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Friday, 15 April 2011

The Retro Look

Looking back. We seem to long for how things used to be -- in the good old days. We love the cars, the fashion, the music, the hairdos. MEN seemed to have MORE HAIR!

Life was simpler, more straightforward.

And people were SMALLER! As were FOOD PORTIONS!

Even though people ate plenty of saturated fats (butter, red meat, full-fat cheese and other dairy, real cream in coffee), plenty of carbohydrates (Wonder bread, biscuits, Mom's apple pie, all KIND of pies, cakes, and homemade cookies), and THREE SQUARE MEALS A DAY plus a small snack or two -- people were NOT as BIG -- ie -- obese -- as they are today. The prevalence of SUPER-OBESITY was also much lower.

What's going on???

Well, there are many reasons, but, certainly people just EAT MORE today. The SIZE of our portions has INCREASED over the past 20 years. What we classify as a NORMAL PORTION is double, often quadruple what it used to be. And our children don't KNOW any better. For some reason the whole 'BIGGER IS BETTER' mentality has stuck when it comes to our food intake. Even though many of us know very well that we are eating WAY TOO MUCH, because it's considered normal, we go into a warped sense of denial and just continue to overeat -- although what's considered 'OVEREATING' today is ALSO different from what it was 20 years ago. Which is why there is more 'SUPER-OBESITY' today.

This all goes along with the redefined weight norms we are seeing today. What was considered overweight, even, obese, 20 years ago looks different from what we consider overweight and obese to be today. Oh, on the scales and measuring tapes and fat calipers -- it's still defined properly, but I'm talking about what people SEE when they look at someone and a group of people. There are SO MANY MORE overweight and obese people today that if one looks into a crowd, you only pick out the few who are SUPER-OBESE, even though there could be many more dangerously overweight and obese people.

One of my first jobs was working in a hospital kitchen of a hospital in a working-class neighborhood in Philadelphia. I had a particular patient up on the wards who was SUPER-OBESE. She had diabetes, congestive heart failure, cardiomyopathy, osteoarthritis, and depression. Ironically enough, she was ONLY in the hospital for a work-up of possible inflammatory bowel disease. The doctor ONLY ordered a residue-restricted diet. Before I ever saw the patient, I started to notice that as her trays came down the food-assembly line, there were COPIOUS amounts of food, albeit, indeed, they were low-residue, but included plenty of jellies, biscuits, crackers, sugar, meat, mashed potatoes etc.! And I had not received any order for a consult for this patient. I investigated. I peeked in to the patient's room and saw that she was extremely overweight/obese. I tracked her doctor down. I asked him (actually I PLEADED with him)if he would refine the diet order to a diet that would not only address her bowel problems, but also her need for control of kcalories, sugars, and fats. I asked him to order a dietary consult so that I would then be free to work out the exact diet and I would be happy to work with the woman to help her, perhaps, lose some of her fat weight, and possibly get her blood sugar under better control without the need for insulin. He flatly refused. He told me to stick to his order as he was not interested in treating her obesity! ( Aaaah, how times have changed!) Anyway, I took charge to vigilantly look after her trays regardless of the doctor's attitude, making sure she didn't get the crazy amounts of food (albeit -- low-residue) that had been going up to her. I found out that one of the dietary supervisors, Mary, who was also a hefty woman herself, was actually putting EXTRA foods on the woman's tray and LIKED the fact that this woman was SO big. Mary told me that when she delivered the woman's tray, it made HER (Mary) feel BETTER about herself -- ie -- to stand next to someone who was BIGGER than HER!!! Oy!!!!

That was one of my first lessons in the importance of IN-SERVICE TRAINING for the DIETARY STAFF!

So, informally, despite the lack of an order from the doctor, I would visit the woman. When I would deliver her trays to her, sure enough, I discovered, she was longing for some guidance on how to lose weight and feel better about herself. I ended up working with her and helped her to lose 40 lbs. This enabled her to decrease her insulin dosages and helped with her knees. Her overall feeling of well-being improved. (Of course!). Unfortunately, her CHF and cardiomyopathy persisted as the damage was done, as did her bowel problems. I lost track of her after my internship ended.

That was one of my first lessons and RUDE awakenings that I had a LONG road ahead of me when it came to dealing with doctors who would take obesity seriously! Fortunately, THAT has also changed DRAMATICALLY! To me, it's ironic that today, often, MDs are the ones considered to be experts on obesity and are writing books and manning TV shows and doling out all the advice. I'm HAPPY about that -- really I am -- but don't forget DIETITIANS! We actually have the exact expertise people need PLUS all the knowledge of foods, better preparation, cookery, recipe development, shopping tips, etc.

I don't long for past days AT ALL, but I DO miss the REALITY of our definitions of OVERWEIGHT and OBESITY and PORTION SIZES being much closer to the TRUTH.

People WERE smaller because of this. But people DID have heart and bowel problems, cancers and diabetes THEN, which is why the CHANGES we HAVE emphasized in switching to MORE WHOLE GRAINS, less saturated/more poly and mono unsaturated fats, less red meat consumption, MORE FIBER etc is all GOOD!!!! But eating BIG PORTIONS OF EVEN HEALTHIER FOODS contributes to an overall excessive intake of the amounts of kcalories, carbohydrates, and essential fats than we need and can lead to being overweight and obese. This is VERY IMPORTANT for people to understand!

We have to work on getting people to GO BACK to how it WAS and EAT LESS. We are doing really well in that folks ARE eating more whole-grains, unsaturated fats, and leaner meats and lower-fat dairy products. We ALSO have to encourage people to GO BACK to how it WAS and EAT MORE BASICS and FRESH foods vs. all the PROCESSED gunk/junk.

We have to get people thinking BACK to when LEANER BODIES were NORMAL.

So, IN with the OLD and OUT with the NEW for body weight norms and food portion sizes!!

We just might get to see more of those small-waist dresses again.

I also happen to think that men will hang onto their hair longer if we go back to the past when it comes to FRESH, more prudent eating! I'm tired of all the dome heads that ALSO seems to be more NORMAL today than years ago. And, take those baseball caps off!!!

Now, THAT would be SWELL.....

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