Dieticians Class 46

January 10

We will start with the American Thanksgiving and read some of the texts. If time allows, we will watch a Jamie Oliver episode (see link below) and/or do sporcle: Kitchen untensils.

Last meeting for 2023: November 8

We continued with Tim Spector’s Spoonfed: Why almost everything we’ve been told about food is wrong. We also watched the TedEd talk Why do people fear the wrong things?

The original plan was to have two meetings in November. On November 2nd, I wanted to start with food and cooking and show you some traditional Thanksgiving dishes with an ethnic twist. If you have the time, take a look yourself at The American Thanksgiving. 15 American families with different ethnic backgrounds share special things they prepare on Thanksgiving that reflect on their individual family background. (Update: Unfortunately, the videos seem to have been taken down, they are no longer available. The texts are still worth reading, though. And we will read some of them.)

We will meet again in January and add the cancelled November meeting on January 17th. We could do the Thanksgiving topic on January 10th; even if Thanksgiving is over by then, the food is still interesting. I personally believe that supporting the tradition of cooking and enjoying food is the best way to counteract many of the food related diseases people have developed over the last decades. Though the problems are much more severe in the US than in Germany, many Germans also seemed to have lost the culture of cooking.

Warm-up for cooking topic: (9) Pick the Kitchen Utensil Quiz (sporcle.com)

Addition: “Nutritional Counselling Becomes Part of Hospital Care” is a series of youtube videos also worth looking into.

August to September

August, 16th, 2023

We had a long break of two months. We started with a Guardian Weekly lesson on 10 common health beliefs and what ‘truth’ is behind them i.e. what does scientific research say about each one of them. One of the most important questions in this context is the difference between beliefs and facts. What is a ‘fact’?

Here, the concept of confirmation bias is interesting. Confirmation bias describes the human tendency to notice those claims that confirm our assumptions and disregard or neglect those that contradict what we believe to be true.

None of us is able to be completely neutral or ‘objective’. So how do we decide that something claimed is true? How do we know if a source is credible? We also need to be aware that what we believe to be true or a ‘fact’ today can always change.

Below are the ten claims we started talking about.

10 Health beliefs – or facts?

  1. Lifting weights will give you big muscles.
  2. Breakfast is the most important meal of the day.
  3. You should walk 10 000 steps a day.
  4. You need eight hours of sleep.
  5. You should try to eat five portions of fruits and vegetable a day.
  6. You need to drink two litres of water a day.
  7. A daily glass of wine is better than not drinking.
  8. Certain exercises will give you a six-pack.
  9. Dieting will slow your metabolism.
  10. Red meat is bad for you.

See also: Top 5 common health myths debunked (medicalnewstoday.com)

30th August

After finishing with the Guardian text – including some vocabulary practice – we looked at the short Ted Ed video on eating disorders: Why are eating disorders so hard to treat? – Anees Bahji | TED-Ed

We started going through the transcript to clarify vocabulary and will continue with that on September 6th.

September 6

Topics we still need to look into are, for one, diet related diseases. Here, out of lack of time, we will focus on diabetes 2 and watch Dr. Berg’s video in which he explains insulin resistance in simple terms. And, secondly, we will watch and listen to Dr Jason Fung explaining insulin resistance. I have prepared some pre-listening questions we will go through before watching and discussing the videos.

A second, slightly shorter video by Dr. Eric Berg on How Insulin Works you find under this link. Dr Eric Berg’s biographical background you find here. Dr Jason Fung is a nephrologist who has come to specialize on the treatment of diabetes 2 after he obeserved that many of his patients with kidney problems also suffered from diabetes type 2. You find links to his books under the resource page for nutrition, health and diet. He has successfully treated many patients with diabetes 2.

Also interesting is Dr Christopher Gardener (and slightly shorter): Understanding Insulin Resistance.

September 13, 20 and 27

We started watching videos explaining insulin resistance. We listened to Dr Berg’s explanation and tried to clarify some questions we had concerning his explanation – e.g. did he confuse hypoglycemia and hyperglycemia.

We continued with the topic of Insulin Resistance on the 20th and watched Dr Jason Fung’s video on the same topic. We compared the two and you all agreed that you preferred Dr Fung’s explanation.

The reason for watching these various different approaches to explaining insulin resistance and diabetes is to find ways how to best explain these conditions to patients seeking advice who do NOT understand or do not have the educational background to understand what is possibly going on in their bodies when they are overweight or obese. And, in addition, to find ways to explain why a dietary change might be necessary and advisable if they want to become healthier or prevent worse conditions, like diabetes, from developing.

On the 27th we started reading passages from Tim Spector’s book Spoonfed: Why almost everything we’ve been told about food is wrong. We will have a longer break again. I handed out chapter 1 for reading during the break. In class, we started explaining some of the unknown vocabulary. We will continue with Spoonfed in November.

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A second complex, related to the one above, is dietary consultation. Here I would also propose to listen to some examples and try to decide together on the quality of the advice. Also interesting in this context could be the text US eating disorder helpline takes down AI chatbot over harmful advice | Artificial intelligence (AI) | The Guardian

If time allows, we should listen to Marion Nestle‘s talk on ‘Who makes our food choices‘. Her talk relates to the US, but several aspects of what she describes will relate to a German context as well. Food choices and food production have a huge political dimension beyond individual health issues:

The sustainable diet plan that includes meat and dairy – Positive News

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As an introductory video to weight loss/gain watch Dr. Jason Fung (‘A Beginner’s Guide to Weight Loss’), who speaks very slowly and clearly. All his videos are recommendable as are his two books The Diabetes Code and The Obesity Code.

A beginning for the topic Nutrition Counselling.

Links to some videos – if you type the keywords ‘nutrition counselling’ into your browser and go to ‘videos’, you will find loads of them. Take a look, listen to as many as you can and decide for yourself, which ones you find well-structured and helpful, which ones not.

A podcast about how to structure a nutrition counselling session

In the context of dietary advice, Dr Attia’s explanation of what cholesterol is and does in The Truth About Dietary Cholesterol is worth listening to as many dieticians and doctors still advise against eating foods rich in cholesterol and statins are still widely prescribed to artificially lower blood cholesterol.

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Februar to June 2023

February 8th is our first meeting. As always, we will spend this session with getting to know each other and looking at the course description that has a page of its own.

Course description

Food image 1 (fruit and vegetables)

Food image 2 (meat and dairy)

Food Pictogram (Sporcle)

Foods and Drinks in Movies (good fun if you know your way around some ‘classics’ – we will try this on in our third meeting)

Can you name the ingredients in a full English breakfast?

Link to my Sporcle post where you find more quizzes further down the list under Health and Health, Body parts etc.

Examples of TED Ed videos:

Can you lose weight fast?

Myths you learned in health class This one refers to an American context. Did you have health education in school?

And below a text on a generally recommendable approach to learning languages:

How languages are learned

After class comments:

We spoke about your English learning background and the English speaking places you visited. Some also told us what they watch on Netflix. I will show you more short things you can watch like TED talks, here especially TED Ed videos that are only around five minutes long.

I would suggest going in loops: looking at basic vocabulary first, then going to more advanced topics and back to basics – circling around the issues of food and health, and diets and disease. By these two complexes I mean, on the one hand, food in general in its relation to health: what is generally considered to be healthy eating, and how have ideas and concepts of what is considered healthy/unhelthy changed over time. This issue includes the history of different food cultures and traditions, e.g. different cuisines.

The other topic complex – diets and disease – relates to specific concepts regarding what kind of foods are recommended (by ???) to treat different health conditions. Recipes and cooking are related to both themes.

We had a tiny little discussion (that could become a wider one) on low-fat dairy. If I understood Frau Nothacker correctly, low-fat dairy is used when cooking for cardio-patients – maybe you can try to explain that in more detail some time. For this we will need to prepare and practice more vocabulary.

I found a study connected to this topic, or actually ABOUT it. It is a genuine research study summarized by Dr. Jason Fung in a 13 minute video in which he makes sure to speak quite slowly and comprehensibly. I would not want to deal with the whole text, but write out some passages from the summary and conclusion before listening to the video.

(You find books and resources by Jason Fung under the respective page on further resources and literature.)

Second meeting

We summarized what we had talked about in our last meeting and then continued with food vocabulary. Next week I will start with some body vocabulary and give you a few tasks for the four weeks break. In addition, I will post some things here for you to look at.

So come here preferably at least once a week and try out some of the things you find here. For example, do some of the sporcle quizzes if the ads don’t bother you too much and basically, enjoy and have some fun.

Third meeting and further activities for four week break

We started with body parts/anatomy vocabulary. As a review or additional exercise please answer the quiz questions on the extra copy I gave you.

We watched the TED ED video  How the Digestive System works. This one is very short, but good practice for those of you whose English level is not so advanced. Please go there again, watch and listen. (The additional exercises you can only do if you register as this service is not for free. I’ve done that now, so we can look at them together.)

There are more videos that you can look at. During our break, try to do at least one a week, more if possible.

You find quite a selection on HEALTH on the TED Ed site, go there and choose anything you like. And if you find something interesting, you can tell us when we meet again.

In our third meeting, we also spoke briefly about obesity and diabetes and we tried to clarify what is meant by the obesity epidemic. Those interested: try to find out if the upward curve is still climbing in countries like the US, UK or Germany. And what doctors and nutritionists say the reasons are for the development of the last 50+ years.

You pointed out that diabetes is not only a disease of the obese, though the correlation is strong. However, people of ‘normal’ body weight can also become diabetic. A TED TALK tip for those of you who are more advanced: Dr Peter Attia’s Ted talk on this topic. He get’s a little sentimentally sad at the end, still what he says is interesting and important. In addition, if you want to check out more TED talks, look at the resources page.

I gave you an exercise sheet for reviewing food vocabulary, this and the other copy mentioned above is your ‘official’ homework.

All else are tips and ideas for further practice. For example what you find under the link below.

Alternative sources for practice (of the things/vocabulary we have done so far):

CIZ Anatomy Zone 

5 Most Important Organs in the Human Body – Kenhub

From here you might see a link to Sam Webster’s 20 minute demonstration of human anatomy (interesting British accent, not sure where he comes from).

Things for later meetings

Diabetes and the Body This video is recommendable for developing your language skills. The visualization is quite amazing. However, there is a marked difference between the videos and/or information provided here and those by Dr Eric Berg, Dr Jason Fung and similar professionals.

Sporcle quiz on Dietician terms (Challenging; we will do this in our fourth meeting, feel free to check before. See how much you already now, we will do the quiz again at end of our course.)

My notes for further later activities: Take a look at TED ED ‘Myths you learned in health class’ after or before text exercise on Common Body Myths

Text work based on Newsweek article Five Healthy Habits

It could also be interesting to take a closer look at the work of Dr Marion Nestle, Professor Emeritus and expert on nutrition and food politics. Listen to her talk where she explains the contradictions between the food recommendations made in dietary guidelines and the politics of subsidies: agricultural produce not recommended, but highly subsidized by the government and overproduced by industrial farming. These products are mainly used by the food industry for highly processed products, aggressively advertized to the American public; products that are considered responsible for the increase in obesity, diabetes and other deceases that have been on the rise in the last decades.

Some additional Sporcles

Food cubes

Food in nature

Body related quizzes 

Body parts in pictograms 

Name parts of digestive system 

Pop quiz anatomy 

Anatomy of the brain 

Match the body parts to the right category 

Body parts starting with L (advanced)

Some additional things to watch

BBC Reel on Food

The truth behind your favourite flavours

Meeting June, 7th

June, 2023 (two sessions)

We described the image above for food vocabulary revision and started with some more intensive text work. We read and discussed a passage from Dr. Andrew Jenkinson’s book Why We Eat (too) Much:

My Typical Patient’s Story

I would like to finish Part One of the book by focusing on what happens to a typical patient of mine. This story is an amalgamation of the hundreds of interviews that I have had with patients in my clinic over the last decade. Most of the stories are quite similar, so it is easy to summarize their struggles with obesity over the years, and then explain everything in terms of metabology. My typical patient is female (80 per cent of patients undergoing bariatric surgery are female). She is in her forties and describes several members of her family who are also suffering with obesity (as we learned, 75 per cent of someone’s size is predetermined by genetics). She has been obese or overweight since her schooldays and says that the school nurse was the first person to put her on a low-calorie diet. The diet worked transiently and she lost some weight; however, after a few weeks her metabolism caught up with, and adapted to, her low-calorie intake. Eventually, despite complying with the diet, she found that she was not losing any more weight as her metabolism matched her calorie intake. She felt tired and hungry and irritable and could not concentrate at school. After no more weight loss she decided to stop the diet as it was not working any more. It is at this point that she started putting the weight back on rapidly, as her low metabolism and voracious appetite helped her body regain its desired weight set-point.

She was worried that when she regained her weight it did not settle again at its previous level; on the contrary, she ended up with an even greater weight than before the diet. Her subconscious brain had calculated that she now lived in an environment where food was not predictable and therefore there could be another famine (or diet) around the corner. It is for this reason that her weight set-point now shifted upwards.

As the years went by, our typical patient tried all the different types of diet on offer (she mentions Slimming World, LighterLife, the South Beach diet, the red and green diet, the cabbage soup diet, Rosemary Conley … the list goes on). The diets are all different, but for our patient the result was usually the same: transient limited weight loss, followed by metabolic adaptation to the diet and a decision to stop it; then weight regain, and after each of the diets a new higher weight set-point.

Eventually our patient reaches a level of obesity where her fat cells cause an inflammatory reaction in her body. The inflammation stimulates insulin resistance, leading to an increased insulin level, and the higher insulin then causes the dreaded leptin resistance. A combination of the evolving leptin resistance and the legacy of previous dieting on her appetite (increased) and satiety (decreased) hormones means that the struggle with her weight gets more difficult the bigger she gets and the more she tries to diet.

This is a typical recurring story of initially successful diets, then weight regain, followed by yo-yo weight fluctuation through the years and, despite the constant conscious battle to diet, an inexorable rise in weight until serious end-stage obesity is reached. It is only at this point, after years of effort and sacrifice, after years of receiving the wrong advice from doctors and dieticians, after years of being misled by the food industry into the health benefits of bad foods, that my typical patient will tearfully admit to failure and blame herself for it. Finally, she will give up on her fight with obesity: many battles have been fought, but the war has been lost. The subconscious brain has won.

We have seen that you can’t fight against your weight set-point by dieting – the only way to beat it is to understand it. We now know how the set-point works to keep your weight at a desired predetermined level, even if you are over-eating or under-eating. And we are now aware, from chapter 2, of the genetic and epigenetic factors involved in set-point calculation. But obesity, even in those people who are genetically primed for it, is not triggered until you are exposed to an obesogenic environment. In Part Two, we will learn how humans came to construct an environment so unsuited to them.

Jenkinson, Andrew. Why We Eat (Too Much): The New Science of Appetite (English Edition) (S.107). Penguin Books Ltd. Kindle-Version.

We listened to and talked about the BBC Reel video on our favorite flavours.