Why don’t all nutritionists agree?

One of the most frequently asked questions I receive on social media is why do nutritionists disagree on so many topics? There’s a huge number of reasons for this, but today I’m going to cover some of the most common reasons for our divergence in opinions.

Education
As the title Nutritionist is not protected, anyone with any (or no) education can call themselves a nutritionist. Particularly common is people using a huge variety of meaningless titles (pet nutritionist, dog nutritionist, canine or feline nutrition specialist etc). There’s hundreds of courses online that claim to make you an animal or pet nutritionist, but the truth is many of these courses either have an agenda, lack the extensive in-depth study required of a nutritionist and certify you in a matter of hours.

The only acceptable and protected titles are “Board Certified Veterinary Nutritionist” or “Veterinary Technician Specialist in Nutrition”. These individuals undertake countless hours studying at University level, clinical training and residencies, continuing education and research to qualify to take Board exams which are notoriously difficult to pass. You cannot use these titles simply by doing an online course, and these titles are fiercely protected to prevent confusion for pet owners looking for reputable, evidence based information.


Clinical Experience
The other thing lacking is clinical experience – as one can call themselves a nutritionist without any study whatsoever, many nutritionists have no clinical experience. This means they have never worked in a veterinary hospital or medical setting, have no medical training and do not have an advanced understanding of physiology, disease states and therapeutic nutrition. These individuals are usually the first to criticize therapeutic diets due to a complete lack of understanding in how they are designed to work. Unfortunately many nutritionists will claim that they are able to cure, treat or prevent disease simply by changing the diet or using some alternative treatment, and telling pet owners to ignore the advice of their veterinary professionals. Many of these ‘nutritionists’ walk a fine line between practicing medicine without a licence as they do not understand the concept of ‘scope of practice’ (what you are legally allowed to do as an unregistered individual or layperson).

It’s vitally important, in my opinion, that you have a grounding in veterinary medicine when discussing and recommending diets and seeing the real world results of your recommendations in a clinical setting, working alongside a veterinarian. While nutrition is incredible, it can do more harm than good – some drugs can interact with food, and vice versa. Without clinical training or knowledge, you could potentially cause harm by changing a diet without taking into consideration the effect it will have on medications or supplements that have been prescribed by a veterinary professional. You should never replace or change medications without your vet’s advice. I recommend asking your ‘nutritionist’ if they have a background in veterinary medicine, or if they will work with your vet in your pet’s treatment plan.


Location
Where is the person located and where did they qualify? Location will often dictate what is recommended and why. In some countries, therapeutic diets are less accessible so it may be more likely the nutritionist will recommend a home cooked diet compared to a more developed country with countless options for prescription or over the counter foods. It doesn’t necessarily mean they don’t agree with these diets, it simply means the access is lacking. Location is also important in understanding educational background; some countries have less access to quality education and may not have the most up to date research, so may need to complete a portion of their education online to ‘top up’ their knowledge. There’s nothing wrong with this, but it’s important to understand their perspective will inform their recommendations.



Personal beliefs
While as scientists we try to account for bias and remove personal opinion, there will always be a lens in which something is being framed. For example, a scientist is unlikely to recommend unproven alternative treatments and will be more realistic on the likely outcome of using certain therapies – compared to someone who does not have a scientific background, they will likely be more open to alternative treatments and expect them to work. This is why many veterinary professionals who work in nutrition are less likely to recommend newer diets and products that lack scientific evidence, compared to laypeople with an online qualification and no scientific background.

The other issue with personal beliefs is that it clouds your judgement and removes the objectivity of the data; if you truly believe something is meant to work, you’ll find data to support that and ignore the data that disagrees with you. This is called ‘cherry picking’ in the scientific community, where you pick data to fit your narrative and ignore everything else.



Will we ever get along?
The problem with veterinary nutrition is noone agrees because there’s no standardised education, and no way of protecting the title against any Tom, Dick or Harry from calling themselves a nutritionist. Until such time, it’s vitally important that pet parents know and understand who they are getting their information from, I would strongly recommend listening to formally qualified and assessed individuals such as DACVN/DACVIM/ECVCNs, Masters or PhDs in Animal Nutrition and VTS Nutritionists.

How do you find a reputable nutritionist?
If you want to work with a Board Certified Veterinary Nutritionist, check out http://www.acvn.org/directory
to find a nutritionist. Alternatively, always ask about what qualifications the individual has to call themselves a nutritionist and where they studied – they should happily volunteer this information if it’s legitimate.