The Most Important Thing

One question I ask all my dietetic students is:

"If your patient walks out of your outpatient consultation, and does one thing, what would be the most important thing for them to do?"

By narrowing down or distilling what is going to make the biggest difference allows clients to focus on what is important, rather than what will make a minor effect, or worse still, just merely a distraction from the goal / outcome in question.

In regards to Type 2 Diabetes, what is the most important thing for clients to understand? The patho-physiology of diabetes? How to read food labels? How to choose lower fat foods? The glycemic index of their carbohydrates? Or to limit salt, or sugar?  Or what time of the day is best to exercise?

No, these all may be legitimate tools to improve diabetes control, but are not the most important thing.

For many people with T2DM, the most important thing is achieving weight loss.

There are many methods of achieving weight loss. A myriad of books, apps, calorie counters, commercial weight loss programs, macronutrient ratios, intermittent fasting, very low calorie diets all sprout their benefits and advantages over each other.

So from dietary intervention studies, which one comes out trumps?

The most important thing is what ever works for the individual client.

I have clients on a range of [insert various programs]. What is important is that their program fits with them, their lifestyle, culture, values, and they are compliant with the program they are on.

The most important thing is that there is a result.

Clients often tell me "I never eat take away, eat cake or drink alcohol". My reply is "I don't care what you don't do, or what you do infrequently. I'm more concerned about what you do most of the time".

This is the most important thing.

Is it better to change variable x first, or variable y first? The most important thing is that something is changed.

And once weight loss has been achieved, the most important thing is preventing weight regain.

It is better to exercise in the morning or evening? So many of my clients ponder this, and in the midst of not knowing when to do it, simply miss out on the most important thing - doing it.

Focusing on the most important thing avoids getting bogged down in the irrelevant, the minutia, the distractions.

Shifting the focus to the most important thing, is itself... the most important thing.