Tuesday, March 13, 2012

Dietitians of Canada Eschew Nutrition Month, Launch Dairy Funded Milk Month Instead

Today's guest post comes from our office's RD Mark McGill who has a few things to say about nutrition month here in Canada.

He was rather horrified to receive his marketing materials for the month given what he felt to be a rather blatant bias. Interestingly, last week 3 other RDs approached me to ask if I would write about what seems to have become "Milk Month".

Here's Mark's take (oh, and you can follow him on Twitter too):
At the Udder of Big Dairy

Every February, since I’ve been a Dietitians of Canada (DC) member, I’ve received a triangular shaped cardboard poster-box in the mail. It acts a tangible reminder that Nutrition Month (March) is just around the corner. And while the theme varies each year (for 2012: Get the Real Deal on Your Meal: Dietitians Bust Food and Nutrition Myths), the primary goal has been a constant: to educate Canadians on what healthy eating is all about and that their best source for obtaining this information is from a Registered Dietitian. It’s something that Dietitians of Canada works hard to promote and rightfully so as that’s their purpose. From our mission, vision and values which state in part to advance,
"the profession's unique body of knowledge of food and nutrition and that our dealings with colleagues, associates, clients and the public [are to be] based on credibility that relies on information from solid, scientific evidence and direct experience to support decision-making"
and that RDs do this with integrity to ensure we function with honesty, fairness, and objectivity to one of this year’s press released busted "myths",
"There is no difference between a dietitian and a nutritionist."
The answer, in part, states that a dietitian is your smart choice for credible advice on healthy eating.

I’m not going to discuss whether or not I agree with how the myths are answered as fellow RD Diana Chard has already taken care of that quite nicely. Instead, my focus is going to be on the blatant bias and conflict of interest that exists in the materials I was sent. These include a cover letter, a colour poster, two double-sided educational sheets for copy and distribution (one students grade 7 and up, one for adults).

The cover letter was signed by Isabelle Neiderer, RD and Director of Nutrition for Dairy Farmers of Canada (DFC). Since DFC are the National Sponsor for Nutrition Month 2012 (they’ve been a sponsor in previous years, as well), I guess the fact that her name is on it shouldn’t come as a huge surprise, or that she states that in addition to the materials I’ve been sent, I can order copies of a brochure entitled “What’s True? What’s Not? Get the Real Story about Milk Products” or that if I have any questions I can email nutrition@dairynutrition.ca. What would be a surprise is if the material in the package, the brochure or a reply from DFC is "honest, fair and objective" as per the statement on the DC website.

So what's inside?  Certainly not "honest, fair and objective".

First there is the student resource entitled "The Myth Buster" which has games and quizzes that aim to shed light on common nutrition myths. Of the 7 crossword puzzle clues, milk's featured in two, which perhaps isn't in and of itself terrible, but clue number 4 is probably worth highlighting,
"4. Chocolate milk has the same _________ as white milk",
where the "correct" answer is "nutrients". Never mind the 15.5 tsp of sugar and 360 calories per 500mL of 1% chocolate milk I suppose.

More amazing though is this statement found at the bottom of that Myth Buster page, entitled, "We're Brilliant,
"Humans may be the only adult mammals that drink the milk of another species. Eating nutrient dense milk products have helped humans survive and thrive all over the world!"
where the answers listed for you consideration are,

"Very True",
"The Truest"
Well just because we can doesn’t mean we should, and while the risks to milk consumption probably aren't particularly high, there is certainly a real body of research that links milk consumption to ovarian cancers and more aggressive forms of prostate cancer, while its benefits to osteoporosis prevention, at least according to the Nurse's Health Study, appear to be non-existent (If you're interested, here's Harvard's take on the subject). And chocolate milk? I think Dr. Freedhoff's covered that pretty well in the past.

Next comes a word scramble. The first question of the word scramble has you sort out the words fattening, yogurt, healthy and less. When finished you get a statement saying it’s a myth that milk products are fattening and that eating them has been associated with a healthy body weight and less body fat. Last time I checked, consuming calorie-dense, higher sugar products (chocolate milk, fruit-on-the-bottom yogurts) contributes to the opposite, and that the data on milk and body weight is at best described as weak, preliminary and under powered, and at worst described as the product of a conflicted researcher who has patented the claim that milk helps with weight loss.

Oh, and hey, how does that answer contrast with this statement,
"Sorry! There is no food that burns fat or makes you lose weight more quickly."
Where's that statement from? Dietitian's of Canada's Nutrition Month 2012 Myth #13.

The adult sheet (entitled "Mythmania") is also awash with dairy goodness.

From the section entitled "Milky Madness" which addresses myths such as "milk causes mucous" to the inclusion of dairy in all three included recipes, milk is featured quite prominently. How prominently? Well the handout is meant to present just a smattering of the myths from Milk Month, oops, I mean Nutrition Month's Dietitians of Canada press release. What's telling is the fact that while the Dietitians of Canada's lists 39 myths, only 3 of which involve milk, the handout I've been given by Dietitians of Canada to provide to my adult patients includes 10 myths, 5 of which feature milk.

Finally, there's the poster I've been given to hang up in my office. If you squint your eyes and look hard, you'll find a few sources of protein that aren't dairy. They're up in the top right corner. That's where you'll find the entirety of your non-dairy based protein choices (nuts, beans, meats, and fish). What won't be hard to find? Milk. The giant glass of white milk splashing in the centre, the flavoured yogurts, the 3 huge hunks of cheese, and of course the chocolate milk. There's also a QR code that you can scan. It's also on all of the handouts I'm supposed to be giving my patients. Wanna guess what image you'll see when you get there?

If you'd like to have a peek at the materials yourself, they're all available for download here.

Suffice to say that I have not and will not be using any of these materials and encourage other DC members to do the same. Doing so goes against the principles that as DC members, we are supposed to stand for. If we truly want to be viewed as authoritative voices it is imperative that our messages this month be unbiased and trustworthy. Both of which are impossible given the large corporate influence that currently exists.

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  1. Rebecca11:41 am

    As a RD I don't like branded material such as these items either. However, DC did not mail any of them out to me and I am a DC member.

  2. Anonymous12:12 pm

    Thanks for the warning.

    What can I do if my kids get these activities in school?
    I wouldn't even know what to beware of without this post.

    If I complain I'll be seen as just another neurotic fussy mom,
    after all, these are "official" resources for schools.

    1. Mark McGill, RD3:51 pm

      Hi Anonymous,

      I'm glad the post was of use to you.

      If your kids do receive these, I would use it as opportunity to make others aware that just because something is 'official', it doesn't mean that one should blindly trust its information.

      If something is funded by a specific company or industry you can be sure that it's message will be biased and as such, may not be presenting the best available or accurate evidence/information.

      In short: practice critical thinking. This makes one better informed and diligent not neurotic and fussy.

      Kind Regards,


  3. My grade 5 daughter brought home a dairy industry branded brochure recently when they were studying a unit on nutrition. I found it rather disturbing that the students were being taught to drink milk or chocolate milk in order to grow strong bones(don't get me started on the sugar in CM!.)

    Since we consume quite a lot of milk in our home, my big problem with the message is that the children aren't being told that dark green leafy vegetables are another great source, and that it's perfectly possible to have strong bones without consuming any dairy products at all.

    For us, it was an opportunity to discuss alternative ways to ensure strong bones, but I wonder how many other parents are as nutrition-obsessed as we are. We also used it as a launching point for a further discussion on the role of magnesium vs. calcium, even though that goes way beyond the curriculum requirements for grade 5 in Ontario.

    I'm all for corporate financial support in our school system, but I have a big problem with marketing messages interfering with the facts.

  4. I agree that corporate sponsorship in the school systems is a problem BUT I would be cautious in saying that a growing child can meet their calcium needs without dairy. Philippa, I would be interested to read the resources you have that demonstrated otherwise. The calcium absorbed from vegetables is much less vs. dairy. To meet their daily requirements of calcium (1300mg), youths between the age of 9-18 would have to consume 29 cups of broccoli! I am by no means a proponent of this campaign, I have actually critiqued their myths here http://shiftthefocus.wordpress.com/2012/03/02/good-grief-charlie-brown/ but again, I am unsure that calcium requirements can be achieved without dairy whatsoever (unless with supplements).

    While the amount of bias in this Nutrition Campaign is enough to make any RD scream or vent themselves via the blogosphere, its not much different than pharmaceuticals sponsoring other organization like the Canadian Obesity Network (CON)- which also happens to have Dairy Farmers of Canada as their “vision partners’ (http://www.obesitynetwork.ca/partners_landing.aspx?menu=38&app=176&cat1=591).
    Its obvious that these organizations require money to run, but is there another means to do this? Can these organizations find alternative ways to make cash? While I am an RD, I’m afraid I can’t answer this but will wait patiently for a comment from those responsible for corporate sponsorship.

    1. There's a world of difference between sponsors who buy advertising and help fund events, and sponsors who apparently pay to write copy for the parent organization.

      That's not to say there isn't a slippery slope with event sponsors, and I don't make the decisions for CON, but here at least, DC has slid right down to the bottom of the hill.

    2. Julie, how is it that millions (billions?) of lactose intolerant Asians are able to get through life without the daily two cups of milk we are told we need for bone health?

    3. KARDPHD5:53 pm

      The traditional Asian diet is very different than the Western diet, so we can't conclude that since they do not drink milk, we do not need it. In the asian diet, small fish (sardines and herring) are frequently eaten with the bones, which is an excellent source of calcium. Tofu is also eaten, and is often set in a calcium base, which can also contribute to the calcium intake. They do eat a lot of green vegetables, but not likely for the calcium content.

      In addition to calcium, dairy provides protein and vitamin A and D. Vit A and D are often in foods not loved by western children (fish, liver, and other organ meats), and not all kids love foods high in protein like meats and legumes. Chocolate milk does have a lot of sugar, although less than soda, and for a kid who refuses white milk and other calcium choices, it's better than nothing until their tastes mature. Balance it out by reducing the sugar elsewhere in the diet.

      Im not a fan of corporate sponsors either, but when did personal responsibility leave the equation? The fact that Dairy is paying for the campaign is not going to make me consume/promote more dairy. Just like attending a lunch and learn sponsored by abbott is not going to make me recommend formula over breast feeding. We choose how we use the information we are given, and DC does not FORCE anyone to share these tools. If you dont want to use them, check the box that says you do not wish to receive the materials, or write to DC and ask them not to send them. If enough people refuse them, maybe they'll have to change them.

  5. VT RD1:27 am

    I am a Dietitians of Canada member and did not get these materials mailed directly to me, and I think it might be because I don't live in Ontario. I agree that it can be misleading that the Dairy Farmers of Canada does their own Nutrition Month website based on the Dietitians of Canada theme, but these are not the "official" materials that Dietitians of Canada is promoting. They have a link to the Dairy Farmers website as part of their Nutrition Month website (www.dietitians.ca/nutritionmonth), but it is certainly not as prominent as the materials developed by DC themselves.

    It is unfortunate that the Dairy Farmers of Canada has access to the DC mailing list AND that DC does not appear to be sending out print copies of the actual official material anymore, but I just want to make it clear that this is NOT the official material and that Nutrition Month is NOT Dairy Month!

  6. Anonymous8:31 am

    I am a day late reading through the posts here, but would still like to comment. I am also an RD, and I did receive the nutrition month promo material from DC, and sadly, the material that Mark is discussing above is the official DC Nutrition Month Material. When I first saw the poster I had to laugh...it remains in the back seat of my car.

    I believe DC has missed the opportunity many years in a row, to promote what dietitians do on a daily basis. I look forward to the year we are promoted as clinicians working in hospitals, family practices and long term care homes, public health nutritionist advocating for healthy schools and environments. Along with promoting our profession, we could certainly inform the public about healthy eating and disease prevention, but it is important to remember that RD's have many roles! To promote Nutrition Month at my workplace, we developed our own Myth and Truths and created our own nutrition month posters on- Label reading, healthy eating on a budget, Re-think your Drink and how to get more vegetables in your diet. I pick and choose the DC's version of NNM as I feel appropriate. --Sarah

  7. As a dietitian, I agree very strongly that dietitians of canada has not always presented the most unbiased information possible. Working in consumer nutrition, I choose not to share these resources with customers as there is already a bias toward the profession as caving to corporate sponsorship and I want to assure people that my advice is given freely and without consideration for corporate influence. However, the sponsorship issue is a tricky one; without corporate sponsorship, a professional association probably wouldn't be economically viable. That said, we can do better. We can ensure that sponsorships are unrestricted grants towards educational initiatives and use those funds to create grounded, cutting edge nutrition information for the public. I think it is important as dietitians that we stop towing the party line and instead practice with our clients best interest at heart.

  8. Anonymous8:24 am

    Along with many others who commented, I'm also a Canadian RD. I have not received the Nutrition Month resources and have been directed to order them. I will not be doing this. I was put off by last year's campaign and this year puts it over the edge! I wonder what happened to all the comments RD's submitted after Nutrition Month last year... they do not seem to be taken into consideration for what the members want. We pay over $500/year to DC (and it's not even a mandatory membership) and the only reason I became a member this past year was to receive my mandatory liability insurance for Ontario. Prior to that I did not live in Ontario and did not have a membership for about 3 years. I found out I can do the insurance privately therefore will not be purchasing a DC membership in the future if I can help it.

    I did not miss anything when I didn't have a DC membership and for $500, that tells me that it is not the best use of my money! Especially when you add in the ethical issues this 'national organization for DC representation' puts on us RD's about big food and sponsorship we obviously feel (and have been taught) is unethical.