I was interested to read this week about a case in the USA where an unlicensed ‘Life Coach’ was suing the Nutrition Licensing Board! Apparently, the ‘Life Coach’ is trying to prevent the North Carolina Board of Dietetics/Nutrition from stopping him providing advice to people with diabetes and has asked the court to void North Carolina’s Dietetics/Nutrition Practice Act, and its accompanying regulations, as unconstitutional. The Board has responded by saying that “The Dietetics/Nutrition Practice Act was created to safeguard the public health, safety and welfare and to protect the public from being harmed by unqualified persons.” They go on to say, “An injunction prohibiting the Board from enforcing the Act would jeopardize the health, safety and welfare of citizens of North Carolina and cannot be countenanced.”
Under the Dietetics/Nutrition Practice Act, in order to practice dietetics or nutrition in North Carolina, one must be licensed unless otherwise exempt. I find this very interesting when compared with the situation inNew Zealand.
So what happens here? Well, in 2003 a new piece of legislation came into force called the Health Practitioners Competency Assurance Act. This Act provides a framework for the regulation of health practitioners in order to protect the public where there is a risk of harm from professional practice.
Dietetics is one of the allied health professions covered by this Act. In order to practice as a dietitian in New Zealand legally, you have to be registered with the Dietitians Board. The Board’s role is to protect the public by putting in place mechanisms which ensure that dietitians are qualified, competent, and fit to practise their profession. Registered Dietitians have to follow a strict code of ethics and are required by law to participate in a continuing competency programme in order to retain their registration.
So the title ‘dietitian’ inNew Zealandis legally protected and no-one can call themselves a dietitian unless they are registered with the Dietitians Board. If someone sees a dietitian for advice they can be confident that the person who they are seeing is qualified and competent to practice and is giving the latest evidence-based information and advice
Unfortunately, however, people who are giving nutrition advice who are not Registered Dietitians have no legal obligations and no requirement to be qualified or to maintain their professional competency.
So, basically, if you are seeking advice from a ‘nutritionist’ you need to check out if they are qualified and, ideally, if they are registered with a professional body. Many bona-fide nutritionists inNew Zealandare registered with the New Zealand Nutrition Society, and to be registered there is a requirement to have an appropriate level of academic qualifications and experience.
It’s a bit concerning, to say the least, that there are people providing nutritional advice and guidance in New Zealand who are not qualified to do so. I saw one client last year who had Type 1 diabetes. She had been advised by a personal fitness trainer from the local gym to follow a low-carbohydrate diet and to have just fried eggs and bacon for breakfast before her exercise workout. Severely restricting carbohydrate intake is not recommended for people with diabetes and could well lead to hypoglycaemia, which can be dangerous.
And a local ‘beauty salon’ near where I live is promoting the hCG diet, another potentially dangerous dietary regimen. For anyone not familiar with hCG, this is a prescription-only product and has not been given approval to be used for any other purpose than fertility treatment in New Zealand. However, homeopathic drops with less than 10 parts per million can be imported into the country! Why? Because, essentially, they have no therapeutic effect.
These are just a couple of examples that I have come across recently of dietary advice that could potentially be harmful for people. Ben Goldacre in his book Bad Science cites many more examples from the UK where ‘pseudo-nutritionists’ are pushing dodgy advice based on a complete lack of scientific evidence. This book is a great read if you haven’t read it already, and he also has a great blog.
It would be good to see more safeguards in place in New Zealand for all people who may be seeking nutritional advice.