Family Medicine Vital Signs

By Susan Saffel-Shrier, M.S., R.D., C.D

Hey, did you celebrate the holiday on January 17^th? No, it was not Martin Luther King Holiday. That was January 18th. And it’s not Presidents’ Day either. That’s February 15th.  January 17^th is a little known holiday called Ditch New Year’s Resolution Day. Sound familiar? Did you know that approximately 85% of Americans make a New Year’s resolution and that most of the well- intended ditch them within 6 weeks? Unfortunately, these statistics seem to repeat themselves every year. I personally seem to make a resolve to eat more fruits and particularly vegetables at this time of year. With the farmer’s markets past history, the standard grocery store fair looks a little pale. But don’t get me wrong, we are most fortunate to have access to produce from around the world throughout the year.

OK, forget the fruits and veggies for now. The real issue is why don’t we keep our resolutions?  More importantly, what can we share with our patients to help them succeed? The idea of addressing motivation when discussing lifestyle change is well recognized. The art of the discussion is another. Physicians have been found to do a great job in the assessing and advising aspects of motivational change but not so good with the agreeing, arranging and assisting process of the 5 A’s of lifestyle change. I think it has a lot to do with visit time. We all know the time with patients is limited and we need to be efficient. I think most of us would acknowledge that the agreeing (identifying barriers) and assisting/arranging (self-monitoring/referrals) takes time that just might not exist. Sounds like a reasonable observation to me. So maybe a team approach might just be the answer. My opinion is to continue to have family physicians continue doing what works well as they are typically the first healthcare contact, asking and advising. From there, the patient can be referred to healthcare professionals that can address the later 3 steps of the 5 A’s of lifestyle change. These last 3 A’s are where the “rubber meets the road”. It is also the later 3 steps that can make or break a resolution. The chances of success are highly depended on teasing out barriers to success. It is with troubleshooting that one can become prepared to respond effectively to challenges  that influence success. Finally, we all need to practice this process ourselves so we can share insights to goal setting and positive lifestyle change.

So back to my fruits and veggies. As I alluded to, I don’t find fruits and veggies very tasty in the middle of winter. I tried a lot of different ideas to improve my intake and came up with one that has worked for me. I make veggie laden soups. Yes, there nutritional value is not as high as fresh produce but there is no nutritional value to a food uneaten. It’s my compromise that has led to a successful resolution!  I now have created quite a repertoire of delicious soup recipes that I can enjoy all winter. Have you read the research showing that soups can help manage your weight? Another good story as well.

Susan Saffel-Shrier, M.S., R.D., C.D., is a registered dietician and certified gerontologist, and currently serves as Associate Professor in the Department of Family and Preventive Medicine  at the University of Utah School of Medicine.