victoriafenton

21st April 2017

I’ll be honest, I’m not sure how I feel about what I’m about to write.  I basically want to come to the defence of people who have qualified in various nutritional/functional medicine/naturopathy/biochemistry ways without going the University/PhD/Dietetics qualification route (like myself), against the onslaughts regularly screamed in their direction by many people, but most recently The Angry Chef and a cohort of Registered Nutritionists online. (linked – caution, explicit language).  I’m not saying we’re all angels – please read the article and don’t take this out of context.  But I don’t always feel we deserve the ire we’re shown…

First up – I want to fully endorse the fact that those who did (go through the aforementioned ‘proper’ educational route) should have a protected title (they’ve chosen “Nutritionist”, which seems fair).  But that should not discount, discredit and essentially defame anyone who didn’t do it the ‘right’ way.

You see, the world of healthcare has become (or perhaps always was) just as much influenced by the opportunity to make money as any other field.  Sickness makes money, seemingly, and so on every corner of the interweb, in podcasts, blogs, on YouTube/Twitter/Facebook/Instagram there are a plethora of gurus who now sell their nutrition information as the answer to our prayers.

Understandably, there’s a backlash.

Because what sells in terms of diet culture has never been what works in terms of individualised health.

You may have read my previous article on Healthcare and the Completion Bias (linked) which explained that we are naturally attracted, for a whole host of reasons, to the ‘quick fix’ approach to health.  Extreme solutions, with rapid applications and speedy results are simply the most appealing ones for our psyche (and perhaps our desperation).  Somewhat predictably, whole industries are set up around this idea of selling to the needy what they want, rather than what they actually need.

Such is the essence of what gives rise to “Nutri-bo****ks”.

And The Angry Chef and his cohort of called upon Nutritionists are absolutely right – spouting nonsense for the clickbait, attractive, money-spinning headlines is really annoying.  And I do think that there should be a way of distinguishing those who are qualified in a degree/PhD kind of way, though thought that was what we had with the whole ‘letters after the name’ protocol, much like any profession.  Protecting the title “Nutritionist” might be a step too far, but perhaps it is necessary.  And yet, it shouldn’t automatically devalue every other person who discusses food in their career, should it?

The reality, as far as I can tell, is that everyone – no matter their qualifications or discipline – should be against pseudoscience.

Whether there needs to be such vituperativeness directed towards the individuals involved, I question (but hey, I’m soft).

In my simplistic terms, nobody should be allowed to peddle mistruths, particularly not if they are doing so for professional/financial gain.  And yet… my concern about the new fashion for lambasting amateurs is complex.

Do They Really Know Better?

I worry because the anger projected by The Angry Chef seems to be attributing malice to the perpetrators of the “nutri-bo****ks” crimes.  I’m pretty sure, however, that some of them are completely ignorant of the mistakes that they are making.  And, often, they’re not specifically making mistakes – they’re simply reading the statistics and the science in a slightly skewed way.  Which, of course, no large-scale pharmaceutical giant or food manufacturer has ever been guilty of doing, right?

It seems to me that, when it comes to science, the best attitude is the slightly jaded, “seen enough zeitgeists not to jump on every bandwagon” approach.  It’s a shame, but acquiring this attitude takes time.  And time takes ageing.

Most nutritional bloggers who come in the line of The Angry Chef’s fire are either young, or new into nutrition.  You know what it’s like whenever you learn some new facts – you are proselytising everywhere, especially when you’re innocent enough to feel like you’ve learned something which maxes out your educational potential.  Proud that you’ve ‘got it’, you basically tell everyone.

It takes a good few rounds of this layered disillusionment process of education to realise that we never really know anything, and certainly not enough.  Every discovery just leads to realising that there’s more to know.

And for the most part, for every single nutritional fact (even the ones in the RNutr/ANutr guidebooks) there is at least one caveat and/or exception.  In this way, the healthcare profession must incorporate part art/part science: understanding the science enough to interpret how it best be applied in practice and in specific situations.  Learning that skill takes time.

Nutritional bloggers, or in fact anyone who gives universal rules or advice… basically hasn’t been around the block enough.  And I’m pretty sure that we’ve all been in that position once or twice ourselves.  Whilst it irks me that they may be gaining clients who I would prefer to protect from their nutritional falsehoods… we all have to learn.  It can take years to become world-weary and out of enthusiasm, but until such time there will always be a tendency to jump on the latest bandwagon like an overjoyed puppy and start spreading a message we haven’t yet fully validated.

Like I say, perhaps I’m naive and want to believe the best in people, but I do genuinely trust that no-one is fully intending to cause harm.

What about those more mature practitioners who come in the firing line of The Angry Chef?  Well, some of them simply don’t claim to be scientists OR nutritionists, just professionals who work within one realm of either food or health (much like The Angry Chef himself) and who are offering their guidance based in their own experience and (more than likely) a personal journey.  Does that automatically relegate them to the realm of unintelligent and pseudoscientific?  To my mind, not really.  As with everything it’s case-specific, surely?

Some of the information mentioned by these professionals in the article The Angry Chef used as a basis for his post was a little dubious, I must admit.  But I don’t blame them at all for their belief in some of the myths that have become rife across the internet.  Around 50% of my clinical day is spent refuting the misinformation, panic, paranoia and over-hype which is prevalent in the internet age.  Sometimes, I’ll admit, like the Angry Chef this makes me a little angry… but I also see it as an opportunity for deep education.  I use misinformation as a starting point to help my clients become more well informed, rather than wasting my energy lamenting that there are falsehoods floating around in the digital forums.

Then there’s the argument over registration with BANT vs. the Association for Nutrition but again, this isn’t really a distinguishing fact which automatically renders any therapist with BANT an idiot (I’m not with BANT, FYI).

Instead, as with any industry, some professionals – with BANT, Association for Nutrition or other organisations – stand to profit from ‘plans’, ‘books’ and ‘diets’ which perpetuate food phobias and meritocracies and… well… I’m sorry, but in a world where we all know about “Fake News” we should always, always know better than simply to trust blindly when money is involved.  The internet age means we have to always question the potential motivation of the sources behind the information.

There are some charlatans out there, that’s true.  But this is not a fault of the nutrition industry, this an issue with industry in general.  The onus is ALWAYS on the ‘customer’ to judge the integrity of the information and we have to be self-sufficient enough to do this, regardless of whether we’re talking food, pharmaceuticals or anything else.  And I, personally, don’t validate my information based on the letters after someone’s name.

Why I, Myself, Am A Little Angry… 

My article has repeatedly referred to nutrition bloggers as ‘they’.  Where do I get off separating myself from them, I hear you cry, when my qualifications aren’t worth anything more than the paper they’re written on (according to The Angry Chef)?

Well I am a little angered and upset by The Angry Chef and his words… not because he lambasts pseudoscience and nutri-bo****ks, but because he lumps everyone without one specific qualification under the same banner of disreputability.  Including me.

I (try to) never peddle pseudoscience.  I am ridiculously measured in my approach that I regularly infuriate my own clients by refusing to run tests or try dietary ‘tweaks’ or newfangled supplements because they’re just… well… nonsense.  (Often expensive nonsense).

In my practice, on my blog and in my life I just talk about what I have studied – and I’m basing my knowledge in science.  But apparently, I’m not allowed say that because I don’t have a PhD.  Somehow I didn’t do the school thing the right way so I am automatically talking rubbish, and under-researched rubbish at that.

So yes, I am annoyed at the rise of the nutritional super blogger who, as far as I can tell, is more skilled in social media than in nutrition.

But I’m also just a little annoyed at being tarred with the same brush as these superficial, instagramming, kale smoothie drinking millennials who snapchat their workouts, meals and ‘healthy’ practices and then tell everyone how they can do the same and they’ll be ‘healthy too’.

I personally can’t eat kale, drink green tea, I don’t do smoothies in general, can’t abide spirulina (which also makes me ill) and I basically reject all nutritional dogma purely because I don’t believe in dogma, as a rule (and yes, I’m educated enough to know that that’s a contradiction!).

But I do deal with illness – real, chronic illness, not just being a bit overweight or wanting to be ‘healthy’ (whatever that means) – on a daily basis.  And I am very much rooted in the complex, scientific (gosh, am I allowed to say that?!) understanding of how interrelated immune, hormone and digestive conditions interplay with our nutrition and our relationship to it – including overlaying mindset, emotions and socio-economic factors.

Am I unqualified to comment or blog, then?  Well my qualifications come through a host of Functional Medicine training, nutritional diplomas (sorry, not the full degree course) AND my personal trials and tribulations through working out what the hell happens when the s**t hits the fan inside one’s body.

I’m never dogmatic and whenever I give an opinion I qualify it as such.  I make ‘recommendations’ to my clients, I am cautious with supporting any one approach (almost to a fault – i.e. I’m sceptical first and foremost) and I never, like never, say that there is either a perfect diet or that making nutritional interventions is all that is required for overall health and wellbeing.

Perhaps I’m not the person that The Angry Chef is so angry with?  But I kind of get the sense that he is, given that I’m not supposedly ‘qualified’.

But do you know what was happening when I should have been getting my PhD?  I was being hospitalised on no less than 5 separate occasions in order to try and fix my body, whilst the doctors had no clue what was happening.  People – professionally trained consultants – who had been specifically taught (in ways The Angry Chef would approve highly of) to isolate and diagnose conditions woefully failed me for almost 8 years.

My own investigations (into … um … sorry … but science (i.e. PubMed and Google Scholar, understanding medical journals and Cochrane Reviews and … well, anyway)) were what took me to finding my route to obtaining the diagnoses I needed to access the care that would eventually assist me.

And do you know what dieticians did during that time?  Prescribed drinks which made me worse and decided that because their recommendations were failing that I must be suffering from any one of a selection of various eating disorders.

I have to be absolutely clear and state that I am in no way disagreeing with The Angry Chef’s comments about pseudoscience, Nutri-Bo****ks and the rise of the Instagram “nutritionists” who have no right to call themselves such.

However, I do think that some caution may be warranted.  As he tars the entirety of the non-PhD-holding population with the brush of under-qualification, he is making exactly the sweeping, castigating generalisations as he is criticising the Nutri-Bo****ks tribe for.  Whilst they target foods or entire food groups for rejection for spurious reasons and without sufficient evidence, he – also without sufficient evidence – is making broad recommendations about rejecting a whole group of not-perfectly-qualified people as if we’re all as bad as one another.

I, respectfully, disagree.  But then again… what do I know?