Category Archives: dietitian

Patrick Holford, Shark Liver Oil and Walnuts

Patrick Holford on ITV Lunchtime 16 April 2008
Former Visiting Professor Patrick Holford is Head of Science and Education at Biocare. From time to time Holford has nothing but harsh words for randomised controlled trials and the perceived iniquity of systematic reviews or meta-analyses. Unless they confirm a point of view that he already holds, of course, or that he can adapt to the self-aggrandisement of his opinions. And so it is with some delight and no obvious trace of irony that Holford welcomes the release of a systematic review and meta-analysis that evaluates the impact of incorporating walnuts into the diet and outcomes for blood lipids as a proxy for a risk factor for cardiovascular disease. Or, as Holford so pithily phrases it, Go (wal) nuts this summer – walnuts lower your cholesterol (as ever, you need to go to the home page to read the first paragraph but Holford is handily re-cycling his blog posts as email newsletters which must be value for money). Continue reading

6 Comments

Filed under dietitian, nutrition, patrick holford

How To Compile an Affordable Diet that Includes Recommended Vitamins and Minerals

Washington Post carries a thought-provoking and slightly depressing article: Even a Dietitian Can Find It Hard to Craft a Diet That Covers All the Bases. Essentially, even a very experienced Registered Dietitian found it difficult to design a diet that met all the dietary guidelines within 1800 calories (day’s menu for a hypothetical 35-year-old, 5-foot-4-inch woman who weighs 130 pounds and exercises three times a week) and that isn’t taking issues such as affordability into account. Continue reading

16 Comments

Filed under dietitian, nutrition, supplements, vitamins

personaldietitians.co.uk: website content taken offline

Last month, we blogged about personaldietitians.co.uk, raising concerns about the products sold, the marketing used and the reference to ‘dietitians’, and asking “how the BDA and HPC feel about this website and company?”

The website’s content has now been removed – I’m afraid I’m not sure where you can get your diet chocolate now – and all that is left is a page saying that “This Domain is parked” and giving a contact e-mail for any questions. I am not sure why this has happened, but hopefully those behind the site have reconsidered – and will now be adopting a more ethical approach to business and marketing.

8 Comments

Filed under dietician, dietitian

Is Holfordism Harmless? Part 1

A commenter recently posted some thoughts, opinions and questions that raised the wider question: Is Holfordism harmless? She obviously has a sufficiently strong interest in nutrition to prompt her to consider dedicating time and money to studying it.

I saw Patrick Holford on tv the other day and was quite impressed. I have also been thinking about studying nutrition and looking at his institute as a place to study.

I certainly don’t agree with everything alternative medicine has to offer, but some of it does work, so please don’t criticise too much!

Nutritionists (as opposed to dieticians) want to help people towards optimum health – who doesn’t want to feel good? Some of us can’t seem to get the balance right ourselves and, since doctors and buying heavily marketed products often doesn’t help (docs, like dietitians, tend to want to cure rather than prevent), we want to ask someone who knows more than us.

Why do you not think that people who have studied the subject for a few years and gained a qualification, are qualified to help people in this way?

Who else would you suggest consulting?

I ask this as someone who both wants nutrition / health advice, and who is considering re-training under the nutrition umbrella.

I was a little taken aback at this characterisation of the work and practice of dietitians; I did wonder what had led this commenter to form such a partial opinion. We were very fortunate to have an excellent and robust response from Registered Dietitian, Catherine Collins.

As a practicing Registered Dietitian (RD), I’m concerned about the biased and inaccurate views that you have of my profession.

I guess you’ve been reading prospectuses from ‘self-styled nutritionist’ organisations such as ION or CNELM – or perhaps the pseudo-regulatory organisation BANT, which typically make these inaccurate claims. I guess this is their way of trying to justify their ‘nutrition-lite’ practices to people like yourselves who are thinking of training in this field.

RD’s are basically BSc graduate nutritionists with an extra year of study tagged on to the original 3 years to learn and practice the interface of nutrition with clinical disease. As such it gives us a very broad and deep spectrum of expertise which we can use to work in any arena we like.

In the community we work in private practice, health promotion attached to local education and health authorities, self-help groups and organisations, and increasingly sports nutrition (2012 beckons!). Our skills are valued by the food industry, food retailers, and other businesses related to healthcare – or not.

Alternatively – and as in my case – we have the skills to work with the clinically unwell in a hospital setting. Yes, some aspects of our work are dealing with those who abrogate health and nutrition issues until seriously unwell. But my field of intensive care also deals with those unfortunate individuals in the wrong place/ wrong time, and for whom nutrition treads a fine line of providing fluid, electrolytes,and macronutrients in the presence of multi-organ failure.

I take your point regarding the occasional benefits of non-conventional approaches to illness. Yet in the field of nutrition, you will find that the ‘alternative’ do not use a parallel evidence base (such as TCM does when compared to western medicine)- they just misintepret the SAME clinical evidence to promote their practices and wares – as this excellent site demonstrates.

It’s rather ironic of you to agree that “buying heavily marketed products” is not the key to good nutritional health, yet you feel an affinity towards an organisation and an individual which – from this site alone- can be seen to promote products which existing research indicates are futile, or even harmful.

Why should self-styled nutritionists take this approach? I guess it comes down to two reasons –
EITHER
they are unconciously incompetent (so they THINK they know the subject, but they don’t have the ability to translate it accurately or in context for the individual or group)
OR
they are deliberately misleading those who seek their advice…..

But where does that lead dietitians? well, you won’t find us promoting detox or superfoods or megadose vitamins – because ‘sexing up’ key nutrition research distorts the context for the public, and we don’t expect our patient to become guinea pigs for future interest – as all the work on high dose vitamins is increasingly demonstrating.

Equally, you won’t find dietitians pestering for column inches and broadcast time. We are well respected in the media because of our sound background, ethical approach and our conduct – incidentally, being the only nutritional professionals regulated by law (HPC Act 2002, formerly the CPSM Act 1980). Just google the term ‘dietitian’/ ‘dietician’ and you can see how we feature ‘out there’.

Finally, I wish you well on whatever nutrition path you take. Check out the dietitians website…or the bona fide Nutritionists website.

You can’t shortcut a route to nutrition, just as you can’t shortcut knowledge of atomic physics – despite what the nutrition-lite lobby will have you believe. If you choose the latter I guess you have to reset your moral compass or ignore the shortfalls in your training when it comes to dealing with the public who trust you……[Minor changes from the original to embed links.]

Depending on your budget, you might also compare and contrast the cost of studying with ION with that of obtaining a Registered Dietitian’s portable qualifications. If you don’t have science qualifications at ‘A’ Level, then ION offers Science Access Courses:

The Science Access courses are designed for those wishing to pursue the Nutritional Therapists’ Diploma/Foundation Degree Course (DipION/FdSc) but having insufficient background in the sciences to support study. The courses concentrate on aspects of these subjects that are relevant to nutrition.

So, you will pay around £3,090 for either the accelerated (3 month) version of this course, or the year-long course (texts and course notes included). You will also need to pick up the travel and maybe accommodation costs of attending the course in Richmond. For the (further) 3 years of the Nutritional Therapy Diploma course, you will need to pay tuition fees of £3,090 per year (I haven’t been able to establish whether the texts etc. are included in this).

If you wish to obtain a BSc in Nutrition Science in association with the University of Luton, you will need to dedicate another year of study and a further £3,000 in fees (if you study full-time, at current prices). I have not yet been able to discover how many ION graduates top-up their diploma with a BSc, nor the degree class that they commonly obtain.

Unlike most tertiary education establishments, ION doesn’t offer an overview of their research facilities, lecturers and researchers online. It would be useful to know the research projects that are in progress at ION and their list of publications. E.g., if I were interested in studying the Sports Nutrition module in Year 3, it might be helpful to know if I could have access to a gas analyser for the study of exhaled breath (e.g., useful for metabolic analysis) or something like one of the latest, very accurate body fat and metabolism analysers; I might want to know if I would be supervised by someone who is certified to conduct blood draws for lactic acid studies or similar. Coracle offers a very interesting overview of research funding in the UK and the research assessment exercise; it would be useful to know if ION is engaged in this sort of academic research .

It might be considerably faster and cheaper to study for a BSc in Nutritional Science; you may be able to qualify as a registered Dietitian in the time that it would take you to study for a Diploma with ION and then top-up to a BSc degree. You can assess for yourself the value of the assurance the DipION/FdSc is accredited by the University of Luton and validated by the British Association of Nutritional Therapists (BANT) and “meets BANT’s stringent requirements for certification of nutritional therapists”.

I’m sure that all of the contributors to Holford Watch wish the commenter well with any future studies and career. However, I am concerned at the role that Holfordism might have played in shaping the mis-perceptions of the role/practice of Registered Dietitians. Further than that, I’m slightly alarmed at the notion that nutritionists have the inside track to ‘feeling good’ or having “optimum health”. To me, this notion not only overlooks the appropriate intervention of professionals such as GPs but it deprecates people’s own commonsense. Is this harmless?

49 Comments

Filed under BANT, BDA, British Association for Nutritional Therapy, dietician, dietitian, Holfordism, institute for optimum nutrition, institute of optimum nutrition, ION, Nutrition Society, patrick holford