Eating Disorders in the Dietetics Profession: Risk vs Reward

by Michelle Wilson BS, DTR

          Certainly, many of you have seen the position papers and research

This Photo by Unknown Author is licensed under CC BY-NC-ND

 pointing out the increased prevalence in eating disorders, previous or current, and disordered eating behaviors in dietetics students and professionals. Orthorexia nervosa, though it is not an official diagnosis in the DSM-V is a growing concern for those who major in nutrition. Previous eating disorders motivated some to choose the career path of dietetics. With this prevalence, we must ask ourselves what we believe about this concern and why.

Dietetic internships are highly competitive. Should a student with an active eating disorder be accepted into an internship? If this is brought up during a DICAS interview, should it be seen as a good or bad trait? Do dietitians with previous eating disorders benefit their field or serve as a risk?

First- let us look to the community to find out. I asked a popular Facebook ED (eating disorder) community what they thought about a dietitian who has recovered from an eating disorder working with ED clients. The responses were overwhelmingly positive. To preface, most people emphasized their RD (Registered Dietitian) should be fully recovered and to make sure any self-disclosures are to the benefit of the patient. Mostly, people said the not only accepted it, they preferred it! They felt their dietitian understood what they were going through and knew the head games the patients might try to play. Some even mentioned how their RD having overcome an ED was an inspiration and seeing a professional fully recovered helped them feel recovery was possible.

Next- the professionals. Out of the Facebook members, some said they were RDs or dietetics students who overcame eating disorders. The RDs said they felt their clients found them “more relatable.” One said she did not feel as though her previous ED ever negatively impacts her work. One of the students said the RDs she worked with who were recovered understood more than a dietitian who has not had an ED in their past. A dietitian I spoke with whom is associated with Saint Louis University noted two main concerns regarding this topic: undiagnosed eating disorders and relapses. She emphasized the tendency of students and dietitians to have beliefs which could be considered orthorexic, or obsessively healthy, and the importance of being diagnosed with an ED to address these concerns. She said, “recovery is a process, not an end point.” Even though an RD may be recovered from an eating disorder, working directly with an ED population may be triggering and requires honest self-reflection. With this in mind, she says she “love(s) that we’re able to use those struggles to help people in this field.”

My family and I at the NEDA Walk

Finally- I think we should all take a moment to think how we want to be seen as professionals. Do we want to be accepting and encouraging for those recovering to pursue a career in dietetics? Or do we want to be so worried about the possibility of negatively impacting clients we rob them of the opportunity of an RD who “gets them.” I, for one, think we NEDA take a walk on the wild side and give them a chance!

Spring Cleaning (Nutrition Style)

By Cassidy Warne

The chirping birds and blooming flowers are sure signs that we are stepping into spring. Let’s chat about Spring Cleaning, nutrition style. No, I am not talking about juice cleanses or the latest fad diets. I’m talking about kickstarting healthy habits and detoxing with REAL food. Spring is full of fresh fruits and vegetables and is the prime time to track down local Farmer’s Markets or spend a little bit more time in the produce section of the grocery stores.

Eating in-season produce is possible year-round, but spring and summer provide the greatest variety of in-season produce available. The perks include enhanced flavor, nutrition, and affordability. So, what’s in season?

                         Apples                                     Peas

                        Apricots                                   Pineapple

                        Asparagus                               Radish

                        Bananas                                  Spinach

                        Cabbage                                  Strawberries

                        Carrots                                     Swiss Chard

                        Celery                                      Turnips

                        Collards

                        Garlic

                        Mushrooms

                        Onions

The benefits of increasing fruit and vegetable intake in the diet are endless. However, it is important to practice proper food safety when consuming fresh produce. It is important to store fruits and vegetables away from raw meats, poultry, and seafood. When preparing fresh produce, wash your hands thoroughly and, if consuming the peels of produce, follow by scrubbing fruits and vegetables with a vegetable brush to remove dirt and debris. After preparing, fresh fruits and vegetables should be refrigerated within 2 hours.

As part of the Dietetic Internship at SLU, we have the opportunity to teach nutrition education to students throughout the city. Throughout the lessons, we discuss healthy eating habits, physical activity, and gardening. We have garden plots at the schools which allow us to demonstrate how to plant a garden, provide care to help the plants grow, how to harvest, and prepare the produce safely. Throughout the spring semester, we have been growing a variety of vegetables that we will harvest and safely prepare for a salad party with the students at the schools. The students seem to enjoy the activities and gardening experience, and it has been very rewarding as an intern.

Whether you have your own garden, visit the local Farmer’s Market, or explore the fresh produce in grocery stores, we are entering prime fruit and vegetable season. This is the perfect time to focus on healthy eating habits and enjoy the flavors and health benefits of fresh produce by spring cleaning your diet!

Herb and Spices

By Nicole Thomson

I am the type of person who sees food primarily as energy. I can just eat a piece of bread and head out the door. However, I noticed my days were better when I ate meals with a variety of foods and foods that satisfied my taste buds. I realized I craved flavor. By discovering this, I began to brainstorm ways to add flavor to my meals without having to spend hours in the kitchen making a 5-star dish. My solution? Herbs and spices, baby!

According to Maslow’s Hierarchy of Needs, food is one of the foundational necessities for human function. Now, to break that down further from a nutrition standpoint, it is important to consume foods that are healthy for us AND satisfy our taste buds at the same time. Some people have the perception that healthy eating equates to a diet that is not going to taste good. But, I beg to differ! Healthy eating does not mean you can’t have a chocolate chip cookie occasionally; nor does it entail that every meal has to be plain grilled chicken breast, rice, and broccoli. Meals like that can get boring fast and it can be easy to fall into that pattern. A great way to combat this and keep you satisfied with meals is to experiment with herbs and spices!

What is an herb?

An herb derives from the leafy part of a plant.

What is a spice?

Spices also derive from a plant but, they are the seed, fruit, bark, or other part of the plant beside the leaf.

Herbs and Spices

Both herbs and spices provide flavor and aroma to a dish rather than substance like a vegetable. These fella’s are also loaded with vitamins which, will keep you feeling good and support your immune system! Now, I know cooking can be a little intimidating at times. I know it can get overwhelming with figuring out how to incorporate spices and herbs in meals too. My suggestion is to start by picking 1-2 at a time. Get familiar with their taste first and begin to experiment! For example, if you like chicken, rosemary might be a good option for you to start with since rosemary pairs well with chicken. If you like spicy foods, try sprinkling cayenne pepper on an omelette!

As an easy and gradual introduction to herbs and spices, I wanted to share with you all one of my favorite breakfast go-to. It is an egg omelette with fresh basil, feta cheese, and vegetables. It has 215kcal, 7g of carbohydrates, 29g of protein, and 40g of fat.  In addition, add a piece of toast on the side to have something with a crunch and slightly more carbohydrates in the morning! Together, this makes for a breakfast that will provide a good source of energy to start the day. The protein and fat will help keep you stay satiated and the flavor will keep you satisfied!

Feta cheese and fresh basil omelette

Foundational ingredients:

3 eggs

1.5 tablespoons of fresh basil leaves (chopped)

1 tablespoon of olive or avocado oil

2 oz of feta cheese (crumbled)

½ cup of sautéed spinach

¼ cup of diced tomatoes (patted dry)

1 pinch of salt

1 pinch of pepper

Optional:

Substitute the feta cheese with parmesan cheese

Sautéed onions

Sautéed mushrooms

Crushed red pepper flakes

Sliced ham

Bacon bits

Directions:

Break the eggs into a bowl and whisk with a fork until yolk is evenly distributed in egg whites.

Add the fresh chopped basil leaves, salt, and pepper to the bowl and mix briefly.

Heat the oil in a small pan (medium-low heat) and evenly disperse.

Pour in the egg mixture into the pan and cook for 4-5 minutes.

-          The trick to this is making sure that the egg mixture is evenly spread in a pan and is not too thin!

At the start of the egg mixture becoming more firm, evenly disperse sautéed spinach, diced tomatoes, and crumbled feta cheese on top of the egg mixture.

Let it cook for 2 minutes and with a flat spatula, fold the omelette over.

More Than a Checklist

Making the Most of Opportunities During Your Dietetic Internship

By: Elise Rodriguez

I love lists, and most of all, I love checking things off my list. My planner has boxes to check off when I’ve completed an assignment or activity, and it feels AMAZING to check one off. Many people, including dietetic interns, love lists too, which is why my internship gives us checklists for each rotation. They are great because they help give some guidance into what we should be completing at each rotation and what competencies we are meeting when we do complete a task (and they know the joy we have when we check something off our to-do list). However, the checklist is just the beginning of the experiences you will have during your internship.

It is very easy to look at a checklist provided for a rotation and feel a sense of being overwhelmed. Sometimes there can be a lot, so it is easy to get caught up in just completing the list and finishing the rotation.

My challenge for you is to look beyond the list.

The checklists for your rotations are helpful and you will learn a lot from them. However, there is much more to learn than what is on the checklist. Every location and rotation where you are placed has unique opportunities that you might not get somewhere else. These opportunities may not come later, even if you are at the same place for another rotation.

This time is unique and valuable, so use it!

I have learned this first hand from my own internship experience. Like I mentioned, I am very checklist driven. I stuck to my list for the first couple of rotations because I wanted to make sure I got everything I needed to do completed. Then I had a preceptor tell me, “Don’t worry, you’ll get the checklist done. Remember it’s what you’re learning from your experiences here [like patient interaction and charting] that will really stick with you when you start working as a dietetic professional.”

I realized then that it was the opportunities between the lines of the checklist that were the memories and experiences I’ll never forget. For example, during my cardiovascular rotation, our checklist included to observe surgeries or procedures, but it only required one. To complete that requirement, I went to the cardiac cath lab at my hospital. I was scheduled to observe a routine stent procedure. Instead, someone with a NSTEMI, or heart attack, came in and they had to perform an emergency stent. Instead of leaving after that procedure was done, I stuck around to ask questions and I asked if I could stay for the scheduled stent procedure. The doctor agreed and before I knew it, another person with a NSTEMI came in. I got to see two heart attacks and two peoples’ lives saved because I asked to stay.

Another opportunity I had was to do rounds in the Neonatal ICU (NICU). If you have ever been in a NICU or have been on rounds (especially in a teaching hospital) you will notice quickly there is not a lot of space in the patients’ rooms for all of the rounding team to get into the room, let alone see the child. There was a baby on our rounding list that was born at 23 weeks gestation, but unfortunately I was unable to see him because of the number of people that were able to go to the room. After rounds were over, my preceptor asked me if  I wanted to go back and see the baby. I could have turned down that chance and moved on with my day. Instead, I said yes and saw the tiniest baby I have ever seen. My preceptor and I talked about his case, and I was able to ask questions about how nutrition support and vitamin supplementation was helping this little child grow. I fell in love with the NICU that day, and that experience has given me a goal for where I want to work in the future.

These experiences (and many more) are moments I will remember for the rest of my life, and they are so unique to my internship year. I could have easily passed on some of the opportunities, finished my packet earlier than I did, and completed what I needed for that rotation. That would have been a perfectly fine option, but instead I chose to look between the lines of the checklist and experience moments of learning that are far beyond what I could have imagined.

I heard it said that it is up to you to make your internship experience what you want it to be. By sticking to the checklist, you will learn a lot, but you risk the chance of missing out on an incredible opportunity. I think back to those rotations where I could have turned down those opportunities and I realize that I learned so much more from my rotation because of those experiences. You never know how those experiences can shape and influence your interests and future career.

As I am coming up on my last couple of months as an intern, these are the things I continue to keep in mind during my rotations. I don’t want to miss so many learning opportunities because I was too focused on the checklist.

You won’t regret the opportunities you take, only the ones you don’t. This is your internship. These are your learning opportunities. Embrace these chances with open arms, and say yes to the opportunities that come your way.

References:

Checklist picture: https://ceriusexecutives.com/the-ceos-checklist-for-operations/

Opportunity picture: https://www.cuinsight.com/take-opportunities-when-they-arise.html

Baby picture: http://www.irishprematurebabies.com/HelpAdvice/FeedingIssues.aspx