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Why We Need to Talk About Trauma in Public Health Nutrition [lucyaphramor.com]

 

When you consider the word trauma in relation to food, health and eating what does it conjure up? In what ways is trauma relevant to dietetic practice? What does it even mean? In this article, I briefly introduce the concept of trauma as used in public health, social justice activism and counselling.

UK DIETETICS TODAY Public health, social justice activism and counselling are three overlapping arenas that are germane to dietetic discourse and practise. Here I talk about those arenas in relation to trauma, plus I explore irritable bowel syndrome to highlight why we need to talk about trauma. I’ve not written a step-by-step guide to consultation - in the space available, this would become a tick box activity and as such, it would miss the point that the topic, including its erstwhile absence from dietetic discourse, deserves lengthy consideration. Instead, I’ve written an overview that flags up why we need to integrate trauma physiology into our practice. I hope it conveys the urgent need for conversation and action.

Shortly after starting work as a community dietitian, I began to suspect that I was missing something important about health, something that couldn’t be pinned down to eating or exercise. Take prejudice: surely racism harmed health. I had no vocabulary for this, no biochemistry of discrimination to draw on from my dietetic education. So I searched a clinical database for ‘racism’ and ‘heart disease’. The results made such an impact on me that I can still recall the first papers I read. One investigated racism and waist circumference;1 another asked, ‘Does racism harm health? Did child abuse exist before 1962?’;2 a third introduced me to Michael Marmot’s work on status syndrome and the social determinants of health.3

I was shocked, including by my ignorance, and by the fact that the ramifications of knowing that it was only by stepping outside of my professional conditioning on knowledge creation that I learnt pathways linking racism, classism and abuse with ‘lifestyle’ disease. I began to think of health in terms of both self-care and social justice. As part of this awakening, I came to realise that understanding the concept of trauma was crucial to my work as a dietitian with individuals and groups, and for addressing health inequalities.

[To read the rest of this article by Lucy Aphramor, click here.]

[Photo of Lucy Aphramor from here.]

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Well written article and fantastic articulation of the approach around trauma and dietary consumption and consultation.

There are many great points to this article and is a sector that needs to be crucially explored.

Pointing out in addition to these strong points, the importance of exploring the types of foods we consume and the scientific insight of its impact on our physiological health, emotional regulation, and behaviour change.

As similar to therapeutic context of defining trauma, "trauma refers to extreme stress exposure resulting in a body response that prioritises".  This is a fact in terms of traumatization effects in mammals.

Although there may not be much similarities within the list of hallmarks. There are significant similarities of the neurotransmitters and hormone secretions, which in turn can have significant and at times, immediate effects.

Clearly identified in research and highlighted in this article.

Bravo on the work and stewardship!

I remember my first presentation I gave in residency, it was on the health affects of substandard housing. Many of my colleagues, including many POC, gave presentations on Liver Failure or Hepatitis A, but there was something that had a far greater effect on health and I was very familiar with it. I wish doctors would keep thinking about the effects of poverty. My little brother was lead poisoned in that horrific substandard housing and his IQ is only 52. He cannot read or write and it pains me dearly. 

For me it conjures up free government cheese, drinking those cups of fluoride liquid and the fraudulent dental work we poor kids had done to us plus it conjures up popcorn and cool aid as the only things to eat because we were dirt poor.

I think everyone needs to know how to garden and can/preserve food.  

Laura-

Thanks for posting Lucy's article. Yes, all professions need to know more about trauma. And all professions need to know how to screen for food insecurity, housing insecurity, medical care insecurity, domestic violence, racism, addictions and other limiting factors that keep trauma in place and is made visible through the labels of mental health challenges, physical health challenges, incarnation, foster care/dependency to name a few. 

Kristen

 

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