Re: Gussow on Nutrition/Food Systems

Karen Lutz (karin@agate.net)
Tue, 10 Dec 1996 16:43:37 -0500

Almost all of the patients/people that we see in our diabetes/nutrition
education center (Eastern Maine Medical Center in Bangor ME) come in with
the expectation that we as the nutrition experts will clear up any confusion
about what is the BEST thing to eat; we can tell them what to eat, what to
avoid, and in doing so their health problems (i.e. diabetes and it's
complications) will be minimized. But, very often, despite an adequate
knowledge base, they feel powerless to change their eating habits and do not
subsequently act on the recommendations we give and the knowledge that they
gain. The factors that interfere with their ability to make the desired
changes can be obvious or obscure. This is truly the challenge we, as a
community, need to face squarely. What is it that prevents the ability to
make these life sustaining changes?

The majority of patients that we see in our practice are folks with Type II
diabetes which affects about 6% of the US population. The complications of
this disease are many, and often serious. This is a major public health
concern. In this population, 80% are considered obese, an alarming
statistic. Nutrition is a core issue for these folks, and poor
nutrition, (as in excess) certainly is a causal factor. An observation that
I have made over the years working with people who are now in the throes of
"needing to change their eating habits" is that they have forgotten how to
eat. They have lost the bond that ties them to their food. Maybe the lack
of connection is due to the intensity of the food industry advertising and
the introduction of about 16,000 new 'food products' per year, maybe it is
a lack of basic understanding of nutrition, maybe it is a general lack of
connected-ness with natural systems, but one thing is for certain, their
current eating patterns are not sustainable for them, and in many instances
it is these eating patterns that have lead them to the disease state that
they are now trying to cope with.

We can debate whether or not the food industry is at fault in it's attempts
to "make-up for" the over-all processing and reshaping of whole, natural
foods but what it comes down to for us as health professionals is how do we
help people understand why they choose to eat certain foods and move them
towards an awareness and an appreciation of the relationship between food
and health, be it global, local or personal.

It is sad, but true that many of the nutritionists practicing today do not
impart this vision of food and nutrition (i.e. eating) as an entire system
that involves more than just the individual and the grocery store. BUT,
there is general consensus among us, that encouraging minimally processed,
whole foods will positively impact nutritional status. Teaching more about
whole foods -from the growing of them to their metabolism- seems to help
with patient's understanding and help them to make the decisions that will
be consistent with improving health (global, local and personal) We are in
the trenches and do need a united campaign with the agricultural community.

Karen Lutz RD CDE
Diabetes and Nutrition Center
Eastern Maine Medical Center
Bangor ME 04401
karin@agate.net