Thursday, January 12, 2012

Extra-Credit Calories

Work this week has been much quieter than anticipated.  The number of clients who have no-showed for appointments outweighs the number of those who actually showed up so my crazy busy intense week of running around like a crazy person to get all my charting done and see clients turned into a catch up on nutrition news week.  As much as I would have much preferred to be crazy busy and have clients, nutrition is a pretty hot topic these days in local and international media. It was great to be able to peruse the web and see what kind of nutrition messages are being sent to the general population and my clients. It’s not uncommon for clients to come see me with a headline on their minds and ideas of what and how they should be eating based on something they saw in the Newspaper.  And even less uncommon is to get e-mails from friends or family asking my opinion on these same headlines. Amongst my fellow Nutrition graduates and Dietitians, the various nutrition stories can spark great conversations and debate related to the legitimacy of the research and the credibility of the claims being made.  I really think that taking time to go through news papers and websites helps my practice; I become aware of what messages my clients are getting, I have time to go back to the original research articles to dissect the findings for myself and I stay current on the most recent studies and best practices.

There seemed to be a bit of a trend in articles this week.  Two articles in particular caught my eye.  The first is a story out of France fueled by Pierre Dukan, the creator of the Dukan diet. He is suggesting that France tackle childhood obesity by awarding slim students with extra points on exams.  He wants high school students to be allowed to get extra points on the “baccalaureat” exam for having a BMI between 18 and 24 and to get double these extra points if they can change their BMI from above 25 to within the target range.  Body Mass Index (BMI) is a calculation (weight in Kg / height in m^2) often used by health professionals to assess and classify body weight.  A BMI of 18.5 0 23.9 is considered “healthy” while a number above 24 is considered overweight or obese based on how high the number is.

The second article came from a little closer to home – a high school in New Brunswick.  This particular high school is grading grade 10 students on more than just math and literacy.  Grade 10 students will also be getting a medical report card listing blood pressure, cholesterol levels, heart rate, blood sugar levels and BMI. The hope of the project is to let students know how they are doing in terms of health and disease risk before they leave high school so that they can make better informed decisions regarding healthy eating and physical activity once they leave home for University or College and have to prepare meals and fend for themselves.  The project’s funding has allowed the school to hire Dietitians to come in to counsel students about healthy eating and leading exercise classes over lunch breaks that are available to all students. The goal of the project is to catch disease risk early enough that the individuals identified as being at high risk have time to alter behaviours and can subsequently prevent future health issues. 

Both of these projects are using high schools as an avenue to fight childhood obesity.  I definitely agree that this is a major issue that warrants intervention but is it really fair to single out students in high schools?  In my opinion, overweight kids know they are overweight.  I’m sure it’s something they deal with every single day, especially in high school, where weight bias is rampant. Do we really need to point out the obvious? Giving extra grades to kids who have a healthy BMI or who are able to lower their BMIs to the healthy range is great, but what resources will be provided to these students to help them achieve this? Are students being taught how to interpret their lab values and results? The cut points for these tests aren't always black and white, and there are many factors that can affect results such as medications etc. At least in New Brunswick they are assessing risk factors that can be prevalent even in ‘skinny’ kids like high cholesterol, blood sugars and blood pressure.  Plus they are providing education for students regarding healthy eating and physical activity. 

I think a better approach would be to begin integrating nutrition and healthy lifestyle education into lesson plans starting in preschool.  There’s no reason that kids can’t learn how to be active, healthy people at the same time as learning reading skills or math skills. Many physical activity programs are being cut from schools to make more time for other subjects but in the grand scheme of things, learning to be healthy and to eat well and be active is going to be way more useful in real life than knowing Pythagoras Theorem for about 99% of students.

Ok my rant is over now. I applaud people for seeing what a big issue obesity has become, particularly childhood obesity, but I also think we should just get back to basics. There’s nothing new or fancy required to be healthy- the formula has always been the same.

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