Build UP Catch Up - 4/14/23

Conflicting information, Criticism of Hospital Meals, possible CPE changes and Book Nook recommendation.

Conflicting Information

As nutrition professionals most of us, when it comes to nutrition, tend to follow science, research and our training. What our customers/clients/patients, or even family members are seeing and hearing, maybe conflicting messages about food and nutrition that cause confusion. The below was spotted on Facebook.

This is a good example of the whiplash effect of nutrition news in the media. Try it for yourself…Ask your favorite browser, “Is_____good for you?”, then use the same item and ask, “Is ____bad for you?’ and see what pops up. Here are some examples:

Coffee

2/13/23 Drinking 3 or more cups of coffee daily may increase kidney dysfunction risk

2/23/23 This Should Perk You Up: The Surprising Health Benefits of Coffee

Red Meat

3/14/23 New Study Rates Dangers of Smoking, Red Meat Eating, Low-Veggie Diet

3/23/23 Red Meat Can be Part of a Heart Healthy Diet

Podcast Picks:

Dietitian Jaclyn (Jackie) London takes on recent headlines in this episode of “Business of Wellness”: Weight Watchers and GLP-1 meds for obesity, MSG and shocking headlines about erythritol.

"Thinking Nutrition" by Dr. Tim Crowe

Another helpful resource:

McGill Office for Science and Society

Bottom Line: It’s important to be aware of what’s being said in the media/social media about food and nutrition so you know what misinformation you may need to debunk.

Book Nook

“Food Truths From Farm To Table: 25 Surprising Ways to Shop and Eat Without Guilt” - by Michele Payn

Who are the purveyors of misinformation and disinformation about food and agriculture? What are some of the food and agriculture myths? What are some important food truths that dietitians, farmers, individuals in agriculture and consumers should know?

Michele answers these questions in a helpful, science-based and easy to understand fashion and quotes a number of dietitians!

Hospital Meals (Food Shaming on Social Media)

As written in this piece from The Economist, “Few sick people consider the quality of food when choosing a hospital.” Hospitals aren’t restaurants, they’re places we go to get diagnosed, receive medical care, have procedures and surgery. The goal of being in the hospital isn’t to prolong your stay to enjoy the food. Often, especially if you are having certain tests, procedures or surgery, you may not be able to eat. While this doesn’t mean the food served to patients should be of poor quality or taste bad; a photo of a tray of hospital food may not necessarily appear appetizing. (Hint: stop expecting it to look like a filtered and staged photo of a restaurant meal).

Actual hospital food trays - Washington State.

This past week these photos (below) of hospital food trays were shared to Twitter. The first tray was mocked for the amount of carbohydrates and the second for the minimal amount of food — it appears the only goal was to vilify hospital food in general.

Posted on Twitter by Nick Norwitz “MD student at Harvard” with the statement that is 258 grams of carbohydrates!

Comments from dietitians about this photo:

“…if this is a hospital tray, the likelihood that the patient eats all of this in one sitting is low.”- Kim H.

“Did the patient request all of this…? We have had people feed all their visitors…Everyone is so quick to judge….” - Allison L.

Hospital meals can vary from hospital to hospital and from country to country.

posted on Twitter - these are apparently hospital trays in a GERMAN hospital.

Comment from dietitian about this photo:

“I've occasionally seen patients tick only a piece of fruit or just cheese & crackers etc on their menu ticket sheet..But our catering assistants are great at spotting patterns like this and alert the ward's dietitian if it's an ongoing for more than a day or so.” - Aimee B.

A patient’s hospital meal can depend on various factors: the illness, ability to chew food or appropriate texture to facilitate swallowing, appetite, nutritional status on admission, if they’re pre or post-surgery, have a pending procedure, any food allergies or food sensitivities or intolerances they may have, and in some cases, what food preferences they’ve conveyed to dietary staff.

Here are photos sent by a dietitian in a long-term care facility in Texas of a pureed meal done with food piping, so it looks like a pizza. Pureed food may be served to individuals with difficulty chewing or swallowing.

Pureed, hand-piped “pizza” photo submitted by (and made by) dietitian Arlayna J.

(If you’re a dietitian or nutrition professional and would like to connect others in Food Service check out our Build UP Dietitians Food Service and Culinary Group. You can also connect with our Clinical Dietians group and Dietitians in Long-Term Care )

Bottom Line: Think about what you like to eat when you’re not feeling well. Soup? Crackers? or maybe something cold like a popsicle…or maybe you don’t have any appetite. It’s ridiculous to see keyboard warriors food shame hospital food trays. Whether they’re criticizing the appearance, claiming they have too many “carbs”, or angry at the amount of “processed” foods; you can even see these Twitter “experts” recommending patients should “just fast” to avoid eating while hospitalized or that food for all patients should be “keto” and “low carb”. Assessing and passing judgement on a hospital, dietary/food service or dietitians based on a single photo of one meal fails to take into consideration a myriad of factors—-as well as what the patient actually ends up consuming from that tray. #StopFoodShaming and stand up for #HospitalFood

Proposed Changes to Continuing Education

We encourage you to be aware of the proposed changes to CPEs (Continuing Professional Education) by the Commission on Dietetic Registration (CDR). See SURVEY from CDR: https://www.surveymonkey.com/r/KLX7RRR (please take this survey before 4/21 and in particular notice #2 (below) which would severely limit the free CPE's available to dietitians as well as potentially allow for far fewer opportunities for RDs to work with groups/brands etc. on CPEs)

Policy Update 2: Marketing and Commercial Bias in CPE Content

CPE is not a vehicle for product or service marketing.  Attempts made by providers, commercial supporters, and funders, as well as all individuals involved in the planning, development, review, marketing, implementation, presentation, hosting, learner feedback, learner assessment, & evaluation of CPE to favor, recommend, purchase, use or promote products, product groups, commodities, equipment, devices, services, branded treatment options diagnostic or screening tools, or tests are not permitted."

While it makes sense to have ethical standards, disclose any conflict of interest, and have a rigorous vetting policy for proposed CPEs…how exactly can you have a CPE that is sponsored by a brand or commodity and that does not in some way “favor, recommend, purchase, use or promote…” that product?

Think about how this would play out for a CPE sponsored by the National Watermelon Board about watermelon and hydration research—would they be unable to promote recipes featuring watermelon? Or how about a CPE by Dexcom about new generation CGMs or by Abbott on research on cronobacter sakasakii in their infant formula? Would they be unable to mention their products or show images during presentations?

Bottom Line: What we are doing about this? We’ve alerted dietitians on all of our platforms and via e-mail and written several times to CDR and the Academy recommending a listening group so they can hear concerns from dietitians, CPE providers, sponsors and brands.

There is room for improvement in the quality of CPEs and oversight of potential for commercialism, conflict of interest and appropriate disclosure. However, the language in this survey indicates a level of overreach that may have adverse consequences for dietitians who work with brands, dietitians looking for free or low-cost CPEs and many businesses, commodities and checkoffs looking to work with and inform dietitians.