Pop-Tarts Image via Wikipedia
Last week was a rather discouraging one for this persevering nutritionist. I knew it was bad, as on Friday I found myself contemplating stopping at a Dunkin’ Donuts and just drowning myself in one of those massive confectionery pond-sized drinks, weighted down with heavy donut shoes.
The final straw so to speak had occurred just moments before. On Fridays, I work in some elementary schools. As I was packing up my Mary Poppins basket musing on the students I had spent my day with, an announcement came over the loud-speaker. The principal was congratulating a boy for his lack of tardiness or absenteeism for the month of February. His reward was that he’d get to share a Burger King lunch with her.
Really? Why don’t you just shoot me in the foot? Well, maybe this boy was being given his fair reward. All the other slackers who had managed to show up on this day got a greasy, square piece of pizza, a cellophane-wrapped bag of carrots (which is more appealing than most of the veggie offerings) a blob of half-frozen mushy blueberries–the ice crystals were visible– and a chocolate milk on their non-recyclable styrofoam tray. That should teach them not to miss school.
The night before I had been at a charter elementary school. I was a presenter with two other speakers on healthy choices for school success. I had been excited that the school had focused a parent meeting on this important topic and was glad to have been invited. Despite good intentions on behalf of the school, only six parents out of a student body of 300 attended. Still, we did our thing.
Out of my Mary Poppins basket, I passed around, along with some other nutrition shockers, a well-worn packet of Pop-Tarts with an attached baggie filled with the eight and a quarter teaspoons of sugar that it contains. I asked the participants to look at the long list of gruesome ingredients as I talked about nutrition and brain health. After the talk, a staff person approached me. She meekly told me, that if kids get to school late, and miss the provided breakfast, they are given Pop-Tarts. Given the rewarding of non-tardy behavior to only one recipient at the other school, I surmise that no small number of kids are getting their brains doused with such artificial intelligence here. I felt like I was going to cry. (We did come up with some alternative ideas for the school though.)
Oh well, no biggie. Maybe I was just sensitive because the day before that I had a new eating disordered client who was restricting herself to three hundred calories a day. Or, maybe it was the young diabetic who I had spent many teaching moments with, who came in the day before that with a high blood sugar of 227 and told me that she had a beef patty, some Pringle-like potato chip I had never heard of, three Oreos and a large-sized can of Arizona Green Tea for breakfast.
Perhaps, most disheartening though was the doctor who totally ignored my concerns about the severe dietary deficiencies of a patient we shared–whose support I really needed to facilitate her care. Like the scenarios I described above, this is really nothing new to me. Doctors untrained in nutrition, give short shrift to diet, except for some lip service when it comes to blood pressure, weight, and cholesterol. I am rather used to being ignored by physicians.
I do not expect my clients, my students, and even school administrators to fully get this whole food and nutrition thing given current conditions. Those with eating struggles would not have them if they were easily understood. Individual schools are not easily able to remedy foodservice and budget limitations. Teachers have many other matters to attend to.
But, I do really expect that by now, even conventionally-trained medical providers would appreciate the connection between diet and health and would give attention to meaningful dietary assessments in supporting the treatment of their patients. It is recognized that patients whose doctors inquire about their smoking habits and are told to quit have higher smoking cessation success. To help turn the tide on the nation’s health crisis, doctors’ true embracing of dietary health is essential. Last week, I really needed that doctor to express to our patient who was in the office, concern about her eating and to provide to her some basic nutritional support. Instead, out the door, the patient went, with a prescription for one more drug in hand and no mention of my recommendations. I slumped in my chair.
Usually, I can handle situations like this with more aplomb. Maybe I am just a bit depleted in B-vitamins which lowered my resilience. Never mind. Time to re-fortify. Onward.
Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.
In health, Elyn
the nutritionist's dilemma 
I hear what you are saying. As an oncology nurse, I really see the role of proper nutrition in recovery for cancer patients. But physicians often don’t see it until nurses and nutritionists suggest it. The docs are so focused on the labs and treatments and they don’t instinctively understand that there is a key decision point if the patient hasn’t eaten properly for 3 days. And eating well is so important in fostering a sense of well being and treating the whole person.
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Carolyn, Thank you so much for this response. I am always surprised that nutrition therapy is still not an integrated part of oncology care. Where else can it be so intimately linked for both its therapeutic aspects as well as supporting the well being of the patient? May we all be grateful for people like you who serve in providing the care, love and support which I am sure you do. Elyn
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So, wait, you never finished … what did you get at Dunkin Donuts? Seriously, though, the school nutrition problem is an almost intractable one, compounded by the current fiscal constraints school districts are facing. Can you imagine even an nutrition-enlightened superintendent being presented with staff and operating cuts trying to focus on long-term outcomes such as health? I often wonder how we can rejigger our educational system so that the essence of education (ie. how to raise the next generation of productive and well rounded citizens) can be the focal point of decision making. I am going to reflect on that over a donut and a supersized cream-drenched coffee.
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well, good luck on the reflection after that little snack. there are districts and communities however who with the help of school food activists, creative food service directors and involved parents, have been successful in generating wellness policies that have affected some changes in school food. one upsetting piece i read about four months ago, was about a mother whose school decided to disallow the bringing in of sweets and candies for in class celebrations like a child’s birthday. she responded by saying she was going to teach her child about civil disobedience by making him break this draconian meausre. cupcakes for all! i mean there is a place for CD, but this is the issue? mon dieu.
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Physician apathy toward diet is just one of the many things fundamentally wrong with health care in this country. If there was a way we could incentivize prevention, it might help to focus them on food and diet. But will that ever happen when private insurers dominate the health care landscape? And that will take a Tahrir Square type of movement!
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Peter, You raise the essential points underlying this problem. I do understand there was due attention to providing medical care to people in Tahrir Square. I imagine some basic, wholesome form of nourishment was provided as well.
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I love your writing.
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I so agree that docs need help in the nutrition field. I do not expect them to do specific nutrition counseling but encouragement of weight loss or at least an interest in their patients’ eating habits or attitudes would help a great deal. Patients listen to them. Perhaps doctors don’t feel qualified? I draw your attention to a recent study entitled:” Nutrition Education in U.S. Medical Schools: Latest Update of a National Survey” in Academic Medicine, Sept. 2010: Volume 85, Issue 9; 1537-1542. There is free access but the abstract tells the dismal facts. Things have gotten worse!
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Thank you for providing the information on that article. I agree that a medical provider’s role is not necessarily to provide specific nutrition counseling but to be looking at the whole person and considering their eating habits. A common example is I encounter many people being treated for anxiety, muscle stiffness, cramping, or headaches who have been put on medications, referred to specialists, etc. without a simple inquiry to find that the person is living on pots of coffee ar day, or other intense sources of caffeine, who drink no water, or who don’t eat all day long. Just this week I spoke with a woman finishing a two year Physician’s Assistant Program and she had not one iota of nutrition education.
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Perhaps what is needed is a seminar series or webcast during which you can provide physicians with your ideas relative to nutrition. This might bring your subject to a top of mind position so that you can compete with the drug therapies actively promoted by the world’s drug companies.
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thanks for commenting richard. there are incredible people already doing that type of work and educating through such means–including some physicians. to navigate around big pharma has become almost impossible but some physicians have chosen to leave the “network”, and thankfully there are integrative and functional medicine doctors, along with naturopaths and many other types of alternative healers who address nutrition and look at the whole person. given the statistics on the number of Americans who have sought out alternative therapies (30%?) it is shocking that most doctors still do not show interest in this and choose to practice with often unproven medications as their main tool.
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Elyn, I love your blog. I can imagine it must feel like you are up against a brick wall trying to make headway with schools and doctors. We need more dedicated nutritionists like you to come forward with real information like you do, not the same old “Here’s the food pyramid. Pop tarts qualify as a serving of carbohydrates.” Your posts are insightful and true.. rock on!
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