May 2007

Where Have the Foodies Gone?
By Meghan A.T.B. Reese
Today’s Dietitian
Vol. 9 No. 5 P. 46

Where have the foodies gone? Seriously, where are they? At last year’s American Dietetic Association’s (ADA) Food & Nutrition Conference & Expo (FNCE), Doris V. Derelian, PhD, JD, RD, FADA, gave a presentation posing this question. Her current mission is highlighting the peril facing dietitians should the dietitian/foodie fade away, an imminent possibility as this particular breed is starving for numbers.

Mmm, Science
Without being a foodie, Derelian says, “You are willing to accept any modification of food whether it looks bad, tastes bad, is an ugly food. You are saying, ‘Well, you have to eat that anyway because it’s good for you, it protects against heart disease.’” In response, she says the foodies have declared, “‘That’s ridiculous.’ If you don’t create aesthetically good food—food that is good looking, good tasting, well presented—then it doesn’t matter how nutritious this new food or modified food is because no one will eat it.”

Since there are not enough supplements out there to do it by pill, Derelian contends you can’t affectively remove the aesthetic and sociological benefits of food. “Do you want to sit around a table where everyone is pointing at the food being served and saying, ‘Oh, that has fat, that has this, this has that’?”

The dietitian/foodie is becoming a dinosaur and soon to meet extinction if a climate change doesn’t occur soon. But did science kill the dietitian/foodie?

Yes, Derelian says. “I would argue it has become nutrient focused instead of food focused. The science of food has been replaced by the science of nutrients. The science is not the issue. The object of the scientific inquiry is the issue. I think there should be a better balance.”

But others, like Dina Aronson, MS, RD, director of Welltech Solutions, don’t think the science of dietetics has become too scientific. “I think dietetics has broadened its horizons, both scientifically and creatively,” she says. “As people are starting to become more interested in the relationship between food and health—not just lowering disease risk but optimizing excellent health, as well as the art of cooking and food’s role in our culture—dietitians have been called upon both as scientists and as creative consultants.”

Chef Kyle Shadix, MS, RD, agrees, saying, “Dietetics is certainly not too scientific.” But Shadix echoes Derelian in noting, “The issue with food and dietetics is that there is too little focus on food science. If nutrition students had a broader understanding of food science principles, RDs would inherently understand the fundamentals of food.”

The shift in the foundation of dietetics occurred, Derelian says, because “for many years, the dietitian was viewed as the woman in the kitchen cooking a batch of soup. In order for us to make a legitimate argument—congressional argument, public arguments, arguments for better salary—we needed to change our image. In the ‘70s and ‘80s, we had to make significant strides by presenting ourselves as clinical specialists—white lab coats instead of white aprons.” Shadix walks the same line with his slogan, “Hotel pans and hairnets are history.”

“RDs have long been confused with the lunchroom ladies. There is not enough understanding from the public as to the training and education we go through. It is more important that we become nutrition science experts, not great cooks. We are trying to get away from that stereotype,” he says.

Thou Shalt Not Fear Food
During her FNCE presentation, Derelian lamented on the days of yesteryear when Julia Child ruled the world and proclaimed, “I was 32 when I started cooking; up until then, I just ate,” and “In spite of food fads, fitness programs, and health concerns, we must never lose sight of a beautifully conceived meal.” But Child was no dietitian, an occupation she nearly vilified in retorting, ”There is far too much fear about food—mostly from the dietitians … who care more about disease than the love of eating good foods.”

Was Child’s gut right? Are dietitians too concerned with food’s relation to disease or nutrient analysis? “Some of them are,” Aronson says. “I think that many dietitians seek work that they are comfortable with. If their education focused primarily on disease risk and nutrition analysis, they would bring that experience into their work.”

But she notes that is just one background type. Dietitians have the unique ability to tailor their approach to their interest and education. For example, an RD with a culinary background might bring the “experience of eating” to the table. An RD with a business degree could seek ways to bring dietetics into the business world. An RD with a music degree can compose songs to teach kids about proper nutrition. “I’ve met a lot of dietitians over the years [who] have successfully united their two sets of expertise,” Aronson says.

Yet, perhaps feeding a healthy helping of fear to some clients could light the fire under them to make lifesaving changes. “For example, for an out-of-control diabetic who is about to lose kidney function and refuses to give up his four liters of Pepsi a day, fear is really the only way to save him,” Aronson says. “This was my client, and I told him he would spend the rest of his life in a dialysis clinic if he didn’t toss the Pepsi and get his blood sugar under control. But this should be the exception, not the rule. Motivation to change does not stem from fear.” However, Aronson believes some RDs inspire a fear of food, specifically a fear that if they (the clients) don’t eat a certain way, they are risking their health. “But there are ways to counsel in a more positive way that will motivate, not intimidate.” Derelian says she believes some dietitians are instilling a fear of food in some clients and especially in dietetic students, which maintains the cycle of fear.

A remedy to all of this could be emphasizing the aesthetic value of good foods and steering patients toward savoring healthy choices. But the only way to do so efficaciously, Derelian notes, is for dietitians themselves to rekindle the joy of cooking.

As for much of the current crop of RDs valuing flavor, culinary skills, and a passion for food, “from my experience, our entire country needs a culinary lesson,” says Shadix. “Luckily, the Food Network and mainstream markets [that] offer international flavors, such as Whole Foods, are popping up everywhere. I saw edamame sushi at Wal-Mart in rural Alabama. Who knew soybeans and raw fish would fly there?”

Although there is ground to suggest that mainstreaming culinary and dietary could be the cause for the rural edamame sighting, Derelian cautions against taking television nutrition at face value. She says, “Even Emeril [Lagasse], who has a nutritionist—at least one—and a dietitian constantly at his fingertips, has made drastic statements, and when I say drastic, I mean totally wrong statements about the nutritional content of the food he is preparing, and I find that abhorrent.”

Nutrition U.
How can the school of eating for the love of food and those eating for health combine in the university setting and ultimately in practice? “It might be a rethink at the highest levels of the profession so they can direct education to require more food aesthetics courses,” Derelian suggests. “Another way for the practice group within the ADA of food and culinary professionals to demonstrate at the student and intern levels is that we should be directing our attention to helping them understand food so they graduate with a better appreciation.” Like the Food Network, other channels and consumer-related media outlets have a renewed interest in food and “that will drive more students wondering where they will work, and since they have seen the Emeril Lagasses and Rachael Rays of the world, will say, ‘Maybe I can add culinary school to my dietetics background, maybe I can take organics,’ but attention has to be paid so that can be fostered,” says Derelian.

Shadix dissents about where he thinks the focal point should lie. “RDs’ focus should remain on medial nutrition therapy and never stray from the focus on nutrition science. However, it is crucial that we know about food, and more important than knowing how to cook is the need to educate ourselves of the foodways of the cultures we service.” But, he says, “a base knowledge of food and general cooking should be mandated.”

Aronson considers some components slanted and in need of reexamination. “Policies and education standards are biased. It’s all about the mighty dollar, not what’s necessarily best or true.” Education seems to be the weak link; Shadix concurs and has a few ideas of his own. “If it were up to me,” he says, “I would modify the educational standards from CADE [Commission on Accreditation for Dietetics Education] and implement more focus on food and counseling.”

Calling All Foodies
Andy Rooney quipped, “The two biggest sellers in bookstores are the cookbooks and the diet books. The cookbooks tell you how to prepare the food, and the diet books tell you how not to eat any of it.”

Obesity in this country is a multivariate condition, Derelian says. “Everything that’s supposed to help obesity ends up being a Band-Aid on a wound that is bleeding. You can do anything you want to school lunch, but what those kids do at home matters.”

While there is no cure-all, she says the exercise component of a healthy lifestyle is the single biggest issue. “Every single thing in America is designed to keep people from being active. We have an attitude in this country where anything you would do to exert yourself should be done by technology,” Derelian says. But it’s not just being sedentary—that is, “we need to control portions. We need to look at the false economy of saying, ‘If you get this much for a dollar, I’ll give you double for $1.05,’” she says.

Through this surge in obesity and its health ramifications, we have created a society where many are “eating for or to prevent fill-in-the-blank.” Through this, it’s not unrealistic to find that some have a fear of food and the possible health repercussions in choosing the “wrong” items. From this notion of eating to prevent disease or prolong life comes the call for the resurgence of the foodie. Come out, come out, wherever you are.

A foodie renaissance could yield better quality food, meaning the food would have a good nutrient profile, and it would have the qualities people eat food for, Derelian says. However, the burden of bringing back the foodie, Shadix reminds us, lay not only in the hands of the dietitian. “I think being a foodie goes beyond our profession. There are nurse foodies, vet tech foodies, mail carrier foodies, and even food borne illness epidemiologists who are foodies.”

At FNCE, Derelian asked the nearly 200 people attending her presentation whether they considered themselves foodies. Nearly all hands were raised. Then she asked how many dietitians were members of the practice group, and again most hands were in the air. Derelian says that’s because that is the only place in dietetics they get exposure to “foodie stuff”—the chance to go to France and learn French cooking or the Culinary Institute of America are experiences they wouldn’t get outside of the practice group.

So where is the love? Derelian thinks it is gone. “Dietetics has lost its joy of cooking, no doubt about it. The emphasis and association of getting them nutritionally trained comes at the expense of knowing about and loving food for all of its elements.” But Aronson defends the standpoint that, “The American Dietetic Association is not encouraging joy of cooking and love of food; they are predominantly about science and policy. But most members seek information, education, and experience beyond the ADA.”

And if the foodie in the profession is gone, “we will have abdicated our role in the process of engaging food as the means to good nutrition, and we will be leaving it to the chefs and Rachael Rays, and we’ll keep our fingers crossed that what they are saying to the consumer actually has scientific basis in nutrition,” Derelian says. “We’ll give up the role of providing a culinary aspect to the intake of nutrition, and we’ll leave it to the psychologists to define the benefit of the table and the meal and how the American table treats its children, again keeping our fingers crossed... I think we are bigger and better than that.”

— Meghan A.T.B. Reese is an editorial assistant at Today’s Dietitian.