July 5, 2008

Speaking With...: Milton Stokes

Milton Stokes, MPH, RD, CDN is the owner of One Source Nutrition, offering a variety of private counseling and media consulting services.

He is also an American Dietetic Association National Media Spokesperson who has been featured in a plethora of publications, including Self, Cooking Light, Men’s Health, Fitness, and the New York Daily News.

I first met Mr. Stokes in January of 2007 when he served as an adjunct professor for New York University’s Department of Nutrition, Food Studies, and Public Health.

He is an intelligent, sharp, and charismatic entrepreneur who is a wonderful asset to the field of nutrition and dietetics and communicates his nutrition knowledge in a most effective manner.

On with the interview:

What shifts, if any, have you noticed with your clients over the past decade? Is nutrition education really more widespread?

Most people come to my office well-educated on nutrition and health.

They develop admirable knowledge from websites, like anything associated with NIH.gov, and certain consumer publications, like Eating Well and Cooking Light. Clients know all about MyPyramid and reading food labels. So it's not a knowledge gap.

Instead, the problem is that gray area of disconnect, that missing spark to motivate clients to implement their knowledge.

A lot of what we do in the practice is boost a client's self-efficacy. We simply point out "You say you want to achieve health, but you continue with this behavior."

From there we proceed by encouraging them to start with a specific change today or this week. Showing clients we believe they can do it helps enhance their sense of self belief, which is what self efficacy is all about.

What do you perceive as two of the most important behavioral modification changes people who are looking to lose weight can do?

Step one is getting proof of what a client's eating and drinking. Proof in the form of a simple food journal. It's amazing what a difference seeing food consumption on paper really makes. Subtle, but significant, patterns start to emerge.

Usually those patterns are enough to guide future work with the client. We work with eating disorders mostly, and as I said earlier, our patients are extremely educated in nutrition. But they do things, like sabotage themselves with unhealthy environments at home.

Premium ice cream and other binge foods don't crawl into the kitchen without help. With exercise, owning a treadmill is a good start, but you can't use it as a wardrobe station in the basement. Take those clothes off of it--or whatever items reside there--and have it ready.

This leads me to the next tip: plan. If you don't plan to exercise, you probably won't. Your sneakers and workout clothes won't magically appear if you don't take them out. Furthermore, take them with you in the morning. After work it's a little easier to get to the gym when you don't have to come home to change.

Once home, it's like pulling teeth to go back out. Home has dishes to be done, laundry to fold, mail to open, and so forth. Those are common distractions that become excuses. So I say bypass those and do the exercise first.

Planning is applicable to food as well.

Do most of your clients share a common obstacle/hurdle in reaching their health/nutrition/weight goals?

We see mostly females in our practice. And the adult women tend to prioritize everything but their health.

For one of many examples: They shop for food, they cook the food, and they clean up after it's all over. I say, "Hold up, why can't you farm out some of this work?" Give the list to your spouse; assign your 10-year-old the task of tearing lettuce for the salads and setting the table; each person clears his own dishes and loads the washer.

That the woman has to do all this is really old fashioned. And it's a common barrier to putting health first. If you aren't healthy, how can you take care of your family?

Finding ways to earn back 5 minutes here, 5 minutes there will add up. Soon you're at 20 minutes, which is enough for a brisk walk and some alone time to clear your head.

Are there two or three popular nutrition myths that most of your clients have interpreted as "truth"?

Eating breakfast makes me gain weight.

Stop eating after 6 pm or all the food turns to fat. But digested food isn't like Cinderella's carriage: at the stroke of midnight (or whatever time) it doesn't turn into a pumpkin....or into fat.

Holy grail of nutrition and feeding is some secret or mystical concoction. What's the minute, teeny tiniest thing I'm missing to make me whole?

Exogenous digestive enzymes....we would've died out ages ago.

As a nutrition educator, are there certain inaccurate messages in the mainstream media regarding nutrition that especially frustrate you?

In general, a lot of marketing jumps the gun on real benefits of specific nutrients or foods. This promotes adult food jags of sorts.

One day dried plums or blueberries or tomatoes are the rage. The next, it's some hideously bitter juice designed to extend life by 7 years.

Then just a pill crammed with all the nutrition of 10 fruits and vegetables. There is no secret or miracle to losing weight or preventing disease. Eating real food does the trick--but that message isn't sexy or provocative or profitable.

Having said that, let me also pause to recognize the work of researchers.

Nutrition is an evolving science, so what we know today may change tomorrow as research is completed. And that's okay. There's nothing wrong with continuing to pursue new findings.

I do wonder, though, what would become of human health if we diverted some of those research dollars to subsidize fruits, vegetables and whole grains? We know that eating this way works. Do we need more research, or can we go ahead and pay farmers with research dollars to deliver their products to all neighborhoods?

People could go to market several times a week, or whenever, and stock up. Farmers could be paid to go door-to-door. Consumers wouldn't pay a thing.

What particular direction would you like the nutrition field to embark in over the next 10 - 15 years?

Stop putting everything under a therapeutic microscope.

Stop hanging on the latest research finding that says a certain micronutrient might do this or might do that. Nobody eats solo nutritients. Clients tire themselves by getting carried away over headlines without understanding the full scope of the study.

Studies isolate single nutrients without considering synergy or total nutrient packages in whole food. This relates to what we talked about earlier: the message to eat more fruits and vegetables isn't glamorous or trendy.

I am concerned with incessant food scares over pathogens and improper food handling.

I'd like to see nutrition researchers partnering with sleep experts. Who isn't sleep deprived? Without enough sleep we know it's quite difficult to lose weight, and you're more likely to reward yourself with high-carbohydrate foods as way to feel better.

Vitamin D [is another subject that we need to look into further].

I might get in trouble for this, but we may have missed out on the opportunity to consider low-carb diets. First of all, I believe no single diet fits every person. I also believe low-fat isn't necessarily top dog.

Researchers, like Jeff Volek, have shown low-carb diets promote fat loss, preserve lean muscle mass, and improve lipid profiles. Am I saying we all need to eat low-carb? No. But we could let the scientific process show us what low-carb eating can do.

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A huge thank you to Milton for participating in this interview.

If you enjoyed this interview, be sure to visit his new blog for more information and tips.


David Brown said...

Glad to see Milton Stokes is familiar with Jeff Volek's work.

Kristy said...

It is great to see a dietitian publicly acknowledge the potential benefits of “low” (or reduced) carbohydrate eating plans. I think the dietetic profession has done an enormous disservice to itself by ignoring the benefits that these plans can have for *some* people and simply toting the party line of “eat more whole grains”. Whole or not, eating plans with a typical distribution of 50-60% carbohydrate are not for everyone. Dietitians as a profession have simply ignored (or dismissed) the ever-emerging body of scientific evidence demonstrating the effectiveness of reducing carbohydrates for weight loss and in improving blood lipids and blood glucose levels. It is a shame because they are supposed to be health professionals whose practice is based on scientific evidence. Just because you don't like what the evidence is showing you doesn't mean you should pretend it does not exist. That is neither professional nor helpful to clients.

D. Milton Stokes, MPH, RD, CDN said...

Dr. Volek is a dietitian and an accomplished author. You'll frequently see his work in Men's Health magazine. I suggest reviewing his findings because it only helps to see what other experts discover via the scientific process, regardless of how it supports--or doesn't--the mainstream viewpoint.

Re: Kristy's comment...
I am curious to know if Kristy is a health professional and/or a dietitian?

Many dietitians, and health professionals for that matter, support position statements of professional associations, such as the American Heart Association and the American Dietetic Association.