Sometimes patients come into appointments inspired, but they might not know what are the most important diet changes. They want to do everything. They are just waiting for me to say start. Sometimes the everything the patient wants to do does not even align with any of their nutrition priorities. I will give you some examples. (Note that all examples are are from my imagination and not a report of an actual patient!)
A 40 year old man came in with newly diagnosed diabetes. He typically drinks juice and soda, and eats most meals at home. He was eager to make all the changes, which to him meant stop drinking coffee and start buying only organic produce.
A 19 year old college student wants to improve his fitness from his usual routine of takeout for breakfast, lunch, and dinner. He decides that he will start with intermittent fasting.
A 35 year old wants to lose the weight she gained after her pregnancies. Currently she relies on frozen prepared foods for herself and her family. She decides to cut out all animal products and be completely vegan.
The people in these examples come in to their nutrition appointments feeling very inspired to do something big. For each person, what they think is a big change is likely dependent on what they are exposed to socially and in the media. While it is at least somewhat plausible that the changes these people want to make may improve their health, it is also possible that more targeted changes will make a bigger difference in a shorter amount of time. That's where it is important to consider what is the most important diet change.
The person with diabetes will likely see improved blood sugar readings by avoiding juice and soda. The college student can have improved fitness by adding in some produce and whole gains. The woman who wants to lose weight may see health improvements with more fresh produce and whole grains.
As a dietitian, I love when my patients come in very enthusiastic. The intention and eagerness to improve really helps people follow through. Ask a dietitian how you can best focus your efforts so that you don't put too much focus on areas that are less important. This will help you save your energies for the most important diet changes.