Next week I start the final year of my Nutrition and Dietetics degree at King’s College London. My nutrition and dietetics course prides itself on evidence based practice and is built on robust foundations of chemistry and biology. However, the people with the most publicity in the field of nutrition at the moment have rarely gone through this level of training, with many opting for courses that are often unregulated and unaccredited. "So why do people take them? And why are their alumni so enthusiastically followed by the public?
In part, I think it is because, as we all know, sex sells. And not the scientific mechanics of reproduction, but the glossy image of beautiful people smiling next to jam jars filled with juice. Us evidence-based scientists aren’t always great at selling ourselves, and our message of moderation is just not as appealing as a charcoal shot (which in my opinion isn’t very appealing at all, but it takes all sorts). Our mantra of healthy eating and a balanced diet is never going to be as 'exciting' as fasts, detoxes and juice cleanses, but we can try and help bridge that gap by noticing what works and applying it to our own message; it is all in the delivery. The world is becoming increasingly social and visual, and presenting information in an unappealing way, like it or not, switches people off. Science needs an image overhaul, and it is only us that can do it.
Another factor is that other people don’t always care as much about the principles of evidence-based science as we do. I have grown to find science fascinating, but that is a process that has taken a good few years – and I had a vested interest of wanting to pursue this career. How do you feel about stamps? Or classical music? Or learning Russian? Indifferent? That is how many people feel about what we do – and that can be annoying, or even hurtful when it is what you are passionate about, but there are stamp-collectors, flautists and Russian translaters who probably feel just the same about your views on their profession. “But look at the evidence! The methodology was flawed! You are not a member of a regulatory body!” I hear you shout – sorry, many people are not as upset as us about this.
Before starting at King’s I saw cranial osteopaths, homeopaths and various other complementary therapists throughout my quest for a diagnosis, as well as various different “healing” diets. Why? Because I was desperate for answers. Dietitians cannot tell you that ‘superfood X’ will solve your problem because the HCPC will not allow it. Not because they are in the pockets of big pharma, or the food industry, or under the influence of Monsanto, but because there is not any evidence that the claim is true. However, unregulated practitioners can say these things with no repercussions, which often means they appear to have the answers when evidence-based practice doesn’t. Does this mean it's true? No. But I can see why people engage with these ideas, and I don’t judge them for that. Explaining that somebody’s juice cleanse or raw diet is not the solution to their problem needs to be done very sensitively. People don't seek alternatives to conventional medicine because they are unintelligent, and making people feel that way is counterproductive; it simply creates a ‘them and us’ situation.
That is not to say that I don’t think the unregulated side of the nutrition and wellness industry can be hugely harmful and dangerous, because I personally believe that it can. It can often portray science as a discipline opposed to healing and well-being which is at best ridiculous, and worst incredibly harmful. I cannot believe that making wild, unsupported claims around food is not only legal but is also tolerated and promoted by the media; I think it’s absurd that most health journalists have had no medical or even scientific training.
People should not be allowed to make claims about food and diet unless they are qualified and informed enough to do so. The advice those people give should have a solid evidence base, it should provide measurable outcomes and it should never do harm.The public should be aware of professional accreditation schemes, what they are, and why they are important. The concepts of critical thinking, cause, effect and correlation should be taught in schools for a much longer time, and in much more depth than they were when I was there. We need to encourage people to question what they are told, to recognise good-quality evidence and where it has and hasn’t been consulted.
But also, as scientific, evidence-based professionals we should also spend some time considering why people are so engaged with this new wave of new-age nutrition. It is managing to convince people to discard their old habits and adopt new ones in a remarkable way. It is selling cookbooks and tickets to supper clubs and quinoa and kale by the kilo. We need to harness this enthusiasm for nutrition and steer it in the direction of the evidence.
We need to make sure people #TrustADietitian.
* If you enjoyed my mini rant you should read Bad Science by Ben Goldacre. He is an actual writer and brilliant
** If you want to read more about the different professional titles and what they mean the BDA has a nice explanation here.