Monday, December 31, 2012

Dietitians, the Media, and Conflicts of Interest.

Hope you're enjoying this holiday season! This week is traditionally my blog-cation and so instead of writing new posts, here is a favourite of mine from back in 2009.
According to my friends over at Fooducate, at this week's American Dietetic Association (ADA) conference there was a talk regarding whether or not we can trust industry sponsored nutrition research. The reason that's in question is because sadly right now there are no guidelines in place to help expose conflict of interest in dietetics. It was the absence of such guidelines which led Marion Nestle in 2001 to write a fascinating journal article about how food company sponsorship impacts on the profession's credibility. Ultimately it led Marion to resign her ADA membership. According to Fooducate,the lecture was not a popular one at the ADA conference and was very poorly attended.

Of course it's not just research articles that demonstrate conflicts and bias, we can see non-evidence based industry bias in a far more dangerous place - the mainstream media.

Case in point?

Yesterday there was a CBC report about an Ipsos-Reid survey which according to the CBC was, "conducted on behalf of Dietitians of Canada" (DC). What the CBC article later reported was that the survey was cosponsored by the Dairy Farmers of Canada. The DC and Dairy Farmers of Canada joint press release on the survey drew these 4 conclusions (highlighting is mine, not theirs):
"1. Consumption of all four food groups is far below recommended levels;

2. A significant number of Canadian adults had not consumed any milk and alternatives or any vegetables and fruit on the day prior to the survey.

3. Many Canadian adults report they have barriers to healthy eating.

4. A majority of Canadian adults are not aware of the many health benefits of milk and alternatives and vegetables and fruit including their role in reducing the risk of some cancers, hypertension and other chronic diseases.

5. When made aware of these important health benefits, Canadians report they are motivated to increase their intake of foods from these food groups."
Well last week we covered how milk doesn't appear to actually have a benefit on hypertension and that calcium supplementation alone impacted on cancer risk while dairy might in fact up the risk of prostate cancer and given milk's failure in preventing osteoporotic fracture and in weight loss, I'm not sure what magic milk is meant to do.

Looking at the actual survey the bias is obvious. The only specific questions regarding choices and healthfulness have to do with either "dairy and alternatives" or "fruits and vegetables" and of the 5 conclusions of the press release, 3 directly relate back to dairy (2, 4 & 5). Absent was information regarding the health benefits of whole grains, nuts, legumes or fish.

The thing is I get it. I fully understand why the Dairy Farmers crafted the survey - it was designed to report that Canadians don't drink enough milk; that there are umpteen-million magical "benefits" to milk consumption; that milk's as healthy and important as fruit and vegetables; and that if we just teach people more about unbelievably healthy milk they'll drink more of it, but the question I've got is why do you think the Dietitians of Canada decided to lend their name and credibility to a survey that ignored multiple food groups and is basically a milk advertisement?

Unfortunately the media certainly treated it like more than simply a milk ad and they ran with it prominently featuring DC's involvement. Had the poll simply been one from the Dairy Farmers of Canada I imagine the coverage of the report, if any, would likely have been very different. As well, in this case, the media also oiled the slippery slope of corporate dietetic collaboration by failing to identify quoting dietitian Kathy Furgala's corporate allegiances referring to her instead as a "Toronto-based dietitian". Frankly it was in fact Kathy's quote from the CBC story that got me riled up enough to write this post and explore the survey in the first place. She was quoted as saying,
"For people who say, 'I don't want to worry about the food groups,' just look at your plate, and see if you can't throw in one veggie or some cheese"
Yup, the two most important things you could ever add to your plate if you don't want to "worry about the food groups" - a single vegetable or of course, some cheese.

I'm not sure what's worse. DC signing off on a milk ad disguised as a national eating survey, a dietitian who would give the advice that all your plate needs for your meal to be healthy is one lonely vegetable or a hunk of cheese, or a reporter who chooses to identify that dietitian as a "Toronto area dietitian" while omitting the fact that she's in fact a nutrition educator for the Dairy Farmers of Canada in an article whose focus is on increasing dairy based on the results of a survey paid for by the Dairy Farmers of Canada.

[Oh, and in case you noticed - the survey found that "consumption of all 4 food groups is far below recommended levels". Strange in a country where over 65% are already overweight or obese. Could it be that the recommended levels recommend too much? Tune in tomorrow for more discussion.]

Nestle, M. (2007). Food company sponsorship of nutrition research and professional activities: a conflict of interest? Public Health Nutrition, 4 (05) DOI: 10.1079/PHN2001253

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  1. Anonymous6:47 am

    I'm not surprised. One thing I find really annoying is the dietitian who has a regular spot on the Steven and Chris show, which is broadcast across the country every day on CBC. She plugs CHOCOLATE MILK as a healthy way to get in your milk and your calcium. I've seen her do it at least twice (and I don't watch the show often since I work during the day).

    Here, she promotes chocolate milk as a good thing to drink after a workout, within an entire segment devoted to promoting milk in general:

    In this segment, she recommends drinking chocolate milk as a healthy way to get calcium, and as an alternative to having a chocolate bar in the afternoon (and notice how the big glass of chocolate milk stands out in the accompanying picture):

    It drives me crazy when I see supposed health experts promoting chocolate milk!

  2. Lol anonymous - you sound like me when I get a bee in my bonnet and hubby has to stop me throwing things at the TV.

    Actually, wrt chocolate milk, while it may not be the superfood it's being made out to be here, it's not exactly the devil's food, particularly if you make your own from milk and cocoa say, without all the added crap from the manufactured kind.

    A lot of the post-exercise research, and there's a fair bit of it, compared the effects of chocolate milk on recovery from fairly hardcore training programmes compared with fancy schmancy expensive heavily marketed sports drinks. It tends to fare well.

    Some of this research may have been sponsored by dairy companies (I'd have to check on that), but I would consider chocolate milk a healthier, more natural option, that electrolyte infused sugar water. Also, I like the stuff. :)

    (PS I have no financial ties to any milk-producing or marketing organisations and I do not own a cow)

  3. Angela, I'm with Anonymous on this one, since I'm also one of those chocolate milk bee in the bonnet people! Have you ever heard anyone recommending a glass of cocoa? I'd agree with you if they did, but my very strong impression is that commercially-made chocolate milk is what they have in mind.

    My understanding from the chocolate milk / sports drink studies is that regular milk would be just as good as a post-workout drink, but it's the chocolate milk they are pushing.

    I'd love to know more about how commercial chocolate milk is made. I do buy it on occasion when it is on sale, and I've started to see small numbers of artificially sweetened cartons in some of our grocery stores. I wonder if chocolate milk is so attractive to the dairy industry because it normally retails for so much more than regular milk, or because it's formulated with cheaper milk products. Probably it's both.

  4. Ir appears that transparency is required all round when it comes to research of any kind. I take issue with a healthy eating guide identifying a food sector (dairy) as a required food group when it should be lumped in with meat & alternatives and why so very much grain?
    I also take issue with lazy dietitians. - throw a veggie or cheese on the plate - seriously? What if the plate is already all protein & grain (hamburger)- adding another protein will make it healthy? Guess that makes a loaded cheese burger (pickle, relish, tomato, onion, ketchup, mustard) healthier than a basic hamburger.

  5. There's that saying that if a food makes health claims that probably means it isn't food.

  6. The meat industry, the dairy industry and the egg industry all have a vested interest in having people (over) eat their food stuff, it's called a profit and not your health or the food pyramid (do they still have that?). Meat, dairy and eggs have been proven to be very bad for our healths and profit mongers push their wares on us and we gobble it up thinking we are eating healthy.