November 9, 2013
ADA Medical Nutrition Therapy by RDs
With eight of the eleven people being registered dietitians on the committee developing the ADA nutrition therapy recommendations for the management of adults with diabetes, is it any surprise that much of the information on page 4 conforms to the Academy of Nutrition and Dietetics (AND) policies. I feel that since the American Diabetes Association (ADA) was behind this and they were under the scrutiny of the ADA, we were spared much of the rhetoric of the AND.
Yet they did get in many policies and pronouncements of the AND. Take for example this statement, “Ideally, the individual with diabetes should be referred to a registered dietitian (RD) (or a similarly credentialed nutrition professional if outside of the U.S.) for nutrition therapy at or soon after diagnosis and for ongoing follow-up.” No, I don't like this statement as this is monopolistic in nature and I prefer someone that will work with us for the meal plan we are using and not some organization's meal plan. Nutritionists that will work with us and are not necessarily members of AND seem more interested in balanced nutrition than many RDs.
The above is from page 4 (PDF file) as is the following promoting RDs as being the only professionals that should be allowed to teach nutrition. The RDs also make a statement that should not set well with nutritionists in other countries when they state, “Health care professionals administering nutrition interventions in studies conducted outside the U.S. did not provide MNT as it is legally defined.” Legally defined here means only as defined by AND. Then they continue promoting RDs with this statement, “However, the unique academic preparation, training, skills, and expertise of the RD make him/her the preferred member of the health care team to provide diabetes MNT.” Bold is my emphasis.
Then at the top of the third column page 4, the RDs promote Table 2, Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guidelines and list them. Remember that the national organization promotes Big Food and this determines what will be promoted. Even though many declared no conflict of interests, I feel that it should be pointed out that if the person is a RD and a member of AND, they automatically have a conflict of interest because of their ties to Big Food.
Once the authors moved past page four, the promotion of food plans did become possible and not the direct claims to how RDs should be the only ones teaching medical nutrition therapy (MNT).
For an article that is more balanced than mine, read this by Laura Dolson on about dot com. She likes this new version on medical nutrition therapy and can look past the points I find troublesome. After reading her summary of the ADA food guidelines, I need to revisit the PDF file.