Thursday, May 6, 2010

Dietitians of Canada & its Industry Partners

January 2013- Note- this post has broken links- see update below.



Dietitians of Canada (DC) is the "national voice of dietitians" and states that it is "the most trusted source of information on food and nutrition for Canadians". However, did you know that DC partners with industry, including Coca-Cola, McDonald's, Monsanto, Nestle, pharmaceutical industry, supplement industry (e.g., Centrum), etc etc. (The American Dietetic Association does as well).

Huh?!

How does this affect DC's message? How does this make dietitians look? Do you think they can be unbiased and critique the food industry, if they're getting money from it?
I decided to write a letter to voice my concern- (it was also an assignment!). I'd love to know what you think!

btw- I was inspired by American dietitian, Marion Nestle's, call to ADA members.

Dear Dietitians of Canada CEO and Board of Directors,

As a new Dietitians of Canada (DC) member, I am surprised by, and cannot condone, this organization’s long history of partnering itself with food, beverage, and pharmaceutical industries - regardless of the nutritional quality of their products, their history, or stated goals. DC professes itself to be “the most trusted source of information on food and nutrition for Canadians,” but these partnerships put into question this trustworthiness, the integrity of DC’s messages and research, as well as my own credibility as a member. I ask that you review your advertisement and sponsorship policies to recognize, and minimize, the many conflicts of interest that arise due to these alliances.

DC partners with, and receives funding from, a large number of companies that that do not align themselves with DC’s vision of “advancing health through food and nutrition,” e.g., McDonald’s Restaurants of Canada Ltd. - which has “a passion and a responsibility for enhancing and protecting the McDonald's brand” as a guiding principle; the Canadian Sugar Institute, whose ultimate goal is to “maintain a healthy and competitive sugar industry;” Coca Cola Ltd., whose mission is to “refresh the world” and vision includes profit and productivity; PepsiCo Canada, representing Pepsi-Cola, Frito-Lay, Tropicana, Gatorade and Quaker brands; Nestlé Healthcare Nutrition, a company with a well-documented history of promoting and distributing infant formula in developing countries; Roche, producer of Xenical, a weight-loss drug; and Compass Group Canada, whose national partners include Harvey’s, Tim Horton’s, Mr. Sub, and Pizza Pizza, among others.

While DC states that “an advertisement for a product or service does not constitute endorsement by Dietitians of Canada,” it definitely gives the appearance of one. Moreover, it is acknowledged that partnerships with industry can compromise credibility of organizations and its professionals, as well as the legitimacy of research.

The following are just a few of the many examples of industry sponsorship of DC activities that raise questions of conflict of interest:

-The Montreal 2010 DC national conference program acknowledges numerous industry sponsors, many with commercial interest in the topics discussed:
  • Kellogg’s - whose products include cereal brands All Bran and Raisin Bran, and All Bran and Fibre Plus cereal bars – is sponsoring a symposium on fibre, “exploring the breadth of science supporting the many health benefits of eating a diet high in fibre...”;
  • The Centrum Foundation is sponsoring ‘Prenatal Nutrition Guidelines,’ which includes the new recommendations for iron, folate, and omega-3 fatty acids;
  • Lallemand Institut Rosell, producer of yeast and bacteria, is sponsoring ‘The Role of Microbiota in Medical Nutrition Therapy’;
  • Campbell Company of Canada, with its line of gluten-free products, is sponsoring ‘The Gluten-Free Boom: Challenges and Opportunities’.
Whether sponsorship of conferences directly influences content or speakers’ opinions is up for debate; however, it does give the appearance of support, and may have an indirect influence by silencing critique of the product.

-As part of DC’s mission to support “ethical, evidence-based best practice in dietetics,” the Canadian Foundation for Dietetic Research (CFDR) was created. However, it becomes impossible to distinguish between independent evidence-based research and corporate involvement:

Five of the 11 CFDR Board of Directors are employed by industry groups Nestlé, Kraft, Compass Group Canada, Unilever, and Dairy Farmers of Canada.

CFDR’s 2009 Annual Report disclosed that it received over $220,000 from more than 20 corporations, including $75,000 from The Centrum Foundation and Wyeth Consumer Health Care Inc. Two of the seven research grants awarded by CFDR in 2009 were directly linked to supplementation:

How can all Canadian infants get the Vitamin D needed for optimal health?’ “examines how children of vegetarian parents can get the vitamin D they need through supplementation...”

Can thiamin supplementation help patients with heart failure?’ aims to “determine an effective dose of thiamin supplementation that will restore red blood cell thiamin levels, leading to better health for patients with heart failure.”

Centrum was also a benefactor in 2008, when CFDR featured a special collaborative research project investigating the use and barriers of vitamin and mineral supplements.

There are different sources of conflicts of interest in research, but financial conflicts of interest have been found to consistently produce a bias.



-A 2009 Ipsos Reid survey, done on behalf of DC and its partner, Dairy Farmers of Canada, sought to provide an informal 24-hour recall of over 2000 Canadians. Two of the four conclusions drawn included the mention of dairy products: “A significant number of Canadian adults had not consumed any milk and alternatives or any vegetables and fruit on the day prior to the survey...,” and “A majority of Canadian adults are not aware of the many health benefits of milk and alternatives....”

Coverage of the survey by the Canadian Broadcasting Corporation ended with a dietitian stating: "For people who say, 'I don't want to worry about the food groups,’ just look at your plate, and see if you can't throw in one veggie or some cheese.”

Corporate sponsorship is pervasive in the field of nutrition. Individuals and organizations engaged in such partnerships justify them in terms of advancing research and bettering the public’s health, maintaining that the relationships do not forfeit integrity; however, the above examples provide just a sampling of the many conflicts of interest that arise from the collaborations between DC and industry that compromise DC’s, and its members’, credibility. In fact, Health Canada’s Sodium Working Group was recently disparaged by the Center for Science in the Public Interest due to the involvement of DC representative Susan Barr, because of DC’s heavy involvement with industry.

Board of Directors, as long as DC continues to align itself with food, beverage and pharmaceutical industries, and rely on these corporations for funding, it will never be respected, and neither will I. As a member of the purported “nation-wide voice of dietitians,” I hope my voice, and my concerns, are heard, and that DC will carefully review its advertising and sponsorship policies to recognize the many conflicts of interest that exist, and their consequences, and take steps to minimize them in order to restore DC’s credibility. These steps may include, but are not limited to, beginning a conversation with members with regards to this issue, increasing transparency of use of corporate funds, being much more selective in choosing which companies to enter into partnerships with, and ensuring DC and CFDR Board Members have no corporate ties.

I look forward to hearing about the steps that will be undertaken in this important matter.

Thank you for your time.

Sybil


Feel as strongly as me?

To have your voice heard, copy and paste the paragraph below – feel free to personalize it - and send it to Marsha Sharp, the Chief Executive Officer of Dietitians of Canada ( msharp@dietitians.ca )

and to the member of the Board of Directors of your area, if your a member of DC:
Matthew Durant, Atlantic, matthew.durant@acadiau.ca
Barbara Khouzam, Quebec, North-East and Eastern Ontario, bkhouzam@uottawa.ca
Kerry Grady-Vincent, Central and Southern Ontario (email NA publicly).
Rosemary Szabadka, Saskatchewan, Manitoba and North Western Ontario, RSzabadka@wrha.mb.ca
Maureen Elhatton, Alberta and the Territories (email NA publicly)
Heather McColl, British Columbia (email NA publicly)
As well, cc. Georgette Harris, the front-line contact on sponsorship and advertising (gharris@dietitians.ca ).

and/OR by clicking here.


Dear DC CEO and Board of Directors,

I would like to express my concern towards the many partnerships DC has with food, beverage and pharmaceutical companies. These alliances, and reliance on their funding, gives the appearance of support, encourages perceptions that sponsorship prevents DC from criticizing the food industry, and makes it impossible for DC to be a trustworthy source of information for Canadians; by extension, as a DC member, I cannot be a credible source of information, or trusted as a professional.
I hope that DC will carefully review its advertising and sponsorship policies to recognize the many existing conflicts of interest, and their consequences, and take steps to minimize them in order to restore DC’s integrity.
I look forward to hearing about the steps that will be undertaken in this important matter.
Thank you.
Sincerely,


Other sources:
Gingras, J. (2005). Evoking trust in the nutrition counsellor:why should we be trusted? Journal of Agricultural and Environmental Ethics, 18, 57-7.

Nestle, M. (2001). Food company sponsorship of nutrition research and professional activities: a conflict of interest, Public Health Nutrition, 4(5), 1015-1022.

Lesser, L.I. (2009). Reducing potentital bias in industry-funded nutrition research. American Journal of Clinical Nutrition, 90(3), 699-700.

_____________________

Update (January 2013)

I had not revisited this post in a while and notice that many of the links are broken. Some updated facts : 


  • The Canadian Foundation for Dietetic Research (CFDR), created to support ethical, evidence-based best practice in dietetics, has a vision of enhancing the health of Canadians by contributing new knowledge about food and nutrition. In 2012, the CFDR received about $200 000 in revenue from corporate "partners". These included the Dairy Farmers of Canada and Nestlé (the two biggest donors, each giving CFDR $125 000 over 5 years), as well as The Centrum Foundation and Pfizer Consumer Health Care Inc., Campbell Company Canada, Compass Group Canada, Kraft Canada Inc., McCain Foods, McDonald's Restaurants of Canada Limited, Unilever Canada Inc, Abbott Nutrition Canada, Aramark Canada Ltd., Canola Council of Canada, Egg Farmers of Canada, General Mills Canada Corporation, Kellogg Canada Inc., Loblaw Companies Limited, Mead Johnson Nutrition, PepsiCo Canada and Sodexo Canada. 
  • They note: "CFDR is grateful to the many corporate partners and donors who believe in the value of dietetic and nutrition research in building a healthy Canada."
  • 8 of the 11 2011/2012 Board members have industry ties. 
  • I'm having trouble finding the program for the 2012 annual conference. The 2011 DC Ontario Regional conference one shows  a breakfast sponsored by Becel and Egg Farmers, a lunch by Unilever, a "special conference memento" courtesy of the Sugar Institute, and industry-sponsored talks.



24 comments:

Fresh Local and Best said...

Sybil, you lay out a strong case in this letter and your effort is commendable. I hope that the word spread out about this information and letter so that you can garner the support that you deserve.

Sybil Hebert, RD said...

Thanks Christine!

Anonymous said...

Sybil, you actually verbalized what you know where as some professionals just think about it. Good for you to be true to your profession. That shows dedication.

ings said...

Thank you for blogging about such an important issue! I sincerely hope that things change within the industry, especially its source of funding.

Chef Anthony said...

What a well thought out and accurate representation of the problem facing DC and their quest to meet their stated mandate.
As a Dietetics student at MSVU here in Halifax I too have been troubled by the impression of influence being exerted upon DC policy and position statements by the food industry. While realizing that it does take considerable funds to run an advocacy group such as DC there must be a better way to fund the way forward.
As I approach my final year before joining the ranks of the Dietetics profession here in Canada, I am very uneasy with the cozy arrangement between industry and DC. Already I have people asking why I want to become a part of the problem rather than a part of the solution regarding the nutritional problems being faced by the population. How can we in good conscious tell people that highly processed foods and high calorie sugar drinks are bad while taking funding from those same companies?
As you have stated a small disclaimer does not erase the impression of support indicated by acknowledging funding from these same companies.
Keep up the pressure and perhaps some day soon the DC position on acceptance of funding will reflect the values of its members rather than those of industry.

Anthony Thomas
Fourth year Applied Human Nutrition Student, MSVU

Jme said...

Great research and information Sybil, this pulls back the sheets on something that concerns us all!

Jacqui said...

Sybil,
As is the case for any professional organization; its members must be able to question and scrutinize how that organization is funded and the relationships that are reinforced through those funding patterns. Active dispute and moral testing is essential to the vitality, veracity, and transparency of such organizations. Active dispute and moral testing (asking questions such as, "Is this appropriate? Who benefits? Who does not benefit?") allow professionals to foster trust between each other and with citizens; this is the only way that we can claim to be the most trusted source of nutrition information, IMHO. Thanks for contributing incisively to this important process of strengthening our organization.

Chrys said...

Well done Sybil,

It's really encouraging to know not all dietitians have been brainwashed by their professional body nor are they towing the party line.

Jennifer said...

Sybil,

Thank you for voicing out loud what so many of us have thought and talked about before.

I wholeheartedly agree that DC needs to rethink its position on partnerships with industry. I am ashamed every time I see another dietitian on another commercial detailing the health benefits of yet another food product. Physicians should not be endorsing drug companies and dietitians should not be partnering with food companies.

Our qualification is something to be honoured. As dietitian we must garner trust. When one RD endorses a food company, it tarnishes the trustworthiness of all of us. When RDs support or advertise a product, whether it is stated explicitly or not, they are lending their credential and trustworthiness to a food company. Dietitians have a duty to support the health of patients/clients/the public. Corporations' only sense of duty is to their shareholders. I feel strongly that our professionalism, public trust, and credibility should not be used in this way.

Well done Sybil!

Thet said...

Sybil,this is definitely eye-opening. I was unaware of DC's extensive involvement with the industry nor the source of its funding. There is definite conflict of interest as you pointed out. Thanks for sharing. I am sure that most of the public is also unaware of this important issue.
Thet

Janine Bolton said...

Sybil,

I am behind you on this 100%. I will be sending my own letter, forwarding this to all my colleagues, and writing my own blog post about it. Kudos to you!!

Janine.

Rachel said...

Good for you! Those of us with nutrition training need to speak up and question alliances with industry.

Julie Negrin said...

Just wanted to say that your blog post made it onto the Hunger and Environmental Nutrition (HEN) list-serv, which is a progressive group of dietitians within the American ADA. We have been discussing the issue of sponsorship with the ADA as well. I applaud your courage to stand up and speak the truth. I hope that your ADA and our ADA, take notice and begin the slow and arduous task of getting of bed with the food industry. Good luck with your endeavors. Best, Julie Negrin

Anonymous said...

Well said. Thank you for speaking up to share your concerns.

Matt said...

Very nicely researched and put together. It's tough to know who to trust on proper nutrition given the current and past states of sponsorship. Good to make your voice heard, thank you for your courage.

Charlotte Cooper said...

Thank you very much for your incendiary work here.

You might be interested and dismayed, though not surprised, to hear that the British Nutrition Foundation in the UK, where I live, also enjoys sponsorship from the food industry. http://www.nutrition.org.uk/

Sponsorship is a real problem in organisations that should be providing impartial information. The National Obesity Forum and the Association for the Study of Obesity, two organisations that enjoy more respect than they deserve, are also sponsored by businesses with interests in weight loss. It's outrageous.

I welcome your work here very much, and hope that you are inspired to keep digging and agitating.

With great respect,

Charlotte Cooper

robinb said...

I think you bring up some awesome points, but I did just want to point out that Dr. Nestle isn't a dietitian....

the fat nutritionist said...

This is very important. Thank you.

Anonymous said...

You rock, girlfriend. Thank you for calling out the elephant in the living room. The 'follow the money' practice reveals pathetic ties - especially when it involves those entrusted to recommend what is best for us. The parents who did the best they could based on professional recommendations... and still buried their children should have some recourse. Hippocrates said, he who does not understand food cannot understand disease. The two are links inextricably. Food, disease. Having an industrial middle man spells death.

Anonymous said...

Thank you, thank you, thank you! It's hard not to have the public thinking conflicts of interest and doubting the trustworthiness of RDs with the golden arches and all other vile symbols of mass-produced food glaring out from every corner of our profession.

Jennifer said...

I just received a letter from Jason Patuano, Communication Manager for McDonald's Restaurants of Canada Limited. He wrote me to invite me to stop at the McDonald's Canada booth during the Sponsor Showcase at the Dietitian's of Canada Conference which is happening this weekend in Montreal.

I didn't sign up for any communications to be sent to my house by McDonald's. By registering to attend the DC conference, I have unwittingly also signed up to receive promotions from their "non" partners.

Aaron Flores, RD said...

Sybil, great letter and I stand by you 100%. I wrote a similar post @ http://bvmrd.blogspot.com with my thoughts on the ADA. Let's continue to spread the word!

Jeffrey Hollister said...

That's a very brave of you, Sybil. I commend your analysis and concern about their partnerships. I'm actually stunned by the idea. Coca-cola and McDonald's? Seriously? They left me doubtful now. My dentists in Greenville, SC already advised my family, especially my kids to reduce the consumption of sugar. We all know sugar is key ingredients in almost every products these days. So what did they say about your concern then?

Jennifer, RD said...

Thanks for the Jan 2013 update! I'm also an RD and I did not attend the recent dietetic conference in big part due to these ties.