I know I’ve written about this before and it probably won’t be the last time I write about it, but it needs to be said; it’s best to think twice before taking dietary advice from anyone other than a Dietitian. Far too often do Dietitians hear about their patients/ clients taking dietary advice from unqualified nutrition “experts.” This list includes doctors, personal trainers, health advocates, celebrities and people that have tried the most recent fad diet (the list goes on, but I’m going to save you a headache and stop right here). You maybe asking or saying to yourself; Aren’t doctor’s more qualified to talk about this? But my neighbours wife lost 30lbs in 2 weeks doing this! But my personal trainer has the body that I want! (And again, I’m going to stop here to save you another headache). The answer is no, they’re simply not qualified and this ends up causing more harm. An this is not one of those situations where the end justifies the means. There’s actually a very simple good and simple reason for this issue. None of the mentioned people/ practitioners fully understand what food actually means to the individual.
Now before I go on I have to say that there are many AMAZING doctors, personal trainers etc. that respect the limitations of their training. This article is not an attack on Doctors or personal trainers as a whole. It’s merely addressing the MANY concerns and issues that are currently preventing the population from actually eating healthy and proper nutrition, which is making the problem worse. This blog post is addressing those practitioners that don’t seem to respect the limitations of their training or the complexity of nutrition and seem to think there’s nothing wrong with giving dietary advice when they are not qualified to do so.
Earlier last week I woke up and a fellow Dietitian posted a link on her social network page that read “Insulin makes you fat, fasting makes you thin, according to Scarborough doctor.” Now having read the title, I obviously clicked the link to read the article (found here), and what I read was just insanity. The article discussed Dr. Jason Fung’s new book “The Obesity Code” which argues that obesity isn’t caused by overeating, but by excessive insulin. After reading the entire article and interview my reaction was “Is this guy kidding me?” Dr. Jason Fung, a nephrologist and founder of The Intensive Dietary Management program (which surprise, doesn’t have a Dietitian on staff and he’s the only one running this program) promotes fasting as a “new” way to combat obesity. There are just too many issues with this. Aside from the fact that he’s looking at just patients in his nephrology clinic to generalize to the entire population (because it’s completely rational to take what he learned from kidney damage and kidney failure patients and apply it to everyone else) it seems that no one bothered to tell Dr. Fung about Insulin resistance, how Insulin actually works instead of his insane “thermostat” analogy, that fasting isn’t new at all or about the difference between fat mass and lean muscle tissue. Dr. Fung seems to have a complete misunderstanding of the obesity issue and doesn’t realize that his “effective system” can actually do more to promote disordered eating. I will give him some credit, he recognizes the impracticality of his proposed “diet,” but that doesn't seem to stop him from promoting it. He just doesn’t understand any of the issues related to obesity at all.
Let’s not forget almost anyone can write a book. Dr. Fung isn’t the first one to try to do this. The Bernstien diet, Dr. Poon’s Metabolic Diet are just a few others. What’s worse is they advertise medically supervised weight loss, but when you look closer at the program, the term ‘medically supervised starvation’ is more appropriate. Further more the strict inclusion and exclusion criteria of the Dr. Poon program raises ethical questions about how successful the program actually is. Lastly, have you ever wondered why these programs don’t post statistics about how successful their clients are at keeping off the weight? That’s because none of them are actually sustainable and therefore they’re just a band-aid solution that causes more harm in the long run.
In the same week I had to call a personal trainer that works out in the Oakville area because he had been verbally harassing and manipulating a client of mine to the point that she was in tears during an assessment. This personal trainer seemed to think his ‘newborn clarity’ of how damaging our food system is and how animals are unethically treated allows him the right to verbally harass everyone that disagrees with him. It also appears that in his “research” he failed to understand the fundamental differences in American and Canadian food production systems and regulations. After admitting that he has no actual training in nutrition aside from a few Google searches, reading nutrition books written by Doctors that simply do not understand nutrition and watching a few documentaries, he plainly stated that he has no intention on stopping despite my educating him in the error of his ways. Ironically no one seemed to explain to him how unethical it is to force your own PERSONAL ethical/ moral code onto other people.
Now you may be thinking to yourself “But Ben, that’s only two examples.” And you’re right, I’m only giving you two examples, because if I listed them all I would never be able to finish this article, also, it was a slow week. All Dietitians have had countless arguments with these self appointed “Nutrition Experts,” so many that we have lost count, and that’s just within our first year in the profession.
What’s the ultimate issue in all of this? (Aside from the lack of formal training in Dietetics and that these practitioners can’t seem to respect the limitations of their scope of practice). These interventions completely ignore the individual. They’ve ignored so many facets of information that desperately need to be considered and are vital to success and sustainable behaviour change. They’ve ignored what food actually means to people. Of course it’s easy to lose weight when you have no actual relationship with food and you think food exists only to fuel the body. The reality is that this type of person is the minority. For the majority of the population, someone’s food choices are a reflection of their culture, their religion, their ethical/ moral beliefs, the way they were raised, their income level, their political beliefs, and their emotional state with many other factors at play. Essentially, someone’s food choice is their identity; it is a reflection of them. Think about that for a second. If someone comes in and tells you to change EVERY aspect of your dietary patterns you may be able to maintain that for a week, maybe a month, but at some point you will abandon that diet or meal plan because you can’t recognize who you are anymore, making the extreme diet methods even more unsustainable and damaging. Am I being overly dramatic here? Not at all, because the emotional toll these changes take on a person are devastating. When you ignore the individual’s identity or relationship with food what you have is a recipe for failure. Furthermore what these practitioners don’t seem to understand is that it’s the Dietitians that have to clean up their irresponsible messes. And what’s worse? These diets cause so much damage that it makes weight loss and healthy living so much more difficult!
The truth is that these people may know one or two things about food and the human body, but by no means does that mean they know anything about nutrition. Nutrition involves so much more than just calories, protein, fat, carbohydrates, food groups etc. Nutrition involves many social sciences, the study of cultural and religious aspects of food, economic patterns, societal and political differences, microbiology, organic chemistry and the list goes on. The important thing here is that Dietitians have been trained to combine all these complex topics into a recommendation specific for the individual that has no other agenda then to improve that person’s health. Most other self-proclaimed “nutrition experts” cannot even fathom how complicated it is to balance that many things and simplify it to a recommendation that promotes health. That is the real art of what a Dietitian does.
At the end of the day, a doctor is only qualified to look at what they’ve been trained to look at. A personal trainer is only qualified to give exercise recommendations and teach you how to safely perform an exercise. The training Doctors get in nutrition is one course over one semester and personal trainers get one chapter in a text book, and what’s worse is most of the nutrition information is completely wrong! (I know because I was a personal trainer) I’m not even going to explore anything else here. If you want someone to give you GOOD dietary advice, go to a Dietitian. A Dietitian has a minimum of a 4-year undergraduate degree and a master’s degree or has completed an internship. A Dietitian will create something specific and personalized for you. So would you trust the dietary advice from someone that took one nutrition course or read one poorly written chapter in a text book over someone that has over 5 years studying nutrition and before they can be considered an entry level Dietitian? I’m hoping you say no, because taking dietary advice from someone without formal training makes as much sense as getting a plumber to install a new hardwood floor. I'm not saying that they're wrong, I'm just saying maybe you should consult with a Dietitan before making any changes, after all Dietitians are the specialists in Food and Nutrition.
Ben Sit, RD, Sports Dietitian
President of Evolved Sport and Nutrition
Complete Lifestyle Management