bite my words

Dispelling nutrition myths, ranting, and occasionally, raving


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The bigger problem with the cosy relationship between dietitians and the food industry

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Lots of drama in the dietetic world last week. No, I’m not talking about the wildly popular Dietitians Day. First, the Academy of Nutrition and Dietetics (AND) in the US brokered a facepalm worthy deal with Kraft to have their logo placed on process cheese slices. Dietitians everywhere (myself included) were outraged, certainly not shocked, but definitely outraged. And rightfully so. How are people supposed to take us seriously when an organization claiming to represent thousands of dietitians is promoting process cheese. A product that the majority of us would neither consume nor recommend to clients. On the defensive, AND released a statement (you may need to scroll down a bit to find the post) claiming that the prominent placement of their logo on the process cheese was not indicative of endorsement. Rather, the logo was indicative of Kraft’s support of AND. Right. We all know that doesn’t matter. It’s the perception that matters and everyone perceived the placement of the AND logo as an endorsement of the questionable product. Especially since the initial accompanying pronouncement stated that AND was proud to have their logo appearing on Kraft singles as many children don’t consume enough calcium and vitamin D. AND will be forming a committee to address the concerns of members regarding this deal with Kraft, in MAY. If you agree that this “partnership” is wrong then please take a minute to sign the Change.org petition asking AND to “repeal the seal”.

Hot on the heels of the AND Kraft debacle was the news that a number of dietitians had promoted mini-Coke cans as “healthy snacks”. These dietitians were likely all paid for selling their souls this work, although one of them couldn’t recall if she was paid by Coke or not. Gee, I wish I was making so much money that I could forget whether or not I was paid for something. While I hate to rag on fellow dietitians, it frustrates me to no end to hear of others doing such a disservice to our profession.

Both of these stories exemplify how the relationship between the food industry and dietetics/dietitians undermines our integrity as health professionals. There is a larger problem here. Dietetic organizations need sources of funding that do not come with conflicts of interest. Dietitians need more and better job opportunities. I understand that it’s a tough job market. Believe me, I’m not raking in the dough and I’m only quasi working as a dietitian. However, I would sooner give-up my status as a registered dietitian than to use it to promote questionable food and beverage choices. With the constantly changing science and messages in nutrition it’s hard enough to convince people to trust us. Is it really worth sacrificing our credibility to make a buck?


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Follow Friday: Dietitian services

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Did you know that many employers don’t offer dietitian services as part of their employee health plans? Considering that food and nutrition are vital to good health and productive employees our services should be covered by health plans. If your employer doesn’t cover our services please let them know that you’d like them too!


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Is it unethical for dietitians to sell supplements?

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Eggcup of Pills photo by John Twohig on Flickr. Used under a Creative Commons Licence.

Something happened recently that kind of blew my mind. I was always under the impression that it was a conflict of interest for a dietitian to sell supplements. Short of causing someone harm, in my mind, it was pretty much one of the most blatantly wrong things that a dietitian could do. In my mind, it still is, but according to at least one College of Dietitians, it’s not.

I happened to be exploring a fellow dietitian’s website, as I’d seen them make some questionable assertions in blog posts. You know, the sort of sensational “sexy” hype that I’m always saying we RDs don’t make. I happened to notice that they had a “shop” in which you could purchase several supplements. I shared this information with a friend, another dietitian, who passed it along to a contact at the College in their region. The response indicated that this might be a concern; however, if there is scientific backing for the supplements, as long as clients don’t feel pressured into purchasing supplements, while not ideal, it’s kind of okay. What??

One of the main reasons that many mainstream healthcare professionals take an exception to some alternative healthcare professionals is that they peddle supplements to their clients. It shouldn’t matter how much science there is supporting the use of a supplement. For any healthcare professional to receive direct compensation for the sale of a supplement or drug is a clear conflict of interest. No matter how amazing the supplement may be, no matter how questionable the supplement may be, the potential to profit from its sale to a client can cloud the judgement of even the most upstanding healthcare provider.

I can understand the desire to make money by selling things. It can be tough to make a living as a dietitian. A supplement may seem like a fitting choice. However, it undermines our credibility. For one thing, there is little evidence to support the use of most nutritional supplements. Imagine the more extreme scenario: You go to see your doctor who diagnoses you with disease X. Fortunately, there is cure Y which she can sell you. Can you not see the potential for corruption? misdiagnosis? Unnecessary treatment? Incorrect treatment? Despite the best of intentions, this can happen when the person who is assessing your condition is also selling you the cure. It’s unethical for healthcare providers to profit from a direct sale of a treatment.

If you ever visit a healthcare professional who offers to sell you a treatment or cure, please report them to their governing body. Get a second opinion. Do some research. We need you to ensure that all healthcare professionals are doing their utmost to ethically optimize your health.


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Sorry, dietitians just aren’t sexy

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Something that’s been weighing on my mind a bit lately is the disappointment that many people seem to have with dietitians and the reasons for this. Basically, it boils down to the fact that we’re not sexy. Nope, we can’t tell you the next great superfood you must buy daily (spoiler: there is no such thing as a “superfood”). We won’t recommend any breakthrough weight loss supplement; sorry, whatever Dr. Oz is selling we’re not buying. We won’t tell you “never eat these five foods“. And we won’t tell you that paleo, Atkins, low-carb, low-fat, gluten-free, vegan, <insert any trendy diet here>, is the best diet.

There are no shortcuts to health. There are no foods that you should never ever eat (I mean, obviously, there are some foods that should be consumed on an occasional basis, such as candy, and others on a regular one, such as vegetables). But we’re never going to tell you not to eat something. We’re also never going to tell you what diet to follow. Our job is to help you figure out the diet that works best for you and how to optimize it to make it as enjoyable and healthy as possible.

Yes, I know that there are loads of other people out there who are more than happy to tell you that their diet is the best, the only, the diet to end all diets. I know that, that level of certainty can be alluring. It’s much more appealing to have someone tell you exactly what you may and may not eat when you’re struggling on your own. It’s not easy to hear that no foods are off the table and that no superfood is going to swoop in to the rescue. However, let’s not confuse confidence with competence. Dietitians are here to help you make the best choices for you, not to impose our own dietary regimes on you. Maybe we’re not sexy or fun or exciting but we’ll be here for you when all of those other diets let you down.


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Dietitians and brand recommendations

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The above tweet really bothered me. Why? For a couple of reasons. One, where is this data coming from? I assume it’s in regards to dietitians in the US, as that’s where the tweet originated. So, can we really paint all dietitians with the same brush? Would dietitians in other countries also be recommending products to clients by brand name 90% of the time in other countries? Are we even talking about dietitians in all areas of practice? After all, we’re a pretty diverse bunch, working in many different areas. 

Two, the implied assumption that this is a bad thing. Maybe I’m the only one, but I immediately felt like we dietitians were somehow doing a disservice to our clients by recommending foods by brand name. The 90% is really quite meaningless. It could mean that a dietitian recommends every food by brand, or it could mean that the dietitian recommends but one of all of the recommended foods by brand. 

Personally, I tend not to recommend foods by brand name. However, I can see times when it might be useful. For example, when telling a client with celiac disease about gluten-free products. Or when someone asks which coconut milk doesn’t contain preservatives or stabilizers. Or when advising someone about humane meat products available at the grocery store. Or when identifying a product which is unique in the market. I don’t think that recommending a product by brand name necessarily means that a dietitian is being influenced by the company in question. I don’t think that it should be taken to mean that his or her credibility is in question. It may simply mean that they are trying to simplify the navigation of grocery store aisles for their clients.