Quackery or Pantomime?

Come the new year, people everywhere talk about nothing but their new year resolutions. Whether it is going to the gym (ie joining a gym on a free Groupon trial but not actually going, then forgetting to cancel the direct debit) doing ‘Dry January’ (why?) or whatever floats your boat, it is all about the changes we plan to make that we could make any other time of the year but choose not to, because we have no desire or motivation to do it. As a Dietitian I wonder if the first month in our calendar should be called Quack January on account of the amount of nutritional bollocks that is published for the ravenous consumption of those desperate to find a quick fix enabling them to keep their new year’s resolution for more than 24 hours. 

At work, minding my own business,  like you do, a colleague suddenly drew my attention to this article on nutrition in an E magazine called Wellbeing Plus:

http://wellbeingplusmag.uk.com/2015winter-sw/files/mobile/index.html#6

The article covers pages 6 – 9. On reading this crock of type 7 stools I was so annoyed I  began banging my head on a table and throwing things. Enough was enough,  I felt I had to respond. With this publication claiming to be aimed at public sector staff,  including NHS staff, I was fuming that it was completely unsuitable for the inboxes of the aforementioned staff. I suppose you could say that I was up for a fight. My dander was well and truly up. This is my letter to the editor Katy Brown:

Hello,

I am emailing you about an article I saw in the Winter edition of Wellbeing Plus magazine.  Your magazine describes itself as “health and wellbeing for the public sector”, but the article that I am referring to contains inaccuracies so could be seen as contrary to that description.  The offending piece is the article on diet where you have chosen to seek the dietary opinion of a “celebrity trainer, gym owner and fitness writer”.  The content of the article lacks evidence in many areas and contains errors.  Unfortunately readers may take the article at face value, so may attempt inappropriate dietary changes as a result.

To give examples, the article makes reference to “detoxing” with diet.  This has absolutely no basis in science, yet not only does the article imply it is a valid dietary concept, but your front cover also entices readers in with the ‘D’ word.  I have attached the food fact sheet from the British Dietetic Association (BDA) for further details on “detoxing”, but prepare yourself for the fact that the sheet contains the statement, “the whole idea of detox is nonsense”.  Also, the statement “sugar is highly addictive” is not correct.  There is no compelling peer reviewed evidence to suggest that this is the case in human beings and if it were then public health guidance would reflect this (unless you are a conspiracy theorist).  The statement could be interpreted as suggesting that most of the UK population are “addicts”.  It could also be seen as an implication that all parents who allow their children to have sugar in their diet are giving them an addictive drug, which would be a matter for social services.  Also, the suggestion that eating food containing added sugar is simply down to “addiction” ignores other factors that may cause people to over eat.  The suggested link between high levels of dairy consumption and osteoporosis is without logic and extremely irresponsible, and does not look at all factors that cause osteoporosis in the countries to which it refers.  If an undergraduate student were to make this conclusion in an essay they would fail.

These are just three examples of the poor dietary advice in the article, there are many others, but life is too short to mention any more right now.

I notice that you interviewed a GP for the article on erectile dysfunction (ED), which makes sense since doctors are registered with the General Medical Council (GMC), legally compelling them to give evidence based advice, so readers can be assured that the content is reliable, and if they feel it is not then there is recourse to approach the GMC and complain.  Your magazine would have been a laughing stock if for this topic you had decided to interview a self-styled “Celebrity Bonerologist” instead, whose article claimed that you can cure ED by having a teaspoon of English mustard, wearing your pants on your head and playing Ravel’s Bolero in the bedroom, but this, sadly, is the base equivalent of the diet article and the headline on your front cover.

If your magazine wants to print credible articles on nutrition, your readers would be better served if you sought the opinion of state registered Dietitians (RDs) or registered Nutritionists (RNutr).  The BDA can easily source its media spokespeople for you and contact details are here https://www.bda.uk.com/media/contact That way you could be sure that the author of any article has, like the GP, an obligation to adhere to the evidence, rather than personal opinion and marketing tactics.  Your readers could then rely on the content as being in their best interests and not the business interests of the author.  If any reader felt an article was inaccurate or downright drivel, they would be able to complain to the Health Care and Professions Council (HCPC) in respect of Dietitians or the Association for Nutrition (AfN) in respect of registered Nutritionists.  As things stand the public has no recourse to complain about this article, other than to write to you directly and ask that you consider a more responsible journalistic approach to diet in future, which is exactly what I am doing.  I have also attached to this email the BDA fact sheet on the difference between Dietitians, Nutritionists, Nutritional Therapists and “diet experts”.

Your magazine was passed to our department by our Wellbeing at Work Steering Group asking if it would be acceptable to link to it in the staff Wellbeing at Work newsletter.  As things stand, having read the magazine, the answer is a definite no as it is clearly unsuitable to be distributed to NHS staff.  However, if in future the content of the magazine does become evidence based and reliable then we would of course be more than happy to reconsider.

Kind regards

Now then,  you think after that I would get a defensive response,  or no response at all. But I don’t care, I was well up for a fight. Bring it on. I will see you all outside etc etc. With baited breath I awaited an angry reply justifying the content…
Instead,  can you believe,  I get this, reasonable and nice response from the aforementioned Katy:
“Thank you for your email and I agree with your comments.  We are generally careful with our content to ensure it comes in from a reputable source, but we had been let down with some copy on this topic and a filler copy was used, which in hindsight was worse than running no copy at all.
Please be assured that this is not standard practice from the magazine.
I will happily send you a copy of the April edition for your review.”
Needless to say,  I was furious. Gutted.  I was so annoyed I  began banging my head on a table and throwing things. Well that was the end of that apparently! 
So, have I inadvertently stumbled on something here? Is all the bullshit published in the media about diet really just a filler? Is all the pig poo about quitting sugar, living off the air, drinking urine, eating coal etc etc all just made up and printed on the basis that dead air is a crime? Are my expectations that all nutrition related media articles should be evidence based too high, because to most of the general public,  evidence based nutrition articles are like paint that never dries?
This got me wondering,  how many Dietitians actually read Dietetics Today in depth? How many don’t take the cellophane off? The role of the media is essentially to provide entertainment,  if they don’t (like Channel 5) everyone switches over. So when we see or read stuff about nutrition that makes our toes curl,  maybe we should put ourselves in the shoes of the magazine editor or director. They don’t actually care what they put out, as long as it stays within the law. They just want bums on seats.
It occurred to me that fad diets are a bit like the pantomime.  There is a different one every year, if there wasn’t,  no one would turn up to watch.  If it was the Krankies playing Dick Whittington and his cat every year, we would all vote with our feet.  Fad diets are the same. They are unsustainable long term for most people,  so a new one comes along every year.
So just as you get Puss in Boots,  Robin Hood and Cinderella, so you get Dukan,  Cabbage Soup and I Quit Sugar. It just so happens that this year it is Dr Aseem Malhotra’s turn to dress up as Buttons for our entertainment.
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