Dispelling nutrition myths, ranting, and occasionally, raving


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Are dietitians getting too sexy?

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A few years ago I wrote a blog post that really hit a nerve with other dietitians. It was about how dietitians just aren’t sexy. This was in the sense that we don’t hop on trends (unlike other unregulated professionals) and instead are moored in evidence-based practice. Unfortunately, I’m noticing a disturbing trend in dietetics and I’m concerned about the future of my profession.

There have always been some dietitians who believe in unproven practices such as detox, fad diets, and questionable supplements. It’s a shame to see others promoting such nonsense as I feel it reflects poorly on all of us but it’s always been the minority. It’s also been somewhat understandable because it can be a tough field in which to find a secure job. And we probably all have some beliefs that aren’t based in evidence. Experience is important in combination with scientific evidence. However, I feel like in this age of fake news where nothing means anything anymore, that this is infiltrating dietetics at a higher level.

Recently there’s been the introduction of “integrative functional nutrition” which sounds very scientific and pretty great, “A central theme of IFNA training is learning to identify “root causes” of disease in a methodical and systematic fashion rather than the mundane prescription of medical nutrition protocols based on a diagnosis”. Who doesn’t want to get to the root causes of illnesses? I think the main frustration with Western medicine is that there’s often a failure to dig deeper to find the root cause for ailments and simply a treating of symptoms. This is why so many people turn to unscientific alternative health practitioners for help. Unfortunately, “integrative functional nutrition/medicine” tends to be code for the smooshing together evidence-based practices and unproven unscientific practices. The creation of bodies of dietetics incorporating these practices lends false credibility to them.

Last week I attended a nutrition conference. It was generally a really great conference with presenters sharing a variety of perspectives and evidence. There were also presentations by people with lived experience. I think there’s a great deal of value in learning from people who have experience with various conditions, circumstances, illnesses, etc. However, the final presenter was by an individual who had “cured” a severe mental illness through nutrition and supplements with the aid of a Christian doctor in the US. I’m not in a position to question this person’s experience but the presentation made me extremely uncomfortable. I don’t doubt that nutrition plays an important role in supporting mental health. Although I do doubt that we can cure most cases of mental illness through nutrition.

As dietitians, we are always trying to promote ourselves as credible sources of nutrition information. Yet here we are, welcoming a presentation from an individual who was treated by a doctor whom would be dubbed as a quack by most. This guy readily fails Dietitians of Canada’s “Five tips to help you spot misinformation“.

1. Is the person or product promising a quick fix like fast weight-loss or a miracle cure? Check!

2. Are they trying to sell you products such as special foods or supplements? Check!

3. Do they provide information based on personal stories rather than on facts? Check!

4. Is their claim based on a single study or a few research studies? Not sure if the claims are based on any research so yeah, Check!

5. What are the person’s qualifications? Unfortunately, he’s a medical doctor which makes it sound like he’s a qualified professional. But we all know that doesn’t stop Dr Oz from operating outside of his scope of practice. Being a MD doesn’t necessarily mean that an individual is qualified to be providing nutrition services (most doctors receive very little nutrition education during medical school). As far as I can discern, he hasn’t received any specialized nutrition education so… CHECK!

Inviting people who are promoting such quackery to professional conferences undermines our credibility as nutrition professionals. It lends false credibility to their practices and allows these unproven beliefs to infiltrate dietetics. It makes it harder for us to present ourselves as credible nutrition professionals and undermines the ability of the public to trust us.

It’s discouraging to see people seeking out healthcare from unregulated professionals with questionable credentials and practices. But I don’t think the solution lies in taking the attitude that if you can’t beat them, join them. It’s important for us to continue to ground our advice in the best possible scientific evidence if we want to remain trusted healthcare professionals. Otherwise we may as well all burn our degrees and licences because they’ll become as meaningless as the credentials of all the self-styled nutrition gurus.

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It ain’t easy feeding greens

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Last week this article: Don’t Make Children Eat Their Greens caught my eye, mainly because of the headline. Great dietitian click-bait Guardian ;)

The article is actually much better than the headline makes it appear but I still have to throw my two-cents into the ring. As the author concedes (near the end of the article and prior to launching into his own advice) he is not a dietitian. It reminded me of a photo I’d seen on Instagram recently. It was a page from a book with a quote along the lines of “Not everyone who eats imagines themselves to be a dietitian”. Which I’m sure will amuse my fellow RDs because, in my experience, nearly everyone who eats does fancy themselves to be dietitians. While lived experience can certainly be valuable, it’s not exactly the gold standard of scientific evidence. I appreciate that the author incorporated viewpoints from professionals, such as a dietitian and psychologist, but I actually found some of the comments he included from them to be a little odd.

According to the RD source for the article, “The human body is very clever and can adapt over generations. It can use what resources it has available”. Which is all well and fine but really has no bearing on feeding children in the here and now. Adapting over generations is not the same as adapting over one’s own lifespan. I can personally decide that I’m going to forego certain essential nutrients and expect that my body will just adapt. Without a source of vitamin C, for example, I would invariably eventually develop scurvy.

The other issue I take with the article comes from a seemingly throw-away comment. The author’s (adult) daughter says that she refused to eat peas (and other green vegetables) growing up because “they don’t taste good”. To which the author writes “They don’t”. And this is an issue that the author misses in much of his advice. That issue is role modelling behaviour. Children learn by watching and if they are watching parents who don’t eat or show displeasure with certain foods they’re quite likely to adopt similar attitudes themselves. I can’t help but wonder, if the author’s attitude was more positive toward peas if his daughter might have developed a more favourable attitude toward them as well.

Much of the other advice in the article is spot-on based on current recommendations. Food should not be used as a reward or punishment, mealtimes should not become battlegrounds, caregivers should respect children’s appetites. It’s unfortunate that the headline gives the impression that vegetables are an unnecessary part of a healthy diet. While I’m sure that many meatetarians would be overjoyed with this stance, it’s not really the point of the article, nor is it the correct message. While not nearly as catchy of click-baity, a more accurate headline would be something like “Give Your Children Nutritious Meals and Snacks and Allow Them to Decide How Much to Eat”.


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Don’t eat this, not that!

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Ever notice the proliferation of magazine articles telling you what to eat instead of something else? It’s almost always one crappy food versus another somewhat less crappy (but much less desirable) food so that you’re left feeling guilty if you choose the “not that” and resentful if you choose the “eat this”. And evidently people eat this shit up because I see articles with some variation of this format pretty much weekly (and I don’t even read magazines). There’s even a whole website devoted to the premise with actual books you can buy. Yes, people will pay money to have people tell them what to eat but heaven forbid the government try to simply make it easier for them to make healthier choices.

Despite their “no-diet weight loss solution!” twitter bio, it seems to me that the “eat this, not that!” is all about restriction and food selection based purely on calories. Their website is literally a compendium of terrible trendy nutrition and fitness click-bait. You’ve got everything from “20 ways to boost your metabolism” to “how to lose weight while doing every day tasks” to the following header:

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Oh okay, that sure sounds like a “no-diet weight loss solution”. I mean, at least make the effort to not put the freaking D-word in there if “no-diet” is your shtick.

I spent sometime the other evening scrolling through their twitter feed and I’m convinced that much of what they post is sponsored content. They’ve got things like Dunkin’ Donuts vs Krispy Kreme, fat burning supplements that actually work, how to eat McDonald’s fries without damaging your body, the best and worst Subway sandwiches, almond milk is bad (no protein) but drink this brand not that brand (even though they both only have 1 gram of protein per cup), yay Starbucks (for – I kid you not – having nut “milk” options) but also boo Starbucks (for having high calorie baked goods). Alongside these there’s also lots of your standard: drink more wine, eat more coconut oil, buy these overpriced so-called paleo superfood snacks.

How about we stop shoving shame-laden food down people’s throats and instead promote healthful choices, ways to get people in the kitchen, and the pleasure of eating.


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No, watching What the Health does not qualify you to provide nutrition counselling

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I saw a couple of RDs I know tweeting about this article a couple of weeks ago and I just had to add my two cents. I honestly think that freedom of speech is being misconstrued in the US and this is not an issue of freedom of speech at all.

So the issue is there’s a “health coach” in Florida who’s mad because she was told that she’s not allowed to provide dietary advice to people because she doesn’t have a licence. She think that impinges on her freedom of speech. Her lawyer claims that “getting a licence is incredibly burdensome”. Well, no frigging shit. Getting a university degree in any field ain’t cheap and then having to complete internships, pay to write the national exam, and then paying annual fees to retain your licence is time consuming and costly. It totally sucks but does that mean we should tell people they can go ahead and practice dietetics without a licence? I think not.

What seems to be lost in this story is the reason why people become licenced dietitians in the first place. That licence is not there for our benefit. It’s there to protect the public, the people who pay to receive credible evidence-based nutrition counselling. It’s not a benefit to dietitians, it’s to protect the public from us. That licence tells anyone seeking counsel from a dietitian that we are qualified to provide that advice and if we screw-up they have legal means by which to hold us accountable.

As registered dietitians we acknowledge our scope of practice and the limitations of our expertise and work within those confines. This “health coach” may be quite knowledgable about nutrition but there’s no accountability. We don’t know what we don’t know and while she may believe that she’s well enough informed to provide nutrition counselling, she’s not in the position to be able to make that assertion. That’s why there are standardized examinations and competencies that must be met by dietitians, to ensure we all meet a certain level of expertise.

Licencing is common in many professions, from doctors to dentists to mechanics to pilots. The reason for that licencing is always the same, to protect the public from charlatans and ensure that these professionals meet a certain standard.

This is not a freedom of speech issue. No one is telling this woman that she can’t talk about nutrition to whomever she wishes. She can proselytize to fellow grocery shoppers in the cereal aisle. She can tweet about her beliefs. This is practicing dietetics/nutrition without a licence. This is making money by providing personalized nutrition advice to individuals without the appropriate qualifications. To allow her to do so would be the same as allowing me to perform bariatric surgery because I’ve read some books and researched it or allowing someone to fly a plane because they flew some in a video game once. To allow a health coach to practice as a dietitian without the appropriate credentials is putting the public at risk.


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Starbucks iced coffee is heavy on the syrup and light on the truth

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It may be getting a little cool for cold brew (no, not beer, coffee brewed with cold water basically a sort of iced coffee) but we recently had a belated summer heatwave here and I thought I might switch-up my usual Starbucks latte order for an iced beverage. I thought I might get a cold brew. You know, nice and refreshing. I knew that I would have to look closely at the options to get something without added sugar because as I’ve ranted about before, sweetened is the ridiculous default option for iced coffee at Starbucks.

I love having the Starbucks app because I can order ahead, walk over from work, and have my drink ready to go. So as I head out from the office I start perusing the menu for a nice cold beverage option. I see “vanilla sweet cream cold brew” which sounds great but clocking in at 110 calories isn’t exactly what I’m looking for. There’s also “Narino 70 cold brew” which is really what I’m looking for at 3 calories, no added, sugar or cream. Just to keep my options open though (maybe I want a little something extra), I scroll down the menu and see “iced coffee” which sounds great. It’s “lightly sweetened” which sounds perfect. Just a touch of sweetness would be a nice treat.

How much sugar would you say “lightly sweetened” means? A teaspoon? Maaaybe two teaspoons? How about FIVE teaspoons??! That’s correct, a “lightly sweetened” iced coffee from Starbucks contains 5 freaking teaspoons of sugar. That’s one teaspoon less than the recommended maximum daily amount of added sugar for an adult woman so forget having any other treats. Just one so-called “lightly” sweetened iced coffee and put a fork in me because I’m done.

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Anyway… I got so annoyed when I saw that, I ended up not ordering anything and just making a coffee (black, no sugar) when I got back to the office because if I’m going to have a treat I want it to be something better than a Starbucks coffee. And if you want your treat to be a Starbucks coffee, that’s cool too, but I just wanted to make sure you were aware that the “lightly” sweetened iced coffee is heavy on the misleading description and light on the accurate advertising.