Cleaning for the House Cleaner

As a Registered Dietitian, I see diet diaries (a list of foods and amounts consumed over the past 3 days) from clients, both children and adults.  They reason they are referred to me or decide to see me is usually because they believe that their diet is not supporting proper health, or they are facing some medical issues that are diet related.  So when I receive a diet diary I expect to see some unhealthy foods and unhealthy quantities listed.  But this not usually what I receive.  I receive diets full of fruits, vegetables, salmon, whole wheat pasta, and non fat yogurt.

But these diet records don’t coincide with what I see in the grocery stores.  Stores would only sell what people are buying.  They will provide large quantities and choices of popular foods and smaller quantities and choices of less popular foods.  I live on an island in WA state.  The community here, about 20,000, is very educated and affluent.  Most people here have the ability to understand nutritional principals and the money to support optimal nutrition.  The parents here are all, at least on paper, supportive of proper nutrition for their children.  

No one that doesn’t live on this island comes here to grocery shop as the grocery stores are part of a national chain, so the same store is available everywhere.  Therefore I was really struck by what I see in the grocery store here.  As I walk in I see a bombardment of white flour/butter/sugar laden dessert foods, decorated in unnatural colors for Halloween.  Cakes, cookies and cupcakes, in non-recycleable plastic containers, and many with “decorative”  plastic Halloween doodahs (probably made in China) on these items. Adjacent, and similarly packaged are the “every day” selection of cookies, cakes, cinnamon rolls, brownies, and cupcakes. In addition to this there is the permanent bakery counter, and the inter-store rows of breakfast cereals, cakes, cookies, energy bars, snack or breakfast bars, crackers, chips, breads, and cake mixes, plus the frozen and refrigerator sections of more cakes, cookies, brownies, ice cream, ice cream novelties, and other frozen foods based on white flour.   The fresh fruit and vegetable section of the store takes up about one fifth of the total space.  So someone must be buying unhealthy foods, but WHO???

Is it possible that when I receive a diet diary the recorder has “cleaned up their act” for me, or perhaps given me what they know they should eat, not what they eat?  If so, perhaps they should just follow this diet diary.  Why see a dietitian when you know what to eat?  How can I help when you have, on paper, made the changes you know you should make?  It would be far better to be upfront so that I can help you to make changes that you know you can sustain over the long term, not for a three day diet diary.

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