On Nutrition Influencers, Wash. Post–The Examination Probe Misses the Mark

By Katie Suleta, DHSc, MPH — Sep 22, 2023
The Washington Post and an investigative journalism outlet called The Examination have partnered to investigate nutrition influencers on social media. Their investigation is ongoing, so we can expect more from them. While I think this work is important, I believe some red flags in this investigation are worthy of discussion.
Image by Gerd Altmann from Pixabay

Nutrition Influencers

This investigation is into nutrition influencers, but a specific subset of nutrition influencers: those who are registered dieticians (RD). I don’t know how many people are nutrition influencers nor what proportion of them are RDs, but given what it takes to become a registered dietician (i.e., a lot of time, money, education, and training) versus what it takes to become a social media influencer (i.e., a social media account), I think it’s safe to assume that many nutrition influencers on social media are not also registered dieticians.

For example,

These are only five examples of nutrition influencers, but they are heavy hitters in the space, and none are RDs. They were, therefore, excluded from this investigation into potential conflicts of interest. That’s important to note, especially since they aren’t cherry-picked examples. There is evidence that those nutrition influencers with less credibility (i.e., less education and training) have more reach than those who do.

Because RDs are credentialed, they carry the weight of expertise, and it is essential to consider how they use that expertise and hold them to account – it is a critical ethical responsibility in a climate of growing mistrust. I have no problem holding them accountable; however, why only investigate nutrition influencers who are registered dieticians? Those who are not dieticians are certainly punching above their weight in terms of attention, so why ignore the elephant in the room?

Conflicts of Interest

The investigation looks into the financial sponsorship of these registered dietician nutrition influencers - uncovering truths relevant to the public interest. It is what good journalism does. However, I find it somewhat strange that they have limited their investigation to sponsorship by food companies. That seems like an oddly limited subset of potential conflicts of interest.

Nutrition influencers can and are sponsored by a slew of companies, including but not limited to, yes, food companies but also companies that make and sell dietary supplements, vitamins, and general wellness products. Ultimately, the number of nutrition influencers hawking vitamins and supplements seems to be just as big of a concern, if not more, than those food company sponsorships.

  • General Nutrition Centers (GNC) has an easy-to-find sponsorship application.
  • KAGED, “an ultra-premium sports nutrition supplement line,” has an article on its website about how to be sponsored by supplement companies.
  • Another “premium” supplement, 1st Phorm, has an open call for people to apply for sponsorship.
  • And what should we make of the wellness advice of David Wolfe or Gwyneth Paltrow, who sell their own nutrition products, primarily vitamins and supplements?

Advertising Practices and Information

The Examination offers an example of warning letters sent by the FDA to influencers, not necessarily registered dietitians, for their lack of transparency inadequately disclosing payments for their postings back in 2020.

“Michael Ostheimer, an attorney for the FTC’s division of advertising practices, said a key test is whether the sponsorship would surprise consumers and affect their opinion of the message’s credibility – what the agency refers to as an ‘unexpected material connection.’”

In the context of this investigation, does this mean that what Paltrow, Wolfe, and other non-registered-dietitian influencers do is expected and, therefore, OK? Paltrow and Wolfe market and sell what the article also correctly identifies as “unproven supplements” under their carefully curated guise of expert wellness influencers, and they aren’t the only ones. Cardi B was sent one of those warning letters even though, I think, she probably falls into the same category as Paltrow and Wolfe and is not a registered dietitian.

Aspartame

“The assessments of aspartame have indicated that, while safety is not a major concern at the doses which are commonly used, potential effects have been described that need to be investigated by more and better studies.”

Aspartame made headlines earlier this year with a report by the World Health Organization and the International Agency for Research on Cancer.

The evidence was limited. The doses needed for harmful effects are higher than we use in food. Other sources sought to assuage concerns about aspartame safety who haven’t been sponsored, including the American Cancer Society, the National Cancer Institute, the Food and Drug Administration, and ACSH.

The registered dietitian influencers provided the same information. I can’t help but ask whether the problem is really “bad” information or who is paying for its dissemination.  

At the heart of this investigation is mis/disinformation and the potential conflicts of interest of those who provide that information. However, the analysis doesn’t seem to give much more than a passing nod to the problem of nutrition mis/disinformation online and, even then, only as potentially pushed by a specific subset of influencers. Furthermore, conflicts of interest are essential to consider for any influencer or celebrity.

Limiting the scope of those defined conflicts of interest to exclude some standard practices seems unnecessarily exclusionary. We should be talking about ways to make labeling of sponsored content more transparent and evident for consumers. The RDs, in some instances, were not clear that their posts were sponsored and by whom - this is problematic. But none of the other influencers are more straightforward than the registered dietitians. While that doesn’t make it acceptable for either group, it does mean we must be consistent about holding people accountable.

As a scientist and researcher, I understand that no investigation can consider every aspect of this issue - there is a reason studies are limited in scope. However, in this instance, restricting the scope of the investigation implies that expertise is not to be trusted because it can be bought and that food companies are engaged in uniquely nefarious practices. Expertise, unfortunately, can sometimes be bought, but so can promotions of other kinds that masquerade as expertise.

Food companies can and have engaged in sponsorships on social media, but so have vitamin and supplement companies, but they’re not under the microscope. Finally, while our funding sources must be known, those sources do not immediately translate into steering the research or reporting.  Keep all of this in mind as you follow the continuing investigation by the Washington Post and The Examination.

Source: The food industry pays 'influencer’ dietitians to shape your eating habits The Examination

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Katie Suleta, DHSc, MPH

Katie Suleta is a regional director of research in graduate medical education for HCA Healthcare. Her background is in public health, health informatics, and infectious diseases. She has an MPH from DePaul University, an MS in Health Informatics from Boston University, and has completed her Doctorate of Health Sciences at George Washington University.

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