On the Job with Jane Drexler, Registered Dietitian
Jane shares what worries her most about the state of our food industry and her best advice for making positive changes in your diet.
March is National Nutrition Month, a month dedicated to providing information and guidance to Canadians, making it easier for them to choose, eat and enjoy healthy food.
Q: What is your current position and how long have you been working at St. Joe's?
I am a registered dietitian on the Inpatient Nephrology Unit and Renal Transplant Unit. I started at St. Joe's in 2006 as a Mental Health Dietitian.
Q: Why were you interested in nutrition?
My interest started in high school when I began working on a nutrition project. I've always been health conscious and active in sports which goes hand in hand with nutrition. I knew some people who were in the nutrition program at University of Guelph and it seemed like a good fit for me.
Q: What is your favourite thing about working at St. Joe's?
I've worked at a few different hospitals, and I really like that St. Joe's is a teaching hospital. There are so many learning environments that you can participate in, whether it's listening to the physicians and residents on the floor, or attending various educational rounds. I also like our multidisciplinary team on the Nephrology floor – we all work together to make sure our patients are cared for and safely discharged home. We work really well together as a group.
Q: How would you describe what you do?
Essentially my role is to identify patients who have or who are at risk for malnutrition. I work with patients at their bedside to assess how much they know about their nutritional health and requirements and work with them to put together a plan to optimize their nutritional needs. I work with their preferences and help them incorporate practical tips based on their dietary requirements. There is a lot of diet education involved in Nephrology, especially if the patient is new to the nephrology program or starting dialysis.
Q: What is the most challenging part of your job?
In Nephrology there is a high portion of patients that are malnourished, and it can be difficult to see all of the people that need to be seen to help them in a timely manner.
As an aside, in a recent Canadian study looking at the prevalence of malnutrition in Canadian hospitals, 45% of adults were identified to be malnourished upon admission to hospital. Moreover, malnutrition at admission was independently associated with length of stay. Patients that were well nourished on admission but had poor food intake during admission had longer lengths of stay than well nourished, stable patients. Specifically those who deteriorated during hospital stayed on average six days longer.
These statistics highlight the importance of screening for malnutrition and getting our registered dietitians involved in the care plan of our patients.
Q: What worries you the most about the state of our food industry and the average Canadian's diet?
I have to say it's the prevalence of processed foods and sodium. In our current food system, there is an abundance of prepared, processed, boxed and canned items, and the sodium content is quite high; I don't think the average consumer really realizes how much sodium or salt is in what they are eating. We are consuming a lot more sodium than is good for our health.
Q: Why is too much sodium bad for us?
Too much sodium can be linked to negative health consequences like hypertension (high blood pressure). High blood pressure can then lead to kidney failure, as well as other heart related conditions.
Q: What leads to an unhealthy diet?
A lack of planning, and due to how busy our lives are, we tend to gravitate towards eating out and purchasing processed foods. It's important to think ahead; don't think about what your next meal will be just 10 minutes before you come home from work. Plan your meals in advance so that you have fresh ingredients on hand.
Q: What is the most important advice you give your patients when it comes to their diet?
To make changes, you need to feel empowered to make your own choices. It's about finding a balance between following your renal diet and trying to incorporate your preferences all while ensuring you are getting enough variety in your day to day life. I also want my patients to enjoy their food and their eating experience. Accomplish little goals at a time – pick two or three things you can change that are fairly easy – and build upon that momentum.
Q: Do you have a favourite restaurant?
If it is a special night we will go out to Spencer's at the Waterfront or Bread Bar in Hamilton. They both have a farm-to-table philosophy, use local and seasonal ingredients and most importantly their food is delicious!
Q: What is your favourite recipe?
I would say my mom's lasagna recipe. It's comfort food and I've had it since I've grown up. Now, I make it for my daughter.
Q: What advice do you have for developing a positive relationship with food in children?
My daughter is 18 months and how I see my role as a parent is to provide a variety of healthy food, at predictable times. My daughter is responsible for how much she wants to eat and whether she wants to eat at all. I encourage her to be in touch with her own appetite cues, and I try to avoid making positive or negative comments about what or how much she eats. It can be hard if I make a nice vegetable dish, and she spits it out. But, eventually I have faith that she'll eat it, especially if she sees her parents modelling healthy eating behaviour. I always provide a fruit, vegetable, protein, grain, and milk to drink, so there is always something among the variety that she likes and eats. I also make sure we sit down together as a family at meal times as much as possible, without the TV on or other distractions, so we can connect and enjoy our meal together.
Q: Where can we find you in your free time?
When I'm home from work, I'm spending time with family and my daughter. On weekends you will find me pulling her around our neighbourhood in a wagon or going to the park. We also enjoy going to the grocery store together, where we have a lot of fun.
Q: What three words describe you?
Organized. Friendly. Detail oriented.
Q: Do you have a go-to coffee tea/order?
A regular black steeped tea with half a sugar and one milk.