Dispelling nutrition myths, ranting, and occasionally, raving


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Another hot take on Canada’s new food guide

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You all know that I can always find something to bitch about. I’m that girl who’s always the one to find a bug in her freshly picked raspberries or the bone in her piece of fish. My mum will attest to that. It was a running joke in my family that if there was anything weird to be found in the food, I would be the one to find it. So, it should come as no surprise that I have lots to say about the new food guide. But… it may come as a surprise that I don’t actually have anything negative to say about it! In fact, I think it’s pretty fucking great.

In no particular order, here are the changes that I’m most excited about:

  • The addition of food skills (and food literacy). This is literally 85% of my job and it feels really good to have Health Canada supporting it as an important part of healthy eating.
  • The removal of juice as a serving of fruit. It’s going to be so nice not to have to deal with that terrible piece of advice anymore.
  • The removal of serving sizes and recommended number of servings. They confused people and it’s impossible to make recommendations that will work for the entire population. I can’t wait to no longer hear “I can’t eat ALL that” again.
  • I’m glad they got rid of the meat and alternatives and milk and alternatives food groups and lumped them into a proteins group from which they encourage plant-based sources of protein.
  • I appreciate the inclusion of Indigenous foods and ways of eating and the acknowledgement that many people in remote communities and on reserves may struggle to meet the recommendations in the food guide.
  • Following from that, I also appreciate the recognition that external factors, in particular, many social determinants of health, can affect the ability of people to follow a healthy diet.
  • I’m glad that water is recommended as the beverage of choice, again bye bye juice and chocolate milk 👋🏻👋🏻👋🏻
  • I like that the emphasis is on promoting health and only once is weight mentioned. As I’ve ranted about in the past, the food guide is not supposed to be a weight loss diet plan.
  • The photos included in the guide are really appealing. They look way more appetizing to me than the old cartoonish images did. Plus, they’re all about full meals and not just random foods.
  • The overall focus is on a healthy pattern of eating, not just individual nutrients. Much more in-line with how we actually eat. Plus it’s advised that we enjoy (wow!) our food.

My one concern (aside from a couple of very minor things) is that apparently Health Canada does not plan on making the resources for the general public available in print. I think this is a huge mistake. Not everyone has ready Internet access. Also, the old food guide was used in schools and other educational settings (including the food literacy classes I teach) as a teaching tool. I work in public health and we get MANY requests from schools, organizations, and individuals for copies of the food guide. I’m not sure how we’re going to educate people and incorporate the food guide into our programs if we don’t have a print resource available. I hope that Health Canada will reconsider this decision so that everyone has equal opportunity to benefit from the new food guide.


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Naturopaths are jumping onboard #NutritionMonth and this boat ain’t big enough for all of us

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As you probably know, March is Nutrition Month. Traditionally this is the month in which dietitians come out in full force on social media, and in news articles, with nutrition tips, recipes, etc. This year I noticed a change. Yes, dietitians are still out there telling everyone to eat more vegetables, promoting the profession, and encouraging people to “unlock the potential of food”. Interspersed throughout those posts and articles though are ones from a new voice, naturopaths.

On March 15th the Institute for Natural Medicine put out a news release titled “Naturopathic Doctors Complete 155 Hours of Nutrition Education in Medical School: March is Nutrition Month“. In the linked FAQ: “What advanced nutrition education do naturopathic doctors receive?” the INM states that, “Naturopathic doctors provide individualized nutrition assessment and guidance utilizing evidence based nutritional recommendations” (emphasis mine). On addition, one of the “areas of concentration” is “collaboration with Registered Dietitians, as needed”. While part of me is glad to see Nutrition Month catching on, rather than being an echo chamber of RDs, another part of me is frustrated to see it being co-opted by a pseudoscientific profession.

The use of the term “evidence based” concerns me. What evidence might that be? Those of us working in dietetics and medicine often talk about the need for treatments, interventions, and programs to be evidence-based. However, these interventions are only as good as the evidence on which they’re based. Ideally, you want high level evidence like guidelines and and summaries which draw on a larger body of research demonstrating consistent results (check out the 6S Pyramid from the National Collaborating Centre for Methods and Tools for more details). At the bottom of the pyramid, are single studies. The single studies aren’t necessarily poor (they’re the foundation for the higher levels of the pyramid) but if there aren’t many and they aren’t in agreement it becomes difficult to make solid evidence-based recommendations. Also, it can be easy to cherry pick single studies to support nearly any position and proclaim your stance to be “evidence-based”. Without attending naturopath school, I can’t say how credible the evidence-base they’re drawing on is with certainty. However, based on what I see on the websites, social media feeds, and have heard from many people who’ve seen naturopaths, I think it’s wise to question the quality of the nutrition education they’re receiving.

I also question the statement about collaborating with RDs. I’m sure that someone will tell me I’m wrong in the comments but in my experience, I have never heard of a naturopath referring a client to a dietitian. Considering their 155 hours of nutrition education and their alleged nutritional knowledge I’m not sure why they would see a benefit to referring a client on to one of us.

Now, I’ll be the first to tell you that the plural of anecdote is not evidence and I’m sure that seeking responses from twitter is likely to have skewed toward my own bias, but I was curious what sort of nutrition advice people are receiving from naturopaths. I received a number of responses ranging from negative to positive. I assured everyone anonymity so names have been changed – thank you to everyone who was willing to share their experience(s) with me. Here you have it:

The good:

Emma told me that they started seeing a naturopath to improve her diet, energy, and overall health. She found the naturopath to be very down-to-earth with realistic expectations and advice in-line with current research. She said, “She’s always been incredibly supportive; always learning; always approaching everybody as an individual and very willing to make adjustments depending upon someone’s reactions to process.” This naturopath also provided affordable recipes and shopping plans.

Ava went to a naturopath for IBS and was told to try a FODMAP elimination diet.

The bad:

Emma’s naturopath promoted organic products as best and advised her to avoid GMOs.

Ava was also told to eliminate gluten (despite having expressed no issue with gluten and not having celiac disease). She was also not provided with sufficient support to feel like she could adhere to the low-FODMAP diet and quickly abandoned it.

Liam was diagnosed with hypercholesterolemia and prescribed medication by his doctor. He didn’t tolerate it well so he went to a naturopath who sold him a special drink and put him on an alkaline diet.

Sophia went to a naturopath to help her control her severe asthma. The naturopath advised her to eliminate gluten and follow a vegan diet with the explanation that, animal products increase inflammation in the body and were worsening her asthma. As she had previously eliminated gluten and experienced no benefit she followed a vegan diet for about 6 months. She experienced no decrease in symptoms during this time so she reintroduced animal products to her diet.

The ugly:

Liver cleanse supplements were part of the plan provided by Emma’s naturopath.

Olivia went to see a naturopath and was told to cut out dairy, given a stack of photocopied book chapters and opinion pieces, and $800 worth of liver detox tablets, supplements, and powders. To be fair, this was pre-Internet times so photocopies were not so odd, and the profession may have grown since then. But, that also makes the cost of supplements even more exorbitant than it sounds today.

Isabella told me, “I got “nutrition advice” from a naturopath. I walked in, he fat-shamed me, and gave me a whole sheaf of paper basically outlining how I already eat.”

Mia was advised to consume raw milk, and to give the same to her three year old child.

Amelia has both celiac disease and multiple sclerosis. Despite following a gluten-free and dairy-free diet, taking recommended supplements and medications, she still experienced digestive issues. She went to see a naturopath who advised her to get IgG allergy testing. Due to the nature of this not recommended form of allergy testing the naturopath told her she could no longer consume the foods that she was consuming the most of leaving her with very little that she could still eat.

Harper went to see a naturopath after being diagnosed with breast cancer. After spending over $15, 000 on a “natural” treatment overseas she ended up having a double mastectomy but sadly died within a year.

If this is the sort of nutrition advice that naturopaths are providing I’d rather have Nutrition Month remain the echo chamber of dietitians promoting truly evidence-based nutrition recommendations.


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Follow Friday: @rooted_project

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I’ve been neglecting follow Friday posts. I’ve also been thinking a lot lately about how most of what I blog about is tearing things apart. Granted, they all deserve our derision… That being said, after ranting a few times about how there’s so much in-fighting in dietetics I thought that maybe in an effort to counterbalance some of that, that I would start devoting my Follow Friday posts to promoting blogs, websites, and initiatives of my fellow RDs.

Since The Rooted Project held their first public event this past week I thought they’d be a great project to start this new positive series off.

The Rooted Project is the brainchild of British dietitians Rosie Saunt and Helen West. Both of whom I’ve mentioned on my blog before. Their aim is to bring evidence-based nutrition to the masses through public panels and events. If you’re in London I recommend keeping an eye on what they have in the works. If you’re not, like me, I recommend following them on twitter.