I’m a registered dietitian (RD) and one of the 74,000 members of the Academy of Nutrition & Dietetics (AND). While you can call me ‘nutritionist’, I prefer RD. I have nothing against nutritionists, after all, I am one. It’s just that ‘nutritionist’ has morphed into a fairly generic term for anyone who provides nutrition advice and may or may not have formal education and training in the field. I have had over 6 years of college education and training, and like other RDs, I continue to polish my credentials through rigorous continuing education. And I’m also licensed, which means I am monitored by my secretary of state licensure office for adherence to safe and ethical practice regulations. So yes, I want my credentials to be distinct from ‘nutritionist’.
I have been fortunate to have worked in public policy for our profession, thanks in part to AND, and it was during this experience that I learned our profession must be vocal advocates to safeguard our credentials and expertise. Many entities who want to practice nutrition believe that AND are monopolizing the field of nutrition by lobbying for its RD members. Well, in this day and age of ‘health awakening’, I am sure that given the opportunity, any entity would want to lead with expertise, especially if they are trained rigorously in the field, and right now RDs are ‘food & nutrition experts’, so why wouldn’t AND want to protect our professional interests? Let alone protect the interests of the public. While healthcare is altruistic, and despite its exponential growth, it is very competitive and many want to take advantage of it and its users. I’m relieved that AND lobbies on my and the public’s behalf, and even I’m happier to be a vocal advocate myself.
But for a while, I have sensed that RDs are facing some challenges. While we have AND supporting our membership on the issues mentioned, it appears that somewhere along the way, we are struggling to engage the public, my proxy for ‘consumer’. While I believe that most (in every profession there is good, mediocre, and bad) RDs are experts in their scope of practice, I’m concerned that our expertise doesn’t quite resonate amongst consumers. From my own experiences, consumers aren’t too sure what RDs do, other than ‘put them on diets’. I have lost count of the number of times I have been labelled ‘food police’, in jest of course, by healthcare providers, educators, and really anyone who eats. While RDs are ‘out there’ as food and nutrition experts, consumers don’t always connect the dots. The result: our messages appear to be falling short of our intended audience. Consumers are seeking or following new food movements, new food trends, fad diets, or the panacea for health and wellness, but they’re rarely seeking RDs. According to the January 2013 issue of the Journal of the Academy of Nutrition and Dietetics, a publication of AND, just 14% of consumers turn to health professionals for nutrition information, and dismally, only 5% refer to a RD. And let’s be honest. Some RDs are doing a great job in the media and public relations (I love that Ellie Krieger is ‘one of us’ and on the Food Network), but when it comes to the honchos, it’s Dr. Oz who is providing nutrition expertise for Time Magazine.
So why are we so good at what we do, but we have to work so hard to convince anyone from physicians, to the government, and yes, consumers, that we’re top notch in the field of food and nutrition?
The answer could be any number of reasons, but last month, one of the potential reasons resonated pretty loud. Trust.
Over the years, consumers have challenged my profession’s relationship with big food companies. I always reassure them that we are not swayed or paid by big food. What I advocate as good food and nutrition is based on part science, part logic, and a good measure of the human element. My go to ethos: eat whole food, preferably cooked yourself, and enjoyed sitting down without your electronic device. I also appreciate that there is a big picture to food and its system, and as a RD, I have an obligation to navigate the ‘grey’ areas in order for me to do a better job for the sake of our communities, environment, and health.
Most RDs I know are on the same page.
But it really does take just one voice, a very vocal and recognized voice, to unravel our legitimacy as food and nutrition experts’. Michele Simon, prominent lawyer, public health advocate, and whistle-blower on how big food is profiting on the backs of American consumers’ at the price of deleterious health consequences, has blown a very loud whistle on how AND is tied to mega food industries through corporate sponsorship.
To many RDs, AND corporate sponsorship by big food may or may not be a surprise. Regardless, this report and it’s outreach should be. We shouldn’t take lightly to our professional ‘liaisons’ being questioned in the New York Times, Forbes and Huffington Post. And honestly, maybe it is time to revisit this contentious issue. I know many RDs, myself included, who have struggled to find a good fit with some of our big food sponsors. Why? Because we’re challenged, professionally, and yes, ethically. For example, some of our sponsors produce the very food and beverage products that we, as RDs, are struggling to communicate to consumers as ‘have only in moderation’. We’re also at the receiving end of when moderation goes wrong: obesity, in adults and especially disconcerting, in our children. Moderation. Turns out it’s subjective and influenced by choice, desire, and need. Sure, science-based dietary guidelines help us conceptualize moderation, but from my own experiences, what is moderate to me may not be to you. So where does the science-base sit here? Therein lies our daily professional challenge; science versus reality.
But is it possible that big food industries, several of which are supporting my profession, capitalize on this inherent flaw of nutritional moderation?
Maybe… And therein lies our ethical challenge…
RDs can yell ‘moderation’ until we’re blue in the face, but the nature of our food environment appears to be shaped by big food capital. And I’m not going out on a limb about this. There is plenty of literature and evidence to support this. And if you don’t have time to peruse these, tune into logical observation. Whose running the prime time ads on your T.V.? Whose dominating the billboards? Or just visit your supermarket and observe how food products are displayed. At eye-level, or on the bottom shelf? Are consumers strictly to blame for making poor nutritional choices?
Another maybe… But what would RDs make of this: I have been in the middle of nowhere in Africa and have been able to get my hands on an ice-cold Coca-Cola. I know Africa well enough to vouch that it takes tremendous capital and marketing strategies to place a product of this nature in the unlikeliest of places. A place where a balanced meal is a tough find, refrigeration is almost non-exisitent, yet the consumer can access chilled sodas and feel happier for it (as depicted by the ads in the dusty tin shack).
Granted, some of these perspectives are entirely my subjective opinion but I believe that logic can either trump or support literature and evidence, including science-based assumptions.
So for the sake of consumers, I strive to view things from several perspectives, besides absolute science. I consider culture, socioeconomic status, beliefs, morals…
What would any logical and somewhat moral consumer seeking accurate nutrition information see if they learned that Coca-Cola and Hershey’s are sponsoring my profession? Is it possible that they see a questionable co-existence and potential for ‘conflict of interest’? While we advocate ‘healthy eating’, consumers may be befuddled and bordering on distrustful when they glance through our list of sponsors. Why should they turn to us? And if they do, why should they listen to us? AND may be able to legitimize its ties with big food for RDs, but can it do this as effectively with the public, the consumer, our livelihood?
Michele Simon’s controversial report is no help to this dilemma, but it may present opportunities for RDs and AND. And now more than ever, what with healthcare moving into challenging territories, and the state of our country’s health at sub-optimal levels compared to other industrialized countries, it’s absolutely necessary for AND to reclaim and reassert ‘food and nutrition experts’. However, it’s up to us, as RD members, to steer AND in a direction we believe to be most prosperous for us. Let this be good time for RDs to determine if we are in fact dissatisfied with AND’s business model for big food corporate sponsors. Although some members have been surveyed before, in view of this recent report, this is a ripe time for AND to canvas its members again. And how about the public too?
Ok, time for reality. Even if it turns out that thousands of RDs question big food and AND, can we truly believe that big food will just go away?
What could RDs do then? Leave AND? Start anew? Or demand some other changes? I understand that for many organizations, corporate sponsorship is necessary. In fact, I’m aware of an urban agriculture organization seeking funds from several big food sponsors. Funding helps organizations with good intentions and altruism to grow and thrive. And as Ms. Simon reports, there are many organizations with credible healthy food products and practices who support our annual conference. I also have to disclose that my father works for a cane sugar industry in South Africa. That’s right, big food paid for my college. Despite many heated arguments, my dad always listened to my concerns about ethics in big food industries. On a positive note, and despite the notoriety of sugar, the bottom line is we all eat it at some point, demand is high, but the industry is also addressing issues of sustainability. Regardless of whether ‘sustainability’ means ‘fiscal’ or ‘environmental’ (an argument I’ll save for him), big on my father’s agenda is using ethanol by-products of sugar processing to operate sugar mills. It’s a start. Maybe we need to credit the ‘good’ deeds of big food, but be more instrumental in demanding and outlining more of these? There is no easy solution, and I don’t believe anyone is going to come out a winner. It is perhaps long overdue, but never too late, for RDs to have this dialogue, amongst ourselves, with our leadership, the public, and big food. And may this dialogue be fruitful in solutions.
I guarantee you that while most RDs I know are have some conflicts concerning big food/ag sponsorship, none have a ‘conflict of interest’. They’re honest, highly experienced, and very committed to promoting our profession and mitigating nutrition-related health issues. They are practicing in many sectors, providing sound nutrition counseling and education, and their utmost desire is for Americans to be happier, healthier, and more attuned to good food. They just don’t toot their horns enough about the remarkable work they do. And yes, they may or may not be happy about AND’s corporate sponsors but just haven’t tooted their horns enough about this too. My upfront apologies, but I can’t avoid gender stereotyping with these next few statements. Most RDs are women, many married, working moms, students, caregivers, and daily jugglers. Some of our personal obligations lie above and beyond AND and what Ms. Simon has written. But one stereotype hard to ignore is that as women, we’ll continue to find our voices, we’ll continue to challenge the status quo for the betterment of our profession, and that with our male colleagues, we continue to be ‘Food and Nutrition Experts’.
Jessica Avasthi MS, RD, LD
Mindful eater, Mindful RD