Question 1
In the future, how might you apply these findings to your
practice as a dietitian?
posted by Molly D @ 7:19 PM
22 comments
ISU Dietetic Internship Journal Club
Objective: To become familiar with current scientific literature on a variety of nutrition topics and to gain experience in gathering, organizing, critically evaluating, presenting and facilitating group discussion of the literature and the implications to practice.
22 Comments:
Studies like this are important in order to assess progress being made in the field of nutrition and dietetics. Although there have been recent efforts to promote fiber consumption, this message is not being received in the manner intended. Even though nutrition education is being provided, it is beneficial to reiterate material in order to achieve the desired outcome. As a Registered Dietitian, it is important to educate about the overall health benefits of adequate fiber consumption on a daily basis (increased motility, reduced risk of CVD, etc). I think that inadequate fiber consumption may be due in part to a lack of knowledge regarding sources of fiber. This is another main education point when talking to patients and clients. Educating individuals about sources of fiber and how they can be incorporated into their diet may make a huge difference in consumption patterns.
Well to know that just telling the public to eat more fiber and telling them sources and benefits are not going to increase fiber intake. With convenient foods taking out all of the fiber and the increased speed of the average persons day it will be important to remember that fiber is important when counseling future clients.
I feel like one of the best methods that a dietitian can increase someones fiber is to educate them on the numerous benefits first. Then after they know why give them several recipes that use high fiber food and high fiber convenient food examples. Show people that they can increase fiber by making simple switches life from white to whole grain, ect.
Many people don't like high fiber foods as well from the bowel movement and gas aspect. It will be important to sell why it is good for them and good tasting recipes to overcome all of these barriers I feel. Also, from these findings I will also pull in that Hispanic decent had the highest fiber intake. This I assume is due to many of their cultural dishes being high in fiber and trying to promote such dishes to the general public may be a good technique for helping to meet these fiber goals.
I agree with Alana that sources of fiber maybe a problem for many people in the population. However, as with so much of dietetics even when people know the information it is hard to get them to follow it. I feel like we need to make the information more powerful and relevant to people other than if you eat this you won't die as young most likely and you won't get constipated. I don't know what the right answer is to do this but I feel like while sources may be a problem, if people were eating vegetables they are recommended to anyway they would get their fiber without ever knowing it was a source.
These findings can certainly be helpful to encourage clients to consume more fiber. There are two main points I think we should cover with clients.
First and, to me, most importantly: We can correlate the inadequate fiber intake to data showing that most Americans are not eating enough fruits, vegetables, and whole grains. We can provide education as to which are high in fiber, but helping the client find easy ways to incorporate more F&V and WG into their diets is more important. As Nate alluded to, if they would simply eat more of these foods, they would come closer to meeting the fiber recommendation.
Second, we know many people rely on pre-packaged and convenience foods, and food manufacturers have formulated lots of fancy products that scream 'High in Fiber!' from their strategic placement on the shelves. I would encourage clients not to buy based solely on the claims on the front of the package, but I think providing simple education on what to look for in the nutrition facts and ingredients can help steer them towards better quality sources of fiber.
Tying into points that Nate and Angela made--I agree that many people steer away from higher sources of fiber due to gas and GI discomfort that may be caused. Many people rely on eating Fiber One cereals, bars, etc. instead of eating fruits, vegetables, whole grains, etc. If these individuals do not consume adequate fiber on a daily basis, and then they have a bowl of cereal with 50% of their daily fiber, they are bound to experience GI discomfort!
Knowing that Americans are not consuming enough fiber and that the trend suggests fiber intake is moving even farther away from the target number, it is important to educate clients and the public on fiber intake. In order to increase intake however, it is vital for people to know how much fiber they should be consuming, what foods are good sources of fiber, where to look for fiber on the nutrition label, the appropriate serving size, etc. Along with education, goal setting would be a good tool to help implement a higher fiber intake based on each individual’s current consumption.
I agree with Nate, Angela, and Alana’s statements about cutting out convenience foods and moving toward more fresh fruits and vegetables in order to implement a high fiber diet. I think it is important to emphasis not only the benefits of high fiber in fruits and vegetables, but also the positive health aspects related to vitamins and minerals, low fat, and low calorie intake that are all associated with fruit and vegetables. Once again, I think setting goals for individuals whether it pertains to eating 1 fruit and 1 vegetable a week to consuming numerous fruits and vegetables a day encourages change through success.
I remember talking to my mom about fiber a while back and after going on about it for a while she interrupted me and asked me what it was and where it was found. This did not even occur to me that she did not know what it was. I think as (almost) dietitians we forget that not everyone knows about basic nutrition. I think so often people hear about what they should be doing but they do not know how to incorporate it into their own lives and diets. I do not believe that just telling people where it is found and why it is good for you is enough anymore. People hear about what is “good for them” through advertisements, gossip, emails, TV, their gym, their doctor, and so on. I think we need to find a different way to reach people and maybe customizing materials for different ethnicities, SES categories, genders, and so on might be beneficial. When counseling a person on consuming more fiber I think asking them to complete a diet recall and going through their day with them and both you and the pt finding ways to include more fiber is a huge learning tool.
I think this study was interesting in that it showed a DECREASE in fiber intake over the last 10 years. This is certainly frustrating but its important to know so that, as a dietitian, you can be aware of the need to do in-depth education on fiber with your clients. I also think it's relevant to consider the differences in ethnic background. You don't necessarily want to stereotype, but it could be important to remember which groups typically consume more than others.
I think Kelsey makes a good point about how we tend to overestimate what the public actually knows. So often, the general public is bombarded with quick messages that tell the consumer "what to do" but not "why to do" or "how to do". We need to find ways to get across the multiple benefits of fiber that are appealing to the population we are trying to reach. I think a lot of people associate fiber with having regular bowel movements but if you can explain several different aspects, perhaps the client would be able to identify more specifically with the need.
Regarding Angela's second point: Advertising and claims on food packaging definitely have an impact on why some people choose to buy a product but, I would guess that a lot of people don't really understand the function of what they buy. Americans are quick to trust an advertisement without fully comprehending the product. If it says its good for me, it must be, right?!!
Studies like this are extremely important in assessing fiber intake progression or regression. Obviously with all of the advertisements and fiber product on the market, this has done nothing regarding the intake of the public. We need to speak with our clients about the many benefits of fiber and show them that dishes with fiber can taste good! I think many people are scared that they have to eat cereal that looks like twigs to get their fiber in for the day. We need to demonstrate how fiber can be delicious and then let them taste it for themselves.
I like what Nate said, it is important to educate a pt on the benefits of consuming fiber. People need to understand why they should be increasing their fiber intake and how it will help them nutritionally. Nate also mentioned giving recipes that provide fiber and if the person is very convenient food-dependent giving examples of convenient foods with high fiber content will help them too. I think this is extremely important. For us to tell a person to increase their fiber intake is like a mechanic telling me to change my oil without any instruction. I would have no idea what to do. Giving recipes and talking about sources of fiber is essential if we expect people to do it on their own.
Ideally, if we were to be counseling pts on fiber intake, we would first educate them on what it is and what it does, and then where to find it. I think the second part is key--we cannot simply list off foods that are high in fiber, we must find a way to incorporate fiber in the pts current eating plan. That is if we have personal contact with the pt. Now if we were to be viewing this as a community RD, we could start delivering more/different PSAs on fiber. For instance, we see TV commercials for food advertising the fiber content of the product, but have you ever seen an unbiased piece on the functionality and health effects of fiber? We need to start thinking how we can reach the most consumers most effectively, and that may involve using media we did not previously use regarding nutrition education.
What Kelsey said about administering a typical day's recall gave me an idea. It may be beneficial to go through that typical day with the pt. and point out where their fiber is CURRENTLY coming from, and how to increase it. I think it's really intimidating for pts to change their diet, especially since most of them are likely not at the appropriate stage of change. So if we can first show them that they are ALREADY eating fiber, it may give them a better idea of how to eat more, if they know familiar foods that contain fiber.
You all seem to have an idea as to how you will address fiber in the future. I think this is an important element to our practice as dietitians, especially since dietary fiber consumption has sadly decreased in the past decade.
I completely agree with the majority of us regarding convenience foods and their lack of fiber. Since, they are being consumed more and more, people are getting full on sugar and carbohydrates that will leave them hungry again in an hour. I also agree with Erin that goal setting be used as a tool to implement increased fiber intake. I believe that it would encourage consumers to read labels and any goal to work toward is beneficial.
These findings can and definitely should be applied to our future practice as dietitians. I personally don't think it has as much to do with what us RDs are doing in daily practice with clients/patients, but more what our society is lacking. If everyone was able to meet with an RD on either an individual or even group basis, I think we would all be much healthier. So, I think we should take these findings and do things like advocate for a more efficient healthcare system (preventative care, health promotion, etc.), maintain our current place and even push for more of a portion of disease treatment care, and continue to make small, positive changes in peoples' lives to continue to build our reputation as RDs.
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I agree with everyone (Alana, Erin, Angela, Nate), that fiber should continue to be promoted in fresh fruit and vegetable form. I agree that using small, personal goals to do this is an excellent strategy.
I like the idea that Taylor brings up about highlighting where fiber is currently being found in a patient's diet. This will show the patient that foods that they prefer can also be nutritious. This may give the patient confidence to continue eating these foods, as well as incorporating other fiber-containing foods into their diet.
I like Kelsey and Taylor's comments regarding reviewing a pt's norma diet with them in regards to fiber. That could be a good way to make it personal so they can at least understand which of the foods they like are good sources of fiber (and which are not). It can also be a good jumping off point to discuss ways to add fiber. In many instances it may be as simple as brown rice instead of white. By getting a glimpse of their food preferences we can make F&V suggestions that they will be more likely to enjoy (and continue to eat) if they try them.
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