Professional Integrity

West Los Angeles Dietitian

Nutrition in Recovery

Dave Cannon, Kristie Moore, and David Wiss

What is it like to be a West Los Angeles Dietitian in 2016?

The field of dietetics is changing rapidly. I have done much reflecting on this lately. Much of the information I was taught in school is entirely obsolete. Much of it was never true in the first place. I am really proud of the work we have done as Dietitians for Professional Integrity attempting to make an impact on the corrupt nature of corporate sponsorship within the Academy of Nutrition and Dietetics. While we have not made much of an impact on the national level, we have made a splash at the local level, particularly in the Los Angeles District (LAD). As a West Los Angeles Dietitian and proud member of LAD, I have made a few short informational videos worth watching. The first is about Corporate Sponsorship and the second is about Food Industry Front Groups.

Staying on the Cutting Edge

Thinking about my journey over the last several years, I am very grateful for my Master’s training at California State University, Northridge. My experience doing a Thesis has positioned me to be a critical evaluator of the latest research in the fields of nutrition, neuroscience, endocrinology, microbiome, addictions, eating disorders, and more! My first real interest was in the concept of Food Addiction and then I became obsessed with hormones. In 2014 I released an intense article called Hormones and Addiction and recorded a webinar on this fascinating topic. In 2015 I presented a webinar called Nutrition Therapy for the Addicted Brain through the International Association of Eating Disorder Professionals. This presentation has been given in several different settings and is the basis of the work we do at Nutrition in Recovery. The webinar is free to view, and I hope you take advantage of it HERE

Excellent Teamwork

Being a training site for RDNs and DTRs has been critical to the growth of the company. Kristie Moore was David Wiss’ first dietetic intern and the magic has continued since that collaboration many years ago. Kristie and David even did research at Breathe Life Healing Centers for Kristie’s Thesis. Read all about in a recent article of the Behavioral Health Nutrition Newsletter. This concept of Hands-on Nutrition for addiction recovery is something we plan to develop more in this upcoming year. Read more about it HERE. Dave Cannon was also an intern with Nutrition in Recovery, and has since joined the team offering his expertise with group facilitation, personal training, in-home cooking instructions, and so much more. Dave Cannon has brought incredible value to the NIR team. Currently we have several other students rotating soon, and two more Master’s Thesis’ on the way. Stay tuned!

Keeping a Strong Presence

This work that we do truly is an uphill battle. It is very difficult to revamp food service systems in addiction treatment centers. There is resistance from the clients and resistance from the staff. It takes persistent and belief in our message. And we have that! So David Wiss gets his name out there in cyberspace to spread the word about the Nutrition in Recovery movement. Read a very potent blog article with a sample meal plan HERE. Mr. Wiss believes that the future of treatment will address addictions and eating disorders concurrently and simultaneously. This concept of integrated treatment is very important at Nutrition in Recovery. Listen to David talk about it on RadioMD.

West Los Angeles

West LA is the hub of many addiction treatment centers. We have helped so many programs integrate nutrition counseling. There are so many more that need our help! Contact us today and see how we can be improve the quality of your recovery!

 

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Corporate Sponsorship

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Corporate Sponsorship

For many years, the Los Angeles District (LAD) of the California Academy of Nutrition and Dietetics (CAND) internally debated corporate sponsorship. Some members of LAD believed we should accept funding from whatever sponsors approached us, while others advocated for a more selective approach when it came to partnerships. This resulted in annual debates, votes, and substantive dialogue.

When Dietitians for Professional Integrity (DFPI) was formed in 2013, two founding DFPI members presented at an LAD Executive Board meeting, highlighting conflicts of interest within the Academy of Nutrition and Dietetics and explaining the need for greater financial transparency and ethical sponsorships with the Academy. The message was clear: if we are more rigorous about our standards for corporate sponsorship, we can improve the public’s perception of the RDN and advance the dietetic profession and credential. This led to a short series of videos where LAD members spoke up on this issue of corporate sponsorship and educated other members of LAD about the role of front groups in the food industry.

Meanwhile, the annual meeting of the California Academy of Nutrition and Dietetics received less-than-flattering coverage from Mother Jones about its McDonald’s “gold sponsorship.” DFPI core group member David Wiss MS RDN attended part of this conference and reported on the conflicts of interest and industry bias he encountered.

In 2014 the LAD Executive Board voted to put all sponsorship on hold for the 2014-2015 year. In lieu of accepting any money from food companies, LAD decided to raise its dues by $5. A very interesting thing happened: membership increased from the previous year. LAD dietitians were proud to be members of a progressive organization that was willing to take a stand on an important issue. LAD decided it would spend a year developing sponsorship guidelines with a standardized vetting and voting process. LAD used DFPI’s Sponsorship Rubric as a guide to creating its own internal rubric that allows its members to evaluate their personal (and anonymous) agreement with a potential sponsor company’s nutrition and ingredients, labor issues, environmental impact, and social responsibility.

After one year without corporate sponsorship, LAD was approached by Zevia. LAD Sponsorship Chair David Wiss MS RDN researched the company and generated a report for members of LAD to use for the vetting and voting process. A majority approval was reached on at least 75% of the established criteria items, making Zevia LAD’s first official sponsor to pass through the vetting and voting process. The sponsorship agreement ensures that LAD maintains editorial control of all content in materials bearing the LAD name, and that there is clear separation of LAD messages and content from brand information or promotion.

Additionally, The California Academy of Nutrition and Dietetics has also started developing more stringent guidelines for sponsorship. The gold sponsor at the 2016 annual meeting is now the Lentil Board. California Almonds are a silver sponsor, and Sun-Maid raisins are a bronze sponsor. For a full list of sponsors please see here.

There is still much work to be done at the national level, but Los Angeles and California are proof that change can happen in a way that is constructive and substantial.

See the original post on Facebook here.

Dietitians for Professional Integrity

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Nutrition and Recovery

NUTRITION and RECOVERY

Introducing the concept of nutrition into an addiction treatment program is not an easy task. Many addicts in early recovery are not ready for health behavior change, since most are simply trying to get past the immediate crisis of addiction, and the associated life adjustments of abstinence. In fact, sobriety can magnify pre-existing dysfunctional eating behavior. Many addicts began using drugs and alcohol in their early teens, and never developed a healthy relationship to food. Most never even considered the link between nutrition and recovery.

Often times, drug addicts in early recovery have food preferences of a juvenile, and prefer candy, juice, cereal, grilled cheese, peanut butter and jelly, ice cream, etc. In addition to childlike food preferences, many may have damaged their guts through the use of alcohol, pills, opiates, and other substances. Needless to say, most addicts in early recovery have little interest in brous foods such as fruits, vegetables, whole grains, beans, nuts, and seeds.

Additionally, the reward deficiency syndrome created by chronic exposure to addictive substances, often requires that the food consumed be highly rewarding to the brain. These foods are typically sweet, salty, high fat, easy to digest, or some combination of these traits. Other examples include chips, cookies, and most processed snack foods. If addicts in early recovery are given unlimited access to highly rewarding food, they will predictably overeat.

While excessive weight gain is certainly an issue and can lead clients back to using substances, the bigger problem is malnourishment, which limits the ability of the brain to heal from the ravages of addiction. Low quality food leads to low quality thoughts and a low quality life, and can lead back to using drugs and alcohol.

Why Not Just Take a Multivitamin and Eat for Pleasure?

It is a common mistake to assume that the daily consumption of a multivitamin will “cover all of the nutritional bases.” Of course, supplemental nutrition can be helpful if the person has a compromised ability to eat or has a limited diet. But too often, patients in early recovery fall into the trap of using multivitamins, to assume they do not have to concern themselves with the nutritional quality of their food. For starters, supplemental vitamins will never be able to contain the antioxidant potency of real food. Phytochemicals that flourish in real food cannot always remain stable in a supplemental form. Second, arguably the most important nutrient for addiction recovery is fiber, which is found in fruits, vegetables, whole grains, beans, nuts, and seeds. It is of paramount importance to eat fiber from food (not fiber supplements) to improve gut function and achieve balance in the microorganisms that live throughout the GI tract. Lastly, consumption of highly processed junk food throughout the day can significantly hinder the recovery process in numerous ways:

• Unstable blood sugar impacts mood and concentration

• Nutrient-void food can leave patients feeling sluggish and reliant upon caffeine (for the illusion of energy)

• Refined grains, added sugars, and added fats will negatively alter the microbi- ome (which we are discovering has an impact on mental health)

• Highly palatable food will condition the brain to expect food to taste a certain way, perpetuating the cycle of food addiction and promoting substance-seeking behavior.

For example:

• Eating candy will make eating fruit become less appealing
• Sweetened beverages will make drinking water less appealing
• Heavily seasoned and sauced food will make plain food be less appealing

What are the Challenges and Barriers to Implementing Nutrition in Recovery?

The biggest barrier is that medical insurance plans do not cover nutrition services for addiction recovery. This is likely due to a shortage of data about the efficacy of nutrition interventions in addiction recovery. For a partial hospitalization program (PHP) or intensive outpatient program (IOP) to include nutrition education and counseling, it can become a financial drain for the program. Some medical billers will be able to get reimbursement for a nutrition education group, if there is proper documentation by the dietitian, but there is no coverage for individual counseling unless there is an official eating disorder diagnosis.

The biggest challenge however, is the need to change the food service system. A nutrition group should educate patients about proper eating and be synchronized with the food being served. Teaching about the importance of nutrition in addiction recovery, and then serving highly processed snack foods undermines the goals of recovery, especially for patients residing in a sober living facility that is essentially a toxic food environment. Generally the food is purchased in bulk from discount stores by operations staff, often someone in early recovery themselves. Many facilities hire chefs to prepare meals, but the chefs often prepare food to please patients by creating highly palatable meals, that light up the pleasure centers in the brain. It is our strong belief that a registered dietitian nutritionist should supervise the menu in addiction treatment settings.

Most addicts will choose addictive food on a daily basis, instinctively selecting food that is highly rewarding and avoiding food that is not. Until upper management in treatment settings embraces the concept of nutrition in recovery, progress will be slow. Currently there is no requirement for nutrition education or the need for consultation with a registered dietitian nutritionist. A majority of treatment programs in Los Angeles serve and allow junk food, and seldom make fresh fruits and vegetables available. Understandably, real food is more expensive than highly processed snack foods that do not spoil. It does cost more to serve nutritious food, but when we serve non-addictive food, the addict eats less. When a treatment center or sober living attempts to save money on food, the entire recovery process continues to suffer.

Consider this a call to action to implement nutrition guidelines in your treatment facility. Consult with a registered dietitian nutritionist, particularly ones that have training and expertise in the addiction population.

This article was originally published in the February 2016 Keys to Recovery Newspaper

Nutrition and Recovery

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Dietitian Speaks up on Food Industry Front Groups

Food Industry Front Groups

Learn more about how food industry front groups attempt to control public discourse. Members of the Los Angeles District (LAD) of California Dietetic Association share information about a very controversial topic!

Download the full report: Best Public Relations Money Can Buy 

(Released by the Center for Food Safety in May 2013)

Written by Michele Simon where you will learn information such as:

What is a Front Group?

  • Represent PR efforts by the food industry (in response to heightened criticism)
  • Reassure media/public/policymakers that our food system is “healthy” and safe
  • Appear to benefit the public, often claiming to represent farmers or consumers (“on your side”)
  • Push industry-friendly science and hide their true agenda/funders (write op-eds as “experts”)

 

What are Common Front Group Tactics?

  • Main goal to control public discourse (give people “talking points”)
  • Attempt to change the way problems are talked about (downplay or discredit)
  • Common tactics are to “debunk” common “myths” about food and nutrition (“science”)

 

What are Some Specific Tactics?

  • Astroturfing (Fake Grassroots): pretending to represent the “little guy”
  • Shooting the Messenger: discrediting critics (mockery, “food police” or “extremist”)
  • Buying Science: paying for research (and placing in media) without proper disclosure
  • Scaremongering: preying on people’s fears (typically related to economy) ex: Prop 37 in CA

 

Food Industry Front Groups

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David Wiss MS RDN presents at CDA 2015

CDA 2015

The California Dietetic Association (CDA) Annual Conference and Exhibition will be held at the Riverside Convention Center Thursday April 9th 2015 through Saturday April 11th 2015. Registered Dietitian Nutritionist David Wiss will be speaking on Saturday April 11th 2015. The title of his presentation will be “Nutrition in Recovery: The Role of the Dietitian in Addiction Treatment” and will essentially describe all of the possible functions and duties of a dietitian in addiction treatment. Southern California is considered one of the “meccas” of private sector addiction treatment, and Mr. Wiss envisions an era where dietitians are a required component of addiction treatment. Most of the information presented at CDA 2015 will be a reflection of the work David has done as Director of Nutrition at Breathe Life Healing Centers in Los Angeles. Mr. Wiss has presented on this topic before but will be bringing cutting-edge experience and insight into this years presentation. View his old presentation HERE

Controversies at CDA 2014

A lot of controversy came out of CDA 2014 when Mother Jones published an article about McDonald’s sponsoring lunch. This article shed some serious light onto issues of food politics that are so prevalent in our field. Read Mother Jones article HERE

Mr. Wiss attended CDA 2014 and published an article about his experience that can be read HERE

Register for CDA 2015 HERE

CDA 2015

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FNCE 2014

FNCE 2014 – Dietitians for Professional Integrity (Original Facebook Post HERE)

This year’s Food and Nutrition Conference and Expo (FNCE) took place in Atlanta, GA October 19-21, 2014. I found last year’s meeting to be dominated by food politics, ranging from corporate logos on tote bags to enforced photo bans on the expo floor. The event felt more like a food industry networking event than a nutrition conference, and educational sessions were often infused with bias or outdated paradigms. Last year, in a session on weight management the speakers discussed calories as the only variable of value, giving no mention to other factors like gut health or hormones. My previous experiences at FNCE have been very disappointing, so I arrived with low expectations. 

Before offering my critique, I want to acknowledge that this year’s FNCE was an improvement. For starters, inappropriate corporate logos were minimized. Abbott and National Dairy Council were the only corporations represented on tote bags, and the exhibit booths had less of an overwhelming advertising approach. It is likely that negative reaction from last year’s FNCE and from California Dietetic Association’s (CDA) Annual Conference featuring sponsorship from McDonald’s led to new practices on the expo floor. While the photo ban remained a FNCE policy, it did not feel enforced like last year. At the very least, there were no signs at the expo prohibiting photography.

The Expo Hall – Educational Materials

Despite the apparent progress towards reducing corporate logos and the overall feel of the expo floor, information offered at the booths by corporations such as Coca-Cola, PepsiCo, The Sugar Association, and food industry front group the International Food Information Council (IFIC) has not changed. Most of the information appeared to be a defense of existing products rather than promotion of health.

A pamphlet from the Coca-Cola Beverage Institute for Health and Wellness, asserted that they “made it easy” for dietitians. The pamphlet outlined educational webinars and Continuing Professional Education (CPE) programs that are accredited by the Commission on Dietetic Registration (CDR). Other pamphlets focused on the importance of exercise, attempting to divert attention away from their nutrient-void beverages, while others emphasized “energy balance” by choosing diet soda for weight loss.

PepsiCo took a similar approach with its educational materials, teaching calorie balance as the most important facet of health. Much like Coca-Cola, PepsiCo referenced an Academy Position Paper which states that “consumers can safely enjoy a range of nutritive and nonnutritive sweeteners when consumed with an eating plan that is guided by current federal nutrition recommendations.”

The Sugar Association was also present, promoting sugar as a way to make a “healthy diet more palatable.” Their pamphlets declared that sugar is not linked to diabetes and obesity. One choice quote: “go ahead, sprinkle a little brown sugar on that bowl of nutritious oatmeal.” A handout for picky eaters suggested “youngsters may find vegetables sprinkled with a small amount of sugar before they are cooked more enjoyable to eat.” The Sugar Association also provided pamphlets about cavities, stating that: “one solution [to prevent cavities] is to brush after every time you eat. Another is not to snack often.”

The International Food Information Council (IFIC) is a front group for several Big Food corporations that have close ties with The Academy. This year they provided a handout co-authored by a dietitian that critiqued Fed Up, which in my opinion was an accurate and insightful documentary about our current food system. Fed Up calls out the food industry for obfuscating science, battling public health policy, and influencing federal dietary guidelines. It also points to the role of added sugars in our current epidemic of diabetes, heart disease, and obesity. While of course added sugar is not the only factor (and simply eating a sugar-free diet is not the only solution), it is an important one that needs to be considered.

IFIC attempted to discredit the film by citing a study from 1953 which concluded that “lack of exercise must be related to weight gain. …Eat less, exercise more has been the commonsense answer to unwanted weight gain for more than a half a century.” This is the tried and true Big Soda angle: always point to exercise as a way of diverting attention away from excessive caloric intake.

“Energy balance” has become the ultimate Big Food weapon, and while it has scientific merit, it does not account for how different foods affect gut health, brain chemistry, and metabolism, all of which represent the future of nutrition science. IFIC is investing their resources in defending old nutrition paradigms, attempting to protect the use of added sugars in the food supply. Read the full report HERE

The Long-Awaited Panel Discussion

The best part about FNCE this year was the panel discussion on October 21, 2014 titled “Industry, Ethics, the Profession, and Practice” which was moderated by Academy President Sonja Connor.

Dietitian Melinda Hemmelgarn discussed guidelines and parameters for sponsorship established by the Hunger and Environmental Nutrition (HEN) Dietetic Practice Group. The guidelines are available HERE

Hemmelgarn emphasized that HEN examines companies’ sustainability and environmental impact, not just their product portfolios. She also made very strong points about sponsorship implying endorsement, and how the Academy’s external agreements impact the public’s perception of dietitians’ credibility. The audience was reminded that the food industry has its own needs (mainly to sell as much product as possible), and we need to be more aware of this before entering into partnerships. Hemmelgarn shared survey data that was collected through HEN and The Academy, which found that dietitians considered candy and soda companies to be the most problematic from a partnership standpoint.

Dietitian Kathy McClusky announced that The Academy had recently formed an official Sponsorship Task Force, of which she is Chair. The twelve members represent a cross-section of dietitians (as well as some Academy staff) with various perspectives on the issue. The main goal of the task force is to develop recommendations regarding current sponsorship guidelines, suggest criteria for establishing a new sponsorship category, and review policies and practices regarding industry-sponsored education. They plan on submitting a report to the Academy Board of Directors this coming January.

President Sonja Connor promised to keep us informed on these issues as they continue to unfold. She also stated that she planned to discuss corporate sponsorship in the Presidents Page of Journal of The Academy of Nutrition and Dietetics before her term was over, most likely in the May 2015 issue. Audience members asked some important questions which did not appear to be answered satisfactorily: What was the selection process for the Sponsorship Task Force? Will Academy members be able to weigh in? Will there more transparency about funding in The Academy?

Despite overall progress that has been made in the FNCE expo hall, The Academy of Nutrition and Dietetics has more changes to make in order to present itself as a credible scientific organization. Sponsorship agreements with Big Soda are shameful and should be aggressively challenged. The most disturbing facet of these sponsorship agreements is the opportunity to educate and train dietitians for CPEs. The time for conflict-free CPEs is now.

The Academy should have more regulations about corporate sponsorship and should not let companies into the FNCE expo hall that do not meet specified criteria. The integrity of my credential is on the line. I am hopeful that the Sponsorship Task Force will address these issues and develop guidelines within their proposed timeline. I will continue to speak up on these issues until real change is enacted, because at present it is largely theoretical. Continued discussion with Academy leadership and members will be critical.

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Dietitians Speak Up On Corporate Sponsorship

Dietitians from LAD take a stand on Corporate Sponsorship

The Los Angeles District (LAD) of the California Dietetic Association has taken a stance on the topic of corporate sponsorship. Members of the executive board have voted and decided to reject all money from corporate sponsors for one year, until a rubric can be used to assess a companies alignment with the stated mission of The Academy of Nutrition and Dietetics. The rubric has been developed by Dietitians For Professional Integrity (DFPI) and can be viewed HERE.

DFPI was developed in response to a report from January 2013 by Michele Simon called “A Now A Word From Our Sponsors”

Michele Simon’s report on the Academy of Nutrition and Dietetics is thoroughly researched and expertly points out the different ways in which the nation’s leading nutrition organization harms its reputation, efficacy, and members by forming partnerships with food companies that care more about selling products than they do about improving the health of Americans. Anyone concerned about public health will realize that the Academy of Nutrition and Dietetics is in dire need of systemic change if it hopes to take a leadership role and be taken seriously as the home base of the nation’s nutrition experts.

Dietitians David Wiss and Reina Capati from the Los Angeles District (LAD) of the California Dietetic Association discuss Michele Simon’s report “And Now A Word From Our Sponsors” and how the findings are being taken seriously by LAD.

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Male Dietitian in Los Angeles

Why are there so few male dietitians?

Nutrition in Recovery owner David Wiss MS RDN is one of the few male private practice dietitians in Los Angeles. It is tempting to speculate why they are so few male dietitians in general, but one of the obvious reasons stems from its historical context. Nutrition programs originated from Home Economics curriculum, and to this day is often considered a “Family and Consumer Science”.

From an observational standpoint, a majority of the male dietitians become interested in Sports Nutrition and many obtain advanced degrees in exercise science. Before deciding to become a Registered Dietitian in Los Angeles, Mr. Wiss worked as a personal trainer, certified through the National Academy of Sports Medicine. While exploring the different domains of nutrition, the areas of behavioral health (addiction, eating disorders, and mental health) became of highest interest to David, particularly since there are so many men struggling with these issues and not seeking or getting adequate help.

Mr. Wiss recently published a chapter called “Muscle Dysmorphia: Where Body Image Obsession, Compulsive Exercise, Disordered Eating, and Substance Abuse Intersect in Susceptible Males” in a textbook titled Eating Disorders, Addictions, and Substance Use Disorders, which is available through Springer Publishing. Click HERE for a quick glance!

If you are a male in Los Angeles struggling with addiction, eating disorders, or mental health issues, contact David today and start the journey towards recovery together.

2014

2014

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David Wiss MS RDN reports on the California Dietetic Association Meeting 2014

How to Combat Corruption in the Food Industry:

Earlier this month, the California Dietetic Association hosted its annual conference (the same conference which had McDonald’s as a gold sponsor and served a McDonald’s lunch to dietitians in attendance). DFPI core member David Wiss attended one day of the conference. Click HERE for his account

DFPI_Button_cofounder

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Dietitians For Professional Integrity

About Dietitians for Professional Integrity (DFPI):

DFPI_Button_cofounder

We are a group of concerned dietetics professionals looking to advance the dietetic profession and credential through advocating for greater financial transparency and ethical sponsorships within the Academy of Nutrition and Dietetics.

Our efforts are guided by professional integrity. We believe the American public deserves nutrition information that is not tainted by food industry interests. Those of us who co-founded DFPI are nutrition experts first and foremost; we went to school to help people achieve better health through food, not to help multinational food companies sell more unhealthy products.

Read David A. Wiss, MS, RDN, CPT Statement of Concern

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