Dispelling nutrition myths, ranting, and occasionally, raving


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Are pharmacists the new dietitians?

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The other day I was in a grocery store when a recording came over the PA system encouraging customers to speak to the in-store pharmacist about making healthy food choices. Naturally, I was like “what the fuck??”. People wonder why dietitians are so defensive of our profession. This. This sort of thing is exactly why. Because everyone seems to think that they’re qualified to dole out nutrition advice despite the fact that dietitians are the only professionals who spend over four years studying nutrition in university and must indefinitely continue our education to maintain our licensure.

It’s not cool of the chain to be asking pharmacists to provide dietary counselling. If you want to offer that service, hire yourselves some damn dietitians. It’s also not cool of the pharmacists to accept that added responsibility.

Yes, pharmacists are a wealth of knowledge when it comes to medications and they can be hugely helpful in advising customers about potential drug-nutrient interactions regarding medications that customers are taking. They more often than not, likely have a greater knowledge about nutrients in food than your average person. However, none of this equips them with the expertise to provide nutrition counselling.

The scope of practice for pharmacists in Canada contains no mention of nutrition or dietary counselling. Store owners may not know that this service is outside the scope of practice for pharmacists. Therefore, I believe that the responsibility lies with the pharmacists on-staff to let the company know that they are should not be providing this service to their customers. As allied health professionals they should recognize the limitations of their own scope of practice and defer to RDs in matters of nutrition counselling.

When I worked in a grocery store we had an in-store dietitian as well as pharmacists on-staff and everyone worked together to provide customers with the best service possible. Pharmacists have enough to do without having to get into nutrition counselling with customers, which, when done appropriately, can be quite time-consuming. Do you really want to wait longer to pick up your prescription? Setting aside the issue of expertise, do pharmacists really have the time to devote to counselling customers on nutrition? Let dietitians, who are actually trained to provide individualized dietary advice, provide this service so that pharmacists can focus on their own area of expertise.

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An open letter to grocery stores

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Dear Grocery Stores,

I’ve noticed that over the past few years many of you (especially those that are affiliated with national chains) have moved toward discounts that are only applied to the purchase of multiple units. For example, buy two get one half price or buy four to receive a discount otherwise pay regular price. I implore you to reconsider this promotional model as it only serves to hurt your customers who need the discounts the most.

There are many reasons why these types of promotions are ill-suited to people living on limited incomes. The obvious reason is that of budget. In order to get the discount, more money must be paid up-front. Thus, more money is needed in order to save money. For someone with a tight grocery budget it may not be possible to afford to buy multiple units of a product in order to get the discount.

There are a couple of other reasons why this practice discriminates against people living on limited incomes. For many people living on limited incomes transportation is an issue. If you don’t have access to your own vehicle and have to walk, bike, or bus to the store, it’s unlikely that you’re going to be able to manage to lug three extra cans of beans home with you just to get the discount. Many people living on limited incomes don’t have stable living situations and may not have anywhere to store more food than is immediately needed.

Offering discounts on the purchase of multiple units only benefits those of us who are fortunate enough to have flexibility in our budgets, access to a car, and space in our kitchens. As much as most of us love getting deals, we are not the ones who truly need them. Please reconsider your promotions model. Work with the companies whose products you sell to develop promotions that don’t necessitate the purchase of multiple units to receive a discount. Do your bit to help those who need discounts the most.

 


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Step away from the chips, the grocery store RD is watching you

Not my usual uniform, I swear!

Not my usual uniform, I swear!

A couple of weeks ago the Globe and Mail published an article about the role of “nutrition experts” in grocery stores. It caused a bit of an uproar in the dietitian community for a couple of reasons: one, there was some conflation between nutritionists, dietitians, and naturopaths (if you don’t know why that would upset dietitians then you should read this); two, it poorly represented our roles in grocery stores. Following that, a dietitian published a blog in Huff Post in response to the inflammatory article in the Globe. As a dietitian who worked in a grocery store for several years and who was interview for, and quoted in, the original Globe article I feel obligated to add my belated two cents to the fray.

I actually had a really nice interview with Shawna, we covered a number of topics, and I felt like she was “getting” what I was saying. So, I was a little disappointed when I read the article and saw the quotes that she had chosen. Not to mention that I had asked that grocery retailer I worked for not be identified as employees cannot speak as representatives of the company, a normal PR policy, my job was not “retail dietitian”. I was a Wellbeing Counsellor, and as part of the interview I explained the different roles of the Wellbeing Counsellor and the in-store Dietitian. Wellbeing Counsellors essentially manage the Natural Source and Wellbeing Department in one store (ordering, stocking shelves, inventory, checking for out dates, dumping expired milk…). In addition, they are there to assist customers with any food, supplement, or nutrition-related question they might have. They also teach classes, do demos, and perform community outreach. The in-store Dietitian teaches classes, does demos, store tours, community outreach, and one-on-one counselling. They’re not tied to one department and they usually split their time between two stores.

In retrospect, Shawna was trying to push the helicopter parent/food police angle a bit, and I found it odd when she brought up orthorexia. While I agreed that many people are taking healthy eating to a whole new disordered level of “clean” eating, I suggested that dietitians (I’m now talking about those of us in both Wellbeing Counsellor and Dietitian roles) working in grocery stores can actually serve to combat this. I said that the food industry, the media, and society have made healthy eating far more complicated than it has to be. Dietitians in grocery stores can help you to look past the front-of-package label claims to the true nutritional value of a foods. They can help you make healthier, more delicious choices. They’re not there peering into your cart and judging what you’re eating. They’re not there to push products on you. No one ever told me to sell more of X or Y and as a regulated health professional I would never have done any such thing. Yes, obviously, grocery stores hire us to boost sales but it’s not by pushing products, it’s by having value-added service; by showing customers what they can do with chia seeds or by helping them find the product that’s best going to meet their needs.

When I said that comment about how people often think that dietitians only eat salad (and that we don’t, sometimes we eat candy or chips) it seemed to be met with some surprise. Especially when I insisted that I’m not in the minority; that most dietitians I know would say the same thing. That it’s important to eat a variety of foods and to allow yourself to have treats. I actually hate the term clean eating and am still hoping that my #eatdirty hashtag will catch on. If you’re not enjoying your food then you’re doing it wrong.


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Warning!: Your groceries may be making you fat

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My friend and fellow dietitian Gemma tweeted a link to this story: Bespoke health warnings on supermarket till receipts to fight obesity last week. After checking to see if she had a blog post planned on the topic, and receiving her go-ahead to write about it, here I am!

The idea is that supermarkets could print tailored nutrition advice on customer receipts based on the items they purchase. These would be warnings based on the purchases a customer makes. Too much fatty food? Your receipt might tell you to skip the chips next time and go for the carrots instead. Too much sugar? Your receipt might tell you to lay off the candy bars and buy some lettuce. As current efforts to curb the obesity epidemic have been failing, apparently Public Health thinks that this might “nudge” customers to make healthier choices. Because shaming works so well. *Tears out hair* Sigh.

Thankfully, this idea is still in the early stages. I hope that this means it will never see the light of day. Why? There are a number of issues with this endeavor. As I pointed out, fat shaming (or any type of dietary shaming) is not an effective method to induce behaviour change. Does anyone really want their grocery store judging their purchases? Telling them they shouldn’t have bought that ice cream for a party? I certainly don’t. I know that with all of the misleading marketing and packaging navigating the grocery store aisles can be difficult and time-consuming. However, I don’t think many people need to be reminded that what they’re buying is crap when they load up their carts with fries and pop. If a grocery store had receipts that made me feel badly about my purchases I would probably just shop at another store. That leads me to a few other issues.

One, if a public health campaign like this were to be undertaken, it would have to be implemented in all supermarkets in order to be effective. I don’t think anyone is going to choose to shop at a chain because the receipts there tell them they made bad choices. Two, would anyone even look at these nutrition statements on their receipts? I know that I rarely examine my receipts. If a campaign doesn’t reach most people, even if were well-designed, it’s unlikely to be effective. Three, public health would need to get buy-in from the supermarkets, and I don’t see that happening. Why would any retailer want customers to leave feeling worse about themselves than when they entered their store? Removing candy from the tills makes sense. It’s great publicity and it’s something that customers want. Shaming customers for their purchases is not good publicity, and as far as I’m aware, it’s not something customers are clamouring for.

My final concern is with how the algorithm to determine nutritional merit of foods would be created. Would someone be told to buy less fatty food if they bought a jar of coconut oil or a stick of butter? Would they be told to buy less sugar if they bought a bottle of maple syrup? How would “unhealthy” be determined? What about someone who buys mostly fresh produce and minimally processed foods but throws a bag of chips in there or some cheese? Would a block of cheese be given the same treatment as a bag of chips? After all, there would be more fat in a block of cheese than a bag of chips.

I see this campaign as both problematic and offensive. If public health really wants to see systemic change they should work to change the system, not the consumer.