This blog has been pretty quiet over the last few months… After finishing my dietetic internship and master’s program in May, I was basically a zombie (sorry friends and family!) while studying for the Registered Dietitian exam in June. While I was a nervous wreck during the whole two hours that I took the exam, learning and relearning the Kreb’s cycle, drug-nutrient interactions, and food management theories among other medical nutrition therapy/food science/food service topics paid off in the end because…
Now, I am officially a Registered Dietitian (RD)!
While I’m so excited to start my career as an RD, I can’t help but reflect on everything I’ve learned in the process of becoming a dietitian. Today, I’m sharing an article that I originally wrote for the Friedman Sprout about what I’ve learned about nutrition over the years—beyond the nutrition tips that may pop up on your social media feed or even what you may an introductory nutrition textbook.
I was one of those odd teenagers who knew exactly what I wanted to be when I grew up and never looked back. Nutrition tips on the sidebar of Self magazine, an over-simplified nutrition lesson from a health class in middle school, and a quick nutrition lecture from my pediatrician summed up my understanding of nutrition before entering college. Now—six years of coursework and 2000+ hours of dietetic rotations later—I not only know the nitty-gritty details of nutrition science, but I also have learned some larger truths about nutrition that are not always talked about openly.
1. Nutrition is an evolving science.
First, let’s be clear that nutrition is a science that relies on concepts from biology, chemistry, anatomy, physiology, and epidemiology to explore how nutrients impact health and disease outcomes. Understanding how diabetes alters carbohydrate metabolism allows people with diabetes to live without fear of dying from diabetic ketoacidosis or seizures due to unsafe blood glucose levels. Understanding how ulcerative colitis can alter mineral absorption and increase protein losses helps those with the condition manage nutrient deficiencies with adequate nutrition supplementation. These are only some of the many ways nutrition science makes it possible to improve individuals’ health outcomes.
However, the more I learn about nutrition, the more I realize that the research still holds many unanswered questions. For example, previous nutrition guidelines, like when to introduce hypoallergenic food to children, are being disproven and questioned by more recent studies. On the other hand, research on the gut microbiota is just beginning to uncover how diet interacts with gut microbiota through hormonal and neural signaling. Staying up-to-date on the latest research and analyzing study results with a critical eye has been crucial as new scientific discoveries challenge our understanding of nutrition and physiology.
Who would have thought a career in nutrition would require so much detective work?
2. Food is medicine, but it can’t cure everything.
The fact that half of the leading causes of death in the U.S. can be influenced by diet and physical activity highlights the importance of nutrition for long-term health. Using medical nutrition therapy for patients with variety of health problems, ranging from cancer and cardiovascular disease to cystic fibrosis and end-stage renal disease, has allowed me to see nutrition powerfully impact the management and treatment of many health conditions. High cholesterol? Avoid trans fat and limit saturated fat in foods. Type 2 diabetes? Adjust the timing and type of carbohydrates eaten.
While making simple changes to eating habits can improve lab values and overall health, nutrition is often only one component of treatment accompanied by medication, surgery, therapy, sleep, and/or stress management. Interacting with patients of all ages and health problems, and working with health professionals from a range of disciplines has forced me to step out of my nutrition bubble and take a more comprehensive approach to patient care. Improving quality of life and overall health and wellbeing is always more important than striving for a perfect diet.
3. Nutrition is political and nutrition messages can be misleading.
Back when the Academy of Nutrition and Dietetics was one of many health organizations sponsored by Coca-Cola and PepsiCo, I realized how much influence large food industries have on food advertising, marketing and lobbying. With known health consequences of drinking too many sugary beverages, the concept of health organizations being sponsored by soda companies was perplexing to me. Learning more about the black box process of developing the government dietary guidelines has also made me more cognizant of government-related conflicts of interest with industries that can color the way nutrition recommendations are presented to the public.
Industry-funded nutrition research raises another issue with nutrition messaging. For example, only recently a study revealed that the sugar industry’s funded research 50 years ago downplayed the risks of sugar, influencing the debate over the relative risks of sugar in years to come. Unfortunately, industry-sponsored nutrition research continues to bias study results by highlighting positive outcomes, leaving out negative ones, or simply using poor study designs. While sponsorships from big companies can provide a generous source of funding for research, as both a nutrition professional and a consumer, I’ve learned to take a closer look at the motives and potential bias of industry-funded nutrition information.
4. Nutrition is not as glamorous as it sounds, but it’s always exciting.
When the media is flooded with nutrition tips for healthy skin, food for a healthy gut, or nutrients to boost mood, the topic of nutrition can seem light and fluffy. With new diets and “superfoods” taking the spotlight in health magazines and websites, nutrition is often overlooked as nothing more than a trend. However, any nutrition student or dietitian will prove you otherwise.
In the words of one of my preceptors, “my job (as a registered dietitian) is not as glamorous and sexy as it sounds.” Throughout my dietetic rotations, my conversations with patients and clients have gone into much more depth than just trendy nutrition topics and weight loss for aesthetics. If I’m working with a patient with Irritable Bowel Syndrome, bowel movements (a.k.a poop) may dominate the conversation. If I’m counseling someone who has been yo-yo dieting, I may be crushing their expectations of fad diets while encouraging more realistic, sustainable healthy goals. If I’m speaking with a group of teenagers with eating disorders, I may not talk about nutrition at all and focus more on challenging unhealthy thoughts and behaviors about food. It is these conversations, discussing what really matters when it comes to food, nutrition, and overall health that make a career in nutrition ever-changing and always exciting.
Job update: Beginning in September, I’ll be working at Boston Children’s Hospital in the Division of Adolescent Medicine as part of an interdisciplinary team involved in management of eating disorders, obesity and polycystic ovarian syndrome. As a new RD, I can’t wait to start my career working with others to challenge food rules and nutrition myths and create a realistic, evidence-based approach to nutrition and health. While I am not sure how frequently I will be posting, I hope to continue to share my latest insights on nutrition on this blog. If you’re curious about any food or nutrition topics in particular, send them over to me at firstname.lastname@example.org!