http://downsyndromenutrition.com/blog/practical-wisdom-blog.html

I posted a new article today:
Taming the Hunger Monster

I hope to see you there!

“Do the concepts we learn only go in one direction–from the general public to those with disabilities? Or can we learn important skills from people with disabilities and modify the concept to fit our lives, too (the reverse direction)?”

When it comes to supplements, the disability community has been in the lead for more than a decade.

Recent articles about the risks of using vitamin supplements sounds so familiar. Using specialty supplements has been a constant in the disability community for decades. In fact, some of my best friendships in the disability community began because of discussions around supplements. That was before the laws regulating health-related claims. Those laws have been extremely helpful as far as I’m concerned. Yet even with those limitations, supplements continue to surge in popularity for everyone as a quick fix to better health.

The reports in the past week have highlighted that supplements are not the risk-free fix for poor eating habits or to prevent health problems. In fact, some are causing more harm than good!

Before I say much more, I do want to point out an important fact. As a science, nutrition is very young. We are still learning how vitamins, minerals, and other nutrition-related elements are used in our body. In fact, when I took my registration exam – just 24 years ago – Selenium and Zinc were so new their effect on our body was not clearly understood. Now we know they are essential minerals, that Zinc is useful in fighting off infections and Selenium has a role in memory among other things. So it’s not surprising that what we’re learning about the role of vitamins and minerals – and how much is too much – is changing.

In 2002, the recommended daily intake (RDI) of vitamins and minerals, the National Academy of Sciences added some very helpful information: an upper limit and signs of excess. Looking up everything you can get in a food is tedious – whether you do it with a program or by hand. But knowing the signs of excess, as well as the signs of deficiency, is a useful thing. Consuming too much of a vitamin or mineral is not limited to supplements or fortified foods. It can be done eating real food too. It’s something I consult when I suspect a child is getting too much “nutrition” in the combination of whole foods, fortified foods, and supplements.

I found it so important that people realize there are upper limits that can have negative effects, I chose to include those tables in my book, The Down Syndrome Nutrition Handbook: A Guide to Healthy Lifestyles (pages 12-21).

My Advice?

• Keep it simple. Eat whole foods.
• Encourage a variety of foods.
• Go for the “crunch”! Choose fresh fruits and vegetables.
• Plan your menus – it helps you manage time so you don’t need the supplements.
• An over-the-counter multivitamin is appropriate for selective eaters. More is likely excessive.
• When in doubt – choose food.

These are lessons learned more than a decade ago for me as I navigated life with my child who has multiple disability labels. If eating a variety of foods, or getting to the crunch of fresh foods is a challenge for your child, your family, or you, consider signing up for the Wellness Walk, my coaching series for creating quality health, quality lives, and a community vision.

 We can- and do – learn from each other. Learning goes both ways.

PS – Don’t forget! There’s a 20% discount on products and services until October 31!

I want to be L A B E L E D.

A Dietitian, that is.

Why? Because you wonder, “What is the difference between a ‘Nutritionist’ and a ‘Dietitian?’”  No need to deny it. You know you do.

I know this because once we talked about it, almost every other health care professional in the room at the Down Syndrome Medical Interest Group Meeting in San Antonio said, “Oh…I’ve always wondered about that! Good to know!” These are some of the most respected names in health care for people with Down syndrome in the United States. And they didn’t know. So don’t feel bad.

Simply put, anyone can call themselves a “nutritionist.” But only some can call themselves a Dietitian.

Let’s compare the two.

Dietitian:
Dietitians are registered nationally, and licensed by their state in which they practice. To be registered, one must have at least a BS in Dietetics or Nutrition and complete an internship (or an approved alternative) following graduation. But wait, they’re not done yet! Once these criterion are met, a person is eligible to take the registration exam, administered by the Committee on Dietetic Registration. Once a person successfully passes this exam, they may call themselves a Registered Dietitian and place the letters. “R.D.” after their signature. Last, one can apply for a license to practice in each state they choose to practice medical nutrition therapy.

This rigorous training teaches the RD to work with you – in tandem with your health care team – to create a nutrition therapy plan that fits your lifestyle.

Nutritionist:
Anyone can call themselves a “nutritionist.” There are no education, ethical, or license-related standards to govern the use of the title. It’s not necessary, but you can obtain a type of certificate from any number of programs – available in magazines, over the internet, on television, and more – for some “training” in nutrition.

Some Dietitians have jobs with the title “Nutritionist.” For example, Dietitians working in the Women Infant and Child program (WIC) are called “Nutritionists,” but their job description requires they are a Registered Dietitian. All individuals working in accredited hospitals, regardless of the job title on the door, are Registered Dietitians.

What about “Coach”?
Another job title to take note of is one that has the word “coach” applied to it. There’s any number of combinations: wellness coach, nutrition coach, lifestyle coach, health coach, and so on. Although accrediting organizations do exist for coaches, there is no regulation on how the term can be used. In the end, anyone can call themselves a “coach.”

Don’t get me wrong. There are some amazing nutritionists and coaches. There are people who can’t meet the rigorous training or pass the registration exam, but have the educational background, for instance.

But there are some who are very scary too. And then, there are those who really just want your money. You may meet a Dietitian like this too. The difference? If you meet a Dietitian whose medical or ethical judgement  you question, you have a course of action.

Nutritionists are not held to ethical standards. There is no mechanism to complain and perhaps strip them of their credentials. If you have a complaint about the professional ethics of an RD, there is a mechanism to do this – just as with physicians.

For example, I make great tools to help people change their environment or develop skills that transform their environment to promote quality health, quality lives, in a connected community. I will coach you to that outcome whether you use my cookbooks or not. I will also sell you my tools without requiring you to participate in any of my programs. They are mutually exclusive.

The short answer is that a Registered Dietitian is someone who is highly trained, whose credentials are monitored, and who is required to complete relevant continuing education to keep their credentials.

I can tell when people wonder if I actually do the things that I talk about in my own home. It’s a reasonable question, really. Andy, with all his uniqueness, is his own person. What we do is tailored to his success.

Tonight is a great example.

Earlier this year we took trips to our local New Seasons Market, with photos of cuts of meat and text for the specific order, and purchased different cuts of meat. Andy  now thinks the meat department is the best part of the store.

Andy decided that today he wanted to be in charge of our dinner menu. It caught Charli, Andy’s support provider, and me by surprise, but we grabbed a couple of the meat order cards and let him make a choice. He chose chicken kebobs.

Off we went to the store. Andy marched straight back to the meat counter, where we met Mason. There were a few people there, but Mason was ready for the next order. As Andy handed over his card, Mason grinned from ear-to-ear, saying “I love this!”

He then asked if he could show the card to his coworkers. They all smiled as they watched Andy waiting – not so patiently – for his kabobs. One person asked if I made these cards. I just smiled and said, “Yes.” (they take less than five minutes to make). They were only impressed for a moment. Andy drew the attention back to himself by peering over the counter to check on Mason’s progress.

Mason handed over our brown wrapped kebobs, and Andy took the package with great pride.

2009 © Phronesis Publishing

Off we went to pay.

As shown in Cooking by Color: Recipes for Independence, I use a broad guide for planning a balanced meal: if the meal has 3 of the 5 food groups, it is balanced. I always warn parents and  providers that this can lead to some odd menus.

Here’s how it went:

I offered Andy a choice of rice or noodles to go with his GF Teriyaki Kabobs. He chose Penne pasta.

Hmmm.

I tried again by offering rice noodles or Penne.

He chose Penne.

I offered a choice of tossed  salad or sauteed vegetables.

He chose sauteed vegetables.

So I chose to mix the vegetables in with the pasta – something I do often.

Menu

Chicken Kabob
Penne Pasta with sauteed Broccoli & Carrots
Milk.

Hmm.

He proudly – and I do mean proudly – ate every bite.

Walking the walk…eating the choices. It’s an adventure I wouldn’t trade for the world.

I am pleased to be able to offer electronic copies of Disability Solutions to visitors to my site. This work represents 10 years of investigation, learning, and collaboration with many talented professionals and parents. The articles, are provided here with the same mission as originally intended: To do good for, and with, people with Down syndrome and related disabilities. Many of the topics are timeless and some are one-of-a-kind!

The work related creating, editing, and publishing Disability Solutions was key to my growth as a professional and, more importantly, as a Mother. Every issue touched my family directly, and still do. I hope they will continue to inspire you as well.

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