This week I received an email from a current dietetic student wondering how it is ‘possible’ to be a Paleo dietitian and promote the lifestyle, even though it doesn’t exactly ‘jive’ with the USDA Food Plate and dietary guidelines. I often receive emails and inquiries like this from students, current registered dietitians, nurses, health professionals and ‘nutritionists’. Here’s how the story goes:
I came across your blog, and it was just what I was looking for. I am a senior Nutrition and Dietetics student, just about to graduate, and am feeling very stressed. Besides the obvious reasons, much of my stress is coming from the fact that I do not agree with what I am being taught to teach! I’m sure you understand how I feel. The paleo lifestyle has improved my life drastically. I’m in the process of applying for dietetic internships and cannot get this topic off my mind. I feel that I should continue to my goal of becoming registered, as I feel I could help more people that way.
I have one major question: how do you work and teach paleo style and not get reprimanded by the ADA/AND? I’m not sure how much liberty you can take with your title as an RD. Does simply focusing on what you do recommend, not what you do not, fly?
Thank you so much for taking time to read this,
Well Allison, there’s a short answer and long answer. I’m going to give you the short answer first; yes, that does mean you’re getting the long answer too; (you can’t say I didn’t warn you…).
The Short Answer
Ultimately, a paleo eating style is a ‘real food’ based approach. There are no fancy supplements, pills, injections, surgeries, or shady tactics (think colonics and sweat wraps). As a ‘paleo RD’, I do not sell anything, I do not make recommendations that will endanger lives, nor do I recommend a lifestyle that is unsustainable or that I do not practice. Yes, it is true that paleo eating requires the ‘elimination’ of grains and dairy – but how does this differ from recommendations to eliminate all animal products (meat, dairy, eggs, honey, etc.) as a vegan diet does. Additionally, raw, macrobiotic, and fat free vegan diets (yes, they exist – Exhibit A the “Helpful Tools” are quite useful… ; Exhibit B) are even more limiting. I’m not saying that if, in fact you have ethical, moral and or religious beliefs that mandate these eating styles or if you are truly healthy and passionate about your way of life that you must convert to paleo – but as a comparison, if these diets are acceptable, how can paleo be argued? It’s simple, real food with absolutely no agenda. There is peer-reviewed science behind the recommendations and the support from the academic community is growing every day. I simply advise my clients to eat high quality meats, lots of non-starchy vegetables, good fats, and some fruit while staying away from processed and/or packaged foods – and that, is hard for anyone to argue.
The Long Answer
This is a complex issue and much of what is and is not okay to do depends less on the ADA/AND (as long as acting within the Code of Ethics for the Profession of Dietetics) and more upon the internship or worksite that you are at. Unfortunately, the “when in Rome, do as the Romans do” rule applies when someone else is signing your paycheck.
One thing that all current students, RDs, health professionals, etc, need to keep in mind is that for the most part – (there may be cases of ‘knowing the right people’ and pure luck) – you will need to work for an organization or establishment that adheres to the dietary guidelines. In these circumstances you will need to follow the policies and procedures as enforced if you wish to stay employed. With that being said, is it possible to somewhat incorporate some paleo principles? The answer is YES!
Okay, personal experience story time… Since my conversion to a paleo lifestyle (um, no I was not born paleo – that is prime content for another blog post…) – I have been employed both as a civilian military dietitian and as food service director for an adjustment training center. Working for the military, I was responsible for delivering nutrition education classes and counseling services to soldiers and their dependants. The classes that I taught consisted of template material and required that certain items be discussed and recommended. Did I follow these ‘guidelines’? You better believe I did – a girl’s gotta eat!! What I was able to do though, is emphasize the importance of selecting “real”, “whole” foods as opposed to processed, packaged fare. It was a case of doing the best that I could within the requirements and constraints of my job.
Next up, food service director; as the ‘boss’ you may think I could do whatever I wanted with the menus. Well, not so much. The facility that I worked at received government funding for meals ala the National School Lunch Program. Yes Virginia, French fries and pizza are considered vegetables… If I wanted to keep feeding the individuals we supported, the menus that I put together HAD to comply with NSLP requirements (2 grain servings, 2-3 ounces of protein, 1 fruit, 1 vegetable, 1 dairy) if funding was to continue. Additionally, there were some MAJOR budgetary constraints and minimal staff available to prepare meals (over 800 meals/day and only 15 staff on a ‘good’ day). Most of the commodity foods that we received were less than ideal – but the price was right… It is sad that this is the case in most school systems and things definitely need to change.
While in this position, I did everything I could to make meals as healthy as possible: replacing corn and peas with broccoli, green beans, lettuce, raw carrots; using corn tortillas and rice to meet the grain requirement as often as possible; incorporating as many fresh fruits and vegetables as I could within the budget and our storage space; etc. What did I learn – kids (and adults) really like chicken nuggets, mac & cheese, pizza, and French fries. On the days we offered the less processed foods like pork loin, turkey, sweet potatoes, broccoli without cheese sauce, etc – the number of meals we served was SIGNIFICANTLY (100’s) less. The end result – wasted food (due to last minute ‘not eating’ decisions), and lost revenue. Unfortunately, both of these were benchmarks of my performance as director and our (food services’) overall image.
Breaking free from the “gig that was paying my bills”, took YEARS. I didn’t walk out of my internship and straight into being a ‘paleo dietitian’. The move to be ‘self-employed’ and do what I love took time, dedication, planning and saving my $$. Contrary to what you may all be thinking – this self-employment thing does not come with a guaranteed paycheck every two weeks, there’s no health insurance, no retirement plan and it will likely not result in early retirement. It’s scary and I am not ‘getting rich’ (food service management pays better) – but I am helping people get healthy and doing what I love. That is PRICELESS!
So, there you have the ‘long and short of it’. It may not be the answer that you were hoping for – but it is the reality. If the person signing your paycheck says pizza is a vegetable and ‘MyPlate’ is the answer then so be it for bill paying purposes. Do as much as you can to steer the current toward ‘real food’. Don’t ever give up and someday (hopefully very soon) – we’ll have more people believing that “Paleo is the Solution”.