Money Matters

Nutrition has a new spokesperson in the form of Bill Clinton. Yesterday CNN posted clips from an interview with Dr. Sanjay Gutpa, in which the former president discussed how changing to a plant-based diet has saved his life and transformed his health. And my first thought was how in those two minutes Clinton may have done more for nutrition, for making the connection between food and health than the ADA has done in years.

To be clear, I am referring to the American Dietetic Association and not the American Diabetic Association (ADA) nor the American Dental Association (also, ADA) and definitely not the Americans with Disabilities Act (again, ADA). But the confusion over their acronym is only the beginning. Even more confusing is their message: "If consumed in moderation with appropriate portion size and combined with regular physical activity, all foods can fit into a healthful diet."

Founded during World War I, ADA initially sought to help the government preserve food and improve the public's health and nutrition. Over time its purpose and mission have evolved and currently it is "committed to improving the nation's health and advancing the profession of dietetics through research, education and advocacy." It is a professional organization, primarily of registered dietitians (RDs), the certification that is bestowed by the ADA upon an individual who has completed a CADE-accredited dietetics program (at either the bachelor's or master's level), an accredited dietetic internship program and then passed an exam.  Much of the organization's advocacy work is spent educating the public and the government about RDs, and establishing them as the authorities on food and nutrition. There are so many people posing as nutritionists these days that some qualifications and credibility are called for and I appreciate that there is a group committed to this task. But ADA receives significant funding from companies like Mars, ARAMARK, Hershey, Coca Cola and the National Dairy Council.  Isn't it a bit problematic when the organization trying to position itself as the unbiased expert on food and nutrition is sponsored by major food corporations built on selling the public on calories and food-like items they don't need and can potentially harm them? 

This appeared at the bottom of ADA's Knowledge Center email on 8/18/11

One day perhaps I could write an entire dissertation on the complexity of these relationships between health organizations and companies that generate most of their profits by saturating the market with high-sugar, high-calories, chemical-laiden, nutrient-poor products that contribute to the rise in nutrition-related chronic diseases.  Despite their "wellness" divisions, their corporate philanthropy and commitments to "healthy living" these ADA sponsors are best known for soda and chocolate bars (and not the high-cocoa content, fair trade varieties). Coca-Cola, for example, doesn't even pretend that its raison d'etre is to feed or nourish people. It's mission statement is simple: "To refresh the world...To inspire moments of optimism and happiness...to create and make a difference." Remember those joyous ads? 

I'm actually more moderate than I sound. Last year I started working with an organization called Cooking Matters (formerly known as Operation Frontline), a nationwide program that provides cooking and nutrition classes to low-income populations. While the program and its curriculum are sponsored by ConAgra and Walmart, the classes are taught by volunteers chefs and nutritionists and as a volunteer I was free to take some liberties with the program. (During the week that focused on calcium, for example, I provided lists of non-dairy dietary sources.) True the funding came from major corporations, but the program was very effective - in some cases truly transformative - without supporting any corporate agenda. We live in a time when corporations have money - let's use their money for good. 

My gripe with ADA's sponsorship is not really that they take money from these companies, it's that they do not address it or demand accountability. ADA constantly comes under attack for their ties to big industry and has never issued a statement explaining their position. In fact, back in May the president sent an email to ADA members stating:

Levelheaded criticism is different from deliberate misinformation, which ADA and many other credible organizations are occasionally subjected to. Blogs and other communications that contain falsehoods about our Association are easily written and – with a click on a keyboard – posted and re-posted the world over. I want to assure members that ADA will not be distracted by engaging in point-by-point rebuttals of disparaging untruths and insults every time they appear on the Internet.  ADA will not issue formal responses to ill-informed attacks or outright lies. Such responses would only lend credibility to erroneous arguments and baseless charges and elevate their authors. This is the intent of our detractors.

First of all, I'm not sure which "falsehoods" they are referring to, since their ties to the food industry are posted on their website. Secondly, to disparage blogs and communications that are "easily written...posted and re-posted" makes them sound as dated and out of touch as their detractors claim. Finally, to defend a position that has come into question does not lend credibility to the argument, it allows an organization to reiterate, clarify and hone its stance. As a card-carrying member of the ADA, I would appreciate a position paper of ADA sponsorship policies. Their website does say:

ADA’s procedures and formal agreements with external organizations are designed to prevent any undue corporate influence particularly where there is a possibility that corporate self-interest might tend to conflict with sound science or ADA positions, policies and philosophies.

Personally I would feel more comfortable if I understood how they get around the "possibility" of corporate self-interest with their current sponsors (for amusement, see the page on "What Our Corporate Sponsors Think").  Additionally, I would like to see more statements calling upon these companies to employ more responsible and honest marketing practices, including the elimination of advertising to children. I don't feel ADA needs to refuse their money, but should use their relationship with Big Food to push an agenda of their own, namely one that promotes public health nutrition, education, greater transparency and increased access to healthy foods. 

It may sounds optimistic, but I do believe the ADA has the potential to be a more potent and effective change leader in national nutrition discourse. Maybe I'm just rationalizing how I could accept scholarship money from the ADA Foundation toward my internship while I criticize ADA for accepting money from corporations with dubious intentions. Can the ends justify the means if the money is going toward quality nutrition programming, toward the training of future nutrition professionals, toward the education of groups that would not otherwise be reached?  I considered this for a moment when I received notification of the award but quickly realized it did not for a moment change my beliefs about nutrition practices, science or politics. If anything, it encourages me to cling to my position, continue doing what I'm doing and work toward changing the field of dietetics from within so that Bill Clinton is not the only harbinger of dietary changes in this country.