Wednesday, January 23, 2013

Author Michele Simon's Devastating Report on the Academy of Nutrition and Dietetics' Corporate Ties

Seldom have I read such a damning report as the one published today by Eat, Drink, Politics' Public Health Lawyer Michele Simon where she painstakingly details the unspeakably cozy relationship between the Academy of Nutrition and Dietetics(AND), America's largest association of nutrition professionals, and the food industry.

I honestly can't even begin to do this report justice in a brief blog post.

What I found the most striking was the fact that it seems pretty clear that from their own accounting AND doesn't need the food industry's dollars.

What I mean is that according to Simon's research, corporate sponsorship only generated $1.8 million in revenue last year - a rather paltry sum all things considered, but that paltry sum afforded the food industry unparalleled access to America's dietitians. It provided sponsors with among other things the ability to produce co-branded "educational" materials, access to mailing lists and even the opportunity to provide accredited continuing education (including one course where Coca-Cola taught RDs that there's no evidence of harm to sugar consumption in children).

Putting that $1.8 million in some perspective, AND is 74,000 members strong. If AND decided to protect its credibility and divorce itself from corporate sponsorship it could do so by raising the cost of membership by just $24 a year. In fact if AND raised membership by $42 a year it would also offset the food industry's annual contributions to the AND Foundation - a Foundation already flush with cash having a reported value of $17 million, or 6 times AND's reported annual expenses.

In a private conversation Simon mentioned to me that there are some who doubt the transparency of AND's accounting and that corporate dollars are much greater than those reported. Of course if that were true, the question to be asked is what, why and how much are they hiding? Alternatively, if the numbers are true, and if AND doesn't truly need the money, the question to be asked is why do they allow their reputation and credibility to be sullied by the food industry? Your guess is as good as mine, and I'd bet at the end of the day the answers to all of those questions are direct or indirect personal pots of gold, power, or influence.

I asked Simon what she thought the answer was and she didn't mince any words,
"These corporate relationships go deeper than just money, which is what makes them so insidious. What’s really going on is a battle over the role of the food industry in shaping the very discourse of nutrition education and policy. It appears that the old guard” at AND is desperately holding on to the outdated notion that the food industry should have a seat at the table. But that leadership will soon have to make way for the younger generation of RDs who realize that partnering with junk food companies only harms their profession."
Truly, if you have any interest at all in the risks of partnerships with the food industry and just how ugly and twisted they can get, take some time and take in this report. It's a must read.

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  1. Anonymous8:25 am

    Wow! Thank you for bringing this to our attention. AND should have it's name revoked. Between this and the Heart and Strokes "Health Check" system I am so discouraged I think I will just grow all my own food. Amazing report, thanks again.

  2. Anonymous9:03 am

    Speaking as a Canadian dietitian I do not hand out any food company branded handouts and I read all reseach and information from any of the "big food" from the milk board to the beef board with a major grain of salt. If our professional organization deems it worthwhile to partner with companies such as Loblaws for nutrition month etc, as individual dietitians we are in no way mandated to participate.

    1. Anonymous9:16 am

      Absolutely agree with this - I'm also a Canadian RD and opt to not receive the food industry info in the mail that I'm automatically signed up for when register for a Dietitians of Canada membership. I use the food guide as a tool for those with low literacy when I do use it - the pictures are useful in these cases but individualized goals as always set besides that. I would probably use the food guide with 1-5% of my patients maximum for those reasons.

      Basically - I'm not stupid! I know when a company is attempting to intertwine with my practice and the college/personal ethics I am bound by. We were also taught to use discretion with industry messaging and the impact on our practice while we were in university.

    2. Rebecca11:17 am

      I totally agree. I also think as young RD's we are challenging this. Hopefully we win soon. I too do not handout industry sponsored handouts and rarely recommend any brand to a client (margarine, bread, etc) but concentrate on teaching them how to make these choices themselves.

  3. Since I am not a member of the "AND" (hate the abbreviation)and haven't been a member for a number of years I still find most RDs do NOT support sodas, etc. Since my hubby is a retired MD I saw all the "gifts" and sponsorships doctors were offered and many took. My hubby stopped going to "drug lunches" (Pharmaceutical sponsored)and to meetings that were heavily sponsored. This is a problem across the board but laws have at least gone after the MDs.

  4. While the association is a red flag (and a worrying trend we also face in Australia), it shouldn’t be an instant condemnation. I think the article gives RDs too little credit for being able to distinguish ‘hidden marketing messages’ from true evidence based practice (and the fact that it reported a large number of members were dissatisfied with some of these associations must mean something).

    Is there any suggestion that members accept the messages from the very sponsors that they question the appropriateness of? The original article directly refers to resource that it suggests states sugar isn't a problem for kids - so what is inferred that dietitians think about sugar (especially in light of the extreme positions taken by the likes of Dr Robert Lustig)? Is any opposition purely the result of corporate influence or vested interests? I know the main players in the anti-fructose movement in Australia already use this "Poisoning the Well" tactic to discredit any challengers! (See point seven at as one example)

    The same ad hominem logical fallacy is applied to doctors who support immunisation, Big Pharma associations become a point to dismiss anything they say. While equally worrying, a doctor’s association with drug companies via professional association and conference sponsorships shouldn’t mean that the default position is to distrust their advice – a tactic opponents of evidence-based medicine and health are quick to infer or in some cases state directly!

    1. No doubt the food industry sees their $s as providing them with a net benefit, and even with RDs who see through corporate double speak (and I'm sure the majority do), their ties may provide industry with the ability to fight industry unfriendly legislation....or purchase silence.

      The point of my piece isn't to suggest that RDs are incapable of critical appraisal, but rather that if the reported dollars involved are accurate the conflict of interest (which by definition exists even if actual conflict doesn't - perception of conflict is sufficient to establish conflict) is wholly unnecessary and I'd bet, were there no corporate involvement, suddenly AND would have much more latitude in actually taking policy stances that might currently upset their corporate donors.

    2. Anonymous1:28 am

      While the point is well taken, with any sponsorship like bought ad space in Medical Journals or drug lunches,MD's, RD's and all professions need to feedback to their pro associations of which we are the membership.I once heard an MD say something like "let's take a limo instead of a cab because my research fund will pay for it." The RD bashing gets a bit wearing.

    3. Anonymous7:30 pm

      I agree with the previous 'anonymous'. The RD bashing does wear and seems that they are the 'only' group to be blamed for industry's influence on the public. What about the positives of their work? This seems to be a common theme of this blog. There are so many RD's doing amazing work in all areas of nutrition but seem to be the scapegoat in these cases. It would be nice to see a shift in perspective and maybe offer supportive solutions to a very complex issue which involves MANY people from varied backgrounds, including doctors.

  5. Anonymous1:45 pm

    I have been a dietitian in the U.S. for nearly 15 years and have rarely found "AND" (I also hate the acronym) to be worth the money for sponsorship. I see that the resources they offer RDs have improved greatly in the past few years, however when they began accepting money from Coca Cola several years ago I swore I would never be a member as long as they accepted corporate sponsorship. I feel as strongly today as I did then, no matter what they might have to offer me as a professional.

  6. Reminds me strongly of the problematic relationship between pharma and some MD associations (particularly in the bad days of the 1990s). Hope RDs don't repeat the mistakes MDs made - it hurt the credibility of the profession.

  7. Anonymous11:09 am

    I'm an RD in Canada and felt forced into a DC membership - I haven't had one for years. When I moved to Ontario, it is mandatory to have liability insurance and DC made it seem they were the only organization where you could purchase insurance through with a DC membership. I realize now this is not the case. $500/year membership is a waste of my income at this point! DC does nothing to help out practicing RD's, only allows industry to send flyers in the mail (I still get them even though I opted out!). I was unimpressed that even after last year's Nutrition Month campaign, DC has taken it one step further and you have to order your Nutrition Month kit directly through the Dairy Farmers of Canada website... I'm angry with DC and how they are portraying RD's in Canada. I know many RD's across Canada feel the same way. Dietitians of Canada is not representative of this profession and crosses many ethical boundaries within the profession. It just puts all of us in a bad place where we constantly feel our back is against the wall - which is highlighted within Dr. Freedhoff's article.

    DC feels they need sponsors because they don't have enough members to pay the feeds... well if they got rid of the sponsors and offered better resources, more RD's may be willing to pay the fees without need of sponsorships. Maybe DC should be integrated into the provincial college organizations that are required for licensing and make it one unified system.

  8. Anonymous8:24 am

    I agree with the comments made by other Canadian RDs; I too have felt pressure to join DC after graduating since most RD positions I applied for required that I was a member of the organization. The coupons and articles I am sent that are endorsed by the food industry are immediately discarded, as I refuse to provide my clients with food industry sponsored information. I am also quick to dismiss any food-industry sponsored research sent my way. Articles that work to discredit RDs frustrate me, as I find they leave the public further confused about where to go for credible information and many turn to the Internet where unregulated nutritionists abound.

  9. I am no longer a member of AND and haven't been for years now. While I appreciate the good work many of their members do...and while I don't demonize most foods...I can't stand going to conferences where Coca Cola and McDonald's proudly wave their flags and promote their products. I simply don't believe those products are good for you. Do I think children should never taste a french fry? Of course not. But neither do I think it's appropriate to sport Coca Cola tote bags and swag at a conference focused on pediatric obesity. The irony is just too painful. Coca Cola and McDonald's will NEVER have as their message, "Drink less Coke. Eat less McDonald's" so I am sorry, having them as sponsers is ridiculous. I've seen RD's challenge AND and the responses they get are riddled with condescending corporate speak. Just as smoking used to be cozy with the AMA, I am hopeful that this will someday be a thing of the past...that someday in the future young dietitians-in-training will laugh and remark how bizarre it was that AND was ever associated with packaged snack foods and fried fast food.