Dispelling nutrition myths, ranting, and occasionally, raving


Leave a comment

Are prenatal vitamins a waste of money?

384px-Prenatal_vitamin_tablets

Last week the news that pregnant women don’t need vitamin supplements seemed to be all over social media. The articles were based on this review article published in the Drug and Therapeutics Bulletin. The authors concluded that based on the evidence, much of which was from research in developing nations, that women (in Britain) do not need to take prenatal vitamins.

They reached this conclusion based on examining studies of the effects of folic acid, vitamin D, iron, vitamin C, vitamin E, and vitamin A supplementation on birth outcomes. While they concluded that multivitamin supplements are unnecessary for women during pregnancy, they stated that there was strong evidence to support women taking folic acid supplements and vitamin D supplements during pregnancy.

The message that came across most strongly (from the news articles) to me was that women are being shamed into purchasing vitamins that they can ill-afford, and don’t need, under the guise of wanting the best for their baby. The implications of these news articles concern me.

Firstly, women should be aware that many pharmacies (in Canada at least) have prenatal programs through which pregnant women can receive free multivitamin supplements, amongst other things. An inability to afford multivitamins should not prevent women from receiving them. Let’s not make this about drug companies trying to make money from poor women desperate to do the best for their unborn children. This should be about doing the best for women and their unborn children.

Okay, now that, that’s out of the way… I worry that the message that women should still be taking folic acid supplements and vitamin D supplements (and not just pregnant women I should add as most women of childbearing age should be taking folic acid supplements and most women in North America at least, should be taking vitamin D during the winter months) will be lost amid the cry that multivitamins are unnecessary. The message is not that all vitamin supplements are unnecessary for most Western women during pregnancy, just that the current evidence doesn’t support the use of multivitamins.

I’d also like to note that the researchers were focussing on birth outcomes. The conclusion that multivitamins are unnecessary was based on whether or not mums gave birth to healthy full-term babies. The authors did not take into consideration any potential long-term benefits maternal supplementation might have on their children. The authors did not take into consideration benefits that multivitamin supplementation might provide to mums. They did note that multivitamins can lower the mums risk of anemia, but as that didn’t seem to affect birth outcomes iron supplementation was deemed unnecessary. There are many other vitamins and minerals in multivitamins that the authors didn’t look at. Quite likely there’s not enough research on them to make a call either way. Regardless, the needs of pregnant women, not just their babies, should be taken into consideration when determining whether or not supplements are needed. Not all mums are going to get all the nutrients they need from food. Especially if they’re suffering from “morning” sickness. Perhaps not all mums will benefit from taking multivitamins. However, some very well may, and I think it would be a shame to tell them that they’re “wasting their money”.

Finally, as my friend Mark (who asked me to write about this topic) mentioned, taking two pills is more effort than taking just one. If it’s still being recommended that women take folic acid and vitamin D during pregnancy then they may as well just get those nutrients from a prenatal multivitamin rather than buying separate bottles of two supplements and having to remember to take both pills. It may be ever so slightly less expensive to buy vitamin D and folic acid instead of a multivitamin but I can’t even be certain of this because there was no folic acid for sale at my local grocery store when I went to price them all out. Which raises the issue of availability as well.

Women shouldn’t be made to feel guilty about not being able to afford a prenatal multivitamin. They also shouldn’t be made to feel like they’re wasting their money by buying them.

 


1 Comment

Follow Friday: @sawsnht

Back to sharing cool food art with you. I saw this article on artist Seiji Kawasaki and was amazed by his realistic wood carvings of food.

If he didn’t leave some raw wood showing on this asparagus you’d think it was real. Or how about these potato chips?

Follow Kawasaki on Instagram or check out his website.


Leave a comment

Is this good for me?

Good

Oh man, this NYT article: Is Sushi “Heathy”? What About Granola? Where Americans and Nutritionists DisagreeHow many other dietitians wanted to scream when they saw the lovely little scatter plot of food? “Is X or Y or Z good for me or healthy?” has to be one of the top questions I get asked as an RD, and one of my most hated.

Why is this not a good question? Well, because there are very few foods that are entirely “good” or entirely “bad” for you. I mean sure, we all agree that Coke is not a nutritious choice. We also all agree that oranges are. That doesn’t mean that you can’t have a nutritious diet and drink the occasional pop. It also doesn’t mean that you can’t be extremely healthy and never eat oranges.

I’ve blogged before about food having virtue so there’s really no sense in repeating myself. Although even I can’t find the old post to link to so maybe I should (if you can find it, let me know and I’ll link back). For now, suffice to say that the point was that food doesn’t have moral value and labelling foods as “good” or “bad” only promotes unhealthy relationships with food.

Individually appraising foods as either good or bad, healthy or unhealthy is a fruitless exercise. When looking at a diet to determine if it’s healthy/nutritious you need to look at the big picture. What does it matter if you have a cookie while you’re blogging (just for example) if the rest of the day you ate mostly whole, minimally processed, nutrient-dense foods? It doesn’t. Conversely, if you ate a head of kale while you were blogging after eating highly processed, nutrient-light foods all day then you’re still not consuming the most nutritious diet.

We all need to lighten up a little. Stop obsessing over whether quinoa is “healthier” than rice. A healthy diet is a diet that provides nutrients and pleasure from a variety of foods.


Leave a comment

Follow Friday: @thelindywest’s book Shrill

imgres

After hearing a couple of great pieces by Lindy West on This American Life, particularly the latest on the episode Tell Me I’m Fat, I had to check out her book.

I recently discovered audiobooks. I mean, I’ve known for a long time that they existed but I never bothered to listen to any. I like to read, so why listen to a book? Well, I listened to Aziz Ansari’s Modern Romance which was so much better than that Netflix series he did. Then I powered through Mindy Kaling’s Why Not Me? which was also much better than her last book, although not quite as good as The Mindy Project. Anyway… I digress. I downloaded Shrill: Notes From a Loud Woman and listened to it over the weekend while I was cooking, cleaning, running.

Everyone should listen to that episode of TAL and listen to (or read) Lindy’s book. It’s an honest, witty, and somewhat brutal story about weight, growing-up, living in the public eye, and being a feminist.


8 Comments

Ditch the meds: a dietitian dispensing drugs

8686686679_a0a3a2edd2_z

Image by mkhmarketing on flickr. Used under a Creative Commons Licence.

One of my biggest pet peeves as a dietitian is the fact that so many non-dietitians fancy themselves to be nutrition experts. It’s one thing when it’s a “holistic nutritionist” at least they have some degree of nutrition education. It’s another entirely when it’s another regulated healthcare professional who seemingly has no concept of scope of practice. For those, such as the pharmacist I came across on twitter who states in her twitter bio “Pharmacist who would rather dispense nutrition than Rx.”, who may not know what scope of practice is: scope of practice describes the procedures, actions, and processes that a healthcare practitioner is permitted to undertake in keeping with the terms of their professional license. For a pharmacist, that means providing evidence-based advice and guidance on medications. For a dietitians, that means providing evidence-based advice and guidance on nutrition.

The pharmacist in question decided not to become a dietitian because she didn’t want spend the money to study the “low-fat” guidelines that apparently comprise the entirety of a degree in dietetics. How easy it is to be critical of a program when you clearly have no idea what the area of study consists of.

You know, I’d really like to be a pharmacist but I don’t agree with the excessive prescription of antibiotics. I think that instead of going to uni and studying pharmacology I’ll just start telling people what medications they should take for their ailments based on my own research and dispensing them online. Oh but that would be dangerous and I’d probably lose my licence to practice dietetics and face prison time. Yet, somehow it’s totally okay for someone who’s never studied nutrition to use their credentials as a regulated health professional (in a completely different field) to advise and influence people through social media, a blog, and conventional media. Ironically, as a registered dietitian I can’t even provide specific nutrition advice through those channels because sensibly one knows that I don’t have enough knowledge about the recipient of that advice to provide appropriate information.

Why even go to university for years, complete internships, pay to write a national exam, pay the college of dietitians $600 a year, and continue to learn about nutrition when it’s so easy? I could be cherry picking sensational “science” and promoting a “sexy” diet without having taken a single course in nutrition/dietetics. Sigh.

My point is, be savvy about where you get your information. Just because someone has credentials in one field does not make them a credible source of information in another field.

 

 

Follow

Get every new post delivered to your Inbox.

Join 2,982 other followers