OK, so maybe they don’t. In fact, everyone was pretty civil in the comments to my nutritionist series last month, and I’d like to thank all the commenters for that…it doesn’t always happen in the blogosphere. I recognize that I ruffled some feathers, and now that the dust has settled, I wanted to address some of the common themes in the feedback.
Many of the comments related to the process of researching and writing this piece, rather than the substantive points I make about nutritionists and their accreditation, so I thought we should get these out of the way first.
1. Why Did I Write This?
Ana asked about my inspiration and Anon wondered what happened to me that I hate nutritionists so. The fact is, I don’t hate nutritionists – the article may have been snarky, but it was not meant to be venomous. With a few exceptions for the shadier accrediting organizations I call out, I’ve found most nutritionists honestly believe what they do is valuable, and that’s not the type of thing that draws my hatred.
As for inspiration, I really hadn’t given the issue much thought until a relative started a nutritionist program in the States last year. In exploring what she was doing, I was struck by both the questionable science in the school’s philosophy, as well as the non-accredited nature of her diploma. It started me wondering whether the same was true in Canada, and one day I decided to look into it more deeply – the result of which was this series of articles conveying what I found.
2. Did I Conduct Myself Ethically?
Eleanor Healy at CAHNPro, with whom I spoke in preparation of this series, complained that I was not above board for failing to disclose during our discussion that I was researching an article. This is a fair charge – I told Healy and others I talked to that I was researching schools and trying to understand how the various designations work, and asked for their help figuring it out. This was of course perfectly true, while not being the whole truth, and I was aware that Healy and others probably assumed I was a prospective student.
I gave the matter a lot of thought before I started making calls. Professional journalists sometimes commit much graver dishonesties than this in pursuit of a story – going undercover, etc. The voluntary ethics code from the Society of Professional Journalists explicitly permits this sort of thing when more open methods are unlikely to yield information the public has an interest in knowing. While I was only really looking for publicly available information, I thought it unlikely I’d get even that if I identified myself as a writer from a Skeptic journal. By allowing their misperception of who I was to persist uncorrected, I was able to access such public information as they would openly tell a prospective student, and no more. This seemed like slim damage to achieve a great benefit, and while I still wasn’t completely comfortable with the deception, I decided it was justified.
In a related charge, Wendy Gibson of CANNP, with whom I also spoke, said that I misrepresented our discussion. This is untrue. Not only do I recall the conversation clearly, I took detailed notes, and I stand by what I wrote as an accurate reflection of our talk. She may have misspoken – people sometimes do – but the words were hers. Nonetheless, she’s clarified her position in the comments.
3. Am I neutral? Am I biased?
This struck me as odd, but it was pointed out several times, so I feel the need to address it. I’m not sure where readers like Kate, Anon, and Anonymous got the impression that I’m supposed to be neutral, but that’s a fundamental misunderstanding of what skepticism is. Skeptics absolutely take sides – we just take them based on the best data available, with a conscious attempt to overcome bias in our analysis, and a respect for the fact that as the span of human knowledge grows, sometimes we have to revise our assessments. So no, I was not neutral, nor was I attempting to be.
But I also do not believe – as was charged – that I was biased either against nutritionists or in favour of Dietitians. My assessment of both the differences in the certifying regimes and the value provided by each may have been unwelcome to the nutritionist community, but as I hope to show in the rest of this post, they were indeed fair and unbiased.
Now for comments on the meat of the articles…
4. On the State of Nutritionist Certification
By and large, there was little debate that the current situation is less than ideal – in fact, most of the comments even from nutritionists supported my assessment. Laurene Sauro, Director of CAHNPro, describes the impetus behind creation of the organization as an attempt to clean up much of the mess I describe in the article: “…we decided we are not going to give them any silly initials after their name because they are meaningless to the public and everyone else and we learned the government prefers schools to give designations, not associations. “
Wendy Gibson of CANNP writes, “Yes, the different ‘letters’ used within our industry can be confusing, and I actually do agree that this is not the best state of affairs.”
Lisa Baston wrote, “unfortunately it’s true that nutrition isn’t strictly regulated in this country, and like you – I wish it were!” Nutritionists seem to want the imprimatur that a single national certification would provide — with the irony that their organizations are multiplying in pursuit of such unity.
5. On the Value of Nutritionists
Here I think many of the respondents mistook my position.
I do not believe that there’s no value in consultative services to improve one’s diet. Of course there are best practices for eating supported by science, and to the extent that people aren’t getting that message, there’s certainly a role for someone to help them. In that Laurene, I agree with you.
I also do not believe that there’s anything wrong with eating a diet full of vegetables, fruits, nuts and whole grains, or in moderating meat consumption. So Sarah, there’s nothing wrong with the diet you’ve outlined — I try to eat that way myself, though perhaps not with the consistency you seem to. I even have the odd smoothie now and again.
My objection is not to the science-based advice nutritionists give – they give lots of it. It’s to the non-science based advice they give alongside it. And to their seeming inability to tell the difference.
One doesn’t need to look farther than the commenters themselves: Lisa and Ilona both couple their nutrition advice with magical nonsense like Reiki. The nutritionists at D’avignon Digestive Health Centre I referenced at the start of the first article offer placebo treatments like colon cleansing and coffee enemas, for which there is no evidence of efficacy. And I already pointed out that the schools themselves teach courses on homeopathy and aromatherapy — wishful thinking masquerading as treatment.
I’m sorry, but nutritionists can’t have it both ways. You can’t say there’s science behind what you do when it’s convenient, and then practice non-scientific treatments, all packaged up as a “cleanse”. At least not if you want to avoid the type of criticisms I make in these articles, or public mockery like this:
Clearly nutritionists are passionate about their profession, and I can respect that. As I’ve said above, I don’t believe many of them operate with malintent, but I also don’t think many of them have been trained to consistently give science-based advice. And that’s ultimately my biggest concern, because at the end of the day, it doesn’t matter whether you believe deeply that a treatment works. If you don’t require proof that it does, or you willfully ignore evidence that it doesn’t, you’re committing fraud.
Still, I actually do believe that there’s a place for science-based nutrition consulting in the world, separate from the domain of the Dietitian, and that such a service can be valuable. Unfortunately that’s not what we have in Canada today. Instead, we get well-meaning individuals who mix fact and fiction, ostensibly with little understanding that they’re doing so.
If organizations like CAHNPro and CANNP are actually going to fix that problem, they’ll have my full support. Until then, I remain highly, justifiably, skeptical.
Photo courtesy of Hourman via Flickr under Creative Commons