Rachel, As a public health nutritionist who studied for six years I would
expect you to say exactly what you have said. As a result of your personal
investment in studying and practising nutrition you are bound to say that
diet is important and should be valued - which it is because so many
professionals and institutions have invested resources. I would expect
similar responses from smoking cessation specialists and those specialising
in promoting physical activity. Sometimes we need to stand back from our own
professional perspectives in this debate. Whenever the lifestyle vs social
and economic determinants debate develops on this list (usually twice a
year) someone will point out that the two positions are not opposed, that
they should be complimentary, that lifestyle interventions need to take into
account social and economic factors and adapt their programmes accordingly.
I agree that the recent debates are not productive, I would love to move the
debate on to the relative effectiveness of social and economic interventions
to promote health, however whereas nutrition is an accepted as a legitimate
area of activity for health services to be engaged in action on the
determinants of health is not. The relatively low numbers of practitioners
engaged in this sort of activity and the paucity of relevant research and
evaluation reports prevents us from having similar debates. Surely the
debate should be about how we can promote the development of health
promotion/public health infrastructure based on the broader determinants of
health so at least the debate about the debates would be more balanced.

> David King
> Health Development & Regeneration Team
> Barnet Primary Care Trust
> Hyde House
> The Hyde
> London NW9 6QQ
>
> email:        [log in to unmask]
> tel:  (020) 8201 4860 (w)
> tel:  07973 739 158 (m)


-----Original Message-----
From: Rachel Moon Kelly [mailto:[log in to unmask]]
Sent: 16 December 2003 14:40
To: [log in to unmask]
Subject: Re: Trans-fat...


Thank you Jane - finally a balanced opinion.  As a public health
nutritionist who studied nutrition for 6 years I can confirm that your
common sense approach of whole grains, vegetables & fruit, &
lower-fat protein i.e. meat & alternatives (I would include lower-fat
milk products as well) is supported by research.  While the details
of nutrition will probably continue to be debated for years to come
since it is a young & complex science, these basics will not.
I am also a strong believer in the determinants of health as well as
in the fact that the two (i.e. determinants of health & healthy
lifestyle) are not mutually exclusive.  In fact, I believe that
constantly debating whether nutrition has any value (which of
course it does) actually diverts the focus from the social
determinants of health even further.  This completely defeats the
purpose of those who are constantly devaluing the importance of
healthy lifestyle.  Does the media focus too much on healthy
lifestyle?  Yes.  Does that mean we need to devalue it's
importance.  No.  It means we need to take every opportunity to
increase the profile of the social determinants of health as well.
Why can we not agree that all facets of health are important &
support each other's work rather than sabotage it?  In-fighting only
reduces the credibility of health professionals & does nothing to
further the social determinants of health agenda.
Thank you,
Rachel Moon Kelly, MHSc, RD
Public Health Nutritionist
HKPR Health Unit
200 Rose Glen Road
Port Hope, ON
L1A 3V6
Phone: (905) 885-9100
Fax:   (905) 885-9551
email: [log in to unmask]

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