Dietary counselling: food for the body and soul

The Report: November / December 2001 vol.22 num.5

by DAN KEETON

With continued advances in medical science, the world is recognizing the importance of the work that dietitians like Colleen Canning do. Its too bad that the health care employers too often do not.

Canning, for several years an activist with HSA including stints as steward, assistant chief steward and member-at-large, works in the three-year-old Adult Metabolic Diseases Clinic near Vancouver Hospital. The centre helps people with a variety of genetic enzyme disorders. Its existence is an acknowledgement that for many, the need for dietary counselling is lifelong.

-When we opened three years ago, we were the only free-standing clinic in North America for adults with metabolic diseases. Most treatment is still carried on at pediatric centres," Canning said.

Canning and other staff trained at Childrens Hospital in Vancouver to prepare for work at the clinic. They handle hundreds of different metabolic diseases, many of which are treated with special diets.

The most common of these is PKU, or phenyl keton uria, affecting about half of Cannings clients. People with this disorder lack a liver enzyme to help break down one amino acid of dietary protein, which then builds up in the body as a toxin. PKU can cause developmental delay if not caught early; all newborn infants in British Columbia are tested for the disease, she said.

Her job is to assess the needs of those with the metabolic disease and counsel an appropriate diet. -PKU is largely responsible for the development of the centre. Its become apparent over time that even adults [with this condition] need to maintain a low-protein diet to prevent a loss of IQ. The benefits of getting those people back on a special diet have been demonstrated."

Among Cannings patients are adults, many from group homes, who were born before 1965 when the PKU testing on newborns became standard practice. -For them, it wasnt caught until damage had been done," Canning said. Still, continued attention to diet helps prevent further erosion of the PKU sufferers health, she said.

Children diagnosed with PKU need to maintain a special diet throughout their lives. But it is now known that pregnant women with PKU should adhere to the dietary requirements to prevent damage to their fetuses, Canning said.

Prior to joining the centre, Canning worked for several years with patients suffering from kidney failure. -I guess I always knew I wanted to be in health care," she said, citing family experiences that led her into the field of nutrition. She was also attracted to the breadth of experience offered dietitians, who work in such varied departments as ICU, public health, and counselling.

She became an HSA activist in 1988 because, as she put it, -I was working in a facility where there were a lot of issues ... especially classification issues. The only way for a dietitian to move up was to join management.

-I worked in a particularly poisoned environment where there was a complete disregard for the collective agreement. People were treated quite unfairly with respect to awarding postings. I started finding out what our rights were.

-For me, the priority was establishing career ladders. The employer resisted creating language [in the collective agreement] for that." Canning said the issue is still very relevant, although the union has made gains.

-Weve got the language. The difficulty is interpreting it for groups like dietitians and social workers. We have a way to go, yet."

Dietitians aree among the health science professionals awarded a lower wage increase when the provincial Liberal government imposed a two-tiered wage structure in August. She is angry about the move she calls an attempt to divide HSA members.

-I really hope HSA members can pull together next time to achieve something more equitable."

Canning is parent to three young children and recently returned to work following maternity leave. The demands of family dictated that she take a hiatus from union work.

But there is plenty of room for future activists: -It would be great if more people attended [the annual] convention. Theyd know what work is done on their behalf by the union."