Dispelling nutrition myths, ranting, and occasionally, raving


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The day the Internet dies

Sometimes I think that we would all be so much better off if the Internet collapsed. Or at the very least, social media networks.

I was reading this article: The Death of Civility in the Digital Age that Yoni Freedhoff shared on his blog last week and thinking about how true it is. People are so ready to attack, always looking for a fight, on social media. The interaction of your fingers with your computer or mobile phone sending out words to someone you’ve probably never even met irl is vastly different from having a conversation with someone face-to-face, or even over the phone. It’s so easy to respond hastily and to neglect to consider that your words will be read by a real actual live human.

While I love that I can find the answer to nearly any question immediately on a tiny computer I carry in my purse I find myself more and more often wondering if it’s worth the cost we’re paying. Egregious cellphone bills in Canada aside, I mean what we’re paying in declining humanity and rampant misinformation.

I can find the answer to nearly any question online but anyone can put what they believe to be the answer out there. This means, especially in the world of nutrition, that there can be heaps of misleading, inaccurate, and completely false information that I need to sift through and assess before I come to the correct answer. There is an ever growing mountain of misinformation online and a tide of dietary dogma on social media. It’s ever so tempting to just shut it out but I feel an obligation to stay online to fight it, to try to dilute it with as much truth as I can. Which is hard because there aren’t many hard and fast truths when it comes to a balanced diet, despite what the radical carnivores, vegans, ketoites (I don’t know what they call themselves), LCHF-ists, HCLF-ists, etc etc would have you believe.

I also hate the constant need for self-promotion. I’m reading the novel Radiant Shimmering Light right now and the whole obsession with getting likes on IG, and RTs on Twitter really rings true. There are a few characters in the book who are “lifestyle” bloggers and they present these varnished, edited versions of their lives as currency. They make money through links on their websites and through selling the idea of perfection and self-marketing. The book is kind of poking fun at this world we’ve created but it’s done so in a way that you really feel the anxiety-provoking compulsion of the narrator to check her notifications. It’s nearly impossible for a dietitian, especially one in private practice, to not use social media. There are dietitians who make a living by coaching others on how to optimize their Instagram feeds. Like are you even a dietitian if you’re not posting perfectly styled photos of acai smoothie bowls and kale salads?

Our years of nutrition education and proof of ongoing education are no longer enough. Now we must be savvy social media marketers, chefs, expert food stylists, and photographers. We must be brands in and of ourselves. We must constantly be competing with self-styled nutrition gurus, other dietitians, and ourselves. I know that I’ve probably got my rose-coloured glasses on, but I yearn for a day when I don’t have to see literal meatheads mocking people for eating plants on twitter. When I can be blissfully unaware of the insane dietary advice naturopaths and some chiropractors are doling out to their clients. When I don’t have to see dietitians promoting juice as nutritious.  When we can all just stay in our lanes and do the jobs we were trained to do.


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Whole Life Challenge review

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You know what I’m sick of? Engineers and people with zero nutrition education making claims that you can “biohack” your life, undermining dietitians, and giving one-size-fits all nutrition advice. This rant seems appropriate coming on the heels of my post about the carnivore diet.

Earlier this summer my brother asked for my thoughts about this “Whole Life Challenge” that a bunch of people in his office were doing. He was a little sceptical about the nutrition advice they were providing and wanted to know my thoughts as a registered dietitian.

My first question was, “who is behind this challenge?” Well, we’ve got the founders: Andy who has a background in sales and engineering (quelle surprise) who then opened a crossfit gym and Michael who was a coach and manager at a crossfit gym, and has a degree in philosophy and culinary arts. Well, at least he’s got a little knowledge of food in there but as most know, culinary arts and dietetics are woefully disconnected professions with chefs learning little to nothing about nutrition. The remainder of the team is comprised of the CEO, social media, web development, content manager, corporate relations, a couple of customer service reps, chief technology officer, and public relations. There is absolutely no one working for this enterprise that has any background in nutrition or health. Sigh. 

At a glance, the “challenge” doesn’t look so bad. The idea is to work on seven daily habits over the course of six weeks. You get points for completing each of the daily habits and you’re supposed to play with a team (the more people playing the more money they make this will help “foster success”). The habits are as follows: nutrition, exercise, mobilize, sleep, hydrate, well-being, and reflect. Many of these are areas that most of us could stand to improve on. Of course, I’d like to reiterate that the people who created this challenge have zero education pertaining to any of these topics. Cost is $39 US per player.

Unfortunately, you have to pay to play so I can’t access all of the materials available to players, including the nutrition plans. Fortunately, I have the inside scoop ;) and was able to view the nutrition material. They’ve created three levels with the highest being the “performance level”. This level is for those who, “already have good eating habits that you just want to fine tune, have athletic or performance-related goals, or have a pressing health or inflammation condition that you’d like to address”. The level below that is the “lifestyle level” which is, “A good choice if you are looking for a long-term lifestyle nutrition program. This is a great start to a sustainable practice of living a healthy lifestyle”. The easiest level is “kick start” which is supposedly, “a great place to start if you’re new to the health and fitness game and need to make the most important tweaks to get yourself started in the right direction”.

At each level of the plan you’re given a list of foods that are “compliant” and “non-compliant”. The higher the level, the fewer the foods that are compliant. How did they determine which foods are “compliant” and which are “non-compliant”? Excellent question. I have no idea other than the statement they make at the top of the charts: “When you see (*) next to a food, it indicates the food is compliant but should be eaten in moderation, as there are potentially negative effects from overconsumption”. I assume that this means that they believe there are negative effects from consumption of “non-compliant” foods. What these negative effects are is anyone’s guess. Maybe weight gain? Inflammation? Enjoyment of life? The non-compliant foods for the “performance level” are: deli or processed meats, soy, corn, white potatoes, soybeans, taro, yucca, beans and other legumes, dried fruit with added sugar, peanuts, peanut butter, hydrogenated oil, industrial vegetable and seed oils, every grain and grain product, alcohol, soda (diet or regular), juice, all dairy (except butter), the only snack foods allowed are baked sweet potato fries or chips and baked vegetable chips. Yum yum. To be fair, they do say that this diet would be difficult to maintain long-term and “maybe not even necessary”. Yeah, no shit.

Just for fun, and your reading pleasure, my brother endeavoured to follow this diet for a few days. My brother is a prolific runner, he’s in his third year of a running streak and he’s fast. He eats a balanced and varied diet and enjoys the occasional beer; a candidate for the “performance level” if there ever was one. Unfortunately, he came down with a cold at the same time so his report was: “my lack of energy could have been the diet or being sick”. N of 1, inconclusive.

That being said, while this diet might work for some, it’s probably not the best diet for most endurance athletes. It can be very difficult to obtain sufficient nutrients and calories and attain peak performance on such a limited diet. Also, beans and legumes and whole grains are full of good nutrients as well as being affordable. Any non-medical diet that tells you to eliminate all of these foods is unlikely to be sustainable or healthy in the long-run, particularly for those who engage in long runs (sorry, not sorry).

Six weeks isn’t all that long and when people are working in a group challenge there’s more incentive to stick to a plan than there would be on their own. There’s also minimal risk of nutrient deficiencies being a serious concern over such a short time frame. However, because this challenge is framed as a short-term undertaking and the diet plans aren’t easily sustained, I worry that this will encourage weight cycling in participants (which may actually be more harmful than maintaining a higher weight long-term) and discourage long-term adoption of healthy behaviours. If you’re only adopting these “habits” for six weeks to win a challenge and it’s a major change from your usual lifestyle I can imagine that at the completion most people celebrate finishing by ditching all the “habits”. It would be interesting to see research on participants of a challenge like this.

This plan is also very prescriptive. Apparently I should be drinking 37 ounces of water a day. There is no mention of drinking to thirst here or adjusting intake based on physical activity, temperature, or other fluid intake. You are not learning to listen to your body on a plan like this. There is no allowance for individual differences or personal preferences. Compliant foods equate to “good” and non-compliant equate to “bad”. This reinforces the false moralistic attitude that many people have about food. It also fails to consider that we eat for many different reasons and that taking pleasure in food and enjoying food socially are important aspects of eating. Framing healthy eating as being complicated and unpleasant only serves to make people adopt an all-or-nothing mindset toward a (perceived) healthy diet. Winning at this challenge may only set you up for failure when it’s over.


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Call in the food police, we’ve got another unruly body

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I feel the need to expand on something I touched on in my post last week. It’s related to people judging dietitians on the basis of our weight. My previous post mainly discussed why it’s inappropriate to judge anyone’s professional abilities, including dietitians, on the basis of their perceived size. However, I think this all too common judgement also speaks to the lack of understanding of what we do.

There’s a common (mis)perception that dietitians are all weight loss counsellors. As a result, if we don’t have that elusive “perfect body” people think that we suck at our jobs. After all, what else do we do other than police the food people put into their mouths. If we can’t control the food going into our own mouths, how on earth can we possibly control the food going into the mouths of all the other owners of “unruly” bodies. While some dietitians certainly do work in weight management, even those dietitians are not actually food police. The majority of dietitians don’t work in weight management. Curious what a dietitian actually does, check out this old post.

It is not part of my job to control my body so that it fits your perceived notion of healthy and fit. Whether or not I am large has no bearing on my knowledge of nutrition. It does not impede my ability to calculate a tube feed, modify a recipe, expound on celiac disease, or help someone with diabetes manage their blood sugar. Just as being small and having no knowledge of nutrition does not automatically imbue me with the capacity to do these things. As with any profession, the size of a dietitian is not a reflection of their knowledge, experience, or capability.

Dietitians do So Much More than help people lose weight. Despite the impression that our name gives, we are not all about putting people on diets. For many of us, aside from medically necessary diets (for example in the case of allergy sufferers or those with celiac disease) “diet” is a four letter word. We’re not all on a mission to rein in unruly bodies and create a world populated solely by thin bodies. When we do work in positions of counsel we usually aim to help people to gain greater compassion for, and appreciation of their own bodies. To help people view food as a source of pleasure rather than an enemy out to destroy our hard-fought-for chiselled physiques.


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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.