Dispelling nutrition myths, ranting, and occasionally, raving


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Hey food industry, get out of RD conferences! #FNCE

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I had a blog post all written for you lovelies, cued-up, ready to go. Then I started seeing the tweets coming out of FNCE (Food and Nutrition Conference and Expo) and I got all annoyed and tweeted what you see above because apparently I’m a masochist. That unleashed a fun afternoon of back-and-forth with fellow RDs on twitter who either don’t see conflict of interest as an issue in our profession or don’t really care.

I keep being about to say “I’m sorry but…” but I’m NOT SORRY DAMMITYou are not immune to marketing. No one is immune. Not me, not you, not anyone and if you think you are then you are the extremely rare exception or you are sorely mistaken. Many dietitians (myself included) regularly bemoan that we can’t get any respect as a profession. Do you really think that showing your influence can be bought with a free sample is helping us to become respected on the same level as other healthcare professionals?

Let me tell you a little tale. Once upon a time I worked in a grocery store (yes, I was an RD at this time). In my position I was responsible for a department, helping customers, teaching classes, providing demos, etc. Myself, and others in the same role at other stores regularly received training, lunch and learns, and samples from vendors. Product knowledge is important if you are talking to customers about food and supplements. The thing is, we didn’t receive training on or samples of all brands. So which products were we more likely to recommend? The ones we’d gotten to try, the ones we felt more connected to. Sure, I never recommended a product that I was morally against (I told people not to buy raspberry ketones if they asked for my opinion)or didn’t genuinely like, but I’m sure that there were equally good alternatives to many products that I didn’t steer people toward because I had no experience with them.

So, when dietitians argue that industry at conferences is fine, I disagree. Sure, walnuts and almonds are great but if they’re the only nuts there what are the chances that dietitians are going to be subconsciously influenced to promote those to their clients over nuts that don’t have representation at the expo? Yoghurt’s great and there are myriad options at grocery stores. If Siggi’s and Chobani are the only yoghurt brands represented at FNCE, which brands do you think that RDs are going to be more likely to choose and recommend?

Some argued that the FNCE is, in part, an expo. True enough, but as a conference organized by the national dietetic organization in the US it’s expected that most attendees will be dietitians. The focus should be on providing them with current evidence-based nutrition information.Having a captive RD audience for marketing at a conference organized by a body that’s meant to represent RDs is reprehensible. It’s time for the FNCE to drop the E.

Lest you still believe that RDs are a higher breed of human and somehow immune to conflicts of interest and marketing tactics, check out the selection of tweets below. Names and handles have been removed because this is not about singling out dietitians, it’s about drawing attention to the larger issue. Kudos to the companies present at FNCE for generating all of these free advertisements. Shame on the Academy of Nutrition and Dietetics for allowing this to occur.

 

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Nutrition sponsorship scandal

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Excerpt from the Nova Scotia Dietetic Association’s Private Practice Guidelines

In the wake of the Olympics I thought that it would be timely to write about product endorsement. Every time the Olympics roll around there’s much hullabaloo about sponsorship and the promotion of crap food like McDonald’s. But the promotion of food is not just associated with the Olympics. It’s going on all the time and marketers are getting savvier about it. Enter the role of dietitians.

As dietitians we position ourselves as the experts on nutrition and healthy eating. We’re constantly battling misinformation and trendy diets, telling people to come to us for guidance in making better food choices. We are the unsexy voice of reason in a sea of cold-pressed juice and expensive shakes. Who better than dietitians then to promote food, beverages, and supplements?

I see so many Tweets, Instagram photos, and blog posts by dietitians promoting myriad brands of food, drink, and supplements. I took a little scroll through some prominent Canadian media RDs Twitter feeds when I was considering writing about this topic. I found a number of sponsored posts; some obviously so and others not. Because this isn’t about pointing fingers, making enemies, and in-fighting, I’ve decided not to share any of these posts with you. Many of them come from excellent dietitians. Perhaps they truly believe in the products they’re promoting. Is it wrong to make money from promoting a product that you like and believe others could benefit from? It’s also a hard truth that we all need to pay the bills and making a living as a private practice dietitian can be extremely difficult.

The problem with dietitians promoting brands and products is that it churns up the murky conflict of interest waters. There is no way for us to know if the dietitian tweeting about a supplement or posting a photo of their branded snack honestly believes in the value of the product. In promoting a product, ethically, a dietitian needs to believe that it would be beneficial to those they’re promoting it to. When you’re posting things to social media you’re posting them to anyone else using that platform. It’s pretty near impossible to know if the people looking at your posts are going to benefit from the products you’re promoting.

As dietitians, our first responsibility lies with the public. It’s our job to help people meet their nutritional needs and goals. When we promote products we may be undermining those goals. As much as I’m loathe to see athletes and pop stars promoting pop and fast food, they don’t have that same ethical obligation. While it’s true that dietitians aren’t generally promoting such nutritionally void products, we still need to be extra careful about the message that we’re sending to people. Seeing the promotion of a sports supplement or an energy bar by a dietitian sends the message to the public that these things are healthy and they should be consuming them.

I mentioned earlier that some of the sponsored posts were obviously sponsored while others were not so clear. Some dietitians have put a note in their profile that they are spokespersons for certain brands. Others use hashtags like #ad and #spons when posting about a product. Others don’t have any indication that a post is sponsored so maybe they’re just huge fans of a product or maybe they don’t make their affiliation readily apparent. If I, another registered dietitian, can’t tell if a post is sponsored, how can anyone from the public be expected to?

The sad truth is, I’ve gotten to the point where every time I see a post by an RD in which a specific brand is mentioned I automatically assume that it’s sponsored and discount the value of the product. And that’s not good. Not being upfront about our conflicts of interest and potential biases undermines our credibility. We have enough trouble gaining the confidence of the public without undermining ourselves. I’m not saying that all dietitians should stop promoting all products. There are some brands that I genuinely love and could theoretically be convinced to promote. We’ve all got to pay the bills and if you can do so by marketing a product that you believe in then power to you. However, people shouldn’t have to dig to find out if a dietitian is being compensated to promote products. We need to be upfront about our affiliations so that the public has all of the information they need to make an informed decision about whether or not the product they’re seeing posted by their fave dietitians is for them.


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The science behind Herbalife

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A while ago I received a request to blog about supplements, in particular Herbalife. I’ve procrastinated on it for a little while because I figure you’ve read about one weight loss supplement scam, you’ve read about them all. Plus, I wasn’t all that familiar with Herbalife and the products they sell and I knew it would take me a little time to look at all of them.

The product lines include: core products, weight management, targeted nutrition, energy and fitness, and outer nutrition. They include everything from soy nuts to protein shakes to canola oil capsule. Yep, canola oil in a capsule. Why anyone would ever want to pay for capsules when you can buy a lovely jug of canola oil at the grocery store for what I’m sure is a much more reasonable price (prices aren’t listed on the Herbalife site) and can actually use to cook with is beyond me. It takes all kinds I suppose.

Herbalife even has a little tab at the top of their website entitled “science“. Which would be awesome if it actually linked to science to support the use of the products their selling. Sadly, no, this is what you get:

“Herbalife products are made from beneficial ingredients and developed using world-class scientific technology and research. Our protein shakes and snacks, vitamins and dietary supplements, energy and fitness drinks, and skin and hair care products, combined with healthy eating and exercise, can help you enjoy a lifetime of good health.”

They then provide a link to a PDF where you can “learn more”. This is a one pager, with plenty of images, that says:

“Herbalife products are formulated by our team of scientists and Ph.D.s for consumer benefits. They also ensure that the science behind our products is substantiated through scientific literature and clinical trials. We share knowledge and best practices through our key partnerships with the most advanced and established ingredient suppliers in the world.”

They name their chairman of the board, David Heber MD, PhD. Naturally, I looked him up. At first glance he appears quite reputable (aside from his willingness to peddle questionable nutritional supplements). He’s a professor at the UCLA school of medicine, an endocrinologist, nutrition specialist… But wait, if you just add “quack” after his name in google you get some much more interesting results; such as, this blog post about his authorship of several questionable diet books, his promotional video for pistachio nuts, and his research (funded by POM Wonderful) you guessed it, extolling the wonders of pomegranate juice. One blog not enough for you? How about a listing on Quack Watch linking to the article Herbalife Cozies Up With UCLA? Which outlines the financial benefits Heber receives from Herbalife in exchange for his promotion of their products? Or this post on Science-Based Medicine detailing the tangled web of Heber’s nutritional genomics research, funding, and chairmanship of the Herbalife board?

This is their credible scientist. A man who is receiving substantial profit from the sale of Herbalife supplements as well as funding for his research. No conflict of interest there. Nope.

Making Herbalife an even more questionable business is the fact that it appears to be a pyramid scheme. You can become an Herbalife distributor and make money selling Herbalife products to others. Despite this sales technique, a judge dismissed a case accusing Herbalife of being a pyramid scheme in July of this year.

The Herbalife website entices you to “get your Herbalife Coach today”. This coach will help you with your goals, product selection, and provide you with solutions and support during your journey to health. Who are these wellness coaches? People who sign-up to be Herbalife distributors through people who signed-up to be Herbalife distributors through people who signed-up to be Herbalife distributors. You get the idea. Apparently there’s some online training that you can take. I’m sure that’s pretty much like being a dietitian. I was hoping to find a disgruntled former Herbalife coach online who would reveal what the coach “training” entailed, but all I turned-up was this article about a woman who lost a large sum of money as a Herbalife distributor. And this blog post by a woman who was angered by her experience with an Herbalife Health and Wellness Coach. Essentially, as a Herbalife coach you’re a glorified sales person.

So, to sum it all up: Herbalife is a company with a dubious sales model, selling questionable products (I’m being generous here) that’s run by a doctor with a clear lack of integrity. If you want soy nuts, go to the Bulk Barn. Don’t waste your money supporting a despicable company like Herbalife.


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Dr Folta and Dr Blair and the problem with industry funding

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Photo: Coke de Plume by BFLV on flickr. Used under a Creative Commons Licence.

A couple of things happened in the scientific world in fairly short succession recently. I spent a lot of time waffling about whether or not I should write about them. Primarily because I don’t want to draw the ire of the pro-GMO community. I see a lot of rabid support for “science” on twitter and I fear being dismissed as anti-science. But this post isn’t about whether or not GMOs are great, or even whether or not they’re safe. It’s not about my opinions on genetic modification nor organic farming. “What is it about?” you ask. It’s about credibility and honesty in scientific research and dissemination of said research.

A few weeks ago the Internets got their collective panties in a twist because some scientists were revealed to have received money from Monsanto. In particular, one scientist received money to pay for his travel expenses in order to enable him to speak at events. Naturally, he was speaking in support of genetic modification, which aligns with Monsanto’s values. I’ve since seen his supporters claim that this information was freely available to anyone who was interested and that he had never failed to disclose his funding sources. I’ve also seen his detractors attribute quotes to him clearly stating that he did not receive money from Monsanto. I don’t know who to believe. It doesn’t really matter who I (or anyone) believes anyway. The important fact of the matter is that he received money from Monsanto to speak at conferences and events.

The following week the news broke that a number of scientists have been receiving funding from Coke (via a nonprofit organization) to support their research and other logistics. That research focusing on the import of exercise in weight management. Once again, the Internet was collectively outraged. Okay, I exaggerate. Nearly everyone I follow on twitter, and much of the mainstream media, were outraged. The researchers shrugged and said: what’s the problem, we’ve never hidden the fact that we received money from Coca Cola and that money had no influence on our research findings. Everyone rolled their eyes and said: um, bias, helllooo. 

Here we have two instances of scientific funding by organizations which have vested interests in the results. Here we have two groups of scientists saying that the funding doesn’t matter and that their findings would be the same no matter where the money was coming from. So, what’s the problem?

The problem is that by accepting financial support from organizations that have a vested interest in the results and the messages from theses scientists creates the perception of bias. Even if these scientists are completely impartial, and that’s being incredibly generous given the fact that the majority of industry funded research findings support the interests of the funders, it raises doubts about that impartiality. At worst, the scientists receiving the funding have a conflict of interest. At best, they have a perceived conflict of interest, and perception matters. It also makes for an uneven scientific playing field. If all of the players on one team are having their expenses covered by a benefactor then how can the other team hope to succeed. Even if they are better players, they can’t afford to go to out-of-town matches or find the time for extra practice.

If only the scientists with the pro-GMO message or the scientists with the pro-exercise message are given the platforms to share those messages how can we ever hope to find out the truth?


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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?