For anyone that’s lived in Egypt for any length of time it will come as no surprise that the quality of the professionals giving dietary advice can vary tremendously. I’ve written before about the lack of oversight of the profession and the fact that most people working as nutritionists/dietitians have little formal training (at least nothing close to what would be considered standard in more developed countries).
As such, it is equally unsurprising that many common practices of nutrition professionals in Egypt are riddled with flaws. One such practice that I find particularly problematic is providing clients with menus of certain calorie levels. On the surface this may not seem like such a terrible idea (and perhaps that’s true in the right context), but the way the practice is being implemented is frankly archaic and largely ineffective.
What I’ve gleaned is that typically most appointments with nutritionists consist of little more than a 30 minute meeting where an appropriate calorie level for the client is determined. Clients are then provided a menu that they are expected to follow. There is little discussion about preference, food knowledge, allergies/intolerances, etc. Basically if you want to achieve your goals, be that weight loss/gain, or to eat healthier, just follow the menu. What’s also concerning is that if upon their return visit clients haven’t met their predetermined targets, the nutritionist blames the client for not following the menu properly.
Here’s a few reasons why you’ll never see me provide my clients with a generic menu to follow.
- Sustainable change is made through small, incremental adjustments. It’s been demonstrated time and again that diets don’t work because people are unable to stick with them for the long term. Part of this is because most diets are a huge deviation from what people are currently eating. I would much rather start with the patient’s existing diet/eating pattern and make adjustments from there instead of basically telling them to scrap everything and start fresh.
- Diets need to be customized to the individual. And by customized, I mean much more than just figuring out what an appropriate level of calories is for someone. What about that person’s food preferences? Do they have allergies/intolerances? Are they even familiar with the foods that are included on the menu? Without taking these factors into account, you’re just asking for failure.
- Portion distortion. Individuals consistently underestimate their portion sizes. Even if the menus include exact quantities, unless there have been instructions for weighing/measuring all foods (which can be incredibly tedious), chances are the clients will serve themselves more than they should. This is not necessarily the fault of the client as societal norms and food marketing have distorted how big portions should really be.
- Life happens. Another reason why diets fail is that they are often too rigid. Life doesn’t follow a menu. It can be demoralizing when you’re expected to follow a menu diligently and for various reasons, it’s just not possible (ie. family/social gatherings, celebrations, etc.). Unfortunately life happens and strict adherence to a menu is not always going to be your top priority. And that’s okay. I’d much rather teach my clients how to make the best choices they can, instead of expecting them to be perfect all the time.
At the end of the day, I want my clients to be successful. Expecting them to strictly adhere to a menu that hasn’t been customized to meet their needs is far from the best way to do this. If menus like this worked, there’d be no need for people like me to provide dietary counselling at all – just hop online and find the right menu for you. Unfortunately, things are a little more complicated than that, and the faster my fellow Egyptian colleagues recognize this, the healthier (and more successful) their clients will be.