Dispelling nutrition myths, ranting, and occasionally, raving


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Why this dietitian hates Nutrition Month

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It’s March and that means it’s Nutrition Month. The time of year when dietitians post a whole bunch of the same social media messages that were created by Dietitians of Canada and a whole bunch of people probably mute the hashtag “NutritionMonth2020” to stop the onslaught. And I have to confess, even as a dietitian, that impulse is strong. But, the bombardment of generic healthy eating messages aside, there’s another reason why I hate Nutrition Month and that’s the fact that it’s more of a vehicle for Big Food to promote their products than it is an opportunity for dietitians to promote nutrition and our profession.

Every year Dietitians of Canada releases a suite of Nutrition Month tools and resources. And every year I find myself feeling frustrated by the obvious bias they exhibit for their sponsors. Let’s see if you can guess the two sponsors this year just by the recipes in their free recipe booklet: Hearty Manitoba Vegetable Soup, Avocado and Fruit Salad with Basil and Honey, Proudly Canadian Beet and Barley Salad, Roasted Cauliflower Farro and Avocado Salad, Avocado and Tuna Salad Sandwich, Easy Red Lentil Dhal, Grilled Vegetable Bean and Avocado Tacos, Mexican Squash and Bean Salad, Super Easy Chicken Parm, Chewy Ginger Pecan Cookies, Peach Strawberry and Almond Muesli, Yoghurt Bark. To help you out a little, I’ve bolded the recipes that were supplied by the sponsors. One is obvious: Avocados from Mexico. The other may be a little trickier: Dairy Farmers of Canada.

Dietitians are supposed to be an unbiased, evidence-based source of nutrition information and yet how can we expect people to believe that when a national dietetic organization accepts sponsorship from food companies and exhibits clear preference for those foods as a result?

Don’t get me wrong, I love avocados as much as a Millennial and I consume plenty of dairy products. However, both of these foods are problematic and should probably not be so heavily promoted by Dietitians of Canada. There are ethical concerns about both avocados and dairy (e.g. methane gas, land use, animal welfare). In addition, these are both fairly high-ticket grocery items, at least in Canada. A single avocado often goes for $1.99 at my local grocery store while a modest block of cheese is at least $7.99. Considering that about one in eight households in Canada is food insecure is it really appropriate for DC to be promoting such costly items as part of national Nutrition Month? I mean, considering that an annual DC membership costs $496 and DC has roughly 6000 members, surely to goodness they could develop a few recipes on their own, or even have members submit them so that they didn’t have to resort to corporate sponsorship.

All this to say, I hate Nutrition Month. Nutrition Month could be great. Dietitians of Canada has a fantastic opportunity to promote nutrition, dietitians, and all that we do. However, as it stands, Nutrition Month does nothing more than to undermine our credibility as nutrition professionals.


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Doctors don’t know about nutrition but who could possibly teach them?

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I came across this journal article in an email digest last week and I discovered that I do have enough fire left in my belly to keep blogging because holy shit y’all was it ever enraging!

The article title and abstract indicate that nutrition education is missing from the education of doctors and that doctors need this education due to the important impact of diet and nutrition on health and in many disease states. No argument here. However, they then go on to say, “Without properly trained trainers, we have no one to train the doctors of tomorrow. This is a “catch 22.” Okay, they must be planning to talk about how dietitians, you know that entire profession devoted to the study of nutrition, can play a role in the full text. I mean, it seems like a pretty obvious solution. But… I find the full text and there is nary a mention of dietitians in the entire article. It was then that my blood began to boil.

Is there some sort of rule that I’m unaware of that only medical doctors are qualified to teach medical students? Have the authors never heard of dietitians? The entire article is quite frankly baffling. I’m honestly appalled that the authors, one of whom appears to be a medical doctor, are incapable of such basic research as to be able to discover that there is in fact an entire regulated allied health profession devoted entirely to the study of nutrition. They’re worried that doctors don’t know about nutrition? Well, I’m worried that doctors can completed medical school without basic research skills. I’m also a little amazed that it was accepted for publication in a peer-reviewed journal devoted to “advances in nutrition” and no one thought “hey, hang on a sec… this is not actually a problem. Dietitians and nutrition scientists can teach these students. Maybe we can just tell them this and save them the embarrassment of publishing this drivel.” But no, apparently everyone was like, “yes. Very serious problem. Doctors need to know about nutrition but doctors don’t know enough about nutrition to teach medical students so future doctors will all continue to graduate without the foggiest understanding of human nutrition and women will continue to suffer from anemia.”

Good news: there are plenty of dietitians and nutrition scientists (not all nutrition researchers have the RD credential) who teach dietetic students who could also teach medical students about nutrition. While they’re at it they can also let them know that doctors don’t have to be experts in every area and they can in fact refer patients to dietitians when they require nutrition support.


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Top 10 of 2018

Easing back into (or maybe out of) blogging in the New Year with my top 10 most popular posts in 2018 (based on number of hits). Thanks for reading!

  1. Being thin is not a qualification for providing nutrition advice
  2. Are Clif Bars a healthy snack?
  3. Are pharmacists the new dietitians?
  4. Call in the food police, we’ve got another unruly body
  5. Breathing vs raw food. Should we be getting our oxygen from our diet?
  6. Whole Life Challenge review
  7. I don’t know why you say Hello (Fresh), I say goodbye
  8. Naturopaths are jumping onboard Nutrition Month and this boat ain’t big enough for all of us
  9. A smile doesn’t hide your weight bias
  10. To keto or not to keto


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Response to: The Rise of the Anti-Diet Movement: Is it No Longer P.C. to Want to Lose Weight?

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Someone I follow on twitter recently shared this blog post: The Rise of the Anti-Diet Movement: Is it No Longer P.C. to Want to Lose Weight? by another dietitian, Janet Helm. In the post she mused about dietitians promoting themselves as “non-diet” and what this might say about other dietitians. She agreed with many points made by dietitians, quoted in RD/writer Cara Rosenbloom’s recent excellent piece for the Washington Post about non-diet dietitians, but seemed unwilling to go so far as to embrace the philosophy herself. She ended her post with the following questions: “Can’t we all get along? Can’t intuitive eating and body positivity coexist with losing weight?  Why must we line up on two sides?  Why the conflict?” I’m going to do my best to respond to these questions.

First, I too have asked that same question: “Can’t we all get along?” at times. Remember craisingate? Personally, I don’t think that as dietitians we have to agree on everything. It’s okay for us to have different perspectives and approaches. Also, in the case of diet vs non-diet, I don’t see it as an issue of getting along. Maybe I’m blissfully unaware, but I haven’t seen any “non-diet” dietitians attacking other dietitians for promoting weight management. I don’t see dietitians referring to themselves as “non-diet” as lining up on an opposing side or creating conflict. Rather, I see this identification as a way for dietitians to let prospective clients know that they do not promote weight loss as a goal. In a profession which so many believe our sole mission is to help people lose weight I think that it’s necessary for RDs who do not promote weight loss diets to make this clear up-front. I don’t believe the intent is to pass judgement on other dietitians who haven’t embraced the same approach, or to create a professional divide. However, I can see how a dietitian who has built a career around weight management counselling might see this new-ish movement as a personal judgement.

My friend Cheryl Strachan, aka “Sweet Spot RD” wrote an excellent blog post last week (while I was mulling over how best to respond to Janet’s post): Why I can’t help you lose weight. This heartfelt post explained why she would no longer work with clients on weight loss. Providing the current evidence on weight loss and health and the struggle she went through to reach this position. Rather than having me regurgitate all of the evidence here, I recommend you take a few minutes to go read it and then come back.

Done? Okay, great. So you’ll note that Cheryl mentions that when she studied nutrition in 2003 it was accepted without question that weight management was a significant part of being a dietitian. I can tell you that it was the same when I went back to uni to study nutrition in 2006. I’m not sure if things have changed since then. I suspect that they haven’t, at least not completely. It takes time for institutions and society to change. As a dietitian who has worked in weight management in the past I too have struggled to fully embrace health at every size. I understand why a fellow dietitian would ask: Can’t intuitive eating and body positivity coexist with losing weight? It’s an incredibly tough question and the answer is nuanced and it may not be the same for everyone.

I do believe that intuitive eating and body positivity can peacefully coexist with weight loss. However, I think that this can only be the case when weight loss is not the ultimate goal. For me, body positivity is appreciating your body as it currently exists and continuing to appreciate it if you gain weight or lose weight. It’s about treating yourself with respect and compassion and providing your body and mind with the nourishment they need. If you are doing these things with the clandestine goal of losing weight then you are doing yourself a disservice. That being said, it’s okay to want to lose weight. We live in a society that has conditioned us from a very young age to believe that being thin is important. It’s unrealistic to except this engrained belief to vanish overnight. It takes time to relearn to listen to your body and to treat it with respect when you’ve been viewing it as the enemy, a captor, keeping the real you the thin you hidden away. So, no, body positivity and weight loss can’t coexist but yes, body positivity and weight loss can coexist.

I think that as time goes on and nutrition programs update their curriculums, as old-school dietitians are more exposed to evidence regarding the harms of weight bias and weight loss diets, and the hold-outs retire, that things will change. After all, as dietitians we are supposed to provide evidence-based best practice and the evidence against weight loss diets is mounting. Eventually there will be no non-diet dietitians because that will be the approach we all take.


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Are pharmacists the new dietitians?

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The other day I was in a grocery store when a recording came over the PA system encouraging customers to speak to the in-store pharmacist about making healthy food choices. Naturally, I was like “what the fuck??”. People wonder why dietitians are so defensive of our profession. This. This sort of thing is exactly why. Because everyone seems to think that they’re qualified to dole out nutrition advice despite the fact that dietitians are the only professionals who spend over four years studying nutrition in university and must indefinitely continue our education to maintain our licensure.

It’s not cool of the chain to be asking pharmacists to provide dietary counselling. If you want to offer that service, hire yourselves some damn dietitians. It’s also not cool of the pharmacists to accept that added responsibility.

Yes, pharmacists are a wealth of knowledge when it comes to medications and they can be hugely helpful in advising customers about potential drug-nutrient interactions regarding medications that customers are taking. They more often than not, likely have a greater knowledge about nutrients in food than your average person. However, none of this equips them with the expertise to provide nutrition counselling.

The scope of practice for pharmacists in Canada contains no mention of nutrition or dietary counselling. Store owners may not know that this service is outside the scope of practice for pharmacists. Therefore, I believe that the responsibility lies with the pharmacists on-staff to let the company know that they are should not be providing this service to their customers. As allied health professionals they should recognize the limitations of their own scope of practice and defer to RDs in matters of nutrition counselling.

When I worked in a grocery store we had an in-store dietitian as well as pharmacists on-staff and everyone worked together to provide customers with the best service possible. Pharmacists have enough to do without having to get into nutrition counselling with customers, which, when done appropriately, can be quite time-consuming. Do you really want to wait longer to pick up your prescription? Setting aside the issue of expertise, do pharmacists really have the time to devote to counselling customers on nutrition? Let dietitians, who are actually trained to provide individualized dietary advice, provide this service so that pharmacists can focus on their own area of expertise.