Heath Knut wakes up at 6:30AM for his morning run. He munches on a granola bar while tying his shoes. It's always good to eat a carbohydrate before working out, he thinks, as he shoves the rest into his mouth.
He walks for five minutes, jogs for four more, then walks for three. Studies have found that interval training boosts people's metabolism higher than regular running, and muscles get more out of a workout.
Heath's neighbor Jeff sees him while getting into his car and waves. "Hey, Heath! How's the fruit and veggie world treating you?"
"It's great," Jeff replies, "I'm getting ready to start training for a marathon for next month."
"Man, you already look in shape. How about coming over and watching the game tomorrow? Plenty of beer and pizza to go around."
"Sure, sounds good...I'll bring a quinoa salad and some poached salmon," Heath yells over his shoulder as he jogs away. Heath has a reputation in the neighborhood for bringing the most inappropriately nutritious snacks to get-togethers. He looks great, but it's not winning him a boatload of friends.
At 8:30AM, Heath pulls into his office. He tells the receptionist that he brought in a vegan angel food cake topped with fruit for the other dietitian's birthday.
She looks up from her Shape magazine. "Okay, I'll just throw away the ice cream cake I brought in."
"We can have both. It's important for people to feel like they have choices," he says.
He looks over his first patient's chart. Rhoda Fry has high blood pressure and diabetes. Heath suspects that her diet includes a lot of salt, fat, and protein. When Rhoda comes into the office, he asks about what she eats on a daily basis.
"I've been on a diet. I've limited myself to eating only ramen, smoothies, granola, and sushi," she says.
Heath sighs. "Hmm. Okay, all of those have good qualities but you need to make sure you are eating them in the right quantities. You should also know that ramen noodles are loaded with calories and sodium, smoothies often have a lot of calories and not enough fiber, granola is usually full of sugar, and sushi is good for protein but bad for fiber. The white rice doesn't really offer much in the way of nutritional value."
Rhoda looks dejected. "I've been trying."
"It's okay," Heath says, reassuringly. "We're going to work together to create a meal plan that feels right for you and lowers your blood pressure."
Before Rhoda leaves, Heath asks her to keep a food diary. Food diaries help people stay on track with their diets. It also helps the dietitian figure out how many calories someone's consuming in a day. The amount of calories that a person needs to eat depends on their weight, height, and age.
For instance, a thirty-four-year-old woman who doesn't work out needs 2,200 calories to maintain her weight. To lose weight, she must either work out or change her diet.
Heath checks his appointment book. Oh, good, it's Harold next. Harold's been seeing Heath for six months. During that time, Harold's taken off more than twenty-five pounds, and the weight loss has helped him get off insulin and other medication. However, Harold gained a couple of pounds over Easter—he has a serious Peeps and Cadbury Egg problem.
"Hey Harold. Wanna get up on the old scale for me?" Heath asks.
"Not particularly. I think I'm gaining my weight back," Harold says, stepping on the scale. "Hot dog! I think I only gained five pounds!"
"Hmm. Hot dogs on the brain, I see. Let's look at your food journal. Oh, look what we have here. You've indeed been eating hot dogs," Heath says disapprovingly.
"Yeah, my sister left them at my house after a barbeque."
"If you want to eat hot dogs, pick healthy franks. They make veggie franks, chicken franks, and turkey franks. However, once a week is probably good when it comes to eating any kind of hot dogs. They have a lot of sodium," Heath says, handing Harold a shopping list.
They discuss other hot dog-related meals that Harold could try. Heath makes a large note on Harold's chart: Loves hot dogs.
It's noon now; time for Heath to eat lunch. He sits down at a table with a couple of doctors from the clinic. Both are eating tuna fish sandwiches. "So Heath, how did we do on this lunch?" one of the doctors asks, laughing.
"The tuna's a good choice. Protein city. And you're eating it on whole wheat, so good on you. Not bad overall, unless you're having trouble with your bowel movements." Heath flashes a wry grin. "Anything you'd like to report?"
The rest of the afternoon is filled with appointments. Heath checks people's weight, assesses their body mass indexes (BMIs), develops meal plans, and gives them workout advice.
He checks the time at 4:00PM, hoping there are a few spare minutes to look at a lecture for a local high school he's giving tomorrow. It's on the dangers of trans fats and is called "Trans Fats in Snacks" (it's actually a rap that he's been working on).
He tries to make his nutritional advice interesting for young audiences—because millions of adolescents are overweight, Heath feels like education will be key to stopping the obesity epidemic.
His receptionist peeks her head into his office, "Ready for birthday time."
Heath lights the candles on his angel food cake. The banana catches on fire, but he puts it out with some of the non-dairy icing.
The cake is a big hit at the party. Most of his coworkers can't believe that the cake is vegan—even the doctors go for seconds.
Heath leaves his office feeling pretty good. While not everyone is open to changing their lives with nutrition, health advice and foods will be waiting for them when they're ready.