Life as a Dietitian: 6 Things I’ve Learned in Practice

It’s hard to qualify a specific date of being *finished* the dietetics program. One of the largest milestones is being able to officially use the term RD, which comes after passing the CDRE (Canadian Dietetics Registration Exam). The timing is a bit funny because my exam was a few weeks after my UBC graduation and 5 months after my internship was finished. Anyway, this November marks one year since I wrote my RD exam! While results didn’t come out until later, it’s a nice time to reflect on some of the biggest things I’ve learned in my dietetics education and in practice.

Life as a dietitian

1. Food is personal.

I have a box of tissues on my desk in my outpatient office, and I offer it to my patients a lot more than I anticipated. People often think that going to see a dietitian involves being chastised for eating any form of dessert or fast food and then being sent home with a copy of Canada’s Food Guide. This isn’t true. (Albeit, I’ll admit that I am a bit of a veggie pusher.) An effective appointment is not simply a prescription to “eat healthier,” but a deeper investigation into the barriers and challenges my clients are facing. This is called nutrition counselling, and it allows me to target the why and the how of behaviour change. (As much as the diet industry likes to tell you otherwise, making sustainable change is not easy.) Our relationship with food is so. much. deeper. than simply what we eat.

So how come people are crying in the dietitian’s office? Sometimes they feel relief that my recommendation is to eat more – not less. These patients may have spent a lot of time Googling the “best” diet for a new diagnosis. Conflicting and restrictive information has left them feeling starved, confused, and overwhelmed. Other patients feel fear about my recommendation to eat more variety. These patients may have eating disorders that cause them to fear certain foods. Other patients may experience feelings of defeat, disappointment, fear, or shame when I share that I’m not going to give them a meal plan, or a set of food rules. It’s these plans diets that have failed them, not their lack of willpower.

2. People already know what healthy eating looks like.

While I have heaps of training that allows me to help others with the nitty-gritty and the science, most people get the basics. Eat more vegetables, choose whole grains, eat out less, drink more water than sugary-sweetened beverages. This isn’t news to anyone. Sure, I may share the odd fun fact about ~hidden ingredients~ like how you’re probably eating a LOT more sodium than you think from prepared foods. (Spoiler alert: only ~10% is added from your salt shaker). I may also share how many grams of sugar are really in that venti strawberry frappuccino. That being said, people already understand that these aren’t the healthiest foods. My job often boils down to the HOW of eating well because knowledge does not equal behaviour.

3. People choose diets because they seem easier than committing to behaviour change.

Okay, I know this is a loaded statement, but hear me out. The reason the diet section at Chapters is two aisles long and two aisles wide is the same reason the diet industry is worth tens of billions of dollars. NONE of these work long-term. Why? Most people (95%, statistically) aren’t stoked on following a diet plan for the rest of their lives. Dieters are also more likely to end up at higher weight than they started off with. So why do I see so many chronic dieters? Because each diet provides a promise – a checklist of “to-dos” that will lead to success as long as you have enough “will power.” Sounds glamorous. You know what doesn’t sound glamorous? Commitment. Here’s the thing, though, whatever somebody chooses to do for weight loss, they will need to maintain for the rest of their lives.

For the record, I don’t like talking about weight loss because “healthy eating” is not synonymous with weight loss. There are SO many other factors that affect weight, and I really don’t want to get into that, but here are a few: GENETICS, hydration status, medications, stress, sleep, medical conditions, ~time of the month~, physical ability/function, occupation. All that aside, you can NOT tell how healthy somebody is by looking at them.

Healthy Choice Quote Kirstie, RD

4. For the rest of my life, I’ll probably have to apologize for what I’m eating.

This one is truly the most disappointing. Unfortunately, I hear statements like this a lot:

“What’s the dietitian going to order off the menu?”

“Oooh, we better hide the dessert, the dietitian is coming.”

“Can’t bring my favourite foods to the lunch room, the dietitian will probably judge me.”

I like cake, cheap Halloween candy, and french fries like everyone else because, in addition to being a dietitian, I am also a human being. (Holidays are no different, by the way.)

For anyone who thinks I should be more virtuous, a dietitian who eats buttery, egg-and-white flour-filled brownies is NOT the same as a cardiologist who smokes. There are no benefits of smoking, but there are benefits of enjoying desserts. This is called having a healthy relationship with food. Eating well should never feel like punishment or restriction. Enjoying certain foods shouldn’t make us feel guilty. Food should taste good. Food should make us feel good. I saw a cute picture on Instagram that sums this up well, “You know what’s healthier than kale? Having a good relationship with food”. Amen.

5. Healthy eating looks A LOT different for everyone.

The healthiest thing to eat for breakfast for one person is steel-cut oats with mixed berries and chia seeds. For another person, it’s avocado toast on rye sourdough with a poached egg on top.

Somebody else has celiac disease, so they can’t have the toast, and they also work minimum wage and have 3 children, so they can’t afford the $6 gluten-free bread or the $10 gluten-free oatmeal. They may also start work at 6 in the morning, so they don’t have that much time to make breakfast.

Factors that come into play:
Work hours.
Money.
Chronic conditions.
Time.

There’s also the person who doesn’t. like. eggs. (My husband, bless him.) Preferences are super important, and they always trump the “healthiest” choice. If you don’t like something, don’t force yourself to eat it.

Healthy Choice Quote Kirstie,RD

6. Nutrition is not black and white.

This would probably be the biggest shocker to my 17-year-old self who thrived on structure and consistency. I imagined dietitians as those who would prescribe the right way to eat via meal plans. NOPE.

More often than not, my answer to other’s nutrition questions is it depends. A classic example is, “What’s the healthiest (nut, fruit, vegetable, yogurt….) ?” I often answer this one with, “Well, which one do you like?” I could talk about how walnuts are a good source of omega-3’s, or how almonds are a better source of calcium, but if you only really like cashews, I’m not helping.

Also, restrictive diets are boring. (See #3.) That’s why another response might be “Keep switching it up.” Variety is super important to keep things interesting. We also need to eat many different things because every food has its own chemical make-up. Nutrients are cool and all, but we don’t eat nutrients, we eat food.

There’s also the fact that nutrition evidence is changing and expanding all. the. time, but that’s for another post. 😉

4 Comments

  1. Kirstie I feel so proud of you. Reading your blog, my heart is warmed by the things you’ve learned and the wisdom you’ve gained and shared. Your approach to helping your clients has not been just about prescribing food but rather coming alongside them, meeting them where they are at and helping them meet their goals in realistic and kind ways. You are a rockstar. ❤️

  2. I loved your blog, Kirstie. I could really hear your aunt’s voice in a lot of your wise words. But I believe you have such a strong commitment to your vocation and a love for food and nutrition. Thanks for passing it on. We can all learn from you!

Leave a Reply

Your email address will not be published. Required fields are marked *