Be a wise consumer of food, nutrition information
Wednesday, September 6, 2017
Dear Readers: I am committed to providing you the best scientific answers to the questions you ask about diet and nutrition. I admit that with all my experience and training, at times, I struggle to sort out the scientific information from the marketing claims and testimonials about new food and beverage products, diet plans, dietary supplements and approaches to eating healthy. It’s got to be confusing to you. Ultimately it’s up to you — along with your family, doctor, registered dietitian nutritionist (RDN) or trusted friend — to decide how the information applies to your life.
My job is a lot tougher today than when I wrote my first column in 1986. You had very little access to nutrition information. At that time the experts were considered the gatekeepers of information and we debated the evidence at meetings and in journals before making pronouncements. Now the results of the smallest study — yet to be replicated — may reach your ears or eyes as proven fact through a blog, a TV or radio or other media program.
A colleague sent me a paper with the title “Researchers: Too much information can be a good thing.” I almost cried. Really? At least the authors acknowledged that TMI — yes they have an abbreviation for “too much information” — can be a serious problem for health care providers.
It turns out that the headline was a bit misleading. The article was about researchers who studied the behaviors of patients responding to the information given by their health care provider. Did the doctor or RDN give them two or three specific recommendations or did the provider give them all the options available to prevent or treat their condition like high blood pressure or diabetes? Not surprisingly, the researchers found that the best number of health behaviors to recommend to a patient, at one time, is dependent on the goal of the intervention.
OK, so if my goal is to help a patient manage his blood pressure using lifestyle strategies I briefly lay out all the options — lose weight if overweight, don’t use tobacco or e-cigarettes, be physically active, follow the DASH eating plan and take prescribed medicine as directed. Then I ask the patient to pick a behavior he is confident he can do. So, in that case, giving the patient too much information is better than me just telling the patient what to do because he is more likely to see some results if he identifies the behavior he will try to change.
In our practice, we like to have patients set a SMART goal based on the known ways lifestyle can improve blood pressure. When the patient selects following the DASH, we will explore the food strategies that can lower blood pressure. They include eating more fruits and vegetables and less meat; consume some low-fat dairy; if you use a lot of salt or salt-containing foods, eat less of them. If you drink alcohol, consume no more than two drinks for men and one for women a day. A drink is 12 ounces of beer or 5 ounces of wine or 1.5 ounces of distilled spirits.
Most patients will see their blood pressure go down the fastest by losing some weight. But it takes doing all these eating behaviors every day to effectively manage systolic blood pressure (top number). Most people can’t do that overnight, but each change contributes to lowering blood pressure.
A SMART goal is Specific, Measurable, Attainable, Realistic and Timely/Trackable. As an example, “for the next seven days, I will eat a piece of fruit for my morning snack.” Hopefully by the end of the week, that behavior will be a habit and the person can add a new SMART goal. Research tells us that success in changing one behavior at a time leads to sustainable changes. For those who work at it and learn to follow DASH most days of the week, they may find they can reduce or eliminate their blood pressure medicines.
I give my patients “too much information” to remember so it’s imperative that I give them a handout. Do yourself a favor: if your provider doesn’t offer you a handout with all your options, ask for one. As for that headline, “Too much information can be a good thing,” be a wise consumer of food and nutrition information. It may be entertaining to read or even try the diets of the celebrities or products touted by experts in infomercials. But you will get bigger dividends if you start with what the scientists know works for most people and see how it applies to you.
Professor emeritus Kathy Kolasa, a registered dietitian nutritionist and Ph.D., is an Affiliate Professor in the Brody School of Medicine at ECU. Contact her at firstname.lastname@example.org.