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Nutrition Support Blog: Let me hear you say everything’s okay

Posted by SF8N at Jul 26, 2012 07:00 AM |
July 26, 2012
Nutrition Support Blog:  Let me hear you say everything’s okay

by Joe Krenitsky, MS, RD

There are certain “vintage” songs that just make me feel good when I hear them.  Almost in spite of myself, regardless of the extravagantly sweet lyrics, I will realize that I am singing along, feeling uplifted. Steve Forbert’s “Romeo’s Tune” comes to mind as an example:  http://www.youtube.com/watch?v=ixTXmKauL8A.  I know that I risk forfeiture of my “man card” for admitting it, but in my defense, I believe that those songs on the radio while growing up get imprinted and become a part of you.  Perhaps certain older songs also recall a time when I did not have adult cares and responsibilities.

I believe that certain “facts” that medical professionals learn in school get integrated into our being similar to old songs. We spend so much time memorizing, and certain factoids are repeated as truths so often, that people will cling to some old ideas long after they are proven untrue.  Albumin and prealbumin as markers of nutrition status, and protein restrictions for patients with hepatic failure come to mind as some obvious examples.

I also think that there is a type of comfort that comes from a time when all you had to do was memorize and repeat the “truths” given to you by authorities.  It is disquieting to have evidence-based medicine open Pandora’s Box, causing us to realize how much of what we learned was incorrect, and how little we actually know for sure.  It is not easy to let go of our “comfortable truths.”  Understandably, some people long for a simpler time, when they were just told what was true.  We have witnessed evaluations from statewide conferences where participants requested that presenters, “talk less about the studies and just tell us what to do.”

Unfortunately there is much more at stake when people cling to outdated medical ideas, compared to just being accused of having old-fashioned taste in music.  In the nutrition support arena I have seen patients grossly overfed or TPN used inappropriately, all because someone clung to dated (and disproven) notions. 

Certainly we have learned that it is absolutely essential to understand the details and limits of available data before you can hope to understand how to implement the latest data in practice.  Sometimes the only honest and unbiased presentation is one that admits to the limitations in current knowledge and outlines available research objectively.  My experience is that those presenters who offer definitive take home messages when the data is poor quality or mixed, are the ones we should look very closely at, and part of our evaluation should be asking if they have a vested interest or who is sponsoring the talk.

It might initially seem more satisfying to go home from a conference with some clear factoids, however, we really do need to hold ourselves to a higher standard.  At any rate, truth about current medical-nutrition therapy should certainly be more objective than choosing your favorite music, and your knowledge base in medical nutrition therapy should certainly be more current than my taste in music. 


“…Meet me in the middle of the day
Let me hear you say everything's okay
Let me see you smiling back at me …”

-"Romeo's Tune"  Steve Forbert, 1979



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