31 January 2012

Which is more reliable: a registered dietician or an unregistered nutritional therapist?

This is an example of why I wrote Trick and Treat

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.


greyhound said...

A very good point. My husband uses low carb to control type 2 diabetes and statins gave him every side effect going about three years ago. The heart specialist queried his comments until I said his brain was not the same since statins! He left the topic alone. Been very hard to 'fight' the medics and stay low carb, no diabetic meds and run normally. Our GP toild him cholesterol of 10 or more caused brain problems. Dont know the answer to that one. Medics can be a nightmare where low carb/cholesterol is concerned.

Sue said...

my 80 year old father now has type 2 diabetes, he was advised by a dietician at the hospital that he can eat biscuits as long as they are plain ones without cream in! I tried to explain about low carb eating but my father says that I am 'gullible and will believe anything the internet tells me' and 'if I am so clever why don't get a job at hospital' Not surprisingly dad has no idea why he cannot lose weight following this dieticians advice and even though I have lost 2.5 stones the low carb way I am apparently misguided.
He insists his friend died of cholesterol and is taking statins to avoid the same fate. He also beleives there is no chance of me avoiding diabetes as my grandmother had it and it is hereditary.
I have tried so hard but in his eyes as with many people the doctors are Gods.

Sue said...

have you seen this video Barry? A doctor has cured herself of MS she says conventional medicine did not have the answer but the internet did.


Anonymous said...

Sue, I am sorry to hear that but you can only say so much. Not everyone has the mettle to go against doctor's orders. Still, it's a shame because while low-carb cannot entirely cure diabetes in the sense that you follow the diet for a bit and then go back to "normal" eating it can make a huge difference. A friend of mine, who is 74 was recently diagnosed as pre-diabetic. When he came to see me for a week he had to eat low-carb because that is what I am eating. I also explained about fighting diabetes with this way of eating. He is also overweight. In one week he lost 5 pounds and when we tested for blood glucose two hours after a meal it was 95. He stuck to the diet, has lost over one stone and blood glucose still looks good. HDL is not too brilliant but one has to give these things time - the effect of lifelong high-carb on the blood lipids is not cured in four weeks. I am confident, though, that things will look different in about three months. His doctor has not offered any dietary advice yet but I am confident that any "high-carb-low-fat" advice will be cheerfully ignored. The numbers speak for themselves!

Barry Groves said...

I feel the medical and other 'health' professions really have to be brought to book and not be allowed to get away with the harm they have done.

Recently, Fred Goodwin of the Royal Bank of Scotland lost the knighthood he had been awarded for his “services to banking”, because they weren't!

There are several people, whom I dare not name, who have been awarded similar honours for, frankly, increasing the ill-health of this nation. They push 'healthy eating', and act as little more than drug pushers for the pharmaceutical industry.

What I find even particularly galling is that, as more people are discovering that they have been duped and are changing to the sort of 'unhealthy' ways I and others preach, instead of being brought to book for the harm they have done, the 'healthy eating' dogmatists are subtly changing their stance and tying to tell us that they have really been saying this all along.

But the general population has been brainwashed now for a quarter of a century. And brainwashing works - if you tell someone something for long enough they will believe it.

And so we trust doctors and nurses and registered dieticians. Despite the fact that their industry is among the world's most corrupt - and we honour them for it!

You are unlikely ever to change your grandfather's ideas now, Sue.

Yes, Sue, I have seen that video. It demonstrates well that MS is not as untreatable as the drugs industry would have us believe. But how can they make money out of such sufferers getting well by natural means?

I beieve that there are basically two types of disease: Those which are caused by micro-organisms such as bacteria and viruses and where drugs might have some value; and others which are caused by our lifestyle for which drugs are inappropriate.

Where we go wrong is in using drugs to ameliorate the effects of our incorrect lifestyle. It doesn't work. And those who promote such a treatment protocol should know that. If they don't, they are ignorant and should not be in the job; if they do know it and continue to push dogma, they are incompetent and arrogant. Either way, they should be stripped of their honours and be forced to find another profession where they can do less harm. IMHO.

End of rant.


Stan (Heretic) said...

You may have already seen it, if not - well worth reading!

An Interview With Guylaine Lanctot:


Guylaine Lanctot: As a medical doctor, I practiced medicine for over 20 years in different countries. I went to different provinces in Canada, and I lived in the U.S. for 6 years. I got to know the medical system. I was questioning, "Why is everything so expensive? Why are we getting sicker and sicker and health care is getting more and more expensive, and everybody's unhappy?" I realized that different systems are totally alike. They have different names but, whether they are a capitalist system, like we have in the U.S., or socialized, like in France, or in between, like in Canada, the bottom line is that the medical systems are all alike. They all serve financiers and not the people. That's the basic thing. The bottom line is that the medical systems are controlled by financiers in order to serve financiers. Since you cannot serve people unless they get sick, the whole medical system is designed to make people sicker and sicker.

...Doctors want to help their patients and the patients want to be helped. How come it doesn't happen?

...The reason is that, coming between the doctor and the patient there are intermediate people. There is the government taking the patient's rights and owning them and putting up the legislation about how medicine is going to be practiced and what's right or wrong. Then, there are the insurance companies taking the patient's money and deciding how this money is going to be returned to the doctors. So, patients and doctors don't have a relationship anymore. Patients and doctors have a relationship only through insurance companies and through the government.

Why did we allow this to happen? That's the question. We allowed it to happen because we believe in two illusions. The first illusion is what we call protection. We think we need protection, but you cannot be protected. You can have all the protection you want. If the ceiling falls on your head, you die. So, protection does not exist. We don't trust ourselves; we don't trust the doctors. We think we need protection. So, we bought the idea that we need protection which can only be given by the external authorities. So, here they are. We're not good enough. We need someone to protect us. We gave our rights away to gain protection. However, external authorities will not protect us.

Our second illusion is security. We need security. Security does not exist. We bought into this illusion and gave our money away in the name of security to insurance companies. So, here we are. No more power. No more control over our money and our rights.

Anonymous said...

I consider myself a reasonably intelligent person and have done a lot of reading over the years on healthy eating. I follow the low carb way and have done so for several years with no problems.However I still get a fleeting surge of what can only be described as fear whenever I hit the cream or butter....such is the power of medical indoctrination !!!

Barry Groves said...

Hi Stan and Anonymous

It's called brainwashing - and it is very powerful. When you are told something over and over again, it becomes so fixed in our mind that it is very difficult to reject. And ill-health is now so widespread in industrialised societies, that we are reluctant to 'go it alone' in case we come unstuck and have no-one to fall back on.

But I really do believe we do not need much of what is available. Several times in my life, I have taken on a large project because I couldn't afford to do otherwise. For example, Monica and I designed and built our own house, ploughing into it every penny I earned, because as both architect and builder (with no experience of either), we couldn't get a mortgage.

having been very poor, we became and now are both very much DIYers and don't trust most professionals if there is any way we can do something for ourselves. If nothing else it has saved us a fortune.

We cannot do everything, of course. But as far as medicine is concerned, if anything goes wrong with our health (fortunately a very rare occurrence), we see our doctor for a diagnosis, then read as much as we can find about it, and make our own decision on what we want to do about it. In the last 3/4 of century, this approach hasn't let us down.

Fortunately, we have a doctor who is prepared to work with us rather than push drugs. Long may he live.

That said, He doesn't agree with the way we eat. But, if that is problem, it is his, not ours.

But I must admit, it can take a lot of courage sometimes to forsake stability and apparent safety for the sake of personal freedom.


Anonymous said...

You're absolutely right Barry, we do to buy professional advice and services when , if we spent a bit of time and effort, we could do the job better ourselves. We tell ourselves we're 'time poor' but in reality we're lazy and have been brainwashed into believing that these jobs are best left to the professionals. In some ways being poor is a blessing as the condition really does force you to use your own brains and ingenuity.My father used to do everything in the house...a right Jack of all trades and though he'd be the first to admit that he was master of none we got by without calling in the decorator, the electrician, the plumber , the interior designer , the gardener etc. etc.
Even illnesses had their home made cures. I can well remember enduring my nan's country remedies and whilst they very often didn't do the trick it was something to concentrate on whilst the body got on with its own job of curing. We survived very well without all these high powered drugs. I really do believe that the body knows best .......certainly more than doctors. Fresh air, sun , walking , a caveman diet and barefoot contact with the earth is my recipe for health and I really don't care how nutty people think I am!!!

Stan (Heretic) said...

I am following in your footsteps and learning from you! You broke free much earlier. For me it was a survival on a scholarship in the West in 1983 (I came from communist Poland back then) when I learned to live and thrive without being eligible for any social welfare or medical assistance whatsoever. The main lesson was that stability kills while an uncertainty is what I believe we thrive upon!
Best regards,
Stan (Heretic)

Albert said...

Hi Barry -

Just checking up on you. Well as you know - YOU saved my life, after 15 doctors, 3 hospitals, 1 & 1/2 years of drugs and supplements COULDN'T do, thank you very much again!!!

I've been pretty faithful to the diet now for almost 2 1/2 years, have NO more symptoms now and aside from having the occasional drink or dessert, I still stay away from virtually all grains. Don't really miss em that much by now, and in fact they taste more and more like mushed up paper or cardboard.

Anyway had a bit of dark humor I wanted to pass on (in bad taste I know ..) I was watching TV with my daughter and my wife (both of whom I made SURE read your book cover to cover). My wife made a comment about Steve Jobs. I noted that he died from Pancreatic Cancer. My daughter made a comment about how brilliant he was. I said .. "I bet he was eating pasta till the day he died." My wife said (with an astonished look on her face).. "He was a devout Vegan - he was sure THAT would save his life!!".

We were all quiet.

I said to my daughter ... "Hey, that means I did something Steve Jobs didn't do. I researched, read Groves' book and cured myself. (I paused) So am I smarter than Steve Jobs??"

My daughter smiled and glared at me ..

(Sorry - I know, in bad taste)

Keep up the fight Capeetan!!

Anonymous said...

Nice one Albert!
I've always thought that there are two types of people in this world. The first ( often very clever and well read) accept everything they are told if the information comes from authoritarian departments or figures. The second ( often ordinary but possessing good old fashioned common sense ) question everything and make up their own minds about Life. I know which category I would rather belong to
I think Barry is one of the few who is both clever and possesses ample common sense. Long may he write!

Barry Groves said...

Delighted to have been of help Albert. Is your daughter vegetarian? If so, she wilL love (or hate) a book I am reading for review at present called The Meat Fix, by a long-term (26 years) vegan, John Nicholson, whose constant illnesses eventually forced him to eat some meat. And it cured him literally overnight. It is a brilliant book - and very entertaining.

You are making me blush, Anonymous. :-)


Albert said...

Hey Barry -
No both my daughters are FAT eaters now ;-)
But my daughter's boyfriends' father and brother are both Vegans. The father has a multitude of heath problems ... of course, they won't listen to me.
But I still keep talking, and sending out books, or loaning them out to whoever I think will read it. People on my facebook often make posts about Cancer. I reply occasionally - 'what would you do if you knew the cause and the cure for Cancer, but no one would believe you?'
PS: Love to read your new book!

Mike said...

Interesting views and ones I agree with despite the fact I am currently studying dietetics! People are likely going to private people as they do get results! Lots of them haven't a clue true, but some of them are so on top of the science its unreal. On the flip side your average dietitian still believes the eatwell plate is actually a good model of "healthy eating". All I can say is that I feel it is changing. People like myself are coming through the ranks with open minds and a massive interest in empowering people and not industry. I myself follow a ketogenic diet so that should give you some idea of my views on things. Hopefully we can effect change from the inside.