January 2009 Issue

A Decade of Today’s Dietitian — Celebrating 10 Years of the Magazine for Nutrition Professionals
By Lindsey Getz
Today’s Dietitian
Vol. 11 No. 1 P. 28

Whether it’s fast food or premade meals in the frozen food section, fast and easy foods have only gained in popularity over the last several years. And fortunately, they’ve also become healthier.

In celebration of Today’s Dietitian’s 10th anniversary, let’s take a look back at a sampling of the major trends and hot topics of the last decade. The industry has certainly experienced some big changes over the years—even the role of the RD has come a long way.

For starters, there are many more career opportunities available today than there were just 10 years ago. Working in a hospital used to be the only path to follow after school, says Cynthia Sass, MPH, MA, RD, CSSD, of New York City. “For today’s dietitian, the nontraditional jobs in dietetics have really taken off,” she says. “Ten years ago, the majority of RDs worked in clinical settings. But today, we are entrepreneurial. Dietitians are in private practice and in specialties. I work for professional sports teams, but other dietitians have been hired by food companies, public relations firms, and beyond. The sky’s the limit.”

Cholesterol and Fat
Ten years ago, dietitians were still trying to understand fat and its impact on cholesterol. “I’ve been in the field approximately 15 years, and when I started out, we were not talking about all the types of fats and even fats within fats,” says Sass. “Now, we are breaking it down more than ever and realizing that certain types of fats might not be as bad as others. And as a result, we’re fine-tuning our idea of how certain fats impact cholesterol.”

In 2008, Today’s Dietitian elaborated on the recent trend toward focusing more on good fats and less on cutting back on all fats. But even as our understanding of fats is further dissected, confusion still remains—especially as new findings continually emerge. It’s no longer so cut and dried as fat is bad for you. “I’ve found the consumer is still very confused about fats,” notes Sass. “Just the other day, I was at Barnes & Noble and saw a magazine on the shelf with a headline that said, ‘Fat will make you thin.’ We’re starting to question how bad fat really is, especially knowing that natural fats are not as bad as man-made fats. But the relationship between fat and cholesterol is still very confusing to the consumer, and that means as dietitians, we really need to provide better education for the future.”

In addition, omega-3 fatty acids have come to the forefront for their effect on cardiovascular disease, inflammation, and brain and nerve health, adds Joanne Larsen, MS, RD, LD, of Ask the Dietitian (www.dietitian.com). “The importance of eating fatty fish like salmon, tuna, and mackerel twice a week is now encouraged for omega-3s,” she says.

Convenience Foods
Whether it’s fast food or premade meals in the frozen food section, fast and easy foods have only gained popularity over the last several years. And fortunately, they’ve also become healthier. In 2002, we reported on some of the healthy fast-food options that were emerging among chains. The average consumer wanted choices that were quick and convenient but wouldn’t ruin their diet.

Today, almost every fast-food chain offers salads, bottled water, grilled options, and even items such as yogurt or apple slices. “I feel really confident in my counseling now that even my clients who eat out pretty regularly can find a healthy choice,” says Suzanne Farrell, MS, RD, a spokesperson for the American Dietetic Association who is in private practice in Denver. “And restaurants have become more helpful in letting people make substitutions or offering healthy sides. It’s definitely gotten easier counseling people who eat out.”

Many consumers are seeking convenience at the grocery store, too, and the options are plentiful. “The frozen-food aisle is no longer just an aisle; it’s a whole section or a number of aisles,” says Julie Albrecht, PhD, RD, a professor and an extension food specialist in the department of nutrition and health sciences at the University of Nebraska-Lincoln. “That explosion has really happened in the last 10 years.”

“Time is an issue, and consumers want fast, convenient foods,” adds Sass. “Luckily, there are healthy grocery store options that are still quick, like bagged salad greens or stir-fries.”

Toward the end of 2008, the Centers for Disease Control and Prevention (CDC) released its first-ever state-by-state review of new diagnoses and found that in the last 10 years, the rate of new diabetes cases has nearly doubled in the United States, with the highest levels occurring in the South. Of those cases, approximately 90% are type 2 diabetes, which is linked to obesity. “There are a number of reasons for this,” suggests Theresa Garnero, APRN, BC-ADM, MSN, CDE, a diabetes educator. “Our diets certainly aren’t better than they were 10 years ago, and we’re probably moving our bodies less, too. Consequently, our waistlines are getting bigger. And if you’re carrying extra fat around your midsection, you’re at a higher risk for diabetes.”

In 10 years, technology and research has come a long way. In 2000, Today’s Dietitian reported that inhaled insulin may make “skin pricks a thing of the past by the year 2001.” We predicted: “On the horizon is inhaled insulin, which could be a welcome relief for these diabetics.” Ironically, however, inhaled insulin was just recently pulled from the market. “While a lot of people do have a fear over the needle, it still flopped,” says Garnero. “It was way too complicated, and patients didn’t like it.”

Despite the advances, some suggest all of the options available just complicate things for patients. “In the last 10 years, we’ve seen a flood of a new classification of drugs, but there have not necessarily been better outcomes,” adds Garnero. “The more choices we have, the more difficult it seems for patients to manage. That’s why we’ve shifted today’s focus to self-care behaviors.”

Disease Prevention
In 2000, we revealed a budding trend of dietitians and research investigating “functional foods” (ie, medicinal foods) but cautioned that consumers needed more education on the subject. Over the next few years, the term became more common and, in 2003, we reported: “In general, eating an array of whole foods may be one of the best strategies for disease prevention.”

“When I first started out as a registered dietitian, the focus was on weight management and what foods to avoid,” recalls Farrell. “I love the research on functional foods and the shift to talking about what foods people should be eating. Whether it’s probiotics in yogurt or drinking more green tea, the focus is now on foods that can have a preventative effect. I find that’s a very useful counseling tool.”

Food Safety
Food safety is one of those issues that has continually waxed and waned over the last 10 years, depending on when there was an outbreak. In 1999, Today’s Dietitian revealed that at least 60 illnesses in 12 states had been caused by a rare strain of the bacterium Listeria monocytogenes, serotype 4b. In 2002, we reported that food-borne illnesses had once again become a major health issue. Three years later, we voiced the need for better food safety policies, and, in 2008, we published a feature on the largest beef recall in U.S. history.

“I still don’t think enough is being done today to prevent food safety issues,” says Beve Kindblade, MS, RD, CD, who is in private practice in Seattle. “Even after 10 years, the regulations on food handling are not stringent enough. Coupled with the fact that people are eating out more than ever means we are seeing a lot of cases of food poisoning. There needs to be a national standard instead of having each state or county mandate the rules.”

And more than ever before, food safety has become an issue for produce, says Albrecht. “Two major outbreaks in just the last year included spinach and what was finally linked back to peppers [though it was originally thought to be tomatoes],” she says. “It may be linked to the fact that the amount we consume has increased and the fact that there is a demand for variety, so we are getting our produce from further distances.”

Tainted food from China is also a concern. Frequent media coverage of this issue has led the public to be wary of what they eat. “People are looking at where their food comes from and then linking that back to safety,” adds Sass. “I have never seen this before in my years as a dietitian. People are not only looking at the ingredients, but they want to know specifically where their food came from.”

Going Green
In 2002 and 2003, we featured articles on farming and the rise of organic foods, as more consumers were beginning to show interest in local, fresh, whole foods. While going green isn’t exactly a new concept, what is new is that the trend toward eating local and organic foods has gone mainstream. “Natural and organic foods is a huge topic today,” notes Sass. “The interest in clean, pure food has been phenomenal, and I’m shocked that it’s happened so quickly. It’s only been about five years since it really made it onto consumers’ radar and, in the last year or two, it has just exploded.”

“It’s been really exciting,” adds Kindblade. “There has become a real awareness about trying to eat more locally grown foods and support more area farmers.”

Internet Age
In 1999, we found ourselves on the brink of a new century, and with it came a lot of fear. We published a feature on preparing for Y2K, writing: “As the new century dawns, hospital information systems may make errors in ordering and calculating, and may even lose medical records altogether … kidney dialysis machines may shut down automatically…” It was a time of the unknown, and many people were frightened, with some going as far as stockpiling food and bunking in the basement as the clock ticked to midnight on January 1, 2000. Of course, we know now that, essentially, nothing happened. There were some minor computer glitches but no major failures and certainly nothing that would have amounted to the catastrophic event many believed was imminent.

Still, some see this year as an ushering into the true Internet Age, where we got over the fear of computers, those who hadn’t already embraced them. In 1999, we quoted Larsen: “If you don’t join the cyber revolution, you will be left behind.” That was really so true, she reflects today. Larsen was ahead of the game, having launched her Web site in July 1995 when the only nutrition-themed Web sites were created by the government. Today, so much has changed. “More dietitians have embraced technology with their own Web sites, blogs, and social networking videos,” says Larsen. “Dietitians realize the value of having an online presence for their business, products for sale, and private practices. And almost all dietitians now use e-mail and the Internet daily to keep in touch with colleagues and patients.”

In the last 10 years, vegetarianism has moved from the fringe to a lifestyle and green environmental choice, says Larsen. “The number of vegetarian foods has exploded, with the versatile soybean as the primary protein source,” she adds.

Years ago, there were fewer vegetarians, and some may have considered eliminating meat from the diet a strange lifestyle choice. It was harder to get a vegetarian alternative at events, on airlines, and sometimes even at restaurants. But today it’s a standard, and being a vegetarian has become practically commonplace. One contributing factor may be that the research has shown you can still meet all of your dietary needs as a vegetarian, suggests Farrell. “And you can carry a healthy pregnancy as a vegetarian, too. These were things that people weren’t sure about in the past.”

The field of dietetics has certainly come a long way and seen many changes in the last decade. It’s difficult to even imagine where we’ll be another 10 years from now. With so many new advances and the always-evolving technology with which we’re presented, there’s no doubt the industry has a bright future. The sky continues to be the limit!

— Lindsey Getz is a freelance writer based in Royersford, Pa.

In the Last 10 Years…
Wondering where the last 10 years went—and how they went by so quickly? Here’s a little refresher with an overview of some key happenings.

1999: Clinton impeachment trial; New York hosts Woodstock reunion; Lance Armstrong wins his first Tour de France; Boris Yeltsin resigns as president of Russia (Prime Minister Vladimir Putin takes over); Columbine school shooting; Y2K scares abound

2000: St. Louis Rams win the NFL Championship for the first time since 1951; Microsoft releases Windows 2000; U.S. Supreme Court stops the Florida presidential recount, and George W. Bush wins the presidency; Billy Crystal hosts the Oscars

2001: On September 11, nearly 3,000 people are killed in attacks on the World Trade Center, the Pentagon, and the plane brought down in Shanksville, Pa.; anthrax attacks begin with letters mailed from Princeton, N.J., to various media outlets; first self-contained artificial heart is implanted; singer Aaliyah dies in small plane crash; Gladiator wins best picture Oscar

2002: Hit show American Idol debuts; Euro bills and coins are issued; No Child Left Behind Act is signed into law; Wall Street Journal reporter Daniel Pearl is kidnapped in Pakistan; U.S. Airways and United Airlines declare bankruptcy

2003: Invasion of Iraq; Saddam Hussein is captured; space shuttle Columbia explodes; Arnold Schwarzenegger is elected California governor; Finding Nemo grosses about $340 million; The Da Vinci Code is published; Bob Hope passes away

2004: Ronald Reagan passes away; tsunami kills roughly 200,000 in Asia; John Kerry secures Democratic presidential nomination; Smarty Jones wins Kentucky Derby; Martha Stewart sentenced to several months in prison; Fahrenheit 9/11 becomes a controversial hit; Janet Jackson creates wardrobe malfunction scandal; Bush reelected president

2005: Terrorist attacks in London; Terri Schiavo case becomes national news; Hurricane Katrina leaves millions homeless and more than 1,000 dead; Live 8 concert takes place in nine countries; Brad Pitt and Angelina Jolie admit their relationship; Brokeback Mountain becomes box office hit; Tom Cruise and Katie Holmes’ engagement leads to publicity not seen since Ben Affleck and Jennifer Lopez

2006: North Korea test fires missiles; Saddam Hussein hanged (cell phone video of hanging released publicly); FDA approves Gardasil vaccine; Steve Irwin, the Crocodile Hunter, killed during filming; Crash wins best picture Oscar

2007: Gordon Brown replaces Tony Blair as prime minister of Great Britain; California Democrat Nancy Pelosi becomes first woman appointed as speaker of the house; Lewis “Scooter” Libby found guilty of lying to FBI agents and a grand jury; Karl Rove resigns

2008: New York Gov Eliot Spitzer admits involvement in prostitution ring; Olympic torch relay draws protests; Sen Edward Kennedy diagnosed with brain tumor; earthquake in China kills thousands; polar bear designated as “threatened” species; Michael Phelps sets record by winning eight gold medals in the Olympics; Illinois Sen Barack Obama becomes president-elect