IS DOWN UNDER’S DAA REALLY IN BED WITH BIG FOOD?

Facebooktwitterredditpinterestlinkedinmail

By Marika Sboros

Is the Dietitians Association of Australia (DAA) in bed with Big Food? It’s nearly two years since US public health lawyer Michele Simon first raised the question. She worded it slightly differently at the time. Her answer was an unequivocal “yes” in And Now A Word From Our Sponsors in February 2015. But has anything changed in the interim?

DAA says that it is not in bed with Big Food now and never has been. It claims that its sponsors – “partners”, it prefers to call them – have no influence on the advice it dishes out.  It also claims to take “great care to guard against conflict of interest”.

Its critics say otherwise. They say that DAA is heavily conflicted and has been for decades. Critics also say that DAA is little more than a front for the food industry. Read on in the first of a four-part series and make up your own mind.

DAA calls itself the country’s “peak nutrition body”. That’s wishful thinking, say critics. What is clear is that it is a voluntary association of nutrition professionals, with branches in each state and territory and around 6,200 members. Thus, it is relatively small yet extraordinarily influential.

It is also self-regulated. Dietitians don’t have to register with the Australian Health Practitioners Regulation Agency (AHPRA) to be able to practice. Peculiarly in Australia, health authorities say dietitians pose “low risk” to the public. That’s debatable, say critics, given well-documented links between diet and disease.

DAA CEO Claire Hewat. Picture: YOUTUBE

And if growing criticism of DAA is anything to go by, little really has changed since Simon’s 2015 report. In the first of a four-part series, I look at elements that Simon identified and others, which I have found:

  • DAA’s corporate sponsors: Nestlé is still a major funder. Campbell Arnott’s, one of Australia’s biggest manufactured food companies, replaced Unilever last year as the second major partner. The Australian Breakfast Cereal Manufacturers Forum (ABCMF) is an associate partner.
  • Revenue source: The food industry is DAA’s second-largest revenue source after membership fees. In 2015, DAA received more than $1.3 million in industry sponsorship, according to its 2015 Annual Report. That comprised $411,735 from partners and $961,225 from sponsors of its annual conference, workshops and seminars.
  •  DAA’s long-standing CEO Clare Hewat may have a vested interest in maintaining industry support, say critics. The DAA 2015 Annual Report shows that Hewat’s annual salary including compensation may be around $500,000 by now. (The report refers only to “key management personnel compensation” in this regard. Hewat is the only one named as key management personnel as Secretary and CEO.) Membership fees may not be able to sustain Hewatt’s salary without industry support.

Click here to read: WHY DOES BIG FOOD LOVE DIETITIANS SO MUCH?

 

  • Benefits for corporates: Until early January 2017, DAA website stated that a benefit for partners was a way to “boost sales and market share by reaching healthcare professionals who influence buying decisions”. Another benefit was “positioning and alignment of (their) brand with trusted, university qualified health professionals”. The updated site  now says that benefits include simply an “unparalleled opportunity to inform the Australian public regarding health and nutrition”. It may just be coincidence that the changes followed a flurry of criticism on social media.  Tweets also highlighted contradictions in DAA’s stated position on independence from Big Food, and in particular Big Sugar, in a 60 Minutes’ programme.
  • Product endorsement: In 2016, DAA partnered Nestlé in its Choose Wellness roadshow. Stands included DAA’s logo alongside Nestlé products, such as Milo, which has a high added-sugar content. Coca-Cola has had stands at DAA’s annual conferences. McDonald’s had a stand at its 2016 conference;
  • DAA Breakfast Seminars: At its 2016 conference Lion Dairy & Drinks was a sponsor and one of its senior dietitians was a speaker.
  • DAA executive member Dr Sara Grafenauer was Nestlé Brand Manager from 1999 to 2004. Her LinkedIn profile states that she has been a private consultant to Nestlé Australia.
  • DAA works closely with Diabetes Australia and Australia’s Heart Foundation. All regularly attack Paleo and other low-carbohydrate, high-fat (LCHF) diets as dangerous “fads” despite compelling evidence to the contrary. All support the largely discredited diet-heart hypothesis that saturated fat causes heart disease.
  • DAA Emerging Researcher Award: Nestlé’s Nutrition Institute has funded the award for years. The updated website site has removed reference to this.
  • DAA Excellence in Nutrition Journalism Award: DAA claims that the award aims to provide “accurate and practical nutrition information to consumers through the media” and to “address misinformation”. Since 2012, DAA has given the award to the same two journalists, Stephanie Osfield and Paula Goodyer, for articles supporting Australia’s low-fat, high-carb dietary guidelines.  Goodyer was the last winner for an article on “fad diets”, in which she says that a low-carb diet can work short-term, but “might kill you sooner”.

Hewat says in public statements that its partnerships are a “considered decision”.  DAA recognises that Australians eat from the “entire food supply”, Hewat says. Thus, DAA needs to work with groups “from all sectors, including the food industry”.

Hewat insists that trade exhibits at DAA’s National Conference do not constitute endorsement. The Conference is for food and nutrition experts, not the public.  Consequently, if a food is available, dietetics professionals “need to know about it and be able to ask questions about it”.

“We believe that by working together with all sectors we can have a positive influence on them,” she says.

DAA critics say that’s naïve – or disingenuous.

Australian social entrepreneur, author, a speaker and “recovering corporate lawyer” David Gillespie says he has yet to see anything come out of the DAA that suggests anyone should regard it as “anything other than a front for the processed food industry”.

Gillespie is author of Sweet Poison: Why Sugar Makes Us Fat. In a blog, Gillespie says that “we should be cautious when DAA starts handing out advice on what to eat”. We should be “especially cautious” when some of Australia’s most powerful food companies fund that advice.

Social entrepreneur David Gillespie

One of the biggest problems for DAA’s credibility is its claim to provide evidence-based advice. In part, that’s a function of its uncritical support for Australia’s low-fat, high-carb dietary guidelines. These closely follow the US guidelines and DAA had the contract to manage their production for the government.

British obesity researcher Dr Zoe Harcombe’s research in the BMJ Open Heart in 2015 shows that these guidelines had no randomised controlled trials (RCTs) backing them up when the US first launched them in 1977. RCTs are considered the “gold standard” of scientific research.

Guideline supporters – and DAA –  claim significant epidemiological research. However, Harcombe’s research in the British Journal of Sports Medicine in 2016 shows there wasn’t any of that either.

Australian GP, author and speaker Dr Joe Kosterich says that the guidelines “are not based on the best science we have today”.

“They remain rooted in 1970’s ideology for reasons that are not clear,” Kosterich says. “No one has ever been able to prove the notion that saturated fat causes heart disease. In fact, we’ll probably find that someone really did just make it up.”

Kosterich refers to research in the JAMA in 2014. The researchers concluded that “current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats”.

They also said that based on years of inaccurate message about total fat, most US residents are still “actively trying to avoid fat while eating far too many refined carbohydrates”.

Dr Joe Kosterich

“You can easily substitute residents of Australia, UK or most other countries for US residents,” Kosterich says. “Science has moved on but not everyone has moved with it. A harsh critic might contend that there are some who have their fingers in their ears and are saying: La,la,la.”

While DAA does dish up some advice that does not overtly serve sponsors’ interests, critics say that doesn’t make up for the significant volume information that does and that often lacks any evidence-base.

One example is DAA’s 7-day-meal-plan contribution to Australia’s Healthy Weight Week in 2016, which gives low-fat, high-carb advice. Independent nutrition experts say that the advice is not optimum for weight-loss long-term and is unhelpful for diabetics.

Another example is DAA’s Smart eating for weight management fact sheet. It cites moderate exercise most days for weight loss. That’s the classic CICO (calories-in, calories-out) model of obesity.

It’s the belief that gluttony and sloth have caused the twin epidemics of obesity and diabetes, which doctors now refer to as diabesity. It’s one that Coca-Cola and Big Food use to justify their products as part of a healthy, “balanced” diet.

Independent nutrition experts, however,  say that it simply is not possible to outrun a bad diet. They also say that CICO is an oversimplification that does not consider the complexity of human metabolism.

DAA also regularly claims that  “a dietary guideline in Australia since 1979” has been to “avoid eating too much sugar”. It appears oblivious to the fact that all carbohydrate foods turn to sugar (glucose) in the bloodstream.

Thus, both Hewat and DAA seem oblivious to the effects on its credibility of advice that favours high-carbs – mostly grains and legumes – and that refers to Australia’s Grains & Legumes Nutrition Council (GLNC), a former partner. Critics say it isn’t all that surprising, given that the Australian Breakfast Cereal Manufacturers Forum is a sponsor.

As well, GLNC research in New Zealand has shown that LCHF diets are hurting sales of grains and legumes. Thus, in boosting sales of those products, DAA acts in industry’s interests.

And DAA appears to be feeling the heat on its promotion of grains and legumes and/or its links with GLNC. It has done significant purging of press releases related to GLNC on its updated website.

Therefore, in regularly attacking Paleo and other LCHF diets, critics say that DAA, whether by design or default, suppresses or ignores information on these as alternatives. It does so despite a growing evidence-base for safety and efficacy of these diets to treat and prevent the diabesity (obesity and diabetes) epidemics.

In an email to me, Hewat says that as DAA CEO, she sits on the Healthy Food Partnership executive. Its aim, she says, is to “drive food reformulation, improved menu choices, better nutrition education and communication and addressing issues of portion size”.

It is in this spirit that DAA engages with a range of key stakeholders, including the food industry, Hewat says.

One problem with that is the Partnership’s Health Star Rating system, which claims to support industry to “reformulate their foods”. The Health star system looks very much like a sham that supports industry, not public health.

For example, it gives Kellogg’s Nutri-Grain a four-star rating and smoked salmon fillets just two stars.  It gives a hefty five stars to a bottle of fruit juice with six spoons of sugar.

Facebooktwitterlinkedinrssyoutube

23 Comments

  1. Very interesting article, thank you Marika. I Just looked at the DAA s facebook page. They seem to have a lot of competitions for writing articles. The DAA choose the winners and promote the articles with the ideas they like. Very clever. Would anyone win with “Ten easy and nutritious recipes for pork belly “? I think not.

    There are very few recent photos of the rather large and unhealthy looking CEO! Is she even fatter? Very unkind of me to say that but she could benefit, as I have, from LCHF. She could then go on to help a significant proportion of the Austalian population, that, as she well knows, are getting larger and sicker by the day.

    • Hi Patricia, you make some good points. DAA and its CEO need to acknowledge that the advice they dish up is clearly not working for themselves or the public. It takes courage to admit that you’ve made a mistake and move forward.

  2. I have suspicions that the DAA is really the country’s “peak nutrition body” when their CEO is so overweight, why would I take advise from her? OR anyone she represents?

  3. Dear Marika,

    I read with interest your thought provoking piece. I do wish to clarify a couple of points as the lay audience is often not aware of the difference and complexity (financial, political/commercial, environmental, behavioural etc) between population based health and nutrition and that of individualized medical nutrition therapy. This does impact on how your interesting opinion piece is interpreted by the public. I am a UK trained clinical dietitian and now Accredited Practising Dietitian (APD) at an Australian university where I teach medical nutrition therapy (MNT), as part of these units students are made fully aware of the current evidence base and the gaps that currently exist. There is currently fierce debate around population based dietary guidelines yet there is a separation between the general population and that of a diseased population. Population based recommendations are incredibly difficult and often based on large retrospective associations that allow statistical manipulation (‘lies, damned lies and statistics’ will always hold true). Most dietitians I know, work with or have had the pleasure of working with will openly highlight blanket recommendations to a population are problematic when you consider heterogeneity (e.g. socioeconomic factors, physical activity levels, age, body composition and their metabolic health – e.g. phenotypic variation are they FOTI (fat the outside thin on the outside) or TOFI (thin on outside and fat on the inside)? how do they metabolize the nutrition they consume, related to the point made by Helen above, how does it impact on their microbiome? (which we are starting to understand is like a human fingerprint), are there hereditary risk factors that might elevate an individuals visceral fat etc etc etc).

    These are all factors clinical dietitians assess as part of Medical Nutrition Therapy, the process is a standardized one but the nutrition care plan is individualized. I can confirm we have used low carbohydrate diets in some of our patients with type 2 diabetes with great effect. In other patients a more conservative approach was required. The therapeutic effect of low carbohydrate diets is not something new to most dietitians, especially those that lived through the Atkins Diet heyday, indeed Dr Iris Shai (Registered Dietitian) published in the New England Journal nearly a decade ago showing the positive effect of a low CHO diet (definitions of low CHO vary and I know this study causes most Low-CHO armchair nutritionist advocates to throw their arms in the air) in the management of type 2 diabetes. This has now been cited over 1300 times. Hopefully more adequately powered randomized studies with the appropriate priori hypothesis will be published in future. I personally always look for compliance/adherence to the prescribed intervention i.e. what is a low CHO diet and did they actually adhere to it?

    One final point again relating to commercial funding of (clinical) nutrition research and one that can be incredibly confusing to the public and potentially harmful to acutely unwell patients that think a dietitian is prescribing a particular therapeutic nutrition product due to ulterior motives. Many of these companies produce prescribable medical nutrition therapy products (you name Nestle) that are often used as part of nutrition support where food fortification strategies alone cannot produce the desired response. Whilst I completely welcome this debate in the population based arena, I would really like to see some acknowledgement somewhere about the difference between the two.

    Personally, I view a blanket HCLF recommendation to that of a blanket LCHF recommendation…if only it were that simple folks! Most likely the two dietary approaches are at either ends of a normal distribution pending the factors mentioned earlier (most people fall somewhere between the two), a skewed distribution is likely to occur in the presence of disease (i.e. a move towards LCHF). This is therapeutic nutrition is it not?

    I’ve always watched, listened and read with both amusement and bemusement the mud slinging that occurs in the nutrition field. I would like to think that nobody practices nutrition to harm individuals and if you entered into nutrition purely for financial gain there are easier ways to make a bit of coin, nutrition is huge, it impacts on everyone everyday, no profession should ‘own’ nutrition we all bring unique skills to the dinner table. If the field of nutrition worked together to simply get people to eat real food we would make huge progress! Although unfortunately rapidly changing, if you mention LFHC or HCLF to a regional French person they would laugh at you and proceed to purchase their food from a grocer, a baker and a butcher…taking very little home in the way of food requiring a label.

    I would encourage anyone that comes across any nutrition professional recommending any blanket approach at an individual level to view them with a healthy dose of skepticism.

    I look forward to reading the rest of the thought provoking series.

    Kind regards

    Peter

    Dr Peter Collins PhD APD

    • Hi Dr Collins, You make very good points. However, I haven’t heard any LCHF medical or dietetic specialist every say that LCHF should be a blanket recommendation. The complaint is that DAA and its spokespersons suppress it or simply ignore it as a viable alternative by knocking it all the time as a dangerous fad and without any evidence-base for doing so. I have made precisely those points. It’s a problem that DAA and its spokespersons so often give dietary advice that is not evidence-based. It may just be coincidence that the advice always pleases DAA sponsors’ interests. I have a much more cynical view.

    • Peter, that’s a long winded and pretentious way of saying not very much. Your discredited ‘profession’ has been actively advocating a low-fat diet to everyone for over forty years and persecuting anyone brave or intelligent enough to see the problem with eating at least 50% glucose. You might take a more nuanced view but you still seem like part of the problem.

      You accept that diabetics benefit from a low-carb approach, so isn’t it inherently sensible to think it might also prevent people becoming diabetic?

      • Precisely! If HCLF is so great where did all the fat and ill people come from and why did they only appear in other than small numbers since the diet was first pushed onto the public?

        I think it was Michael Eades who suggested watching Woodstock or other films from the seventies or earlier – the crowd scenes look like stick people compared to today’s streets.

  4. Another well researched article Marika. Looking forward to the rest of the series. The pressure is building and the true motives in the ‘health care’ industry are being exposed.

  5. Well, at least the DAA and the dietitians in South Africa are consistent in that they all look overweight. Perhaps I’ll live long enough to see an ‘official’ dietitian who isn’t.

    The DAA is a disgrace. No reputable organisation that cared about its reputation would take money from junk food manufacturers. You do not have to take money from industry to engage with them. Indeed, you can only stand up to industry on behalf of the public if you don’t take money. If that means the chubby CEO has to take a paycut to be independent and credible, so be it. ‘Dietitian’ means scientific joke, compromised and working to make people fat and ill. It keeps their ‘partners’ happy.

    • Now, now, Stephen. Not ALL dietitians in SA or Australia are overweight. I’ve seen many that are not. I do agree with you, though. I prefer practitioners who look like they practise what they preach, but that’s just my personal quirk. I am sure that overweight dietitians still have something to contribute – if only in their battles to control their own weight.

      • Marika, I’m sure you’re right that some dietitians aren’t overweight, just most of them. These people should surely be the slim, shining examples of how to manage our weight if only we were sensible and followed their simple advice. “Eat less and move more” they tell us, and you can be overweight like most dietitians.

        Why has obesity risen ten fold and diabetes nine fold during the period they’ve been dispensing this ‘wisdom’? The taxpayer is funding this stupidity. I’d sack the lot. It should give them more time to exercise and balance their calories in and out.

        • Hey they aren’t ALL fat! Some of the young ones are still slim – and there’s a huge problem (pun intended) – most dieticians and an increasing number of doctors and nurses aren’t old enough to remember a time when obesity, diabetes and other metabolic diseases were NOT the norm. Let alone the New Young Narcicists in the research community.

          Nevertheless I’d like to know how they justify becoming fat. Do they blame themselves for failing to comply with their diet?

  6. I’ve been watching the DAA closely lately on its social media. Just about every 2nd article they post is a dig at “fad diets” of which they include Paleo, LCHF, and even the sugar free trend. And their members spend an awful lot of their time writing articles in the press with a similar tune. Here’s one example of one of its members with all of the articles he has written for the HuffingtonPost…

    http://www.huffingtonpost.com.au/joel-feren/

  7. As a NZRD, I have grave concerns that the only way we can afford to have a professional organisation that provides us with professional development opportunities is by getting funding from food industry partnerships. Why is this? I pay over $500 for registration (mandatory) and $500 for indemnity insurance (you would be mad to see any private patients without it), so when it comes to my Dietitians NZ membership (also $500ish – but voluntary), I’m really counting my pennies and if it goes up much more I’m going to have to consider if I can afford it.
    Many articles claim Dietitians are sheep over our high carb stance. That is misleading and disingenuous on two counts. 1) I’m constantly updating and critically evaluating papers on different weight management strategies, and I’m still concerned about the lack of strong long term evidence saying there is no harm from reduced carbohydrates. The most recent papers on the microbiome of the gut being adversely affected by reduced fibre have heightened my concern; 2) I will use reduced carbohydrate approaches where the clinical presentation warrants a different tack from usual. Population guidelines are that and clinical reasoning can be used to justify individualised diets.
    IMHO we are all missing the point and nutrigenomic approaches will mean some people need high carb and some need high protein. What we can all agree on it lots of vegetables and minimal processed food.

    • Dear Helen,
      Where’s the evidence that a high carb “heart-healthy” prudent diet based on cereals and grains is safe in the long-term? Especially in those who are insulin-resistant.
      Where are the RCT’s showing the benefits of “lots of vegetables”? There are none of which I am aware.
      Where are the RCT’s showing benefits of increased dietary fibre? There are none of which I am aware.
      Who exactly do you think benefits from a high carbohydrate diet? How do you make that assessment?
      Not saying you are wrong; just wondering on what evidence you base your opinions.

      • Hi Professor Noakes,
        Great questions!
        I’m participating in a clinical trial in Australia currently, looking at gut and cardiovascular health of non grain/legume diet group vs control group who eat grains/legumes regularly. Can’t wait for the results – due end of 2017.
        I’ve been LCHF for 2 years and never felt better!

  8. Do you understand the DAA accreditation process? I am trying to understand if it is a monopoly and the consequences for institutions if they don’t tow the line. I have noted the consequences for individuals e.g. Dr Gary Fettke and Jennifer Elliott. The suppression of LCHF is doing my head in. I feel like, if I advocate HCLF for people if they are carbohydrate intolerant that I am committing a form of genocide since we have numerous evidence of LCHF being benifical for insulin resitance.

      • A monopoly is concerning if they are only accountable to themselves. It seems they have it sewn up in many areas, medicare, veteran affairs, private health insurers, universities and government policy. I noted on their website it said the vast majority of employers require employees to be eligible to become DAA members. If you don’t have APD accreditation, is it difficult to get a job or have a course recognised ?

      • Good points, Janet and John. I deal briefly with the APD accreditation system, which DAA created, in Part 3 of the series.

        • I appreciate very much how you manage to unravel this issue point by point. Your making sense of something I haven’t been able to for three years. Look forward to the next parts.

Leave a Reply

Your email address will not be published.


*


This site uses Akismet to reduce spam. Learn how your comment data is processed.