Earth to Cleveland Clinic dietitians: please stop sharing your joyless, preachy, pinched-face, finger-wagging lectures about foods you consider to be evil. In a rush to convince the great unwashed out here to improve our daily diet, many so-called “experts” like you seem to believe that nagging and food-shaming are the most effective ways to change behaviour. Trust me, they are not.
Today, I offer two examples of dietary advice, one that I plan to not only ignore but publicly mock, as well as one terrific example (definitely not from Cleveland Clinic) that’s already printed and posted on my fridge door.
Example #1: a Tweet from Cleveland Clinic, below: “Our dietitians picked 7 snacks they would NEVER eat.”
Can you guess the seven deadly snacks they would NEVER eat?
The answers are, surprisingly, not chocolate bars, not ice cream, not even a nice gooey Tim Hortons Maple Dip. Instead, the Cleveland Clinic dietitians slammed baked chips, granola bars, potato chips, veggie sticks, store-bought smoothies (even the expensive kind from your local health food shop, described as being “often jam-packed with added sugar from fruit juice”), or rice cakes (yes! the humble rice cake, bland staple of every dieting woman I know!)
But the final verboten snack that pushed me right off the deep end was the pretzel, trashed dismissively by Cleveland Clinic registered dietician (RD) Kristin Kirkpatrick as “a nutrient zero.”
Of course, it’s a nutrient zero, Kristin. It’s a PRETZEL! Nobody nibbles a little pretzel hoping to fulfill their daily nutrient requirement of protein.
I was pleased to see almost immediately that apparently I’m not the only person annoyed by this judgmental Tweet. Enter Emily, a real life registered dietitian from the Boston area, with her brilliant Twitter response: “Hey Watch me, an RD, NEVER eating pretzels. It’s food not poison! There are no NEVER foods – ugh”
On behalf of all normal people out here who occasionally allow a pretzel (or a rice cake) to pass their lips, thank you, Emily for reminding Cleveland Clinic dietitians how NOT to motivate behaviour change.
(Kristin, by the way, also mentions on her website that she serves on the advisory board for the Dr. Oz Show, which is not something you’d think a registered dietician would want to brag about, considering his quackery topics like (seriously!) “Six Super Foods That Will Save Your Marriage!” (For a brilliant takedown of a once-respected cardiac surgeon-turned-TV-ratings hog, watch Senator Claire McCaskill’s withering dissection of his unfortunate promotion of diet scams and “miracle fat-burner in a bottle” craziness).
But I digress.
As I once wrote here, researchers in the field of behaviour change and goal-setting theory tell us that the most effective goals are indeed ones that move you toward a particular objective (approach goal) rather than away from something you’re trying to avoid (avoidance goal).
Any “expert” who tells you that your only option is to STOP doing whatever it is they want you to stop doing (like eating a NEVER food!), is unlikely, in fact, going to convince you by nagging – because that’s an avoidance goal.
Example #2: Now contrast that finger-wagging/pinched-face/STOP DOING THAT! avoidance goal with an approach goal from Oldways Preservation Trust. This is a non-profit organization (based in Boston, just like our nice Registered Dietitian Emily) whose motto is “Inspiring Good Health Through Cultural Food Traditions”. To celebrate Mediterranean Month starting on May 1st, Oldways produced this simple calendar poster to encourage us to make at least one healthy change per day. Make every day Mediterranean!
Cleveland Clinic offers us a nagging avoidance goal (NEVER eat these snacks!) while Oldways offers us an approach goal (try just one simple idea every day for a month and see what happens!) What happens (spoiler alert!) is that at the end, you’ll get to have a glass of wine to celebrate the great month you’ve just had making small but important improvements in diet and in your life! And every day is a small but doable adventure (like the first one: “Take a passeggiata, an evening walk around the neighbourhood tonight.”)
This concept of approach/avoidance goals is critically important for those living with chronic illness like heart disease. Such a diagnosis can mean we encounter a wall of new rules to live by, during a time when we’re already reeling from trying to make sense of something that makes no sense. We now hear a list of new rules that can sound ominously like:
“Stop doing everything you really like doing, and start doing everything you don’t like doing.”
I remember sitting in at the back of a lecture hall listening to a talk directed at recently diagnosed heart patients. A lovely middle-aged woman sat directly in front of me. Before the lecture started, I had the chance to chat briefly with this woman, who told me she was scared to death since being diagnosed with heart disease. Since that diagnosis, she had dutifully stopped smoking (a pack-a-day habit over the past 35 years), stopped adding salt to her food, and stopped her evening gin and tonics with her husband before weekend dinners. She’d also been having a lot of trouble getting her new cardiac meds straight so far (take this pill twice a day, these two pills three times a day, and these three pills once a day). She looked miserable and scared.
When the guest speaker got to the part of his lecture where he explained how he was now following the Ornish diet, had decided that all meat was poison, and had become a strict vegan since his own heart surgery, I could actually watch the woman’s shoulders slump forward. I could tell she was worn down by the enormity of far too much reality. She’d already given up the things she most loved to do in life – and now this?
I wish that, instead of going on (and on) about his own enthusiastic embrace of vegan life, the speaker had suggested instead something more doable – like try a Meatless Monday. That would have been an approach goal.
As our new favourite dietitian Emily reminds us, there are no NEVER foods. No food is evil. Thinking it so simply makes us crave that forbidden food even more. When Cleveland Clinic tells us that even a stupid little rice cake is somehow evil, it’s discouraging enough to make us give up and head straight for the Häagen-Dazs.
As the late tennis legend Arthur Ashe once advised:
“Start where you are, use what you have, do what you can.”
Find out how I did with my Make Each Day Mediterranean calendar, what I liked best, and what I’ll likely not do much more of. Let me know how your own Mediterranean calendar works out for you and your family.
My guess is that we’ll enjoy some of these approach goals so much that we’ll continue incorporating them into everyday life. And that’s good news for our hearts.
Now, go enjoy a nice little rice cake. . .
Q: What behaviour changes have you tried since your own diagnosis? What worked best to help make the change stick?
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- What overweight women may have in common with drug addicts
- Physical exercise vs the ‘plumber’s pipe’ theory of heart disease treatment