In January 2012, The Daily Mail published an article which began:
Nutrition therapists condemned as 'quacks' who put patients' health at risk
Nutrition therapists have been condemned as quacks and accused of putting the health of the sick – including those suffering from breast cancer – at risk.
An industry has grown up based on the concept that ‘food doctor’ nutritionists can cure patients’ ills and allergies through diet.
However at least some of the practitioners, who charge up to £80 for a consultation, are providing advice that could harm health, a study by the consumer watchdog Which? found.
Read more: http://www.dailymail.co.uk/health/article-2087167/Nutrition-therapists-condemned-quacks-patients-health-risk.html
The article told readers that Which? had found nutritional therapists who gave questionable advice, had charged high fees for it and were unlicensed. Well, they might have a point but there may also be another side to this story.
Which?'s questionable methods
The first point is that Which?'s research methods and basic criteria are suspect. I have been on the receiving end of a Which? story so I can write this with some authority.
Back in 2001, Which? magazine tested the 14 best-selling slimming diet books to see if the dietary advice they gave worked. My book, Eat Fat, Get Thin! was one of those they 'tested'. But Which? did not actually test them at all. Instead, they looked to see if the books recommended 'healthy eating' and, if they didn't, they were adjudged to be of no benefit, an were not recommended. But, as I knew then, and as much more recent research has confirmed, healthy eating is a cause of obesity. So, as I was more knowledgeable, I wrote Eat Fat, Get Thin! to be of value to people wanting to lose weight, not to put more weight on. And for that reason, Eat Fat, Get Thin! did not fit with their preconceived, but totally wrong criteria. The full story is at http://www.second-opinions.co.uk/which.html
Is the same thing happening here?
Okay, I give dietary advice, if asked, but I wouldn't suggest to a breast cancer sufferer that she disregard her oncologist's advice, just cut sugar out of her diet, and keep her fingers crossed. But I might well point her in the direction of published research so that she can make an informed decision.
For example, the statistics for conventional breast cancer treatment are woefully bad at best, so a no-sugar diet might well work as effectively as (or even better than), say, chemotherapy, which is about 1.5% effective in breast cancer – and has lots of quality-of-life destroying adverse side effects. (Morgan G, et al. The Contribution of Cytotoxic Chemotherapy to 5-year Survival in Adult Malignancies. Clinical Oncology 2004; 16: 549-560. doi:10.1016/j.clon.2004.06.007)
Is registration a sign of quality?
The other point that the Daily Mail's article makes is that nutritional therapists are not registered or regulated, whereas dieticians are. And as the British Dietetic Association says: ‘Anybody can set up shop as a nutrition therapist, with no qualifications. Registered dieticians working in the UK are educated to degree level and must be registered with the Health Professions Council.’
But is that a guarantee of getting good advice? In my experience it is not.
In 2001, I was the interviewer and nutritional adviser in a documentary video which was attempting to sort out the confusion caused by books like mine and Atkins and the obvious conflict with current dietary advice. We interviewed nutritionists, dieticians and doctors as well as people attempting to lose weight. The doctors were fine: they knew that they didn't know much about diet. However, we found that registered nutritionists and dieticians were, to put it bluntly, ignorant, incompetent and arrogant. They were qualified; they knew their stuff – except they didn't! You can read about one of the interviews at http://www.second-opinions.co.uk/why-eat-5-portions-1.html.
She was not alone. We interviewed two others. Neither of them knew much about foods, nutrients and the effects on the body of even basics such as carbohydrates and fats. One openly admitted, when she asked for and I showed her the questions to come – they were about ketones and the effects of exercise – that she couldn't answer any of them! In fact, by the third interview, an NF registered nutritionist, it was obvious even to our nutritionally-uneducated production crew that the interviewees were completely ignorant of even the basic facts and could do little more than waffle. After the first three, we didn't interview any others: they were obviously going to be a waste of money.
In the end we didn't use any of these interviews in the documentary. We would have loved to, but couldn't: it would have ruined their careers.
Why are people going to unregistered nutritional therapists?
Registered nutritionists and dieticians effectively cost patients nothing: they are NHS-funded. To consult a nutritional therapist, on the other hand, is expensive. As the Daily Mail article points out, they might charge £80 ($120.00US) an hour. So why are people turning away from the registered dieticians and going to the alternatives?
There can only be one answer: They are dissatisfied with the NHS. And, from talking to many of them, I know that it is the sheer incompetence, indifference and inability to look outside the box they encounter within the ranks of registered dieticians.
I used to lecture on diabetes in hospitals to NHS diabetes staff. The NHS paid for me to do so. But the doctors, I found out, did not like what I was teaching – despite the fact that everything I said was backed by solid evidence and research published in their own medical journals. They had been taught one thing (and learned nothing) and nothing I said or was published subsequently was going to alter their minds or their treatment protocols. And so, diseases such as diabetes, obesity and other conditions associated with these diseases, continue to spiral upwards exponentially, while an ignorant and arrogant – but all powerful – regulated and registered 'health industry' bemoans the facts and suggests it's all the fault of their patients.
The bottom line
As I see it, any patient has two options: The first is to read articles on the Internet and select a nutritional therapist who might or might not know what they are talking about, or go to a qualified member of the British Dietetic Association and be sure that they don't.