Registered Dietitians get attacked by a lot of sub-groups in nutrition for not being one of a myriad of things, depending upon the dietary mantra of the group - low carb'ers accuse RDs of heresy for recommendations concerning the consumption of carbohydrates and allotting for some level of added sugars in the diet; paleo'ers attack RDs because they push whole grains and dairy, purporting that these are two of the major toxins in our food supply; vegetarians/vegans say that RDs are pushing cancer-causing animal products that harm the environment and cause unnecessary suffering.
These are just a few of the major nutrition-minded groups that have asserted their dominant, superior nutrition viewpoint and attacked the current medical model of nutrition. But who is correct? Put any of these 3 major groups alone in a room together and everyone may very well not make it out alive, or at least without being covered in Red paint and/or being accused of ignoring your primal blueprint.
So what is the average, health-conscious consumer to believe? Should you stick with one mantra? Or moreso, should you take from all of them? The latter is what I have run into the most - health minded individuals who are close to vegetarian, dairy free, gluten free, low carb/grain. I often feel the need to remind these individuals that air is not a good source of calories.
I have a couple thoughts on this:
1. The need for evidence based assessments - Dietitians can only truly recommend what has been thoroughly researched. This is information that is usually backed up by randomized, double blind, placebo controlled studies, that is supported by epidemiological and population data, and has a plausible mechanism behind it. A lot of what specific groups following a nutrition mantra follow is based off a small pool of research, not clearly showing an effect for a large percentage of the population - take gluten-free diets: much of the research in this field surrounds celiac's disease. A lot of the other data comes from clinical anecdotes of people who make huge lifestyle changes, drop their caloric intake to lose weight, increase their fruit and vegetable consumption, eat generally less processed, increase their micro/phytonutrient loads and also remove gluten. The end result leads to a large group of individuals who swear by the gluten-free diet mantra. Most individuals I have met didn't have a health lifestyle with all of these factors, switch out their whole grain pasta for brown rice, and suddenly alleviate all of their symptoms. I don't think anyone is entirely dismissing that gluten free diets might have other roles - I know some dermatologists recommend GF diets for individuals with rashes - but before we can go telling everyone with rashes to try a GF diet, we need the data on that to show that it's effective. I don't believe that RD's are opposed to advising a gluten-free diet, if research would show that it is inherently better. Again, where is that research? Individuals can sit and discredit RDs from behind their computer screens all they want, but they're not doing anything to scientifically validate their cause - they also don't sit and see patients and have their lives in their hands as they make recommendations. A lot of RDs are opposed to these nutrition-minded groups because they come in with a bias - their entire group-think relies on gluten/carbs/meat/dairy being bad. If that disappeared, they wouldn't be a group, and wouldn't have a modus operandi.If you're looking for true science, go to someone who presents both sides of the argument, admits where there are potential shortcomings, and humbly notes where there are advantages, while providing you with peer-reviewed research.
2. The need for flexibility -RDs are trained to not only understand the physiological and biochemical roles of food in the body but also the psycho-socio-eco-political factors that play into a patient's life, and effect the best change for them. An RD might recommend the use of artificial sweeteners for a period of time as a tool for one person that they feel would benefit from them to ween off of sugar-sweetened beverages, and in another instance, may not recommend them at all. An RD might recommend someone in a financially stressed situation to consume whole-wheat bread several times a day, whereas someone with a higher budget for food might be challenged to broaden their range of carbohydrate sources. An RD knows the research, the necessary considerations for people adhering to a number of different diets, with a number of different conditions, in a range of lifestyles. This is the purpose of dietetics - not to come in being the minions of a food autocracy, but rather be open to working with patients, their lifestyle needs, and to go from there.
3. The need for more research - I have no issue with people who follow specific diets - some work for some people, others don't, some people can afford, others can't, some the planet can sustain, others can't (without a drastic reduction in population size) - that's the point of the flexibility I just talked about. My issue is with Evangelization. Going out and spreading the Gospel of your non-peer reviewed, not consensus opinion is only hurting the credibility of science, and potentially harming the individuals who are listening to your advice. If you want to evangelize, go get your PhD/medical license in nutrition. Take all of the coursework - the physiology, the microbiology, the biochemistry, the psychology, the medical nutrition therapy, the statistics, the research methods. All of that is essential background for truly understanding and analyzing the research, to make recommendations. And once you get that PhD, take the research that is there, develop a hypothesis, and get funding. Go do that double blind, placebo controlled trial on gluten. If you don't want to do that, then don't expect the major medical paradigm to take you seriously - it's not to sound harsh, it's the reality - otherwise, you're at best, spreading potential truths, and at worst, hurting people.
I am not trying to say that RDs are perfect - there are certainly some things I've seen RDs say/write that make me want to jump off a cliff and/or disassociate myself entirely from the profession. But just as not every doctor/physician, nurse, physical therapist, etc is perfect, neither is every dietitian. RDs are just in a particularly interesting field where their science has a very relate-able application, and everyone has a general knowledge of nutrition. I would say this is unique to RDs but I have seen other professions (chiropractors, naturopaths, etc) attacking the mainstream medical paradigm - my challenge to all of these individuals is to produce the data. Enter the field and change it from within if you are so confident that your mantra is correct. If not, sitting and attacking the medical professions from the internet is rather unproductive and will never garner you the respect you think that you deserve.
These are just a few of the major nutrition-minded groups that have asserted their dominant, superior nutrition viewpoint and attacked the current medical model of nutrition. But who is correct? Put any of these 3 major groups alone in a room together and everyone may very well not make it out alive, or at least without being covered in Red paint and/or being accused of ignoring your primal blueprint.
So what is the average, health-conscious consumer to believe? Should you stick with one mantra? Or moreso, should you take from all of them? The latter is what I have run into the most - health minded individuals who are close to vegetarian, dairy free, gluten free, low carb/grain. I often feel the need to remind these individuals that air is not a good source of calories.
I have a couple thoughts on this:
1. The need for evidence based assessments - Dietitians can only truly recommend what has been thoroughly researched. This is information that is usually backed up by randomized, double blind, placebo controlled studies, that is supported by epidemiological and population data, and has a plausible mechanism behind it. A lot of what specific groups following a nutrition mantra follow is based off a small pool of research, not clearly showing an effect for a large percentage of the population - take gluten-free diets: much of the research in this field surrounds celiac's disease. A lot of the other data comes from clinical anecdotes of people who make huge lifestyle changes, drop their caloric intake to lose weight, increase their fruit and vegetable consumption, eat generally less processed, increase their micro/phytonutrient loads and also remove gluten. The end result leads to a large group of individuals who swear by the gluten-free diet mantra. Most individuals I have met didn't have a health lifestyle with all of these factors, switch out their whole grain pasta for brown rice, and suddenly alleviate all of their symptoms. I don't think anyone is entirely dismissing that gluten free diets might have other roles - I know some dermatologists recommend GF diets for individuals with rashes - but before we can go telling everyone with rashes to try a GF diet, we need the data on that to show that it's effective. I don't believe that RD's are opposed to advising a gluten-free diet, if research would show that it is inherently better. Again, where is that research? Individuals can sit and discredit RDs from behind their computer screens all they want, but they're not doing anything to scientifically validate their cause - they also don't sit and see patients and have their lives in their hands as they make recommendations. A lot of RDs are opposed to these nutrition-minded groups because they come in with a bias - their entire group-think relies on gluten/carbs/meat/dairy being bad. If that disappeared, they wouldn't be a group, and wouldn't have a modus operandi.If you're looking for true science, go to someone who presents both sides of the argument, admits where there are potential shortcomings, and humbly notes where there are advantages, while providing you with peer-reviewed research.
2. The need for flexibility -RDs are trained to not only understand the physiological and biochemical roles of food in the body but also the psycho-socio-eco-political factors that play into a patient's life, and effect the best change for them. An RD might recommend the use of artificial sweeteners for a period of time as a tool for one person that they feel would benefit from them to ween off of sugar-sweetened beverages, and in another instance, may not recommend them at all. An RD might recommend someone in a financially stressed situation to consume whole-wheat bread several times a day, whereas someone with a higher budget for food might be challenged to broaden their range of carbohydrate sources. An RD knows the research, the necessary considerations for people adhering to a number of different diets, with a number of different conditions, in a range of lifestyles. This is the purpose of dietetics - not to come in being the minions of a food autocracy, but rather be open to working with patients, their lifestyle needs, and to go from there.
3. The need for more research - I have no issue with people who follow specific diets - some work for some people, others don't, some people can afford, others can't, some the planet can sustain, others can't (without a drastic reduction in population size) - that's the point of the flexibility I just talked about. My issue is with Evangelization. Going out and spreading the Gospel of your non-peer reviewed, not consensus opinion is only hurting the credibility of science, and potentially harming the individuals who are listening to your advice. If you want to evangelize, go get your PhD/medical license in nutrition. Take all of the coursework - the physiology, the microbiology, the biochemistry, the psychology, the medical nutrition therapy, the statistics, the research methods. All of that is essential background for truly understanding and analyzing the research, to make recommendations. And once you get that PhD, take the research that is there, develop a hypothesis, and get funding. Go do that double blind, placebo controlled trial on gluten. If you don't want to do that, then don't expect the major medical paradigm to take you seriously - it's not to sound harsh, it's the reality - otherwise, you're at best, spreading potential truths, and at worst, hurting people.
I am not trying to say that RDs are perfect - there are certainly some things I've seen RDs say/write that make me want to jump off a cliff and/or disassociate myself entirely from the profession. But just as not every doctor/physician, nurse, physical therapist, etc is perfect, neither is every dietitian. RDs are just in a particularly interesting field where their science has a very relate-able application, and everyone has a general knowledge of nutrition. I would say this is unique to RDs but I have seen other professions (chiropractors, naturopaths, etc) attacking the mainstream medical paradigm - my challenge to all of these individuals is to produce the data. Enter the field and change it from within if you are so confident that your mantra is correct. If not, sitting and attacking the medical professions from the internet is rather unproductive and will never garner you the respect you think that you deserve.
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