Ask a public-health/nutrition student

[Aractus]

I am a Registered Dietitian!  It is SO nice to meet not only a fellow Atheist, but fellow nutrition professional as well.  Are you working toward your RD?  Thank you for clarifying the Gluten issue for others.  It is one of my biggest pet peeves!

One of the other things that deeply concerns me is the issue of eating disorders, and fad diets in particular 80/10/10 (/veganisim in general).

I am genuinely shocked at the number of 80/10/10 adherents that are on youtube going on about how great the diet is AND also admit to having had an eating disorder. Here's but one:

https://www.youtube.com/watch?v=FYdfWhBpQUs


Perhaps even more shocking is that she also sells a "health ebook". She's 19, hasn't studied nutrition (obviously) got her information from the likes of Doug Graham (who also never studied nutrition which you would know but I'm mentioning it for the other AF members), and Leanne Ratcliffe (better known as "Freelee") who just like Graham sells her unqualified health advice, she's also an ex-anorexic (that's if she isn't still suffering from an eating disorder that is), and they're participating in the "fad diet" arena the same way that every large corporate does which is that when people complain "it's bad and it doesn't work" they blame the people not the diet. Although she claims to be qualified, she also claims her anecdotal experience is more important and accurate (see this). I imagine the qualification she claims to have is this worthless piece of junk.

They have so much junk-information out there that it dwarfs proper scientific research. Obviously since you're a dietician and not a psychiatrist you're probably not the best person for  people suffering from eating disorders to see, but clearly not everyone who follows this shit has an eating disorder, so my question is does it frustrate you when clients have beliefs about food that run contrary to professional opinion? And do you ever tell clients that following such diets is a risk factor for developing mental illnesses?

Last semester in a class I was, well more horrified than shocked to be truthful, when one group presentation made the claim that people can get Vitamin D from mushrooms. And that was in a third-year course (with two previous unit prerequisites), not a first-year course! I wonder what mushrooms they've been eating...

[LadyForCamus]

I am a Registered Dietitian!  It is SO nice to meet not only a fellow Atheist, but fellow nutrition professional as well.  Are you working toward your RD?  Thank you for clarifying the Gluten issue for others.  It is one of my biggest pet peeves!

One of the other things that deeply concerns me is the issue of eating disorders, and fad diets in particular 80/10/10 (/veganisim in general).

I am genuinely shocked at the number of 80/10/10 adherents that are on youtube going on about how great the diet is AND also admit to having had an eating disorder. Here's but one:

https://www.youtube.com/watch?v=FYdfWhBpQUs


Perhaps even more shocking is that she also sells a "health ebook". She's 19, hasn't studied nutrition (obviously) got her information from the likes of Doug Graham (who also never studied nutrition which you would know but I'm mentioning it for the other AF members), and Leanne Ratcliffe (better known as "Freelee") who just like Graham sells her unqualified health advice, she's also an ex-anorexic (that's if she isn't still suffering from an eating disorder that is), and they're participating in the "fad diet" arena the same way that every large corporate does which is that when people complain "it's bad and it doesn't work" they blame the people not the diet. Although she claims to be qualified, she also claims her anecdotal experience is more important and accurate (see this). I imagine the qualification she claims to have is this worthless piece of junk.

They have so much junk-information out there that it dwarfs proper scientific research. Obviously since you're a dietician and not a psychiatrist you're probably not the best person for  people suffering from eating disorders to see, but clearly not everyone who follows this shit has an eating disorder, so my question is does it frustrate you when clients have beliefs about food that run contrary to professional opinion? And do you ever tell clients that following such diets is a risk factor for developing mental illnesses?

Last semester in a class I was, well more horrified than shocked to be truthful, when one group presentation made the claim that people can get Vitamin D from mushrooms. And that was in a third-year course (with two previous unit prerequisites), not a first-year course! I wonder what mushrooms they've been eating...

What a great question! It is very frustrating when clients have warped or extremist beliefs about diet and nutrition, but I am not frustrated with the client, I am frustrated with the unqualified individuals (like the two great examples you provided above) who are infecting people with such nonsense. It infuriates me on so many levels.

For one, they don't realize they could cause someone serious physical and/or mental harm (like you mentioned about eating disorders) by dispensing medical nutrition therapy, or even false ideas about what diet is "right" for good health, without a formal education.

It also pisses me off that in this country people don't feel they NEED a formal education in nutrition. It's ironic how so many "nutritionists" scoff at the importance of scientific evidence, or even more sinister, spread the poisonous idea that you can't trust nutrition research, or the FDA, or the USDA, or the AHA and ADA because it's all one big national conspiracy to keep us fat. People are so confused as it is, and then they hear "don't trust the professionals!"

So, I am rambling, I apologize! To answer the second part of your question, yes, I definitely try and steer anyone I can away from harmful, restrictive, scientifically unsubstantiated diet fads. As you mentioned, I am not qualified to treat eating disorders, but maybe I can stop someone from going down that road in the first place. I had not heard of "freelee" until your post, and I have to admit after reading up she is one of the wackiest I've come across. She is a good example of someone who may actually be giving people eating disorders with all that nonsense about only raw until 4pm and her crazy macronutrient ratio. Scary. What is your work like as a public health professional?

[LadyForCamus]

That is such a great question!  Yes, I do get very frustrated, but my frustration is not with the clients, it is with the unqualified individuals who infect innocent people with potentially harmful  information.  It infuriates me on a number of levels, actually.  Many self declared "nutritionists" are ignorant of the physical and/or mental harm they can cause (like an eating disorder, as you mentioned) by dispensing medical nutrition therapy, or even generalized diet advice for good health, without a formal education.  

It also infuriates me that for some reason in this country people don't feel they NEED a formal education in nutrition science in order to practice it.  I find it ironic how many nutrition "experts," and "gurus," scoff at scientific research, ignore it, or more insidious, spread the idea that the general public cannot TRUST nutrition research, public health guidelines, the FDA, the USDA, the WHO, the AND, AHA, and the ADA (ect...lol) because it's all one big government conspiracy.  

So, I am rambling, and I apologize!     To answer the second part of your question: yes, I do try and steer people away from restrictive, potentially harmful fad diets that are unsubstantiated by scientific evidence.  Like you mentioned, I am not qualified to treat eating disorders, but maybe I can keep someone from walking through that door, so to speak.  I admit I had not heard of this "FreeLee" woman.  After reading up on her, I think she is one of the biggest nutrition nut jobs I have come across on the internet!  She is the PERFECT example of someone who could cause serious harm with all that nonsense about raw foods until 4pm (WTF?!), and  her insane macronutrient ratios.  Not to mention her restricted sodium recommendation I would feel guilty giving to a CHF patient!

What type of work do you do in public health?  Do you come across a lot of these wackos from a day to day basis?

[Aractus]

At the moment I'm just studying not working. Doug Graham claims in his book that if you follow his diet (80/10/10) then you won't need to use pharmaceutical medicine (and he also tells his readers/cult-followers not to brush with toothpaste either - just use water according to him).

Given how long he's been selling his diet for - I would have respect for him if he'd stopped and said "you know what, science has advanced a huge amount since I originally wrote all of this, and I now realise I was wrong". But no, he's completely deluded. In fact last year he nearly killed a woman that took his water retreat, and subsequently he's been banned from life from the Woodstock Fruit Festival (an event specifically for 80/10/10 raw food vegans) . For anyone who's interested here's the video from Leah, the woman that almost died (and that's not at all an understatement):

https://www.youtube.com/watch?v=l4Ge2OCti4I

Notice how even though the man that started the 80/10/10 diet nearly killed her, she still follows it?

I actually stumbled across Freelee when watching some anorexia videos - I wasn't even interested in looking at 80/10/10, and then one of the first videos of hers I watched was one denouncing eggs and dairy. "The body makes cholesterol so we don't need to eat it" - wrong on so many levels. No one has clinically established that holds true for everyone, and besides dietary cholesterol itself doesn't even raise LDL. Just because there isn't a nutrient reference value for it doesn't mean it's OK to make broad-sweeping claims like that (in fact I've learned that NUTTAB doesn't even list the Vitamin D content of food!) She's basically daemonizing one of the body's most essential molecules (the parent steroid from which all other human/animal steroids are made), based on the fact that 20 years ago we didn't know what it did and thought it was "bad". Too much LDL leads to clogged arteries, sure, too little leads to serious mental health conditions.

I met someone a few months back, IRL and outside of university, who'd considered taking a IIN "course". She wasn't stupid though, she saw right through their bullshit and instead enrolled in a university degree. However, IIN specifically tells its "gradates" to go out and be health coaches, so there's a whole culture building around unqualified people who think they have the qualifications necessary to "help" people through nutrition. The problem is that nutrition isn't homoeopathy - it's a science.

As I mentioned before, Freelee freely admits she suffered anorexia. And a drug habit. But she could well be still suffering from an eating disorder such as orthorexia. Obviously you don't blame the patient for suffering from an illness, no matter how obnoxious and downright loony they might be. She's constantly on a sugar-high from eating so much fruit, and sugar is addictive, so she's probably a sugar addict too. The whole movement is like a religion, they're just not interested in hearing real evidence. Instead they get information from people like her: ex-drug addict, ex-eating disorder sufferer, and unqualified to give nutrition advice.

Yes I agree she's the perfect example. She looks in the mirror and says "I'm not emaciated" and "look how great my body is" (even though those are breast-implants, and she appears to be clearly underweight).

The information from Government, WHO, Cancer & Heart NGO's, etc. often isn't packaged nicely or endorsed by celebrities (or loud-mouth idiot youtubers). And no, I only come across these nutters on youtube.

[paulpablo]

Have you heard of alpha brain, or turmeric, what are your opinions of these things? Or the chaga mushroom

[Aractus]

I haven't heard of Alpha Brain but I'd caution you to be wary of claims that are unverified by 3rd party research. The way these products generally work is they're given a scientific test with a small sample and the data is then mined for a positive result. It's a way of guaranteeing that you have something to sell - doesn't matter at the start what you find, once you've found it you make the claim. "it reduces stress" or "it sharpens your concentration" or whatever it might be. By design you will almost always get something you can claim doing this.

Like all Vitamin supplements it appears to be marketed towards people that don't need it.

I can't really comment on traditional medicines. They might work, they might not, but in either case it's probably more expensive with less reliability and knowability of the side-effects, if I were you I'd treat traditional medicines as if they were a new as yet untested pharmaceutical drug, unless its effects have been studied to the same extent as other medicines.

[Aractus]

One of the things I find interesting is the issue of parental responsibility for providing adequate health care for their offspring. Well not so much that I find it interesting in itself, what fascinates me most is the the public viewpoints and policy on this.

We've already debated whether so-called "anti-vaxers" are moronic invalids or not. I did try pointing out that of people who don't vaccinate their children not at the advice of their doctors, the majority of them are not "anti vaccine". It's important to think about because focusing resources and attention on the actual "anti vaxers" would yeiled far less promising results than focusing on those who miss vaccinations for other reasons: the biggest reason being that the need is not seen as seriously to the healthcare consumers as it is to health professionals. Address that and the vaccination rate will increase, back to where it needs to be.

And there's another reason I don't believe in taking draconian measures to "force" people to vaccinate their children, and that is that any draconian action has the potential to create distrust between healthcare consumers and healthcare providers, and establishing and keeping that trust is far more important. Without it people will not seek the healthcare products and services they need because of their fear. In Australia this is a big problem, and in fact it would be a problem anywhere in the world that has Indigenous people, and that is that Indigenous people have a huge fear of any White-Australia institutions, whether they're schools, hospitals, police departments, or governments.

And besides, people are right to distrust pharmaceutical companies, and they should distrust the companies. I absolutely loathe them. Nurofen was ordered in December to remove the "targeted pain" products from their website as part of a court ruling against them, and yet they still display the misleading information here and here (and I've sent through a notification to ACCC about the breech). The products themselves are no longer available for sale being that they've been banned in the same aforementioned ruling. That's why people should never, ever get their information from a drug company, or a supplement manufacturer, they should get advice from health professionals. And even pharmacies can't be trusted when they knowingly put quackery on their shelves (and I'm talking other shit that gets sold in pharmacies that has no medical benefit).

But looking beyond this, we currently have people who do put their children at risk by following alternative ideas of medicine and diet. And this I think is far more serious. I was just reading about the case of David & Collet Stephan providing inadequate medical care for their child by self-diagnosing his illness. That's a gross negligence on their behalf. And it has nothing to do with their anti-vax beliefs, and I don't think that should even be relevant at the trial, the relevance is on the fact that the parents decided to diagnose the child's illness without seeing a medical practitioner. The fact they were giving a toddler a multivitamin is just beyond belief. It defies the conventional limits of stupidity. Just to clarify, I'm not alleging giving the toddler a multivitamin was a substitute for medicine.