I was hired recently by a worksite health promotion company to facilitate training of its health coaches who, among other things, provide nutritional counseling. We started the day by playing “the food game.” Here is how it works:
- I ask for two volunteers. I give each a marker and a place to write on a white or chalk board. I have the volunteers set up two columns, one on either end of the board. One column is titled “Good Foods (Healthy)” and the other “Bad Foods (Unhealthy).”
- Someone calls out a food and then says under which column it should be placed. The person in charge of that column writes it down.
- People can then agree or disagree. If they disagree with the placement and think it belongs under the other column, the other volunteer writes it down there as well.
- So, someone might say, “Chicken/ healthy.” But someone else might say, “But fried chicken is unhealthy,” and so we might put fried under unhealthy and baked under healthy.
- Someone then might say that white meat is healthy but dark is not and so on. From there, we move on to the next food.
After about 30 minutes of what sometimes deteriorates into rather heated arguments of the virtues and evils of various foods, people get quite anxious and are more than ready to quit. This happens, by the way, regardless of the group involved, from lay folks to nutritionists to doctors and nurses. I finish the game by acknowledging the participants’ confusion and anxiety, and asking them to think about how the people they counsel might feel, particularly given that whatever information the coaches might be providing about good vs. bad/healthy vs. unhealthy foods is likely to be continually changing.
One individual in particular had some real issues with this portion of the workshop. At one point during the game, she called out “fast food/bad.” I asked the group if all fast food was bad, and most people, but not all, agreed it was. This was not enough for this individual who continued to say the reason all fast food was bad was because (and she used a Big Mac as her example) “it has no nutritional value.” I paused for a second and explained there is, in fact, a significant amount of nutritional value in a Big Mac to which she replied “Well, I don’t believe that is so.” I suggested to her (and the group) that regardless of whether she thought the Big Mac contained too much of this or that (fat, CHO, salt, etc.) to be healthy; because it provided fat, carbohydrate and protein – the three major nutrients – it was factually incorrect to make the claim she had made. She continued (quite vehemently) to disagree, and I saw that any more discussion was pointless. It reminded me of a colleague who says math is not a popularity contest and therefore 2+2 equals 4 regardless of how you feel about it!
So, here is a person who has only an extremely limited understanding of basic nutrition doing nutritional counseling for employees following blood screenings and HRAs. And while making the ridiculous statement that a Big Mac has no nutritional value may not do a lot of harm, the thought of people without any training counseling people on the intricacies of nutrition is worrisome for me.
Many People View Themselves as Qualified to Give Nutrition Counsel
Unfortunately, it seems many people, regardless of training or actual knowledge base, view themselves as qualified to give others nutrition counsel. This phenomenon has surprised me many times over the last few decades. Doctors, most of whom have little or no nutrition training, do it all the time. Recently, a kid on my son’s college soccer team told my son and the other boys that they shouldn’t drink Gatorade because it has too much sugar and salt, is bad for them, and they can get everything they need from water. Of course, this is completely false and potentially dangerous for the boys, especially if they are exercising in the heat. Water can help with hydration, but it does not replenish the electrolytes and calories from sugar that are so critical to endurance activities like soccer. By limiting their intake of these substances, they are opening themselves to premature fatigue, slower recovery time and potential increased injuries. I am guessing the advice was handed down from a parent restricting calories and carbs for weight loss.
Wondering how widespread this somewhat scary (at least to me) phenomenon might be, I took a quick trip down Google Lane and discovered that there are apparently a wide variety of nutrition counseling credentials that just about anyone can obtain without much fanfare. One of my favorites was the title of “Certified Nutritional Consultant” bestowed by The American Association of Nutritional Consultants (AANC) upon pretty much anyone who:
- passes a self-administered, open-book exam – oh yes and
- pays the fee to take the test!
It is unlikely most people would hire someone with no training to fix their car, television or air conditioner, and yet many people are willing to listen to (and pay) health professionals and others who have little or no training in nourishing the most important “machine” of all – their bodies. So, the next time you seek nutrition advice from someone, doesn’t it make sense to ask about their training, education and experience?
It is completely ethical and appropriate to ask these questions of a healthcare professional to get an initial feeling about whether working with that person might be a good fit for you. Here are some questions you might want to include:
- Can you tell me a little about your training and experience?
- What is your educational background in nutrition?
- How many years have you been practicing?
- What kind of experience have you had with people presenting with my concerns?
- What kinds of outcomes have you seen with people presenting with my concerns?
In the end of course, the relationship will either be helpful or not, and there is certainly no way to be 100% sure at the start. But spending a little time up front may help save time and money in the long run and increase the likelihood of a positive outcome. And after all, it is at least as much as you would do for your car, television or air conditioner.