By Rhythm Sachdeva, Declan Keogh, and Robert Cribb
Accompanied by a video of children holding candy and set to the beat of a chart-topping pop song, the social media post from a Canadian registered dietitian said: “If your kiddo is obsessed with sweets they likely need MORE access to sweets rather than LESS.”
The dietitian’s advice, superimposed over the video, encouraged parents to “talk about these foods neutrally and let them eat as much as they want.”
This social media post and many others were paid for by the Canadian Sugar Institute, a Toronto-based association of sugar producers that has a branding relationship with dietitians across the country.
But in some cases that industry influence was not made clear enough, a U.S. consumer protection agency said in a public admonishment of the institute’s potentially deceptive marketing practices.
The Federal Trade Commission (FTC) expressed alarm at the lack of transparency in sponsored, pro-sugar posts by two B.C.-based dietitians.
The agency’s censure had immediate impact, provoking a promise of change from the institute and more transparency in some dietitians’ posts.
Here in Canada, regulators have been comparatively muted. While they say generally that any financial relationship that may cause conflict of interest should be disclosed, neither the Competition Bureau in Ottawa nor the regulatory colleges that oversee dietitians in Ontario and British Columbia have issued public warnings about the popular Canadian social media posts sponsored by the sugar institute.
Sponsored posts will be more transparent, sugar institute says
Meanwhile, the ties between Canadian dietitians and industry appear to be strengthening. One Toronto practitioner has started a side business training other dietitians how to land sponsorship deals worth up to tens of thousands of dollars a year.
Dietitians are regulated health professionals trained in food and nutrition whose duties include translating medical and scientific evidence for the general public, and offering dietary and nutritional guidance to clients.
The Toronto Star and the Investigative Journalism Bureau (IJB) have found two dozen Canadian registered dietitians, from Halifax to Vancouver, who have posted pro-sugar social media messages sponsored by the country’s largest sugar producers. Together, the dietitians have extolled the nutritional benefits of sugar to a combined Instagram audience of more than 350,000 followers.
Several of the dietitians told reporters their videos are only promoting information they already believe as professionals. However, experts say by accepting the sugar industry’s money, it raises clear conflicts of interest and undermines the credibility of their professional advice.
“It’s shocking,” says Alison Thompson, a University of Toronto bioethicist, who calls the monetary relationships between dietitians and food industry players “wrong.”
“If you were a doctor and you were courting drug companies to get money on the side and give the pills to your patients, that would not fly. So why is this OK? They are essentially selling their professional credibility to the highest bidder.”
In response to the U.S. concern, the Canadian Sugar Institute will bolster disclosure statements made by the dietitians it pays, “so all disclosures are very transparent,” said spokesperson Chiara DiAngelo, who is also a registered dietitian. Among the changes, DiAngelo told the Star/IJB, will be “ensuring that our actual name, Canadian Sugar Institute, is indicated along with that ad or sponsorship hashtag to make it very, very clear and conspicuous who the sponsor is for that post.”
Several dietitians’ social media posts reviewed by the IJB and Star have been edited to make it clearer that it’s part of a “paid partnership” with the sugar institute.
Sponsored posts may be ‘deceptive or unfair’
A recent investigation by The Examination — an online publication based in the U.S. — and the Washington Post found dietitians were promoting sugary foods and beverages through sponsored posts paid for by industry groups, including the Canadian Sugar Institute.
The reporting prompted the FTC to warn the Canadian Sugar Institute that its “marketing practices on Instagram may be deceptive or unfair,” and that the industry group could face tens of thousands in fines if found to be violating truth-in-advertising laws.
“It’s irresponsible for any trade group to hire influencers to tout its members’ products and fail to ensure that the influencers come clean about that relationship,” Samuel Levine, director of the FTC’s Bureau of Consumer Protection, said in a public statement.
It is unclear what exactly the institute expects in exchange for its sponsorship money. The industry group reviews the posts for “pre-approval” before they go live, said DiAngelo, who says she does a final “disaster check” on sponsored messages prior to publication.
“I really do not edit the content,” she said. “I want it to be very genuine and reflective of a dietitian’s voice.”
Canadian authorities called on to take action
Quinn Grundy, a University of Toronto professor who researches conflict of interest and interactions between health professionals and industry, says the FTC’s leadership in calling out conflict of interest issues is “clearly an effective lever in bringing transparency, truth in advertising, and calling professionals to account. To protect the health and the interests of the Canadian public, Canadian regulators should consider following in these tracks.”
It is not known if Canadian regulators have directly contacted the institute or its affiliated dietitians.
Quinn Grundy, a University of Toronto professor who researches interactions between health professionals and industry, says the practice of dietitians accepting money for social media posts requires tighter ethical oversight. Photo credit: Richard Lautens / Toronto Star
The Competition Bureau’s rules governing advertising standards and proper disclosure of potential conflicts of interest echo the FTC’s.
Both regulators say promotional material should include clear references to any industry influence, name the sponsor explicitly, reference the payments in videos and avoid vague hashtags such as #ad or #paidpartnership that fail to make the deals clear — something that was rarely the case in the dietitians’ sponsored social media videos and blog posts reviewed by IJB/Star reporters.
In a statement, the Competition Bureau said it can’t comment on specific posts identified by the Star/IJB or whether it is currently investigating any posts, but that influencers must “clearly disclose the relationships they have with the business, product or service they promote.”
“We take all allegations of wrongdoing seriously, including with respect to potentially false or misleading influencer advertising,” the bureau said.
The College of Dietitians of Ontario, which regulates the profession, refused to comment on members’ conduct or the social media posts found by the Star/IJB.
The provincial regulatory body has not received complaints about the advertising sponsorships of registered dietitians in the province, said Melanie Woodbeck, the college’s registrar, but it has “addressed” social media posts by some dietitians. “No dietitian was disciplined as a result of these discussions,” she said in a statement.
The college’s code of ethics, last updated in 2019, says dietitians must “identify and manage potential situations that may lead to conflicts of interest, including any financial interests in products or services that are recommended.”
Woodbeck said those conflict-of-interest guidelines are “currently being reviewed,” and a new version will be available next month.
Sponsorship deals can be lucrative
The growing ties between industry and registered dietitians have inspired Toronto practitioner Elis Halenko to start a business training other dietitians to land sponsorship deals worth up to $80,000.
“There is a HUGE demand for food industry professionals and dietitians to link arms,” her website reads. “Brands (are) shelling out $10,000’s of dollars to work with dietitians and nutrition experts just like YOU. I know this because I am one of them.”
Halenko, who has posted Canadian Sugar Institute-sponsored recipes highlighting the importance of sugar, told the Star/IJB that her practice focuses on “allowing for enjoyment of all types of foods. … Any sponsored content that I create as part of brand partnerships is fully my own.” She said she trains other dietitians to create “authentic and transparent partnerships that are based on evidence about overall healthy and enjoyable eating.”
Grundy says the practice of dietitians accepting money from industry for social media posts requires tighter ethical oversight.
Dietitians, like other health-care workers, should be especially mindful of any perception of competing interests because of the inherent trust that comes with the profession, she said.
“Health professionals do have a lot of credibility, legitimacy and public trust … We kind of have a contract with society that we will hold ourselves to a higher ethical standard and that we will consistently put patient and public interests first.”
Calgary dietitian Kristyn Hall, who posted sponsored content for the Canadian Sugar Institute, believes that the practice of accepting money for content is often misunderstood.
“It’s not wrong to be paid to communicate an evidence-based message,” she said. “What if a particular brand has a kind of product that you see many of your clients using, and they want to understand more about that?”
“People have a right to earn money, and just because it’s sponsored doesn’t make it lies,” she said.
Hall’s post sponsored by the Canadian Sugar Institute clearly indicates at the top of the page that she was paid by the organization for the post. “At the end of the day, disclosure is very important,” she said.
Christina Iaboni, a Toronto dietitian who has made at least three Instagram posts sponsored by the institute, says the messages “do not promote sugar consumption but rather correct common myths and misinformation about sugars.”
The sponsored content Iaboni has made do not include disclosures in the videos or images. But the Instagram posts were edited this week to include more detailed disclosure of the relationship with the Canadian Sugar Institute.
B.C. dietitians’ online posts under U.S. scrutiny
In its letter to the Canadian Sugar Institute, the U.S. FTC focused on posts made by two B.C.-based registered dietitians — Jenn Messina and Lindsay Pleskot — in which disclosure of the industry group’s sponsorship was “insufficiently conspicuous.”
Messina is the dietitian who had made a post instructing parents that sugar-obsessed kids “likely need MORE access to sweets rather than LESS.” Her posts have also dismissed that sugar addiction is “a real addiction” and advised parents to allow their kids “regular access to sweet foods including some days that they get to use their own $$ and eat as much as they want.” (These posts have recently been deleted.)
Her website offers her services as a spokesperson. “Having a Registered Dietitian stand behind your brand will give it the edge to appeal to today’s consumer,” it reads. “I work with organizations and brands that align with my professional values and those foods I would feed my own family!”
The IJB/Star has found 17 social media posts Messina or Pleskot made under sponsorship deals with the institute. Both Messina and Pleskot declined to be interviewed for this story.
The College of Dietitians of British Columbia’s professional guidelines say dietitians in the province must “disclose and mitigate any potential, real, or perceived conflict of interest.”
“While the college has not received a formal complaint against the practice of these registrants, it has received questions and concerns. We are proactively looking into the matter and, therefore, cannot comment at this time,” reads a statement from Mélanie Journoud, the B.C. college’s deputy registrar.
Grundy said professional regulatory bodies need to take steps to implement more oversight and safeguards for industry-sponsored content.
“Otherwise, these industry relationships … really undermine that credibility.”
With files from Blair Bigham/Investigative Journalism Bureau
The Investigative Journalism Bureau is a non-profit newsroom based at the University of Toronto’s Dalla Lana School of Public Health.
The story is also available on the Toronto Star website.
