Dispelling nutrition myths, ranting, and occasionally, raving


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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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What does a dietitian do?

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As a dietitian I feel like I’m constantly shouting into a void. I can repeat myself a hundred times and then a (white male) doctor says the same thing and suddenly it’s all over my twitter feed or the news. And while of course I’m always glad for people to be receiving credible nutrition information there’s a huge part of me that resents the fact that I feel like I don’t get any respect. Is it because dietetics is such a female dominated profession? Is it because people think that all we do is tell people what to eat and run around slapping hotdogs out of their hands? Is it because there is often a lack of consensus when it comes to nutrition and there’s a lot of vocal charlatans profiting from selling people extreme ideas and diets? Maybe all of these. I do know one thing and it’s that nearly everyone thinks that they know all about nutrition simply because they eat and they like to share that “expertise” with others (usually unsolicited) in person, on social media, or by lecturing dietitians in the comments on their blogs.

I would never be so presumptuous as to refer to myself as an expert. While I think that my four years of studying nutrition at university and the nearly seven years (where does the time go??) of self-study since then do give me an edge-up on the average individual, I know that there’s loads more that I don’t know and loads more to be discovered. Unfortunately, those who know the least tend to be the most vocal and the most certain. You only have to check-out any self-styled wellness guru to see this in full effect. There’s also the weird assumption that many people have that doctors (and scientists) are experts in all areas, including nutrition. Most doctors are not and those who are have become so in spite of their standard education, not because of it. Nutrition is not standard education for doctors. Scientists also  have fields of study and just because someone is an astrophysicist does not mean they know the first thing about human nutrition. Any doctor or scientist worth his or her salt will be aware of the limits to their own knowledge and adhere to their scope of practice, deferring to those in other areas of study as applicable.

If this lack of respect for dietitians comes from a lack of awareness of what we do, perhaps I can help with that. Even though the dominant view of dietitians is that we counsel people on food, nutrition, and diet, that’s only one of many different avenues that we can take. Also, those who work in clinical nutrition may focus on very different areas from pediatrics to diabetes to eating disorders to cardiac rehab, etc. Dietitians working in private practice also counsel people for a wide range of nutritional concerns and some may specialize in specific topics as well; for example, one dietitian might only work with athletes while another might only work with clients looking to manage their weight. Many dietitians work with the food industry in various roles ranging from spokespeople to product development and nutrient analysis. There are dietitians who work in grocery stores helping customers to make healthy choices, try new foods and recipes, and boosting store sales. There are also dietitians who work in various aspects of nutrition research. Others of us work in public health and in the government with the goal of improving the health of the population. Rather than working with individuals we try to improve health and nutrition through policy and large-scale initiatives. Many dietitians work in longterm care; some in administrative roles with food services and some in a clinical capacity helping residents meet their dietary needs (and wants). Some dietitians work in the community with organizations such as community health teams providing counselling and classes for clients. Some dietitians provide food skills education for clients through nutrition-focused cooking classes. Yet other dietitians work with sports teams to ensure optimal health and performance of all the athletes. And the list goes on. If you’re a dietitian reading this and I missed your area of employment please feel free to share in the comments!

My point being that we all have a strong knowledge of nutrition but we all do different things with that knowledge. We don’t just tell people what to eat (in fact, most of us don’t) and while we can tell you what’s “good for you” in spinach that’s not the real focus of what we do – unless you’re a dietitian with the spinach growers association ;) We are all trying to help people make healthier choices (directly or indirectly) in our own ways.


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How a dietitian does a juice cleanse

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Image by 从峰 陈 on flickr. Used under a Creative Commons Licence

I really like the idea of Bon Appetit’s Healthyish column because, as I’ve mentioned before, a healthy diet isn’t about bland deprivation. However, a recent column made my blood boil.

I knew that nothing good would come from reading a column titled: How a Food Critic Does a Juice Cleanse but like a moth to a flame I just couldn’t help myself from clicking on the link when it appeared in my inbox. It was even worse than I imagined.

I can understand the difficulty that a food critic would have maintaining a balanced diet. Travelling can do a number on even the most conscientious eaters with the large portions at restaurants and the often insufficient quantities of vegetables, particularly in the States. It must be even more difficult for a food critic who has to sample many dishes and courses. That being said, the article should have ended mid-way through the first sentence: “Step 1: Don’t do it unless you have to” should have read: Don’t do it. Probably not enough words for SEO, but a much better message.

Initially I was pleasantly surprised to see the author, food critic Andrew Knowlton write: “Yes, I’m aware that pretty much every dietician says that juicing is not good for you.” Okay, good, he misspelled dietitian but at least he’s acknowledging that the profession devoted to nutrition and helping people make good food choices is opposed to juice cleanses. Sadly, it was all downhill from there.

It’s not that Knowlton chose to torture himself by consuming only juice for five days. Yes, I think that’s foolish, unhealthy, and unnecessary, but he’s an adult and can make his own decisions. It’s that he did this in front of his daughters. This honestly enraged me. Children learn from what they see others doing and their parents are usually their most powerful role models. Yes, Knowlton continued to cook bacon and actual food for his daughters but they saw him subsisting off juice. What message is that giving them? It’s teaching them that this is normal adult behaviour. That we can’t be healthy by consuming whole foods. That when we believe we’ve overindulged the solution is to starve ourselves. That diets, disordered eating, and self-inflicted punishment are synonymous with health and virtue. That is not a healthy message to be teaching children. Regardless of what Knowlton is telling his girls, actions speak louder than words. He may well be telling them to eat balanced meals and whole foods but if he’s doing that while sipping on a beet-ginger juice the juice is going to speak louder than the words.

If I may be so bold, I’d like to propose a rebuttal column: How a Dietitian Does a Juice Cleanse. Step 1: Don’t do it.


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Follow Friday: @Evergreen_RD

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Back on track with the RD Follow Fridays for the penultimate Friday in Nutrition Month. This week I’d like to suggest you follow the fabulous Marianne Bloudoff of BC. Like me, she took a meandering path to a career in dietetics. Unlike me, she had a cool career in fisheries management before heading back to uni to study dietetics in order to combine her love for both science and nutrition.

Much like me, again, she ended up moving away from the ocean to work in public health. She’s currently employed as a population health dietitian with the Northern Health Authority and is the regional lead for food security. The region being the entire northern half of the province. She’s a regular contributor to the Northern Health Matters blog.

I got to find out some other cool facts about Marianne when I told her I wanted to write a post on her. Like, did you know that she competed for Australia in synchronized skating at the world championships?? How cool is that?! On a less cool note, she’s one of those unfortunate souls who dislikes cilantro :(

You can find Marianne blogging at Evergreen Eats or follow her on various social medias… She’s on twitter as @Evergreen_RD where you can find her posting about nutrition, recipes, politics, and whatever else strikes her fancy. On Instagram as @Evergreen_RD where she primarily posts gorgeous food photos. On Facebook as (nope, she fooled you!) EvergreeneatsRD where she shares lots of food porn and recipes and I’m getting hungry writing this post. Last but not least, for the dog lovers out there, you can follow her French Bulldog Barley on Instagram too @barley_thefrenchie.

Do you know an amazing RD who should be featured in a future Follow Friday post? Get at me!


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Follow Friday: @fatnutritionist

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This week I’m telling you all that you should follow Michelle Allison (aka @fatnutritionist). That is, if you don’t already.

Michelle is a dietitian in Toronto who is a strong advocate for loving your body, no matter its size, and for being friends with food. She has the best twitter rants. I also really admire that she’s been using her platform on twitter to advocate for resistance in the US.

You can also find Michelle at thefatnutritionist.com.

Do you know a dietitian who I should feature in a future Follow Friday post? Let me know in the comments, via twitter, or email.