Behavior Change – if it was easy it wouldn’t be change

If it looks too good to be true, it probably is…

In many diet and exercise sales ploys, there are before and after shots. This one person is showing f sexy six-pack or loss of half their body weight. They look great.All you can see is their before and after. Yes, they probably did what the site is selling you. What you don’t know is what other things were in their favor at that particular time. It is likely that there were a lot of other good things happening to them that made their success more likely.The other thing we don’t see is their progress between the before and after. Progress could have been full of plateaus, lapses and times where they got stuck. For whatever reason they found the support offered by the organization good for them. The people selling the product kept them going through their tough times

To be successful making change you need several things:

  • Identify goals that are targeted to your needs.
  • Information on how to make the appropriate changes to achieve those goals.
  • Resources, tips, and tricks to help you develop plans to embed the changes in your daily life.
  • Support for when things don’t go as planned – for example when daily life takes a surprising detour.
  • Time to establish the new routines.
  • Monitoring to measure your outcome.
  • A cheer squad to help you celebrate your success.

This blog series is going to go into some details about the how, why and what around behavior change. My experience as a dietitian has taught me some interesting things about change. If you have a different experience or other ideas please post a comment. We can chat about them – I love learning from others.

What 7 steps help reduce both diabetes and heart disease?

Diabetes and Heart Disease are intimately linked. During Heart Month (February 2019) I will be posting regularly how individuals and employers can tackle these diseases together.

People with Type 2 diabetes (T2DM) have 2-4 times the risk heart attack or a stroke than people who don’t. Making lifestyle change to either preventT2DM, reverse it or manage it better reduces this risk.  Managing risk needs to happen in all parts of people’s lives. As an employer if you want a healthier workforce, invest in advice and education to support your staff.

The American Heart Association has defined a list called Life’s simple 7. These changes manage heart disease risk and diabetes. They are core to the messages taught in group, online and individual education sessions by Helen Gibbs Dietitian Ltd

1.            If you smoke, stop.

How can you help those who still smoke? Many smokers fear weight gain.  Getting information on the relative risk of weight vs. smoking is important. Receiving education on how to minimize this gain helps.  

2.            Eat better.

My education sessions promote dietary improvement. Diet improvement can improve health independent of weight loss. Recent research has demonstrated the importance of a high fibre diet, part of ‘nutrient dense eating.’. In my courses and 1:1 sessions I focus on “nutrient dense eating”. This style of eating improves health and reduces disease risk, regardless of weight change.

3.            Get regular physical activity

I work hard achieve appropriate physical activity levels, so I get it.  I have a lot of empathy for clients and their struggles to be active. This personal experience has informed my learning. I use what I have learned to motivate people to be more active.  Employers may need to think how they can support increased activity in daily living. If people are active there is a benefit to the employer in reduced absenteeism

4.            Lose weight if you are overweight

Unlike some dietitians I am not a proponent of Health At Every Size (HAES) model of care. We have to get rid of the worst parts of dieting culture; but we need to support people to improve their health through body fat reduction. Individual care means addressing the most important aspect of eating for that person. If clients have disordered eating or eating distress, they need support to address this. Many people are too ashamed to discuss their eating distress. Having a compassionate and experienced dietitian accessible to your workforce increases their chance of asking for help.

5.            Keep your blood pressure in the proper range

In group sessions I talk about what to do, and how to do it. This includes the changes needed to reduce blood pressure. The good news is these changes can also improve other aspects of health.  Workplaces with canteens or onsite food supplies may need to match education with better choices. If you are large enough to have these services you are large enough to need a detailed food policy. The impact of alcohol can not be overstated with blood pressure. I provide alcohol harm reduction education as part of lifestyle education.

6.            Keep your blood fats and cholesterol levels in a healthy range.

The media coverage of the possible causes of heart disease has left people confused.  Providing evidence-based advice and practical ‘How to’ education helps your staff make informed choices.

7.            Keep your blood glucose under control.

Elevated blood sugar damages the circulation.  Even if you have a fit and healthy workforce, they damage their health by drinking sugar containing soft drinks and energy drinks. Your business can have policy to support water drinking.  Once people have pre-diabetes or Type 2 diabetes, cutting back sugar is not enough. I work with people so they understand that they need to cut their saturated fat to lower blood glucose levels. Saturated fat acts to increase insulin resistance, making the locks stickier (link to video). Insulin resistance limits the work of circulating insulin.

New Zealand has an aging workforce. We also have increasing rates of diabetes and heart disease. Having unwell staff costs you money. Investing in prevention makes sense. Contact me if you want to know more about the services I offer.

First step: If you have health insurance for your staff see if dietetic services are covered. If they are not ask why.

Some of my best friends are nutritionists…

Lots of people ask me why they should see a dietitian rather than a nutritionist.
I am a dietitian. So I am registered to practice with the dietitian’s board. I have completed a recognized qualification in Dietetitics . Each year I have to provide evidence I am maintaining my professional learning.
I am also a nutritionist, although currently not on the Nutrition Society register.
This illustrates an important difference.

Anyone can call themselves a nutritionist. It is illegal to use the term dietitian unless you are on the register.

What about qualifications? In the title I hint at an irony. I have worked with nutritionists. I have seen very skilled practitioners with an undergraduate qualification in nutrition. I believe that nutritionists and dietitians can work in partnership. Here is the difficulty. Everyone needs to know what they are good at. They need to know what to do when a patient has some health issue they are not familiar with.

Why come and see me , not another dietitian?

I have spent 20 years in practice learning how my job fits in with other health professionals working in primary care. As a result I have gained a lot of experience in the health conditions that a GP will see and treat. So I am more of a generalist than a specialist, and that works for most people who need dietary advice in our community.

I have also worked with enough secondary care team members, that my sense of “that’s not routine” is quite well developed. I am quite happy to share that with anyone who needs to hear it too. I have good relationships with specialists and I work to maintain them.

The single most important qualification a dietitian or nutritionist can have other than their professional learning is the ability to listen. In psychology they talk about a therapeutic relationship. Because food is such an intimate subject, you need to trust the person giving you advice. This is why I am happy to speak to you on the phone before you book. This is so you can work out if I am the right person for you.
So if you need dietary advice, give me a call, no obligations.