trust that the stories they read summarizing said articles do so with a high degree of accuracy.  Unfortunately, just like in the game of telephone, details and facts get lost or skewed with each iteration; the ultimate and initial messages conveyed often do not match.  The mismatch is what makes playing telephone fun and interesting, but in real life the consequences are negative.  A patient comes into my office having read the more popular article and understandably believes the content to be true, but then he or she hears me present the position statement’s stance.  “Have the guidelines already changed?” the patient asks.  “Who should I believe?  What am I supposed to do now?”  No wonder people feel stuck and confused.  Part of our work then becomes to undo this confusion so that the patient can move forward.

In a culture where we have limited time and attention spans, we get a great deal of our news through tweets, scrolling headlines at the bottom of the television, and sound bites.  Media members, fully aware of the small window they have to present an idea and under pressure to break a story first, sometimes sacrifice checking facts and preserving key messages.  The pressure to be first and to accumulate clicks, retweets, and Facebook likes is king while the responsibility to be accurate gets lost in the shuffle.

Somewhere along the line, somebody suggested to me that I should shorten my blogs.  People have neither the time nor attention span for my entries, and who besides my mom reads all the way through to the end?  Shortening my blogs, I am told, could increase our Facebook fans and Twitter followers, thereby making Soolman Nutrition and Wellness LLC more popular.  That could be true, but my position as a source of reliable information is one that I take seriously, and I am not about to sacrifice my credibility for some extra likes and retweets.  Despite today’s be-first-and-keep-it-short media culture, accuracy and completeness are still necessary in order to minimize confusion.