I had an interesting couple of days on Twitter earlier in the week. It began with a tweet from the South African doctor I described in this post … the one who insisted that hard-working, professional dietitians would never recommend pancakes as “heart healthy.” As you’ll recall, I posted several hospital menus designed by dietitians listing foods like pancakes and Frosted Mini-Wheats in the “heart healthy” section.

In response to being proven wrong beyond a shadow of a doubt, The Doc of course tried to change the argument. Twitter trolls never, ever, ever admit they’re wrong — and The Doc is quite a troll. Tim Noakes is one of his favorite troll targets. The Doc must have been beside himself when the dietitian-initiated charges against Noakes were dismissed.

Anyway, as you know, dietitians have tried – and in some cases succeeded – to convince state legislatures to grant them a legal monopoly on dispensing dietary advice. They’re doing this to insulate themselves from competition.

That’s not just my opinion. In a video you can watch on this page, the president of the Academy of Nutrition and Dietetics actually encourages people to report “disruptors” to state licensing boards. Here’s the official description of the video:

President Lucille Beseler, MS, RDN, LDN. CDE, FAND, offers members ways to protect the public’s health (and the nutrition and dietetics profession) from “disruptors” – competitors who offer lower-quality care and less-comprehensive services.

Absolutely no doubt about it. Straight from the horse’s mouth: dietitians want these laws to protect the profession from competitors.

On Twitter, Crossfit (one of those competing “disruptors”) posted a link to an article encouraging the Missouri legislature to legalize diet advice – in other words, get rid of laws making it illegal to give advice without a license. Crossfit’s tweet included this quote from the article:

“… rather than genuine health and safety concerns, licensed dietitians are mostly just worried about protecting their monopoly status as the only group that can provide nutritional services in states like Missouri.”

That just annoyed the heck out The Doc. He replied to Crossfit’s tweet with this:

This unconscionable slur against mostly hard-working and knowledgeable professionals shows just what a nasty, unscientific little outfit CrossFit is.

Somebody needs to sit down with The Doc and explain that engaging in wild hyperbole doesn’t strengthen an argument; it simply makes the arguer look pathetic. Unconscionable slur? Really?

The first definition I looked up for unconscionable is shockingly unfair or unjust. Given that the president of the Academy of Nutrition and Dietetics posted a video stating that one purpose of licensing laws is to protect the profession from competition, I don’t see how The Doc could possibly interpret “licensed dietitians are mostly just worried about protecting their monopoly status” as shockingly unjust or unfair. In fact, it’s clearly fair.

And then there’s the fact that Crossfit was merely quoting an article. How exactly does that show them to be a nasty, unscientific little outfit … ?

So I couldn’t resist. I know arguing with trolls is a waste of time, but I tweeted this reply, which included the graphic below: Crossfit doesn’t want the “hard-working and knowledgeable professionals” who designed this “heart-healthy” hospital menu to have a monopoly on dispensing dietary advice? Why that’s an UNCONSCIONABLE SLUR! Shame, Crossfit!

The Doc replied by calling me a clown and telling me my reasoning is very poor. Heh-heh …. people who want to simply dismiss me after starting an argument they’re going to lose like to point out that I was once a comedian, as if that settles something.

I worked a with a lot of comedians back in the day. If you remove the ones who rely on scatological material to get laughs (what we in the biz call “dick joke” comedians), they were all highly intelligent. Guess what? It actually requires high intelligence to write material that can make a room full of strangers laugh for an hour without resorting to “dick jokes.” And of course, The Doc and other trolls like to conveniently forget I’m a programmer who designs complex systems.

But since The Doc likes to dismiss me as a comedian, I pointed out that his habit of immediately resorting to insults when he’s proven wrong makes for great comedy. I asked if he’d charge a fee for me to quote him directly when I need new material.

When he replied with another insult, I suggested that instead of borrowing his tweets as material, we should work together as comedy duo.

THE DOC: Tom, stop saying dietitians recommend Frosted Flakes as heart healthy. It’s not true!

TOM: Uh, Doc? (Tom holds up big ‘heart healthy’ hospital menu designed by dietitian.)

THE DOC: Your reasoning is very poor.

TOM: Look, Doc, we’ve got people out there recommending Frosted Flakes, Frosted Mini-Wheats and pancakes as “heart healthy.” Shouldn’t we do something about this?

THE DOC: Yes. Give them a legal monopoly on dietary advice.

TOM: But they’ve even got cinnamon rolls and blueberry muffins listed as “heart healthy.” You do see the big threat to public health, don’t you?

THE DOC: Of course. It’s Tim Noakes.

I don’t think The Doc liked my idea to work as a team.

In the meantime, some dietitians chimed in. Turns out they believe (and as Dave Barry used to say, I’m not making this up!) they’re in the same category as doctors. Some of their tweets:

You’re so right! Licensed physicians — who needs em’ for medical treatments and care? Who needs health care professionals anyway? Lets let blogs & 3rd-party gyms diagnose disease & prescribe meds too. RDs have a 4-year science-based degree. Regulated professions are regulated for a reason, why is that so hard to get!?

Regulated professions are regulated for a reason? You mean like when Illinois made it illegal to charge a fee for braiding hair without first acquiring a cosmetology license? Yeah, that was certainly to protect the public. Lord only knows how many people were rushed to emergency rooms with bad braids.

Milton Friedman once pointed that people have an inexhaustible capacity to believe that whatever benefits them personally also benefits society as a whole. If you have the I.Q. of an eggplant or happen to be a registered dietitian, I suppose Oh, sure, why don’t just let gyms prescribe medical treatments too! sounds like a sensible argument for regulating who can give dietary advice.

For those whose I.Q. is higher than an eggplant’s (and who aren’t registered dietitians anxious to stifle competition), that argument is laughable.

Hate to break it to you, dietitians, but what you do isn’t at all like prescribing medical treatments. The effects of prescription drugs are often profound. The effects of surgery are irreversible. A bad decision by a doctor – the wrong drug, a mistake during surgery – can maim or kill the patient. Quite often, there’s no coming back from a bad medical decision.

Recommending a diet is like that, is it? Don’t make me laugh. The effects of a diet play out over months or years. Patients can easily monitor many of the effects. Is my weight going down? Are those irritable bowel symptoms going away? Is my skin clearer? Do I sleep better? Do I have more energy? Toss in few inexpensive home testing kits, and patients can also monitor their glucose, blood pressure, A1C, lipids, etc.

If the results of a diet aren’t good, there’s a fix for that: try a different diet. That’s exactly how many of us finally found a diet that works: experiment, monitor the results, adjust the diet, monitor again.

If (egads!) someone takes dietary advice from a trainer at Crossfit and the results aren’t good, nobody was maimed or killed. It means Crossfit has lost a customer. The frustrated dieter will seek advice elsewhere. But of course, that’s exactly what some of these dietitians fear. People who get lousy results following our advice could GO ELSEWHERE?! We can’t let that happen! We need laws to make sure our advice is the only advice! It’s to protect the public!

As you might suspect, some dietitians on Twitter took issue with me posting those hospital menus. No, no, no, those hospital menus weren’t designed by dietitians!

Oh, okay. I guess that explains the text at the top of this menu:

One dietitian began arguing with me back and forth. She eventually tweeted this:

I am sure you have skill in managing the complications of diabetes, medications insulin dose adjustment and nutritional support of the gut microbiota. Maybe I should focus on entertainment.

If only she had any idea how many diabetic readers over the years have described how they couldn’t get their blood sugar under control until they ditched their dietitian’s advice.

I replied: Heh-heh … the hospital dietitian’s “skill” in managing my father-in-law’s diabetes was to tell him to eat at least 30 carbs per meal and then inject more insulin to bring down his blood sugar. The “insulin dose adjustment” is done by my mother-in-law, who measures his glucose, reads a chart, and injects insulin. Not complicated, apparently. And yes, I know how to support the gut microbiota.

She kept coming back for more, so I asked a simple question: I tweeted a link to this post about the dietitian who explained why it’s just crazy to give up sugar, and asked, Seriously, would you want me taking advice from this dietitian?

She ignored the question and changed the subject in her next reply. Troll tactic #4: if someone asks you a direct question and you have no good answer, change the subject.

I replied: Still waiting for an answer: should I take advice from this registered dietitian, since she has all that specialized training and such? I mean, if I had diabetes, she’d give me excellent advice, right?

She replied:

You have already made up your mind.

Now that’s a truly creative answer. Yes, of course, I’d already made up my mind about whether I’d take advice from a dietitian who says it’s crazy to give up “an entire food group” like sugar, but is also a vegetarian. But that shouldn’t stop the dietitian debater on Twitter from answering my question. One has nothing to do with the other. It’s about as logical as replying, “I’m not going to answer your question because it’s already Tuesday.”

I asked her to stop dodging the question and give me an answer. Should I follow that registered dietitian’s advice? The reply:

Not dodging the question at all. You made a general stereotype about my profession and I took acceptance to it. You clearly have a strong belief system and a business model that runs off it. Good for you. Do I think you should give medical advice about a specific disease- nope

Brilliant. She isn’t dodging the question, ya see, but still refuses to answer it. And somehow the issue morphed into me giving medical advice about a specific disease. Yes, ladies and gentlemen, when I say Crossfit trainers and other non-licensed individuals should be legally allowed to give dietary advice, what I really mean is I should be able to give medical advice about a specific disease.

I tried one more time: Wow. Still won’t answer a simple question — should I follow this registered dietitian’s advice or not? Pointing out what is clearly lousy advice from registered dietitians is not stereotyping your profession. Your profession shouldn’t be immune from criticism or competition.

That brought this reply:

I respect that you have a movie to promote.

Fascinating. Really and truly fascinating. After refusing once again to answer a simple question, she implies I’m motivated by the desire to promote my movie. So let’s see … if you have a movie to promote, your motives are suspect. If your living depends on people paying you for dietary advice and you want to stifle competition, your motives aren’t suspect at all. You just want to protect the public. Makes sense.

Eventually, someone who might be her daughter (same last name, younger-looking picture) chimed in and told me to just give it up already, because I was arguing with the smartest person she knows.

I replied: I already gave up when the smartest person you know refused over and over to answer a simple yes/no question about whether I should follow this woman’s advice because she’s a registered dietitian.

The daughter or whatever replied with something like That’s because internet trolls like you aren’t worth her time.

I say something like because the message appeared for a few seconds, then the daughter or whatever quickly blocked me from seeing her tweets. Now there’s a confident debater. Jump into an argument, fire off a couple of rounds, then block the other person from seeing or replying to what you just wrote.

That bit about internet trolls like you aren’t worth her time made me laugh. I had been replying to The Doc. I’d never heard of Mom The Dietitian. Mom The Dietitian jumped in and started debating me, not the other way around. I asked the same simple question several times, which Mom The Dietitian refused to answer — but she’s definitely not dodging the question! — and yet she kept debating me. Then the daughter jumped in. But I’m the troll.

Man, if I’m not worth her time, she had a funny way of showing it.

Anyway, here’s a quote from the article that prompted this whole Twitter storm in the first place:

Dressing up their concerns in warnings about consumer safety, licensed dietitian groups are quick to invoke images of non-licensed individuals dispensing quack diet advice to uninformed clients. The problem with this argument is that the data utterly fails to back it up. Dozens of states allow non-dietitians to provide nutritional advice, and there has been no rise in negative health outcomes in any of these states. In fact, there has yet to be a single complaint about bad results from non-licensed nutritional advice in Missouri or anywhere else. This means that rather than genuine health and safety concerns, licensed dietitians are mostly just worried about protecting their monopoly status as the only group that can provide nutritional services in states like Missouri.

Bingo. I’ve been ignoring those highly trained licensed dietitians for years. My diet is high in meat and animal fats. It’s high in cholesterol. I don’t eat “heart healthy” whole grains, whether in pancakes or cereals or breads. I follow the advice I’ve gleaned from reading books, reading studies, attending lectures, listening to podcasts, watching presentations by doctors and scientists on YouTube, etc.

So how’s that working for me? As it happens, lectures like the one posted below (by Ivor Cummins, who isn’t a doctor or dietitian) finally prompted me to get a coronary calcium test this week. The result: ZERO.

The lab couldn’t send the results directly to me, so they forwarded them to my doctor’s office. His nurse called to tell me the happy news and to say, “The doctor says that’s fantastic, and keep doing whatever you’re doing.”

I think I’m doing just fine without the government “protecting” me by limiting who’s allowed to give me dietary advice.