Columnist demonizes nutrition practitioners the same way he does sugar.

Published on: 09/19/2023

In response to “The food industry pays “influencer” dietitians to shape your eating habits” by Anahad O’Connor.

Behind The Washington Post’s paywall lies an article of half-truths and nutrition gossip written by Mr. O’Connor and his team. Perhaps this is what the journalist himself considers an ‘investigation.’ What it is is an attempt to discredit an entire profession using an incredibly one-sided story. He is concerned that these dietitians did not make it clear that “they were paid to post videos by American Beverage, a trade and lobbying group representing Coca-Cola, PepsiCo and other companies.” Under the guise of consumer protection, this author believes these dietitians and lobbying groups organized a campaign to “sway consumers faced with often contradictory health messages.” Using the ‘evidence’ of actual posts by dietitians with a substantial following, he and his fellow authors try to show that registered dietitians influence the consumption of sugar and “unhealthy” food by the very hands of a big industry. Mr. O’Connor calls out these dietitians one by one, revealing their affiliations with organizations such as the American Beverage Association and the Canadian Sugar Institute.

I must admit that, for a brief moment, I felt relieved that neither my mere 1,550 followers (151 on my business page) nor I were the targets of this columnist and his researchers. After all, my role is to help my clients foster a healthy relationship with food, which, yes, includes my own moderate amounts of homemade cake on my niece’s birthday, homemade cookies made by my daughter, and french fries from Chic-fil-A after a long day of work, school, and sports (Disclosure: I am NOT paid to represent my family’s baking abilities and Chic-fil-A). As a dietitian, I make darn well sure that my eating habits are not theirs because I am not them. Clients who come to me with autoimmune disorders, disordered eating, gastrointestinal disorders, single-family households struggling to make ends meet, and athletes all have very different nutritional needs, and I counsel them as such. None of them are given the same advice and are never shamed for the foods they eat. I prioritize promoting a healthy dietary pattern, but the specific nutrients and their quantities vary for each individual.

Dietitians understand that nutrition is a part of the equation, not the entire solution. We are part of an interdisciplinary team that consists of physicians, therapists, and other medical practitioners. Nutrition may help prevent disease and help with symptoms, but it is not a cure. 

The columnist harbors a bias that exists within all of us, shaped by a culture commonly referred to as ‘diet culture.’ Mr. O’Connor has penned books entitled Lose It!: The Personalized Weight Loss Revolution (2010) and The 10 Things You Need to Eat: And More Than 100 Easy and Delicious Ways to Prepare Them (2009). I have not read either of these. According to the description of The 10 Things You Need to Eat, you will find that “each chapter will be devoted to a new food from the list — cinnamon, beets, quinoa, nuts, wild salmon, berries, tomatoes, spinach, avocado, cabbage and some honorable mentions, including pomegranate, turmeric, Sicilian wine and more — which have been proven to help prevent early onset of aging, cancer, or general fatigue, among other health benefits.” Sounds lovely. Unless these foods are contraindicated for a particular disease, condition, or allergy – or that you could even afford pomegranate seeds in your regular meal planning. After all, it is a regular dietary pattern that brings about good health, not individual nutrients or meals. Can you imagine me telling an individual recovering from alcohol addiction that red wine will benefit their health??

On the Washington Post website, under his bio, you can find direct links to purchase his books. In order to sell these books, he would need to keep the belief going that it’s the foods he tells you to put on your plate that you need to eat will, in fact, he claims,” make you healthier.” A book written for the masses isn’t exactly personalized nutrition advice. That is the difference between a columnist and a practitioner.

The article repeatedly mentions that the dietitians declined to provide comments or responses. It should be mentioned that he has targeted dietitians before. This seems to be a continued undermining of our position. I question how hard they tried to get a response when the comments on their Instagram post have been “limited” or, essentially, closed. I have been a dietitian for a year. When I came into this industry I realized quickly that our biggest limitation is that no one knows or understands what we do. This is evident in this article. But it’s time we clarify some things.

What Mr. O’Connor should be attacking is how we as a culture have elevated the likes, literally, of social media to influence our eating at all. Before there were “what I eat in a day” posts by online ‘doctors’ and targeted ads to adolescents on YouTube for energy drinks filled with caffeine and proprietary ingredients, there were magazine, radio, and television advertisements (all the feel-good ads including this one “I’d like to teach the world to sing in perfect harmony…buy the world a Coke“) – all paid for by the manufacturer. Behind this payment was no social script to which any advertiser had to adhere other than their own internal code of ethics, if in existence.

The marketing landscape has changed. The publisher or media company is not the only one who can make a dime off advertising in our current landscape. An individual with expertise in just about any subject could and does get paid to influence a product as long as they have a following and audience worthy of the dollars spent. These dietitians have an audience built on not only their expertise but on their lived experiences, both as a consumer of nutrition information and a practitioner who counsels and listens to every story told of advice gone wrong. These dietitians aren’t promoting another diet. I follow them for the reason that they DON’T. I am guessing their followers feel the same. Because these dietitians are practitioners, not journalists, they have seen the damage and understand the struggle.

Missing context

The reality of social media, of most nutrition-based accounts, is prompting weight loss at every possible cost. It’s everywhere, from celebrities to coaches to everyday cooks. We have a term for this weight loss and beauty at any cost – it’s called beauty sickness. The “pervasive energy and effort that females divert to their appearance, which takes a toll on their cognitive resources, their self-esteem, and often, their bank accounts, given how much money it takes to attempt to uphold the unattainable beauty standards of the modern age.” (Psychology Today, 2019)

Private practice dietitians like me work with are people who have dieted so hard in multiple attempts to be thinner that they have spent thousands of dollars to remedy themselves of the screaming voices in their head that their lives will be better when they are thinner or healthier without a chronic condition. They have been sold a bill of goods only to discover that the restriction led them to a greater fixation on food, the very foods that this author tells everyone are so bad for them: highly palatable, ultra-processed foods. For some people, this is a never-ending cycle.

Social media doesn’t allow for much context to a very nuanced topic. Every dietitian or trainer will tell you that, but not doing anything when we see so much misinformation being consumed isn’t a wise choice either. We know it isn’t an ideal platform but we have to have our voices heard.

Instead of the columnist trying to sell more “eat healthy” books, maybe spend an unpaid semester in treating patients battling eating disorders and uncover the human element of eating and social problems in this country. This experience might alter his perspective on how we should all approach nutrition science, a field that heavily relies on self-reported dietary data, known for its inherent unreliability. After spending a year with my kids in a study on the effects of fiber on bone health in children, I can tell you first-hand how incredibly difficult it is to recall dietary habits, especially in children ages 10 – 13, and to get a child to drink a supplement every single day, two times per day for 365 days.

It’s important not to become so immersed in nutritionism and science that we overlook the cultural and behavioral aspects of eating.

If you give a reporter a lollipop

If you read The Washington Post article you may be convinced to think that dietitians are “encouraging followers to eat sugar and candy.” That is what the subheading says.

If you give a reporter a lollipop on his dinner plate, he may want a soda (“pop” for my Buffalo folks) to go with it. When you give him the soda, he may say, “Oh, I’ve had enough.” When he has had enough he may learn that too much sugar gives him a belly ache. So he may learn to trust his body and his choices instead of listening to the fearmongers who tell him sugar is evil. Or he may continue to eat.

This illustrates the inherent variability in human eating behaviors. Dietitians may use tools like food (go figure!) to help resolve a problem. Many times, so much restriction is the problem.

(This paragraph is inspired by the book If You Give a Cat a Cupcake by Laura Numeroff.)

For context of how a dietitian may use a lollipop.

A lollipop could mean:

  • Raising the blood sugar of a person with diabetes in a hypoglycemic state with carbohydrates
  • Quick energy for a high school athlete needing a source of fuel before a game or maybe because they are amongst friends enjoying their sport
  • A parent showing children that all foods can fit in moderation and not label foods “good” and “bad” to prevent feelings of eating certain foods as a moral acts
  • A dietitian counseling a patient with an eating disorder who developed a fear of sugar to help face those fears
  • Giving an oncology patient a Queasy Pop® during chemotherapy for nausea

We do agree, kind of…

It seems we are all in the same space, caring about the food we eat and helping people to live longer and healthier lives. Then why, Mr. O’Connor, would you write such a piece about the .08% of the 78,000 dietitians making a living doing so? (Dietitian jobs are also in the clinical, retail, and public health sectors). Who are you protecting from the dangerous food industry? This industry wouldn’t exist without consumers. We try to help our clients moderate both – a busy world full of convenience foods and the time constraints of preparing healthy meals at home with wholesome ingredients. The number of dietitians pales in comparison to the food and pharmaceutical industries. We feel this every day in our jobs. The jobs with an average salary of $66,450, according to 2022 data from the Bureau of Labor Statistics you quoted. This salary barely pays the rent in most areas by today’s standards (the median home sold price in Palm Beach County was $450,384), and with college loans resuming next month, tearing down our profession isn’t likely to garner more students at the cost of $98,000 for tuition for the master’s degree required to be a dietitian to help promote health behaviors.

This begs the question of who pays your salary Mr. O’Connor? The advertising in the Washington Post? I saw Rolex and L’Oreal advertisements. May I assume these companies?

Show me this isn’t about monetary value without telling me it’s not about monetary value. But yet we are all trying to earn a living.

Could we use more reform in our food system, yes. 

Could we use more reform in our children’s school meals, yes. 

Could we use more physicians referring to us for nutritional counseling, yes. 

Could we use more insurance coverage for medical nutrition therapy, yes!! My clients would appreciate using their healthcare coverage.

So please Mr. O’Connor, use your voice to uncover a bigger issue than the dietitians advertising their own crafted message with the help of big brand funding. It’s one big system and we are all fighting the good fight.

Disclosure: Let me make it clear that if you purchase his books with my affiliate links above, I get paid. Not a lot.

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Nicole Roesch, RDN, LDN, CPT provides nutrition counseling services in-person and virtually in Palm Beach County, FL. She specializes in helping families create a positive relationship with real, wholesome food – through education, meal planning & behavioral changes that fit their lifestyle.

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