A Dietitian’s Response to the CrossFit Journal

 

CrossFit is well known for having a long list of “haters”. After a blog post put out by the CrossFit Journal this week, you can likely add a lot more Registered Dietitians to that list. As a Registered Dietitian and Certified Personal Trainer who does “drink the CrossFit koolaid” so to speak, at least as it relates to the functional fitness model, I’m here to share my thoughts on this blog post bashing my profession.

Credit: @hai_intensity

This CrossFit Journal piece is very much an attack on the nutrition policy and governmental nutrition recommendations, as well as the Academy of Nutrition and Dietetics, the governing body of Registered Dietitians. For those outside the field of nutrition and dietetics (such as the author), it may be surprising to know that a large percentage of us RDs also disagree with many of the positions of the AND. In fact, there are very few dietitians I know who fully support the dietary guidelines or agree with recommendations like MyPlate.  I personally continue to debate whether I want to remain a member of the Academy and I wholeheartedly agree that we have a long way to go when it comes to systematic reform. Flaws exist on many levels—the undergraduate programs in nutrition, dietetic internship, the RD exam itself and of course, continuing education for practicing RDs.

But things are changing in our field, however slowly. The good news is that, like most CrossFit affiliates, dietitians have the autonomy to practice in different ways within our scope of practice after completing the standardized education and training. We have to adhere to a code of ethics indicating that we will not and cannot practice outside of our scope. Unless we have a dual licensure or certification (such as a personal trainer credential), we literally cannot speak to fitness or training programs. Instead, we must refer out to the experts in those areas. Compare that with how CrossFit founders, coaches and trainers practice.

Before I get any further in, I want to be clear that A) I respect the author’s credentials, background and experience as it relates to fitness and CrossFit  and B) I don’t believe he is incorrect in calling out some of the concerns within the AND. That being said, I still have plenty of bones to pick with his post and feel it’s absolutely unacceptable to state that trainers are better qualified than RDs to provide nutrition education. I also understand that this is a highly controversial discussion, so while I encourage feedback and welcome arguments, I ask that it be respectful and professional. For the sake of organization, I’ve pulled out a few specific quotes to share my thoughts on each. Let’s do it!

“The group purposefully extends its advice beyond the clinical, extrapolating it to the general public and to people who exercise.”

The author’s argument here is that dietitians who focus more on clinical nutrition and may have little to no education in fitness or exercise should not be providing recommendations for “healthy” populations in the fitness realm. Sure, there are many RDs who practice in clinical settings using Medical Nutrition Therapy and I would wholeheartedly agree that those dietitians are not the ones who should be speaking to nutrition as it relates to athletes (of most any level).  Just like you wouldn’t go to a CrossFit gym or listen to a trainer with no functional fitness experience, don’t go to a dietitian who works solely with diabetes or kidney disease when you’re looking for sports nutrition advice.

Assuming that all Registered Dietitians only work in or focus on clinical therapeutic nutrition is incorrect and uneducated about the field. No, not all Registered Dietitians are qualified to speak to nutrition as it relates to sports performance and fitness. Just like physicians, many Registered Dietitians specialize in areas of treatment and counseling, sports nutrition being one of them.  I asked my friend and colleague Kelly Jones, MS, RD, CSSD to weigh in on this as well.  Kelly herself has experience as a CSSD, a graduate degree in exercise nutrition and teaches sports nutrition at the college level. She also consults for a large fitness club and has written programming for several other fitness facilities, too. In fact, there are almost 1000 RDs with an additional CSSD credential (Certified Specialist in Sports Dietetics) and plenty of us working toward that credential by logging hours working with sports nutrition under mentors. The Sports, Cardiovascular and Wellness Nutrition (SCAN) dietetic practice group  also has over 7,000 members. Kelly notes that “SCAN regularly collaborates with not only the NCAA to create educational materials for division I athletes, but has also built a partnership with NATA and has begun forging a partnership with NSCA.” I’d advise trainers to seek out RDs with these additional certifications as well as ones focused on fitness and exercise such as CPT or CSCS.

“But if we consider one single indicator—obesity—it is quite clear the dietetic initiatives that have been in play for the past few decades have not made any progress in reducing or preventing obesity.”

To this I ask: what qualified health professional is declaring health, or lack thereof, based on one single indicator, especially if that indicator is obesity? A discussion of the “obesity epidemic” could be an entire post on its own, so I won’t dive too deep here, but long story short, obesity (or BMI as an indicator) is not a valid measurement of health. I would encourage readers to dive into the research on Health at Every Size and how the research that drives this “war on obesity” is heavily influenced by pharmaceutical companies and the weight loss industry. Again, my post today is not about fighting the obesity argument, but I think I’d be remiss not to mention this. More resources and information can be found here. Further, let’s be clear that no one owes anyone else their health. There is certainly a crusade out there, especially in the fitness realm, to “save” people from their fatness or this “obesity epidemic”. 

“Principles for treating disease are not the same principles for improving fitness in healthy populations.”

100% agreed and see above arguments for seeking out a Registered Dietitians specializing in whatever the need may be.

“General information about eating for basic health and to support fitness can and should be part of the services provided by trainers and coaches.”

I’m not sure how this is even an argument IF the trainer or coach is in no way trained or qualified to do so. The author goes on to say “about two-thirds of personal trainers have received some form of nutritional education as part of their training, but some suggest preparatory education is not enough, and membership, certification and licensure are touted as better.” Of course a minimum of a 4-year college degree, followed by a 12-18 month long supervised internship program and comprehensive exam are “better” than the a few chapters in a Certified Personal Trainer workbook that talk about nutrition. Is this even a question? Kelly Jones, MS, RD, CSSD, adds that “RDs aren’t here to say ‘only eat these foods and you’ll get better.’ Our education also involves psychology and behavior change so that we can meet each individual where they are in order to help them recognize certain behaviors and reframe them into positive habits that benefit them both physically and mentally.”

If we are talking about CrossFit specifically, the requirement to become a Level 1 trainer is simply the completion of a weekend long course. The requirements to become a CrossFit affiliate is that an owner is at least a Level 1 CrossFit trainer and pays an annual fee of $1000. After that, there is little to no oversight from the CrossFit brand, meaning that many trainers and affiliates may be teaching poor mechanics and the original “message” of CrossFit as a brand is not adequately implemented as it may have been intended. I raise this point to support the fact that no, that type of “prepatory education” is not enough.

“For the fitness industry, it’s key that trainers and coaches who provide nutritional information supply accurate, complete and implementable advice.”

NOPE. Trainers and coaches should not be the ones providing nutritional information, if they are in no way qualified to do so, plain and simple. We know that many either make nutrition recommendations freely to their clientele (a la Greg Glassman’s nutrition advice) or bring in a “nutrition coach” who may only have personal anecdotal experience or what I call a “weekend warrior” certification.  I would love to ask the author how they would feel about non-fitness professionals giving out fitness and exercise advice. What would make someone qualified to do so? Doing research on it until they are certain? What would make someone capable of analyzing the research? Keep in mind that Registered Dietitians are required to take courses in analyzing research studies.

It’s important to call out something that isn’t being considered in the argument of trainers providing nutrition advice. The quality of recommendations is surely of concern, but what about the potential for doing harm? What do we mean when we talk about nutrition advice for health? The best RDs I know are considering mental, psychological and emotional aspects of health when making their recommendations. There are extremely high risks for disordered eating and orthorexic tendencies in the fitness space and often times, strict meal plans and fear-based recommendations bring those on or make them worse.

FINAL THOUGHTS

So as the author asks…”where should the general public get information about nutrition and eating habits?” I argue that regardless of the failures and struggles of our governing body, the answer is and will continue to be Registered Dietitians. Policy change takes time and there will always be “bad information” out there, as there is in any field, including fitness and CrossFit. What if fitness professionals worked WITH us rather than against us in this space? I’d encourage all gym owners and trainers to reach out and speak with Registered Dietitians and learn about their work, their philosophies and approaches to nutrition coaching/counseling. View Registered Dietitians as friends, rather than enemies, because together we truly can have a lasting impact on the health and habits of our mutual clients.

RDs, trainers, CrossFitters…I’d love your input on this! Share in the comments below, but I do ask that we all be kind and respectful. 🙂