Dispelling nutrition myths, ranting, and occasionally, raving


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The bigger problem with the cosy relationship between dietitians and the food industry

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Lots of drama in the dietetic world last week. No, I’m not talking about the wildly popular Dietitians Day. First, the Academy of Nutrition and Dietetics (AND) in the US brokered a facepalm worthy deal with Kraft to have their logo placed on process cheese slices. Dietitians everywhere (myself included) were outraged, certainly not shocked, but definitely outraged. And rightfully so. How are people supposed to take us seriously when an organization claiming to represent thousands of dietitians is promoting process cheese. A product that the majority of us would neither consume nor recommend to clients. On the defensive, AND released a statement (you may need to scroll down a bit to find the post) claiming that the prominent placement of their logo on the process cheese was not indicative of endorsement. Rather, the logo was indicative of Kraft’s support of AND. Right. We all know that doesn’t matter. It’s the perception that matters and everyone perceived the placement of the AND logo as an endorsement of the questionable product. Especially since the initial accompanying pronouncement stated that AND was proud to have their logo appearing on Kraft singles as many children don’t consume enough calcium and vitamin D. AND will be forming a committee to address the concerns of members regarding this deal with Kraft, in MAY. If you agree that this “partnership” is wrong then please take a minute to sign the Change.org petition asking AND to “repeal the seal”.

Hot on the heels of the AND Kraft debacle was the news that a number of dietitians had promoted mini-Coke cans as “healthy snacks”. These dietitians were likely all paid for selling their souls this work, although one of them couldn’t recall if she was paid by Coke or not. Gee, I wish I was making so much money that I could forget whether or not I was paid for something. While I hate to rag on fellow dietitians, it frustrates me to no end to hear of others doing such a disservice to our profession.

Both of these stories exemplify how the relationship between the food industry and dietetics/dietitians undermines our integrity as health professionals. There is a larger problem here. Dietetic organizations need sources of funding that do not come with conflicts of interest. Dietitians need more and better job opportunities. I understand that it’s a tough job market. Believe me, I’m not raking in the dough and I’m only quasi working as a dietitian. However, I would sooner give-up my status as a registered dietitian than to use it to promote questionable food and beverage choices. With the constantly changing science and messages in nutrition it’s hard enough to convince people to trust us. Is it really worth sacrificing our credibility to make a buck?


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Second guessing the second guessing the dietitian post

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I’ve been noticing a disturbing trend among dietitians lately. It involves a certain division of RDs into two groups: “real” food RDs and all of the other RDs. Honestly, I’m not sure what the non-real food RDs are eating and advising others to eat. So far as I can tell, “real” food is the paleo diet and if you’re not paleo you’re not a “real” food RD. The implication being that dietitians advising you to consume anything other than paleo are inferior. I wrote a bit about this nutritional elitism last week. It offends me that, despite being an avid cook, some dietitians would suggest that I don’t eat “real” food because I don’t buy-in to a particular diet. I can assure you, I am not a machine (despite what some on fito have suggested), I do not run on diesel, electricity, nor hot air, I consume a variety of foods for fuel.

This “real” food RD group lead me to this post: Why you should second guess the dietitian. Now, I know that things are different in the US than they are in Canada so I’m trying not to take this too personally. However, it’s extremely frustrating to devote years of my life to a profession that I’m passionate about and to see others (including those within the profession) bashing it. It’s understandable that the author would have a hate-on for dietitians. She’s a holistic nutritionist, and as such, would be subject to much disdain on the part of dietitians due to the lack of evidence-based practice and of professional accountability in her chosen career. I don’t want to turn this into an “us versus them” diatribe though. I have no desire to get into a mud-slinging match. I know some reasonable and intelligent holistic nutritionists. No, my issue is the undermining of dietitians based on a couple of negative personal experiences the author had and based on the actions of the American governing organization (Academy of Nutrition and Dietetics – AND).

The gist of the article is that dietitians lack credibility because their governing organization is in cahoots with the food industry. There is no doubt about it; that’s a huge conflict of interest. It’s ludicrous that the food industry would be providing funding and education for dietitians via their professional organization. However, this does not mean that you can’t trust dietitians. It’s also important to note that there are a number of dietitians rallying against the relationship between the AND and the food industry, both through the group Dietitians for Professional Integrity, and through personal decisions. Despite what the author would have you believe, we dietitians are not all attending conferences and lapping up nutrition “education” provided by Hershey and Coke.

Sure, there are going to be some (as in any profession) who are going to unquestioningly accept any nutrition information provided to them in a conference or a webinar. However, from my experience, the vast majority of RDs are intelligent enough to question information presented to them (regardless of the source) and to filter out the wheat from the chaff.

Yes, as the author says, any reputable dietitian will also suggest that you should question any health information given to you. Doctors, dietitians, holistic nutritionists, none of us are infallible and the field of nutrition is constantly evolving. Dietitians are committed to life-long learning and to providing evidence-based advice. We are not droids for the food industry.


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Why the nut study made me nuts

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A study published last week in the New England Journal of Medicine found that the consumption of nuts was tied to lower mortality rates. I love nuts but I hate studies like this.

The research was funded by the International Tree Nut Council Nutrition Research and Education Foundation. Yep, that sounds like an impartial sponsor. I’m sure that didn’t affect the results whatsoever. Yes, they may have had no influence on the design and results but if they study hadn’t found a benefit to eating nuts would it have been published? Would it still have been promoted in the press?

Even putting aside the significant issue of bias, this study wasn’t great. It used the data from the Nurses’ Health Study. Why do I see this as an issue? Well, it relied on self-reported data. We know that self-reported food intake surveys are flawed and tend to provide inaccurate information. Even if the information provided was accurate, we don’t know how generalizable the results from a survey solely of nursing staff is to the general population. These nurses may differ in some fundamental way from the general populace. There’s huge potential for confounding factors in studies like this. Lower mortality rates may be attributed to other aspects of lifestyle, diet, or socioeconomic status. The nut eaters could have been eating the nuts with something else that was the actual health promoter or they may have been eating the nuts in place of something else that was detrimental to health.

It also bothers me that people who had previously had cancer, heart disease, or stroke were excluded from the study. This means that even if eating nuts benefits healthy people (as the study claims) we still don’t know if it benefits those who are, or who have been, ill.

The study also fails to tell us if there is a limit to how many nuts we should eat in a day for maximum benefit. They found that those who eat nuts at least daily had the lowest mortality rates. However, they didn’t say how many nuts people were eating each day. Nuts are undoubtedly delicious and nutrient dense. They are also calorie dense. Having a handful of nuts on your oatmeal or a walnut pesto on your pasta may be beneficial but eating a large bag of trail mix for a snack most likely is not. Simply telling people to eat more nuts is not helpful dietary advice.