Washington, DC–December 15, 2011–Under pressure from the Healthy Nation Coalition, the USDA recently revealed the identities of the 2010 Dietary Guidelines “Independent Scientific Review Panel,” which is credited with peer-reviewing the Guidelines to ensure they are based on the preponderance of the scientific evidence available. Seven out of the eight panel members are Registered Dietitians (RDs), chosen according to the USDA, “for their knowledge in nutrition communication and dietary guidance.”
At the same time, RDs across America are reeling from the news that the Centers for Medicare and Medicaid Services (CMS) will not reimburse them to provide intensive behavioral counseling for obesity. While the Federal government appears to be relying on RDs as experts in the midst of America’s obesity crisis, it doesn’t want to pay them to help people lose weight. This news comes as the American Dietetic Association (ADA)—the professional organization for RDs—is under scrutiny for its ties to food and pharmaceutical industries.
“An ongoing investigation by Congress recently revealed that the ADA receives over $1 million a year in payments from pharmaceutical companies and an undisclosed amount from companies such as Coca-Cola, PepsiCo, and Hershey. In addition to receiving payments from industries with obvious conflicts of interest, earlier this year the Alliance for Natural Health-USA revealed that ADA’s continuing education courses for RDs are being taught by the Coca-Cola Company’s Beverage Institute,” stated Darrell Rogers from Alliance for Natural Health-USA. RDs have voiced their dissatisfaction with the ADA’s corporate ties, with members indicating that the ADA’s relationship with corporate sponsors has a negative impact on the public image of RDs and undermines the credibility of the profession.
Credibility has been further undermined by the lack of evidence that the methods RDs use to treat obesity are effective. The ADA’s own Evidence Analysis Library contains few studies that demonstrate that dietitian-led dietary interventions result in meaningful weight loss.
As a result, many insurance companies, and now CMS, do not reimburse RDs for its treatment. Tennessee’s state insurance doesn’t cover seeing a dietitian for weight loss. Why? “There’s really no evidence to support the fact that providing those services would result in a decrease in medical cost, certainly not immediately, and even in the longer term,” according to Dr. Wendy Long, chief medical officer of TennCare.
This lack of evidence may be due in part to the limited scope of dietetic education and practice. TheADArelies on the USDA as a scientific authority and follows its lead in most matters of nutrition, limiting the training of RDs to USDA-approved diet recommendations.
Valerie Berkowitz, RD, Director of Nutrition at the Center for Balanced Health and author of the award-winning nutrition guide “The Stubborn Fat Fix” states: “Registered Dietitians lack education and practice in manipulating macronutrients [protein, fat, and carbohydrate] to switch fuel sources from carbohydrate to fat burning. It is unfortunate that educators do not acknowledge the therapeutic value of lower carbohydrate consumption at least as an additional tool to increase the success of medical nutrition therapy for obesity prevention and treatment.”
The ADA not only limits the training of RDs, it is sponsoring legislation in New York and multiple other states that would essentially restrict the practice of nutrition to RDs, and outlaw highly-qualified non-RD nutrition professionals from practicing. If successful, this would restrict consumer choice of nutrition professionals to those trained to follow USDA recommendations.
Given the ADA’s close ties with the food and drug industry and the lack of effectiveness for USDA-approved dietitian-led interventions for obesity, the public should be concerned about the dominant role that RDs and other ADA members played in the creation of the 2010 Dietary Guidelines. In addition to the Independent Scientific Review Panel being comprised primarily of RDs, ADA members were also one-third of the Dietary Guidelines Advisory Committee, the group of experts that creates the Report that guides the writing of the Dietary Guidelines. The majority of the USDA and HHS staff members who worked with the Committee or on the Dietary Guidelines are also RDs.
According to Adele Hite, Director of the Healthy Nation Coalition and lead author of a 2010 peer-reviewed article examining the limitations of the Dietary Guideline process, “The ADA is an industry-friendly organization. The USDA appears to rely on the dietetics focus of ADA-trained Registered Dietitians to confirm their own industry-friendly guidelines. The self-supporting relationship between the ADA and the USDA does not benefit either the credibility of RDs or the health of Americans.”
The Healthy Nation Coalition is an organization dedicated to improving the health of Americans through reforming national food and nutrition policy and does not solicit or accept contributions from the food or pharmaceutical industry.