Feeding Poison to the Sick and Other Thoughts of a Disgruntled Dietitian

13 Oct

I am currently taking a writing class with one of my besties.  We were supposed to write a few pages of something to workshop during class.  I decided to write a mini research paper (found below).  It’s basically a rant with references.  Enjoy!

I work in a hospital, and I am a dietitian.  However, I do not work as a dietitian for the hospital.  Instead, I am a room service host.  I deliver trays of food to the patients.  I spent several years trying to secure a position as a dietitian but to no avail.  I had reached a point of I need a new job! and figured it was time to get as close to my goal as I could.  I don’t get to assign diets or offer nutritional education, but as everyone assures me, it’s a foot in the door.  I have only been in my new position for 1 month.  On a daily basis, I am reminded of why I had gotten so depressed during my dietetic internships.  The hospital setting is dreary in its own right, but it’s the politics of being an RD (registered dietitian) that I dread.  You know what really grinds my gears?  As simple and disgusting as it sounds, most giant organizations are corrupt.  The ADA (American Dietetic Association) is no exception.  They rub elbows with the food companies, and public health suffers as a result.  The ADA markets subpar nutritional products in exchange for monetary compensation and everyone wins.  Well, everyone except for the American people.

Here is an example provided by Marion Nestle, author of Food Politics.  Does everybody remember Olestra?  If you ever tried it, you may have had some traumatic experiences that burned it in your memory.  It made the 2010 Time’s List for “The 50 Worst Inventions”.  Olestra was approved as a fat substitute by the FDA (Food & Drug Administration) in 1996.  It has the same greasy mouthfeel without the calories.  It was used in junk foods such as chips to make them healthier.  It almost sounds too good to be true, right?  Well, it is.  Unfortunately, Olestra also interferes with the absorption of fat soluble vitamins: A, D, E, & K.  There’s also the slight matter of possible anal leakage due to overconsumption.  But hey!  Who has ever eaten too many potato chips (especially the “healthy” kind) in one sitting?

Um, everyone!

Surprisingly, Olestra lost its popularity among the public relatively quickly, fizzling out of product lines by the end of the 90s.  The ADA’s fact sheet about Olestra only talked about the benefits (like no calories) and failed to mention the side effects (like the explosive diarrhea…)  Olestra was sponsored by the consumer mega group Proctor and Gamble.  And wouldn’t you know it?  The AMA (American Medical Association) thought that Olestra was pretty cool too!  I’m sure their endorsement had nothing to do with the $800,000 grant they received from Proctor & Gamble.  Let’s explore this notion of corruption further with a case study.


Water, Sugar, Corn Maltodextrin, Milk Protein Concentrate, Soy Oil, Soy Protein Isolate, Pea Protein Concentrate, Canola Oil. Less than 0.5% of the Following: Corn Oil, Magnesium Phosphate, Potassium Citrate, Cellulose Gel, Natural & Artificial Flavor, Calcium Carbonate, Potassium Chloride, Calcium Phosphate, Sodium Citrate, Salt, Choline Chloride, Ascorbic Acid, Cellulose Gum, Monoglycerides, Soy Lecithin, Carrageenan, Potassium Hydroxide, Ferrous Sulfate, dl-Alpha-Tocopheryl Acetate, Zinc Sulfate, Niacinamide, Manganese Sulfate, Calcium Pantothenate, Cupric Sulfate, FD&C Red #3, Thiamine Chloride Hydrochloride, Vitamin A Palmitate, Pyridoxine Hydrochloride, Riboflavin, Folic Acid, Chromium Chloride, Biotin, Sodium Molybdate, Potassium Iodide, Sodium Selenate, Phylloquinone, Vitamin D3, and Cyanocobalamin.


This is the ingredient list of a Strawberry Ensure.  Ensure is a liquid supplemental drink often given to people in need of a nutritional boost.  Dietitians will recommend it as a snack or meal replacement for those with diminished appetites.  Here’s why this disturbs me.  As evidenced by the ingredient list, Ensure is not food.  People who are ill need nourishment, not a sugar high concoction full of synthetic nutrients, refined oils, and food coloring.

The main ingredients are a perfect storm: sugar combined with vegetable oils.  As stated by Paul Jaminet, coauthor of The Perfect Health Diet:

If you feed lab animals high doses of polyunsaturated fat (either omega-6 or omega-3 will do) along with high doses of either fructose or alcohol, then fatty liver disease develops along with metabolic syndrome. Metabolic syndrome is a major risk factor for obesity, and it’s not very difficult to induce obesity on these diets.

Have you heard?  Inflammation (or the avoidance of it) is all the rage these days.  Many chronic diseases, such as heart disease, cancer, and diabetes, have been linked to inflammation.  Soy oil and canola oil have more omega-6 (pro-inflammatory) fatty acids than omega-3 (anti-inflammatory) fatty acids. Meanwhile eating sugar spikes your insulin, causing inflammatory molecules called cytokines to be released into the bloodstream.  It’s as if our bodies weren’t designed to drink 32 oz sodas all day.  Oh wait…

As for some of the minor ingredients, I was struck most by the Red #3.  This additive doesn’t show up very often, as Red #40 is more prevalent.  Red #3 has an interesting history.  The FDA banned its use in cosmetics and externally applied drugs in 1990 due to its connection to thyroid tumors in lab rats.  A New York Times article from 1990 commented on the subject:

Red Dye No. 3 still has some approved uses in foods and drugs, but the F.D.A. said it is in the process of extending the ban to cover those.

Twenty three years later, how are we coming along on that FDA?  Hmm…

How about soy protein isolate?  Animal studies have suggested that isolated isoflavones may have cancer-promoting effects.  As a result, women with breast cancer are encouraged to limit their intake of soy protein isolate.  That’s funny, considering how cancer patients are a target market for Ensure products.

Carrageenan is another gem of interest.  A recent study suggests this additive may increase intestinal permeability, contributing to a “leaky gut”.  Gut health is an exploding area of research right now.  There seems to be a correlation between many, if not all, autoimmune diseases and the existence of a leaky gut.

I don’t mean to rain on everyone’s parade.  I like the idea of Ensure.  We should have delicious, easy to digest snack options for those in the process of healing.  I just know that there’s got to be a better way.  The companies who create these types of products, such as Nestle and Abbott Nutrition, are not hurting for cash.  I believe it is economically feasible to offer a more nutritional product.  However when it comes to corporations, it’s always about the bottom line.

I just wish sick people weren’t getting pinned underneath it.


Mahan, L. & Escott-Stump, S. (2008).  Krause’s Food & Nutrition Therapy. Pg. 964.

Nestle, M. (2010) Food Politics (Pg. 352).














6 Responses to “Feeding Poison to the Sick and Other Thoughts of a Disgruntled Dietitian”

  1. Shelley Wilson October 14, 2013 at 12:13 am #

    Hi just read a little of your rant. I was an ICU RN for a long time and couldn’t believe the junk given as nutrition to recovering old frail people. I remember just trying to get full fat yogurt (not low fat) for an undernourished frail 90 year old was impossible. The Ensure above is an example. If there were investors and researchers, I think there would be a hugh market for inovative new NG feeds and supplemental feeds for hospital patients. But sadly looking at the history of one of our largest hospital here in Brisbane (Australia) that 100 years ago had its own cows and vegetable garden it’s woeful to see how the quality of hospital “food” has declined.

    • thehungryguineapig October 14, 2013 at 2:41 am #

      Hi Shelley. Thanks for reading! I have noticed that when patients are put on a “heart healthy” hospital diet they can order 2 Mountain Dews at a time. However, they would probably be discouraged from drinking a container of whole milk. What’s wrong with this picture?

  2. tessatito October 21, 2013 at 3:34 am #

    I am so flattered to be referenced as a bestie 😀 Hooray! I love this rant, love that you are smart and scientific enough to include references in said “rant.” I might start posting on my blog again too.. I have a few things that might be worthy of sharing.

    • thehungryguineapig October 23, 2013 at 1:05 am #

      How do you know I wasn’t talking about Bruce? We go way back (like 2 class periods). 😉 Okay, I was talking about you. 🙂 You should definitely update your blog, so I have something awesome to read.

  3. Kim January 29, 2014 at 11:49 pm #

    Found this while googling “disgruntled dietitian” – which I am too. Thanks for a great essay that mirrored so many of my own concerns!

    Like you, I felt like my job as a clinical RD (both acute and long term care settings) was beyond meaningless. I mostly worked with the elderly including advanced dementia and hospital patients, and also with oncology patients. People struggling with poor appetites were offered supplements like Ensure, instead of food. All the food service directors were bound to managed ordering, which meant they could only order off a strict list of approved foods. One place I worked had such a small food budget, we couldn’t even afford calorically dense and well-accepted “extras” like ice cream. Another place instituted a strict Skim Milk Only policy, no exceptions, despite the RDs protest that starving people benefit from all the calories and fat in whole milk! There was no room to cook “off the menu,” or even from scratch at most places. We all know there’s nothing like home cooking when you’re sick or depressed, and most of these corporate-controlled kitchens aren’t even allowed to take a stab at it.

    So I’d watch my patients starve and die, one after another after another, while I wrote the same progress notes that no one read. It was beyond frustrating, depressing really. Here I spent 4 years of my life and went into immense personal debt to finance my own way through university and internship, in hopes of “making a difference,” but the only jobs I could find were at places where I very definitely made no difference whatsoever. Other RDs and healthcare professionals I worked with were hard and jaded. Getting a paycheck was enough for them and most didn’t question the system like I did. But the principle of it all, the whole gross healthcare system and junk food culture, I couldn’t get over it! I was always mad about the way things were.

    The good news is I was able to transition out of being a dietitian, and was able to leave the field completely last year, after 5 years of service. I’m self employed in a totally different field altogether, making just as much money, certainly working way harder, but one million times happier.

    Good luck to you!!! Listen to your heart, it will never steer you wrong.

    • thehungryguineapig January 30, 2014 at 12:30 am #

      Thanks for sharing your story Kim! You’ve just made my day. 🙂

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