A Step Backward In The Field Of Dietetics

In November’s Academy of Nutrition and Dietetics (AND) Journal, dietary recommendations for the treatment of obesity are shared with registered dietitians. These recommendations are based on the AHA/TOS/ACC Obesity Treatment Guidelines. I am distressed to see that dietitians are being encouraged to:

• Set specific calorie restrictions for individuals and
• Choose from between 15 diets that were analyzed – including low carbohydrate diets

These recommendations bring us back to the dark ages. This is an old approach that has an abysmal success rate for achieving long-term sustainable weight loss. Research shows that only about five per cent of people who try to lose weight ultimately succeed in the long term (> 5 years) and calorie restriction, in many variations, has been the most favoured approach by far.

The panel members state that these recommendations are based on evidence. They’re correct, but it is incomplete and misinterpreted evidence. They make conclusions about long term weight maintenance even though it appears that none of the studies they investigated assessed long term weight loss (> 5 years).

They ignore calorie restriction’s abominable track record for long term weight loss and they completely ignore wholistic evidence such as biomimicry and evolutionary biological evidence.

The craziest recommendation is allowing nutrition counsellors to choose from between 15 different diets as if each was equally health-promoting.

This ignores mountains of evidence that show diets high in animal foods and low in whole and minimally processed plant foods lead to our most common chronic diseases.

In a recent webinar, Dr. Tom Campbell MD expressed his dismay about these recommendations. Based on such instruction, he said that many physicians will feel justified in telling overweight/obese patients to lose weight by any means necessary. Essentially the message is that the content of a patient’s diet doesn’t really matter, only caloric intake matters. This is such a misguided view of nutrition.

I’m doing my best to persuade registered dietitians and other health professionals to begin viewing nutrition from a wholistic perspective by encouraging them to read T.Colin Campbell’s “Whole: Rethinking the Science of Nutrition”.  I’ve written about Dr. Campbell’s views in this article.

I am very concerned that new dietitians and dietetic interns are going to be led down the same ineffective reductionist “rabbit hole” from which some of us old-timers have escaped.