In the more recent article (The Red Baron) mention is made of a couple of RNutr and they are attacked for their practices, one of them however would seem to be in training to become a Dietician.

So, once Mr Abu-Jabir registered as a Dietician does that suddenly make his advice more sound?

On going use of titles and registers means little unless they are supported by CPD and monitoring to ensure not just that you have a qualification that means something but that you are delivering quality care, most nutritionists (myself included) would welcome this.

Drew

Flattery, I understand what you are saying and maybe I entered the field of nutrition when people had become more cynical about the lifestyle nutritionists. I am sure people who were initially flattered by the interest didn’t predict that this potentially symbiotic relationship would end up with diet manuals by Carol Vorderman and Anthony Worrell Thompson or TV shows by a fake PhD nutritionist (The worlds leading nutritionist apparently, I cannot remember voting for her) who sniffs turd. I guess it is too late to put the genie back in the bottle.

Of course learning or prior experience has an impact on food preference and selection. How these factors interact with the physiological appetite system to determine body-weight is currently anybody’s guess. The impact of physical activity on body-weight is also debatable. Many believe the appetite system attempts to match energy intake to energy expenditure – therefore, even if energy expenditure has fallen, why hasn’t food intake fallen in concert? There are other ideas regarding the purpose of the appetite system, but the idea of body-weight homeostasis remains probably the most prevalent. Also, the data suggesting that energy intake has not changed over the past few decades is pretty suspect. Changes in methodology and substantial under-reporting demand cautious interpretation. I am not saying it is wrong, I just wouldn’t put my house on it.

With regards to carbohydrates, I believe Sciencefan is referring to the concept of glycemic index (or the revolutionary new science of glycemix index – first mooted in 1981). GI relates to the ability of a food to raise blood glucose levels (high GI = rapid rise, low GI = slow prolonged rise). Foods with a high GI tend to contain a greater proportion of simple sugars whereas low GI foods consist of complex carbohydrates. Some evidence suggests that low GI foods are associated with increased satiety and lower food and high GI with reduced satiety and increased food intake. This is debatable. Moreover, the GI of a food (never mind a diet) is not completely predictable (a foods GI changes with cooking, processing and ripening) which makes following a low GI diet difficult. In answer to Sciencefan’s point, and to cut a long one short, there have been so many changes in dietary habits over the past few decades that to blame one in isolation is unwise.

To join in on the Nutrition Society debate, I have to disagree with Ben’s assertion that since Boyd Orr things have gone downhill! There are currently some top class members of the Nutrition Society and the current President (Dr Ann Prentice) is an excellent scientist. However, some of the individuals on the register…

Also, the media nutritionists trivialize the subject and are a constant source of annoyance to the nutritional scientists I know (myself included). When I read their interpretation of nutritional science, I tend to cringe with embarrassment rather than feel flattered.

With you 100%…. of course, this is what makes it all such a pain in the a@!e… One reason why we are trying to grow veg in the garden to make the stuff personal / interesting for Junior Aust.

I was thinking more of my own 40-something generation being made to eat lukewarm leather-tough Sunday lamb and soggy spuds “flavoured” with chemical mint. My father used to tell us that during the war his mother would encourage him to “eat up” with the words “You have to eat that, it’s got SAILOR’S BLOOD on it”. Now that’s what I call positive reinforcement.

Talking of “child taming”, think the child psychology-based shows (e.g. Houseof Tiny Terrors) progs are FAR more useful in terms of inculcating sensible “life habits” (in all spheres) than the nutri-bollocks. Of course, the child psychologist is also a trained professional, probably significant (compare the average TV “nutritionist”).

It also stops you getting constipated…

Good grief… I’m turrning into “Doctor” McKeith….

…can I have my RNutr now, please?

http://www.physoc.org/publications/pn/subjectcollections/pncollectionspdfs/Integrative/2005/Bloom.PDF

(and that one doesn’t even mention insulin, I thnk….!)

To make it worse, the whole question of how much you are “programmed” to eat is not wholly a biological one – there is plenty of evidence that early life learning of eating habits also plays a role. “Finish up everything on your plate!” Or ask the Q: why do some people keep eating when they are full while others stop? Probably behavioural psychology rather than “genetic programming”.

So it is probably a good idea NOT to force your kids to eat everything, rather contrary to how I was brought up.

On the specific subject of carbohydrates, the theory I think you are alluding to is the idea that simple carbohydrates cause a more rapid rise in blood glucose than complex ones, and hence also a faster/larger increase in insulin. But if anything, insulin is a satiety signal (swirches off eating). Of course, a lot of insulin secretion will in turn cause hypoglycaemia, which promotes eating. So as you can see, it is hard to be definite (!).

The best way to put as far as I can see is probably that the nutrient uptake / satiety system is finely balanced normally, and just tweaks itself up a bit when you add food. Complex carbohydrates need to be broken down in your gut for absorption, so will arrive in the blood at a nice manageable rate, requiring minor tweaks to get the body to “store the energy away”. Huge doses of refined carbohydrates require bigger “excursions” of the control system, which in general “push” the system more and are best avoided. Sorry, bit waffly, and haven’t really answered the Q, but hard to be definite. Perhaps a proper nutrition scientist (!) can give you a better answer.

I take your point about the balance between energy intake and expenditure and the general reduction in physical activity.
But hasn’t there also been a dramatic shift from the intake of complex to simple carbohydrates, influencing the satiety response,and thus leading to overeating. Or is this merely anecdotal?

Leaving aside the Qs about precisely WHAT we eat, the total CALORIES that we eat have NOT gone up in the last 30 yrs, contrary to what many people believe. It is more that the energy we “burn off” has gone DOWN. This is due to a whole range of things: less people working in jobs involving physical activity, less people walking or bicycling to work or to do the shopping, less kids walking to school, loss of school playing fields and parks, people go everywhere in cars, one-stop supermarket shopping instead of walking along a local high street, more cars are on the streets so kids don’t play outside, the rise of recreational activities based on sitting around (TV, computers), etc.etc.

Anyway, overall we don’t eat more than 30 yrs ago – we just have a major problem with eating more than we need to eat. To lose weight you can eat less OR do more. Hence all the medical advice about regular physical activity.

I’m not a good cook, but why shouldn’t I eat nice food? And life’s too short anyway.

A reasonable basis for scientific investigation of active chemicals in natural sources is that in nature they’re mixed up with all the other chemicals in the same product – suppose it’s something poisonous, like cyanide precursor in apple seeds – and you don’t necessarily get a regular dose from different varieties of the same plant, or from plants grown under different conditions – this is mentioned in connection with St John’s wort, and of course cannabis.

The evidence from studies suggests a lot of people who DON’T eat healthy diets (often the urban poor) have surprisingly good awareness of what should be in a healthy diet. They don’t because of what the social scientists call “structural and access constraints” – e.g. problems of time (working/childcare) lack of money (junk food superficially seem cheap – £ 2.00 a Happy Meal or whatever), lack of access to good raw ingredients (shop on estate sells only processed garbage, no car to get to Sainsburys) etc.etc.

Education is also important -but at home as well as in school. See Jamie Oliver’s show where many kids couldn’t even RECOGNISE common vegetables.

When you consider that the number of nutrients identified in e.g. an apple or broccoli runs into the tens of thousands (and the total number present is estimated to be an order of magnitude greater) AND that no one component works in isolation but in synergy with others, the idea that we can create a supplement with some 20 or 30 (usually synthetic) vitamins and expect it to have the same effect as eating even ‘five a day’ is laughable.

But scientists are not blameless here – as soon as a fruit / vegetable / herb / seed / fungus etc is discovered to have a particular health benefit, what happens? Immediately the search starts to identify and isolate the ‘active component’ (note the singular form) with the objective of synthesing it to produce a new drug. OK, this is how e.g. antibiotics were developed and it can be a valid approach for the treatment of disease, but we tend to lose sight of the bigger picture: good nutition offers the opportunity for real prevention, which is not in the interests of the pharmaceutical industry but which would save the NHS billions and improve the quality of life of the whole population. How the pension system would cope is another matter!
A study published in Nature showed that one 100g apple contains more cancer-fighting antioxidant capacity than a 1,500-milligram dose of vitamin C. (Nature, 2000, 405: 903-904). Some may argue that the jury is still out on whether antioxidants are significant, but it isn’t just epidemiological studies that suggest that is far better to eat an apple than to take a vitamin C supplement ; this is (presumably) because of the complex synergy at work between the myriad nutrients available in the apple.
No wonder that a nuclear physicist friend recently stated that nutrition is far more complex than his subject!

I appreciate that many people are eating poor diets. But I don’t think they need specialist nutrition advice, as it is extremely simple to eat a good diet. Prepare and cook your meals yourself, rather than eat ready meals. And eat a varied diet including plenty of fruit and veg. It’s really easy to eat a balanced diet. You don’t have to think about it. Just get a nice thick recipe book and work through the various different recipes in it. It’s easy and fun!

Even junk foods aren’t all bad, because some of them do have vitamins etc. added to them.

About the link between diet and cancer: yes, I accept there may well be a link, but I’m sceptical about whether we know enough about it to say precisely that certain foods cause certain kinds of cancer. Ben posted a link a while back to an epidemiological site that said the evidence about smoking and cancer was overwhelming, while the evidence relating to nutrition and cancer was much more patchy and debatable. (This is from memory; I hope I’m not misrepresenting here.)

I wouldn’t know about 50 years ago, but my chief recollection of food from the early 1960s was that it was bloody horrible. In particular it was in the tail-end of an era of ludicrously long cooking times for vegetables (I have a cookbook here recommending cooking carrots for 45-50 minutes) which I don’t suppose left much in the way of vitamins.

I admire your confidence in the face of the overwhelming evidence to the contrary! Sure, if you choose the right foods you can eat as healthily today as 50 years ago (and not worry too much about supplementation), but the reality is that the vast majority of people just don’t or won’t do it – hence e.g. the worrying increase in the numbers of overweight and obese adults and children, the concomitant increase in the incidence of ‘adult-onset’ lifestyle diseases and conditions in ever-younger children etc. The link between diet and disease has been shown time and again to exist (not least by Doll and Peto’s work on the factors leading to cancer; if I remember correctly, nutrition was approx. as significant a factor as smoking).

There is an urgent need for good nutrition advice to families – just telling them to eat a balanced diet is not enough. But who is to provide sensible advice? The RNutrs? The dieticians? GPs?

IMHO anyone recommending multivitamins has automatically disqualified him/herself. Look for the evidence of the efficacy of such supplements: it is thin on the ground, I fear, while the evidence of their harmful effects is documented in several large-scale studies.

No answers as to why some of us can investigate independently what a “balanced diet” is and others want to be told by an “expert”, let alone follow fads.

I do see a reason for experts and research though, as stagnation of knowledge leads stagnation all around. “Balanced diet” was different when I was a kid, but smoking was cool and associated with cowboys.

Anyway – deleted contribution below.

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This thread to me seems to boil down to two issues:-

1) What is a RNutr, especially when we have Dietitians ?

2) If the Nutrition Society is, as it claims, the best organisation to administer such a register then why are the top brass so instinctively secretive?

I have looked a little at these and it seems simple:

1) Dietitians versus RNutr:

Dietitians are primary focussed on giving one-to-one dietary advice (mainly NHS based). They are protected and need, like most nurses/midwives etc nowadays, an appropriate specialist Degree and experience.

RNutr and PHNutr are primarily focussed upon research, health policy, communication etc., but NOT primarily on one-to-one advice. They also need an appropriate specialist degree or PhD and experience to be registered, but are not protected in any way so others can use titles like “Nutritional Therapist” and nobody can do anything.

At the official levels the RNutr/PHNutr registers certainly seem to be recognised as being reliable. A couple of links to the Food Standards Agency and the British Nutrition Foundation are attached.

FSA – 3rd question on page: http://www.eatwell.gov.uk/asksam/healthydiet/healthyweightq/

BNF: http://www.nutrition.org.uk/home.asp?siteId=43&sectionId=1164&parentSection=299&which=4

2) Are the Nutrition Society the “right” management?

The timidity with the press when questioned by a journalist is common in academic institutions and bodies so I can’t say I am shocked. This may not be the best approach but is hardly a sensation.

You point to the the transparency of complaints in the medical profession but my understanding is that GMC panels are reserved for only the most serious cases of gross and sustained misconduct/incompetence and are only reached after many earlier “private” stages of medical complaints processes through hospitals, trusts etc. If ALL complaints ever made against doctors, regardless of verdict, are published somewhere where they can be examined then I will happily stand corrected.

Openness versus Privacy is always a huge debate. Personally as a general principle I am in favour of privacy until verdict, and then release of details only if the verdict is guilty. Many Sun and Daily Mail readers may disagree.