Interview with a Dietician

The day gets going in the same usual manner as it does just about every day. I get into the office around 7:30 to check notes from the night before and see what kind of e-mails the nursing staff or doctors have sent to me. I will print my census sheet, the log of all the patients on the floor that includes their medical information, diagnosis, their current diet, goals and plan; basically their history since they were delivered into this world at St. Joe’s Hospital. These are the premature babies. They can’t breathe, eat or function by themselves because they came out to early, their respiratory and digestive systems are immature and very sensitive. It is up to me to make sure they get the required nutrition at this critical stage in their brand new lives.
Ann Lewis is a clinical dietician at St. Joe’s Hospital in Denver, Colorado. Her specialty is in the NICU, the Neonatal Intensive Care Unit. She received a BS in Clinical Dietetics from the State University of NY at Oneonta, completed an internship at the National Institute of Health in Washington, D.C. and studied in the graduate program at the University of Maryland in the Human Nutrition Department. Also, for the past 7 years she has been a private consultant for adults who have taken the step towards better health and a better life through a better diet. When she first moved to Denver she worked for 2 years at the Center for Human Nutrition assisting with research studies investigating reasons for human obesity.
Q: What is it that you do for people that approach you for a healthier diet?
A: Well, first of all, I get all types that come to me for a variety of reasons. The majority are middle-aged women who want to lose weight or are concerned with improving their health. They want to look better and feel better. They want to try diet before the begin medication for things such as high cholesterol.
What I strive to do for them is to take the focus off their weight. There is a broad spectrum of weight relative to your height that is still considered healthy. I want to focus on their motivation and goals, focus on their health and not their weight. I tell them that a healthy diet will reduce the risk of diabetes and heart disease. This is not a quick fix, it is a commitment and they have to understand it's long term. I have to get them to change their knowledge about their eating habits. The deep seeded knowledge they grew up with, those bad habits they did not think were bad have to change.
Q: How do they go about this change? What kind of program do you recommend?
A: Since this is a long-term goal there is no quick fix about it. I work in small increments, baby steps if you will. I don't want to shock them physically or psychologically. This way they are still able to enjoy what they used to, knowing that they have to begin cutting down on it and replacing it with something else.
Q: What are the worst aspects of the American diet?
A: It's something that is known as the Western Diet. It contains lots of red meat, saturated fats, high fat dairy products and processed foods. Those processed foods are pretty bad; they are anything that has been modified from its original form. The Western Diet is also high in sodium. I think it goes without saying that convenience is a major factor. Fast food is loaded with fat, sodium and especially calories. Not only are these foods high in calories, but they are easily accessible. We live in a society that is often in a hurry and does not take the time to eat better or they are lazy and go for convenience. Add that to a society that does not include regular physical activity and you have a recipe for flabbiness. We exceed caloric intake sometimes even doubling and tripling that on a daily basis.
"It's easier and cheaper to go to McDonalds than it is to buy fresh fruits and vegetables and prepare them yourself."
Q: How do we change their minds? How do we get people to understand that this lifestyle is too destructive, unhealthy and needs to change?
A: You have to start early, early as kindergarten. It is simple education that needs to be instilled in these kids at an early age.
"You have to start with the kids, most adults are already too far gone.”
The government needs to take the lead; it has to be a priority that the American society is not healthy. No society deserves that reputation. Physical education has to be brought back to the schools; parents should also put their kids on physical education programs at home. A well-rounded Nutritional Education program will put kids on the right track. Our free economy and capitalist society lets us eat when we want,there wasn’t the amount of readily available, high calorie foods decades ago. Government subsidized food that goes to schools is still poor quality, although the schools themselves are starting to take the initiative towards improving nutrition in their lunchrooms. Much like my philosophy for a single persons health, we will not see immediate results. It took the U.S. 50 years to get this fat; I think it should take another 50 to slim down a bunch.
Q: What has the government been doing lately to step up to the American plate and take responsibility for making a healthier America?
A: Clever use of words! There is a government agency, the National Cancer Institute, which initiated the "5-a-day" program in conjunction with the Produce for Better Health Foundation about a year ago. It promotes 5 vegetables or fruits a day. You'll see it primarily in schools and grocery stores, since it's inception they have decided to raise the 5 to 7-9 servings a day. It depends on who you are, your metabolism, age, weight and or/gender. You really can’t go overboard with fruits and vegetables. When was the last time you heard you husband, friend or 8 year old say, “Hey, can I get that broccoli super sized?” These programs take a long time because of the clinical research that has to take place; the results need to be proven. That’s why it will take quite some tome to get the U.S. back on track.
"What you put in your mouth affects your health, how you feel and your mental well being."
Q: What has happened to American lifestyles?
A: They have grown very sedentary. We have so many labor saving devices. Elevators and escalators speed up our day but keep us from routine activity that burns calories. Instead, we go to gym…if we decide to go. I see lots of people at work who are taking the elevator for 1, 2 or 3 floors. That exercise is so critically important but the thought of taking the steps to get exercise just doesn't enter their minds. We think that work is just for that, work. This needs to be a conscious decision and a daily commitment. General activity on a day-to-day basis has dropped. Kids need to be forced away from their computers and X-Box video games. Suburbs promote this sedentary activity; it's not an urban area that allows you to walk to the market or cinema. Parents need to structure their kids time so that it limits time in front of the computer and emphasizes outdoor physical activity.
Q: Finish this sentence. “When people think of dieting, they think of…?”
A: Sacrifice and restriction. I don’t believe in dieting. The problem with dieting is that it is perceived as temporary, that means you are either “on” or “off” your diet. When people think of dieting they think of going hungry and eating all those things that must be good for you because they taste bad.

Q: So what would you call it?
A: I would call it a lifestyle approach. A diet is a certain way of eating; dieting is a restrictive intake, which is what most people think of. When you are on one diet you are off another, this is the perception. It’s all or nothing and it sets people up for failure. There are 21 meals a week, what you are doing most of the time is what counts. People can’t look at themselves as alcoholics who feel like failures when they have one drink after weeks of abstinence. We don’t want to be completely on a diet, it’s too difficult. There has to be an in-between, a compromise that people need to follow. It’s like cheesecake. People are shocked to see me eat cheesecake. I tell them of course I eat it…just not everyday!
Q: You are quite skinny; do you practice what you preach?
A: Yes, most of the time. But that is the point of my philosophy. I am very active too.
Q: How does physical activity tie into all of this?
A: It’s unrealistic to think that you don’t have to exercise to maintain your weight. You have to come to terms with your exercise and realize that there is no “best” exercise. The one that you will do and do consistently is the best one for you. You have to identify that and incorporate it into your day or every other day.
Q: Why don’t Americans pay attention to their diets?
A: I think people are aware they just don’t pay attention to it. They were brought up not to and got into bad habits. They got married, had kids, work very hard; their lives got too busy.
Q: I have heard reports that 6 small meals are better than the standard “3 squares” that we all grew up with. Those meals we consume here in America 3 times a day have grown to ridiculous sizes at home and in the restaurants. Why is that?
A: Everything is big in America, from the state of Texas to our SUV’s. It’s how we as Americans look at life and success. So many want the big house with the big yard, or at least bigger than the Jones’ across the street. The American way is “bigger is better” and “more for less” is where it’s at. People don’t realize that they are not obligated to eat everything that is one their plate. The fast food companies are making this idea even more prevalent with their value sizing ad campaigns. “Come to my drive through window and for the same price you can get more than the place across the street”. Well you know what America, you don’t need more! You actually need less.
Q: What is it that you feel is the most important aspect of your business that you do that helps people?
A: So many people come to me and say, “I know what I need to do, I just can’t do it”. I provide structure, accountability and support. I am here to motivate and be realistic about their ideas and goals. I am the cheerleader and the ogre that encourages and at the same time provides discipline. People benefit from my expertise and troubleshooting. I am very good about observation of their lifestyle and how to decide what changes need to be made and how to implement them.
Q: Men vs. women, who is more self-conscious about there diet?
A: Women for sure are more self-conscious. We have an American standard that people feel they need to live up to. There are societal pressures that you have to conform to physical and beauty values.
Q: Last thing, if you could offer one piece of advice to people who are concerned about their weight and diet, what would it be?
A: Eat fruits, vegetables and exercise regularly. They are plain and simple rules to follow for a better health.