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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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.